Positions

Assistant Professor

Department of Medicine
Baylor College of Medicine
Houston, TX US
Clinical teaching faculty: Ben Taub General Hospital

Addresses

Ben Taub Hospital (Clinic)

1504 Taub Loop
Houston, TX 77030
United States
Phone: (913) 961-5852
tdmay@bcm.edu

Education

BS from Eastern Mennonite University

04/2002 - Harrisonburg, Virginia United States

Residency at Baylor College of Medicine

07/2011 - Houston, Texas USA

Postdoctoral Fellowship at Baylor College of Medicine

04/2018 - Houston, Texas USA

MD from University of Kansas School of Medicine

05/2007 - Kansas City, Kansas United States

Fellowship at Baylor College of Medicine

07/2015 - Houston, TX USA

Professional Statement

Through the course of a combined clinical residency in pediatrics and internal medicine I became increasingly interested in the gastroenterological system. This interest was greatly strengthened by an opportunity to participate in a clinical investigation in South Africa to examine the relationship between helminth infection in early childhood and subsequent risk of inflammatory bowel disease. During fellowship training in pediatric gastroenterology, hepatology, and nutrition my research efforts were directed towards clinical issues in two separate clinical contexts; Houston Texas and rural Malawi. In Houston my efforts were directed towards developing a longitudinal cohort to examine the risk of acute on chronic liver failure among children with biliary atresia listed for liver transplant. This investigation revealed that the weight based metrics commonly used to assess a nutritional status in children on the liver transplant list (i.e. body mass index and weight for height Z scores), are heavily influenced by ascites which increases with the severity of underlying liver disease. These interests are reflected by my publications stemming from this investigation which are related to predictive models for predicting acute on chronic liver failure among children with biliary atresia. In Malawi I investigated the effects of resistant starch supplementation on zinc homeostasis among children with growth stunting and environmental enteric dysfunction. These findings continue to strengthen ongoing efforts to use resistant starch as a vehicle for the delivery of key micronutrients necessary for the maintenance of distal small bowel and colonic health among children with environmental enteric dysfunction and growth stunting. These separate interests in pediatric liver disease and malnutrition which were developed during clinical fellowship training have been brought together in my current research to better understand the pathogenesis of fatty liver disease in kwashiorkor malnutrition. I anticipate that the findings of my present investigation of methionine metabolism in kwashiorkor will increase understanding of the pathogenesis of kwashiorkor malnutrition, yielding information to guide the development of new strategies to prevent and treat kwashiorkor malnutrition, with the potential to save the lives of hundreds of thousands of children in the coming decade.

Websites

Projects

One Carbon Metabolism in Kwashiorkor and Marasmus

Baylor College of Medicine (04/2015 - 04/2018)

CNRC

Kwashiorkor is a childhood syndrome of severe malnutrition. Unlike marasmus, which is defined by severe weight loss, kwashiorkor is defined by oedema. Kwashiorkor was once a global disease. However, its global distribution has since shrunk. Most cases now occur in Sub-Saharan Africa, where it is estimated that kwashiorkor kills tens of thousands of children each year. Survivors are at increased risk for neurocognitive dysfunction, lower academic performance, cardio-metabolic disease, and limited economic achievement. Kwashiorkor perpetuates cycles of poverty. Despite its impact on human health kwashiorkor is now often overlooked. Its cause remains uncertain and largely unstudied. Knowledge of its epidemiology is poor. Institutions and policy makers pay little attention however. Meeting these needs requires the closure of a critical knowledge gap: the cause of kwashiorkor remains uncertain. Recent insights offer clues. Kwashiorkor is marked by an array of metabolic and organ level disturbances. These include skin changes, fatty liver of undernutrition, diffuse DNA hypomethylation, and systemic one-carbon metabolism disturbances. This pattern of changes suggests that kwashiorkor is an acquired syndrome of nutritionally mediated one-carbon metabolism dysfunction. Pre-clinical models indicate that supplementation with certain essential one-carbon nutrients might prevent kwashiorkor. Clinical trials are needed to establish the cause of kwashiorkor. At Baylor College of Medicine we are pursuing this work. We aim to pioneer better approaches for the prevention and treatment of kwashiorkor.

Languages

Spanish