UTSW Research: Python guts, emergency room visits, and more
Studies investigate link between snake intestines and humans, cancer patients’ ED use, and tDCS stroke treatment
Regeneration insights from snake intestines
Most vertebrates undergo intestinal regeneration to repair digestion wear and tear. The best understood regeneration mechanism occurs in humans and other mammals, in which stem cells that regenerate the intestines reside in depressions in the intestinal walls called crypts.
Many large snakes that can go months between meals, including boa constrictors and pythons, undergo massive regeneration of atrophied intestines after eating. But since these reptiles don’t have intestinal crypts, their regeneration process has been unclear.
To investigate this phenomenon, researchers from Children’s Medical Center Research Institute at UT Southwestern (CRI) and colleagues assessed the activity of intestinal genes before and after Burmese pythons ate. Their findings showed an uptick in the activity of genes involved in embryonic intestinal development and wound healing. Many of these overlapped with genes that increase activity in humans who undergo gastric bypass surgery.
These results, published in PNAS, could lead to new treatments for diseases affecting the intestines, including Crohn’s, celiac disease, and cancer.
Members of CRI who contributed to this study are first author Aundrea Westfall, Ph.D., postdoctoral fellow; Trevor Tippetts, Ph.D., Ruth L. Kirschstein NRSA Postdoctoral Fellow; and Margaret Cervantes, B.S., graduate student researcher.
Understanding why cancer patients visit the ED
Oncology programs have sought to decrease visits by cancer patients to a hospital emergency department (ED) by offering resources such as 24/7 phone triage lines and urgent care clinics. However, these tend to be underutilized.
To understand why patients visited EDs for commonly anticipated needs during cancer treatment, a team of UT Southwestern Medical Center researchers led by Arthur Hong, M.D., M.P.H., Assistant Professor of Internal Medicine and in the Peter O’Donnell Jr. School of Public Health, interviewed 24 patients at UTSW and 16 at Parkland Health in English and Spanish. Parkland is a public safety-net health system that serves as the primary teaching hospital for UTSW. The researchers’ findings, published in the American Journal of Managed Care, showed patients were largely unaware of the triage lines and urgent care clinics available at both hospitals.
The Parkland patients, especially Spanish speakers, reported less access to outpatient cancer teams to ask for advice. Positive ED experiences for patients at both UTSW and Parkland inadvertently seemed to reinforce returning in the future. The authors suggest patient education programs should incorporate patient perspectives to further reduce ED use.
Other UTSW researchers who contributed to this study are Beverly Kyalwazi, M.D., resident, Internal Medicine; D. Mark Courtney, M.D., Professor of Emergency Medicine; Navid Sadeghi, M.D., M.S.P.H., Associate Professor of Internal Medicine; and John Cox, D.O., Adjunct Professor of Internal Medicine. Drs. Hong and Sadeghi are members of the Harold C. Simmons Comprehensive Cancer Center.
How burr holes affect transcranial direct current stimulation
Transcranial direct current stimulation (tDCS) therapy stimulates the brain by placing a positive electrode (anode) and negative electrode (cathode) on the scalp and passing a weak current between them. This therapy has shown promise in stroke treatment, but patients with burr holes – skull access points often created to remove the clots that cause ischemic strokes – have been excluded from tDCS because of the effects they might have on the electric field.
To investigate these effects, researchers from UT Southwestern and colleagues from Korea used computer modeling on stroke patient data. Their findings, reported in Computers in Biology and Medicine, showed the electric field intensity increased as the anode approached the burr hole, varying in strength depending on whether the hole was filled with scar tissue or cerebrospinal fluid. When the anode was placed more than 60 millimeters from the hole, the intensity remained low and constant.
The authors suggest these findings may provide guidance for safely performing tDCS in patients with burr holes.
UTSW study contributors were co-first author Hyungtaek Kim, M.S., doctoral student in Physical Medicine & Rehabilitation, and Yasin Dhaher, Ph.D., Professor of Physical Medicine & Rehabilitation and Orthopaedic Surgery.
About UT Southwestern Medical Center
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 25 members of the National Academy of Sciences, 24 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,200 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 120,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5 million outpatient visits a year.
About Parkland Health
Parkland Health is one of the largest public hospital systems in the country. Premier services at the state-of-the-art Parkland Memorial Hospital include the Level I Rees-Jones Trauma Center, the only burn center in North Texas verified by the American Burn Association for adult and pediatric patients, and a Level III Neonatal Intensive Care Unit. The system also includes two on-campus outpatient clinics – the Ron J. Anderson, MD Clinic and the Moody Outpatient Center, as well as more than 30 community-based clinics and numerous outreach and education programs. By cultivating its diversity, inclusion, and health equity efforts, Parkland enriches the health and wellness of the communities it serves. For more information, visit parklandhealth.org.