Internal Medicine Commons^™

Prostate Cancer Patients’ Understanding Of The Gleason Scoring System: Implications For Shared Decision-Making, E. K. Tagai, S. M. Miller, A. Kutikov, M. A. Diefenbach, R. A. Gor, T. Al-Saleem, D. Y. Chen, S. Fleszar, G. Roy

Journal Articles

© 2018 American Association for Cancer Education The Gleason scoring system is a key component of a prostate cancer diagnosis, since it indicates disease aggressiveness. It also serves as a risk communication tool that facilitates shared treatment decision-making. However, the system is highly complex and therefore difficult to communicate: factors which have been shown to undermine well-informed and high-quality shared treatment decision-making. To systematically explore prostate cancer patients’ understanding of the Gleason scoring system (GSS), we assessed knowledge and perceived importance among men who had completed treatment (N = 50). Patients were administered a survey that assessed patient knowledge and …

Reduction In Social Activities Mediates The Relationship Between Diarrhea And Distress In Rectal/Anal Cancer Survivors, C. Benedict, K. Duhamel, C. J. Nelson

Journal Articles

No abstract provided.

Streptococcus Intermedius Brain And Diverticular Abscesses After Dental Manipulation: A Case Report., H. Al Moussawi, M. Krzyzak, Z. Awada, J. M. Chalhoub

Journal Articles

A brain abscess is defined as a focal intracerebral infection consisting of an encapsulated collection of pus, which can be a life-threatening complication of infections, trauma, or surgery. While immunocompromised patients can have a wide array of causative organisms, bacterial species represent the most common etiology in immunocompetent individuals. The incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000, with a high predisposition among immunocompromised patients and in those with disruption of the blood-brain barrier. The most common causative organisms found were Streptococcus species, particularly S. viridians and S. pneumonia, Enterococcus, and Staphylococcus species, mainly S. aurieus and …

Alk-Negative Anaplastic Large Cell Lymphoma Presenting As Disseminated Intravascular Coagulation And Hemophagocytic Lymphohistiocytosis: A Potentially Fatal Presentation., U. Ibrahim, A. Saqib, M. Rehan, J. P. Atallah

Journal Articles

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder that can be familial in etiology or a result of infections, malignancy, and autoimmune or inflammatory disorders. Disseminated intravascular coagulation (DIC) is common in patients admitted to intensive care units and can confound and delay the diagnosis of HLH. We present a case of a 69-year-old female who presented with dyspnea and malaise. Her condition declined rapidly with laboratory parameters consistent with DIC. In addition, she had a ferritin of 32,522 ng/mL, low haptoglobin, and elevated LDH, and bone marrow biopsy showed hemophagocytic lymphohistiocytes. She was started on HLH-directed therapy, and later, a …

Indwelling Pleural Catheters: Complications And Management Strategies, M. Chalhoub, A. Saqib, M. Castellano

Journal Articles

©Journal of Thoracic Disease. Indwelling pleural catheters (IPCs) are increasingly being used for patients with recurrent malignant pleural effusions. They are simple to place and can be done on an outpatient basis under local anesthesia. IPCs uniformly relieve dyspnea and improve quality of life of patients with malignant pleural effusions. In some patients with recurrent non-malignant pleural effusions, IPCs proved to be effective as well. With increasing use of IPCs, physicians and patients are faced with complications related to the presence of an indwelling catheter for extended periods of time. The purpose of this review is to describe the various …

The Association Between Asymptomatic And Mild Neurocognitive Impairment And Adherence To Antiretroviral Therapy Among People Living With Human Immunodeficiency Virus, Violet Awori, Peter Mativo, Gerald Yonga, Reena Shah

Internal Medicine, East Africa

Background: Asymptomatic cognitive impairment in human immunodeficiency virus (HIV)-infected patients has recently been recognised as part of HIV-associated neurocognitive disorders. This has been implicated as one of the causes of poor adherence to antiretroviral therapy (ART).

Objective: To assess the association between neurocognitive impairment (asymptomatic and mild forms) and adherence to ART.

