Disparities in Cervical Cancer Among LHS+ Women: A Primer for Medical Students.

Introduction: Latina, Latino, Latinx, Latine, Hispanic, or of Spanish origin+ (LHS+) women face higher cervical cancer risks, incidence, and mortality compared to non-Hispanic White women. These disparities are attributable to socioeconomic factors, limited access to health care, language and cultural barriers, and negative health care experiences.

Methods: We used the Kern model to design, implement, and evaluate a workshop to educate medical students and health care professionals on cervical cancer disparities among LHS+ women and culturally competent communication skills.

Integrated Behavioral Health: A Curriculum for Residents in Rural and Community Psychiatry.

Introduction: Mental health and substance use disorders are common in the United States; however, only a portion of adults with these conditions receive treatment. Recent recommendations include using integrated behavioral health (IBH) models to increase patient access to care. Despite IBH's effectiveness, few psychiatry residents are trained in it.

Ancestral Genomic Functional Differences in Oligodendroglia: Implications for Alzheimer's Disease.

Background: This study aims to elucidate ancestry-specific changes to the genomic regulatory architecture in induced pluripotent stem cell (iPSC)-derived oligodendroglia, focusing on their implications for Alzheimer's disease (AD). This work addresses the lack of diversity in previous iPSC studies by including ancestries that contribute to African American (European/African) and Hispanic/Latino populations (Amerindian/African/European).

Methods: We generated 12 iPSC lines-four African, four Amerindian, and four European- from both AD patients and non-cognitively impaired individuals, with varying genotypes ( and ).

Addressing Diagnostic Challenges in Livedoid Vasculopathy: A Case Report on Interdisciplinary Management.

Livedoid vasculopathy (LV) is a rare vascular disorder characterized by excessive thrombosis of cutaneous vasculature, leading to dermal vessel occlusion, skin hypoxia, and ulceration. The nonspecific nature of its clinical manifestations often complicates diagnosis and inadequate oxygenation results in lesions that take longer to heal and are more susceptible to infections and complications. Despite its impact on patient quality of life, LV remains largely undocumented in the literature, making effective management challenging.

Academic Career Exploration: Learner Opportunities Through the Office of Faculty Affairs.

Introduction: Early exposure to medical school offices can help to facilitate interest in academic medicine and senior leadership positions. This workshop provides an overview of the roles, responsibilities, and activities within the Office of Faculty Affairs (OFA) and highlights opportunities for trainee engagement and leadership.

Methods: The Kern model was applied in the design of a 60-minute interactive module for medical students.

Unusual Presentation of Bladder Cancer in a Young Male With Significant Tattoo Exposure: A Case Report.

Recent studies have shown that polycyclic aromatic hydrocarbons (PAHs) can be found in commercial black tattoo inks raising suspicion of tattoo-related PAHs exposure to cancer risk. We present a case of a 27-year-old Hispanic nonsmoker male with bladder cancer (BC) following extensive tattoo sessions totaling over 100 hours. The patient was treated with transurethral resection of the bladder tumor (TURBT) and adjuvant intravesical Bacillus Calmette-Guerin (BCG) therapy.

Measuring Restrictive Lung Disease Severity Using FEV vs TLC.

Background: No clear parameters currently exist to grade severity in restrictive lung disease as for other ventilatory diseases. This article evaluates whether total lung capacity (TLC) or forced expiratory volume in 1 second (FEV) better correlates with the symptomatology of patients with restrictive lung disease.

Methods: A retrospective review of 6461 patient records at Veterans Affairs Caribbean Healthcare System in Puerto Rico was conducted, and 414 patients met the inclusion criteria.

The role of emboli detection studies in acute inpatient vertebral artery dissection.

Background: Prompt diagnosis and treatment of vertebral artery dissection (VAD) is critical for preventing stroke. The use of emboli detection studies (EDS) using Doppler ultrasonography is an emerging method that has been proposed to predict stroke risk and guide subsequent treatment. Limited data exists on the predictive value of this emerging modality in the posterior circulation.

Designing Prefaculty Competencies for Diverse Learners Through a Modified Delphi Process.

Importance: Faculty diversity in academic medicine may better prepare the next generation of equity-minded health care practitioners and leaders. Prefaculty development is an emerging concept to support trainees in achieving key knowledge, skills, and experiences to become successful faculty.

Objective: To outline competencies, with corresponding milestones, to support the academic career development of learners, inclusive of racial, ethnic, sexual, and gender identities minoritized in medicine.

Incidental Discovery of Klippel-Feil Syndrome: Beyond the Expected Clinical Triad.

Klippel-Feil syndrome (KFS) is a rare congenital disorder characterized by the fusion of cervical vertebrae, limiting neck mobility, and often presenting with clinical manifestations such as neck pain, stiffness, and neurological deficits. While the classical presentation of KFS includes a "clinical triad" comprising a shortened neck, a low posterior hairline, and limited cervical motion, not all patients exhibit all three features. This case report presents an 81-year-old male with the complete KFS triad and underscores the diagnostic challenges and management strategies associated with this condition.

