UT Health East Texas - North Campus refers to the clinical operations of the University of Texas Health Science Center at Tyler (UTHSCT) academic campus on U.S. Highway 271. UTHSCT was chartered in 1977 by The University of Texas System Board of Regents. UTHSCT is the only academic medical center in Northeast Texas. Located in Tyler, TX, UTHSCT was originally named "East Texas Tuberculosis Sanitarium", established in 1947 as a tuberculosis treatment facility at the location of the retired World War II U.S. Army Infantry Training Base called Camp Fannin. It eventually became a state hospital known as the East Texas Chest Hospital. Following the 1977 acquisition by The University of Texas System, it became The University of Texas Health Science Center at Tyler (UTSHCT). The institution served Northeast Texas, as UT Health Northeast, until the 2018 expansion of clinical operations through a merger with the former East Texas Medical Center to form the clinical affiliate, UT Health East Texas (UTHET).
ABSTRACT:Repeated bleeding into joints in hemophilia leads to chronic inflammation that plays a central role in the pathogenesis of hemophilic arthropathy (HA). Our recent studies revealed that factor VIIa (FVIIa) treatment releases extracellular vesicles from endothelial cells (eEVs) and FVIIa-released eEVs exhibit anti-inflammatory and barrier-protective functions. The present study was undertaken to investigate the effect of FVIIa-released eEVs on HA and the mechanism of their protective effect. Joint bleeding in hemophilia (F8-/-) mice was induced by a needle puncture injury. Injured mice were treated with saline, control eEVs, or FVIIa-released eEVs, and the changes in the knee joints were analyzed by gross examination of knees as well as histological and immunohistochemical analysis. Joint tissues were examined for evidence of synovial hyperplasia, macrophage infiltration, neoangiogenesis, cartilage degeneration, and chondrocyte apoptosis. The data showed that treatment of mice with control eEVs had no significant effect on the development of HA, whereas treatment with FVIIa-released eEVs markedly reduced all pathological features of joint bleed-induced HA. Incorporation of microRNA10a (miR10a) inhibitor into FVIIa-released eEVs abrogated the protective effect of FVIIa-released eEVs on HA. More importantly, loading miR10a mimic into control eEVs conferred a protective effect. Administration of miR10a-containing FVIIa-released eEVs or control eEVs loaded with miR10a mimic was found to abrogate joint bleed-induced interleukin-6 production in the synovium. miR10a in eEVs had no effect on hemostasis. Cumulatively, our data indicate that EVs containing miR10a that effectively suppress synovial inflammation would have immense therapeutic value in treating HA.
Nontuberculous mycobacteria (NTM) are environmental microorganisms for which large, systematic studies of niche diversity are lacking. We performed a semi-longitudinal state-wide sampling campaign (2015-2019) for environmental NTM across Hawai'i. A volunteer network collected 2,334 water biofilms, soil, and dust samples from built (n = 1,946) and natural (n = 388) sites. Of these, 541 contained culturable NTM (23%) and per island hotspots identified. Of 74 NTM species recovered, the most prevalent rapid growing mycobacteria (RGM) were Mycobacterium porcinum, Mycobacterium chelonae, and Mycobacterium abscessus. Mycobacterium intracellulare subsp. chimaera was the most frequently isolated slow growing mycobacteria (SGM). Our longitudinal analyses indicate widespread colonization of diverse niches by species less associated with lung infections such as M. chelonae. In contrast, household water biofilms tended to be reliable niches for M. abscessus and M. avium complex species colonization across the 5-year study. Analysis of 590 deidentified lung samples from Hawai'i and other Pacific Islands revealed M. chimaera as the most frequently isolated species (40%, 238/590). Phylogenetic analysis of environmental and lung M. abscessus suggests most cluster within dominant circulating clone 1 (DCC1). Contrastingly, most Hawai'i and other Pacific Island M. chimaera were distinct from previously studied European isolates, leading to the identification of two novel clusters of phylogenetically related strains we have termed Pacific Island Circulating Cluster 1 and 2 (PCC1, PCC2). PCC1 consists exclusively of Hawai'i/Pacific Island isolates, while PCC2 was enriched by lung samples and was mostly collected from Hawai'i/Pacific Islands. These data reveal the genetic diversity, ecological niches, and potential reservoirs of NTM in varied Hawai'i ecosystems.IMPORTANCENearly one in four environmental Hawai'i samples tested positive for any NTM species, with hotspots often overlapping population centers. Recovery of any NTM species occurred just as often from natural settings as homes and public buildings, highlighting exposures as a normal part of life. Soil was the most common reservoir for NTM colonization, but we distinguish NTM species pertinent to lung disease that were far more likely to be found in water biofilms, such as showerheads and kitchen sinks. No single species dominated the environment; yet, the type of NTM found in water systems closely mirrored those recovered from patients' lung samples. Genetic analyses revealed that Hawai'i harbors distinct, locally circulating strains, including lineages not linked to known hospital outbreaks. Together, these findings improve our understanding of where precarious exposures can occur and inform public health strategies to reduce exposures by highlighting niches that are common hotspots for NTM colonization.