Methods: This was a cross-sectional survey involving 218 participants consecutively sampled from those attending the HIV treatment clinic at Aga Khan University Hospital in Nairobi. Data collected included quantitative primary data on pre-defined baseline characteristics, neurocognitive assessment by Montreal Cognitive Assessment (MoCA) tool (Appendix 1), instrumental …

Computerized Cognitive Training In Prostate Cancer Patients On Androgen Deprivation Therapy: A Pilot Study, L. M. Wu, A. Amidi, M. L. Tanenbaum, G. Winkel, W. A. Gordon, S. J. Hall, K. Bovbjerg, M. A. Diefenbach

Journal Articles

© 2017, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Prostate cancer patients who have undergone androgen deprivation therapy (ADT) may experience cognitive impairment, yet there is an unmet need for nonpharmacological interventions to address cognitive impairment in this population. This study examines the feasibility, acceptability, and preliminary efficacy of a home-based computerized cognitive training (CCT) program to treat cancer-related cognitive impairment. Methods: Sixty men who had received ≥ 3 months of ADT were screened for at least mild cognitive or neurobehavioral impairment and randomized to 8 weeks of CCT or usual care. Follow-up assessments occurred immediately post-intervention or equivalent …

Examining The Impact Of A Multimedia Intervention On Treatment Decision-Making Among Newly Diagnosed Prostate Cancer Patients: Results From A Nationwide Rct., M. A. Diefenbach, C. Benedict, S. M. Miller, A. L. Stanton, M. E. Ropka, K. Wen, N. E. Mohamed, S. J. Hall

Journal Articles

Men diagnosed with early stage prostate cancer face multiple treatment options, each with distinctive side effects that have significant implications for post-treatment quality of life. Healing Choices for Men with Prostate Cancer is a multimedia educational and decision aid program. This nation-wide randomized controlled trial evaluated the impact of Healing Choices on reducing decisional conflict and distress. Eligible prostate cancer patients who called the National Cancer Institute's Cancer Information Service (CIS) were invited to participate. After a baseline interview, participants were randomized to usual personalized consultation with a CIS specialist (comparison condition) or CIS personalized consultation plus the Healing Choices …

Racial And Ethnic Disparities In Diagnosis Of Chronic Medical Conditions In The Usa, E. J. Kim, T. Kim, J. Conigliaro, J. M. Liebschutz, M. K. Paasche-Orlow, A. D. Hanchate

Journal Articles

No abstract provided.

Is 30-Day Posthospitalization Mortality Lower Among Racial/Ethnic Minorities?: A Reexamination, M. Lin, N. R. Kressin, M. K. Paasche-Orlow, E. J. Kim, L. Lopez, J. E. Rosen, A. D. Hanchate

Journal Articles

No abstract provided.

Sex Differences In Prevalence Of Emergency Department Patient Substance Use, Robert D. Cannon Do, Gillian A. Beauchamp Md, Paige Roth Lsw, Jennifer Stephens Do, David B. Burmeister Do, Facep, Cpe, David M. Richardson Md, Alanna Balbi Bs, Tennessee Park Ba, Stephen W. Dusza Drph, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

Purpose

Substance use and misuse is prevalent in emergency department (ED) populations. While the prevalence of substance use and misuse is reported, sex-specific trends in ED populations have not been documented. We set out to determine the sex-specific prevalence of ED patient substance use during this current epidemic.

Methods

A retrospective electronic data abstraction tool, developed for quality-improvement purposes, was used to assess ED visits in 3 hospitals in northeastern Pennsylvania. All patients with ED diagnosis codes for substance use F10.000 through F 19.999 (excluding F17 codes for nicotine) were abstracted for network ED visits at all 3 hospitals. Data …

Prevalence Of Hla-B*5701 In A Kenyan Population With Hiv Infection, Reena Shah, H. Nabiswa, Nancy Okinda, Gunturu Revathi, Mark Hawken, Nelson M.

Internal Medicine, East Africa

We read with interest the article published in your Journal entitled “Real-world persistence with antiretroviral therapy for HIV in the United Kingdom: a multicentre retrospective cohort study”1 which concluded that treatment discontinuation attributable to toxicity profile is not an uncommon event. They also acknowledged lack of data collection on HLA-B*5701 status, which would heavily influence initial ART regimen and the choice to discontinue medication. Of the 25.6 million living with Human Immunodeficiency Virus (HIV) in Africa, an estimated 1.6 million people live in Kenya.2 With an HIV prevalence of 5.6%, Kenya has upscaled HIV treatment and care in the past …