4R-cembranoid suppresses glial cells inflammatory phenotypes and prevents hippocampal neuronal loss in LPS-treated mice.

Chronic neuroinflammation has been implicated in neurodegenerative disease pathogenesis. A key feature of neuroinflammation is neuronal loss and glial activation, including microglia and astrocytes. 4R-cembranoid (4R) is a natural compound that inhibits hippocampal pro-inflammatory cytokines and increases memory function in mice.

Sports Medicine Patient Experience: Implicit Bias Mitigation and Communication Strategies.

Unconscious bias, also known as implicit bias, is the principal contributor to the perpetuation of discrimination and is a robust determinant of people's decision-making. Unconscious bias occurs despite conscious nonprejudiced intentions and interferes with the actions of the reflective and conscious side. Education and self-awareness about implicit bias and its potentially harmful effects on judgment and behavior may lead individuals to pursue corrective action and follow implicit bias mitigation communication strategies.

Anti-hyperalgesic and anti-inflammatory effects of 4R-tobacco cembranoid in a mouse model of inflammatory pain.

4R is a tobacco cembranoid that binds to and modulates cholinergic receptors and exhibits neuroprotective and anti-inflammatory activity. Given the established function of the cholinergic system in pain and inflammation, we propose that 4R is also analgesic. Here, we tested the hypothesis that systemic 4R treatment decreases pain-related behaviors and peripheral inflammation via modulation of the alpha 7 nicotinic acetylcholine receptors (α7 nAChRs) in a mouse model of inflammatory pain.

Double-Barrel Vascularized Free Fibula Flap for Reconstruction of Sternal Nonunion with Bone Defect: A Case Report.

Case: Given the rare incidence of sternal nonunion after traumatic injury, literature describing the management of posttraumatic sternal reconstruction is limited. We present a case of a 54-year-old man with a history of traumatic chest wall injury with multiple unsuccessful attempts at sternal repair who presented with chronic sternal nonunion and persistent bone defect. Sternal reconstruction using a vascularized double-barrel free fibula flap with rigid fixation in multiple planes was performed, with confirmed bony union at 6 months.

Long-Term Follow-up of Untreated Adult Patients with Spondylothoracic Dysostosis (Jarcho-Levin Syndrome).

Background: Spondylothoracic dysostosis (STD), also known as Jarcho-Levin syndrome (JLS), is a rare autosomal recessive disorder affecting the formation of the spine, characterized by a complete bilateral fusion of the ribs at the costovertebral junction, producing a "crablike" appearance of the thorax. Despite being declared a core indication for a V-osteotomy vertical expandable prosthetic titanium rib (VEPTR) expansion thoracoplasty of the posterior thorax, the natural history of STD in untreated subjects remains poorly documented. In this study, we report radiographic and pulmonary function findings and Patient-Reported Outcomes Measurement Information System (PROMIS) and 24-Item Early Onset Scoliosis Questionnaire (EOSQ-24) scores for untreated adult subjects with STD to gain insights into the natural history.

An Integrative Approach to the Current Treatment of HIV-Associated Neurocognitive Disorders and the Implementation of Leukemia Inhibitor Factor as a Mediator of Neurocognitive Preservation.

HIV-associated neurocognitive disorders (HANDs) continue to impact patients despite antiretroviral therapy. A combination of antiretroviral therapies can diminish the HIV viral load to near undetectable levels, but fails to preserve neurocognitive integrity. The cytokine leukemia inhibitory factor (LIF) has shown neuroprotective properties that could mitigate neurodegeneration in HANDs.

Effect of surgical timing in outcomes in Hispanic patients after arthroscopic capsular release in diabetic and idiopathic adhesive capsulitis.

Background: Adhesive capsulitis of the shoulder is a painful and debilitating condition. While the majority of patients improve with conservative treatment, those who do not improve require surgery such as arthroscopic capsular release (ACR) for symptom relief. However, there is limited literature regarding the optimal timeframe to proceed with surgery.

Gynecologic Conditions in a Cohort with Inflammatory Bowel Disease: A Descriptive Analysis.

Objective: Past studies have demonstrated that women with inflammatory bowel disease (IBD) have a higher risk of gynecological conditions than do women without it. We aimed to characterize the gynecological histories of Hispanic Women living in Puerto Rico with IBD.

Methods: We identified women, aged 21 to 55 years, with a confirmed IBD diagnosis and receiving follow-up care from the University of Puerto Rico IBD clinics from 2017 through 2020.

Adjuvant effect of dendritic cells activator Imiquimod in genetic immunization with HIV-1 p55 Gag.

Dendritic cells (DC) are important antigen-presenting cells that have abilities to induce and maintain T-cell immunity, or attenuate it during hyperimmunization. Additional activation of DCs may be useful for vaccination purposes. Imiquimod is known to be a specific agonist of the Toll-like receptors (TLR7), which are located mainly on DCs.