Medicine and Health Sciences Commons^™

Management Of Asymptomatic Hypertension In The Inpatient Setting., Charles Meadows, Mehiar Elhamdani, Dial Larry, Murad Kheetan, Khaled Al-Baqain

Marshall Journal of Medicine

Hypertension is common in hospitalized patients and is most often asymptomatic. While there are no guidelines for management of such patients, aggressive blood pressure treatment, including the use of intravenous antihypertensives, is often undertaken. While evidence of benefit is lacking, emerging data suggest that treatment of asymptomatic hypertension in the inpatient setting is associated with adverse outcomes, including acute kidney injury and ischemic stroke. In addition, the intensification of a preexisting antihypertensive regimen at hospital discharge significantly increases the risk of readmission without significant improvement in outpatient hypertension control. Such a combination of a common problem with the demonstrable benefit …

Outcomes Of Transcutaneous Aortic Valve Replacement Among High Risk Wv Sample Population., George M. Yousef, Julia Poe, Cameron Killmer, Basel Edris, Jason Mader, Ellen A. Thompson, Daniel Snavely, Silvestre Cansino, Joseph I. Shapiro, Mark A. Studeny

Marshall Journal of Medicine

Introduction:Transcatheter aortic valve replacement (TAVR) is a relatively new strategy for replacing the aortic valve. We elected to review our early experience to see if we could identify clinical characteristics at baseline or immediately following the procedure that would predict death within one year.

Methods:Charts for all patients assigned to receive TAVR procedure at St Mary’s medical center, Huntington, West Virginia between April, 2013 till November, 2016 were identified and reviewed. A total of seventy-two (72) cases were included.

Results: All cause mortality rate at index hospitalization, 30 days, and 12 months was 5.6%(N=4), 6.9%(N=5), 19.4%(N=14) respectively. Stroke …

Predicting Adverse Outcomes In Chronic Kidney Disease Using Machine Learning Methods: Data From The Modification Of Diet In Renal Disease, Zeid Khitan, Anna P. Shapiro, Preeya T. Shah, Juan R. Sanabria, Prasanna Santhanam, Komal Sodhi, Nader G. Abraham, Joseph I. Shapiro

Marshall Journal of Medicine

Background: Understanding factors which predict progression of renal failure is of great interest to clinicians.

Objectives: We examined machine learning methods to predict the composite outcome of death, dialysis or doubling of serum creatinine using the modification of diet in renal disease (MDRD) data set.

Methods: We specifically evaluated a generalized linear model, a support vector machine, a decision tree, a feed-forward neural network and a random forest evaluated within the context of 10 fold validation using the CARET package available within the open source architecture R program.

Results: We found that using clinical parameters available at entry into the …

Spinal Cord Injury And Autonomic Dysreflexia- A Case Report, Apurva Bhatt, Brit Moore, Talal Asif, Kristy E. Steigerwalt, Rebecca R. Pauly

Marshall Journal of Medicine

Autonomic dysreflexia (AD) is a life threatening condition affecting patients with spinal cord lesions T6 level and above. A 51 year old male with a history of paraplegia due to a C6 spinal cord injury (30 years prior) presented with recurrent debilitating episodic diaphoresis, hypertension, low body temperature, and bradycardia. Previous hospitalizations presumed sepsis from UTI to be the etiology, however on further evaluation his symptoms were consistent with undiagnosed AD. This article describes a unique case presentation and reviews AD in depth, including the etiology, pathophysiology and management.

Why Does Obesity Lead To Hypertension? Further Lessons From The Intersalt Study., Preeya T. Shah, Anna P. Shapiro, Zeid Khitan Md, Prasanna Santhanam Md, Joseph I. Shapiro Md

Marshall Journal of Medicine

Objectives

To analyze correlations between major determinants of blood pressure (BP), in efforts to generate and compare predictive models that explain for variance in systolic, diastolic, and mean BP amongst participants of the Intersalt study.

Methods

Data from the Intersalt study, consisting of nearly 10,000 subjects from 32 different countries, were reviewed and analyzed. Published mean values of 24 hour urinary electrolyte excretion (Na+, K+), 24 hour urine creatinine excretion, body mass index (BMI, kg/m^2), and blood pressure data were extracted and imported into Matlab™ for stepwise linear regression analysis.

Results

As shown earlier, strong correlations between urinary sodium excretion …