This paper is based on a symposium delivered at the 21st Annual American Psychosocial Oncology Society Conference in Albuquerque, New Mexico in March 2024. The symposium derived from presenters' clinical and academic experiences, spanning from trainee to experienced senior mental health practitioners, working in diverse clinical cancer settings with persons dying from cancer across the life course. The final goodbye is not just a statement of farewell, but rather a conversation begun from the moment of "hello" in a therapeutic psychosocial-oncology relationship that may encompass a range of dimensions including time and space, verbal utterances, bodily gestures, and unspoken thoughts. Consideration of the ultimate goodbye, and the universality of death, especially when unpredictable, and even if never articulated, can inform the therapy and mold a helpful and caring end to the relationship. Maintaining a focus on living with present circumstances - what is feared, what is regretted, what is cherished, and what can still be hoped for, while understanding the certitude of death during the end stages of cancer - may be considered the art of psychosocial oncology. Since it can only be garnered over time with practice, there are few "wrong" ways to do this with humility-and many formidable experiences to learn from.
INTRODUCTION:Irritable bowel syndrome (IBS) affects between 10% and 20% of the global population. The therapeutic effect of yoga on IBS symptoms has been investigated by several randomized controlled trials (RCTs) with inconsistent findings. We conducted this review to synthesize the current evidence on yoga's effect on IBS symptoms. METHODS:A systematic review and meta-analysis were performed through systematically searching PubMed, EMBASE, WOS, SCOPUS, and Cochrane through October 2024. Continuous variables were pooled using the standardized mean difference (SMD), with confidence intervals (CIs) using Stata MP version 17. We assessed heterogeneity using the χ 2 test and I2 statistics. PROSPERO ID: CRD42024611633. RESULTS:Eleven RCTs with 535 patients were included. Seven RCTs included adults, 3 included pediatric or adolescent patients, and another included adolescents and young adults. The yoga intervention type varied among the included trials, with the program duration ranging from 6 weeks to 8 months and the session duration ranging from 40 to 90 minutes. There was no difference between yoga and control groups in alleviating the severity of gastrointestinal symptoms (SMD -0.66, with 95% CI -1.51 to 0.18, P = 0.12), anxiety (SMD -0.39, with 95% CI -0.85 to 0.06, P = 0.09), and depression (SMD -0.46, with 95% CI -1.15 to 0.22, P = 0.19) or improving quality of life (SMD 0.53, with 95% CI -0.38 to 1.44, P = 0.25). DISCUSSION:With uncertain evidence, yoga did not reduce the gastrointestinal severity of symptoms, anxiety, and depression or improve quality of life in patients with IBS. In light of the considerable methodological heterogeneity and the high risk of bias within the included RCTs, Yoga cannot be recommended as a treatment for IBS before conducting further large-scale RCTs to fill the current evidence gaps.
Introduction Bronchiectasis is a chronic inflammatory airway disease. Brensocatib, an oral, reversible inhibitor of dipeptidyl peptidase 1 (DPP1), reduces pulmonary inflammation by preventing the activation of neutrophil serine proteases. In the phase II WILLOW trial, brensocatib prolonged time to first exacerbation in patients with bronchiectasis. In this post hoc analysis we compare clinical outcomes in patients from WILLOW according to baseline disease characteristics. Methods Adults with bronchiectasis treated with brensocatib (10 or 25 mg) or placebo once daily were analysed by baseline Bronchiectasis Severity Index (BSI) score (≤4 (mild), 5–8 (moderate), or ≥9 (severe)), exacerbation history (2 or ≥3 in the previous year), blood eosinophil count (<300 cells per µL or ≥300 cells per µL), long-term macrolide use (≥6 months; no or yes) and Pseudomonas aeruginosa culture at screening (negative or positive). End-points were time to first exacerbation, annualised exacerbation rate, change in lung function from baseline, and safety. All patients who received brensocatib were pooled and compared with placebo. Results Treatment with brensocatib versus placebo was associated with a longer time to first exacerbation (hazard ratio (95% confidence interval), BSI: ≤4, 0.28 (0.08–0.96); 5–8, 0.75 (0.35–1.60); ≥9, 0.61 (0.35–1.04); prior exacerbations: 2, 0.56 (0.34–0.90); ≥3, 0.71 (0.32–1.59); blood eosinophils per µL: <300, 0.66 (0.42–1.06); ≥300, 0.49 (0.20–1.20); long-term macrolide use: no, 0.60 (0.38–0.94); yes, 0.60 (0.25–1.45); P. aeruginosa culture: negative, 0.54 (0.32–0.92); positive, 0.68 (0.37–1.27)). Safety results were similar across subgroups. Discussion Patients treated with brensocatib had a numerically longer time to first exacerbation and reduced annualised rate of exacerbation versus placebo across all key baseline disease characteristics.
