Internal Medicine Commons^™

Investigating The Effects Of A Mindfulness Based Stress Reduction Course On A Grouping Of Oncology Patients, Health Care Workers And Their Families On Measures Of Stress And Burnout In Health Care Workers: A Randomized Control Trial, Michael Moussa, Patrick Herndon, Alyssa Heintschel, Scott Sabbagh, Ruth Lerman

Posters

INTRODUCTION
Mindfulness Based Stress Reduction (MBSR) can improve the mental health of health care workers (HCW). How will the inclusion of oncology patients (OP) in MBSR classes for HCW affect the mental health of HCW?

Mindfulness-Based Stress Reduction For Pre-Clinical Medical Students: Exploring Efficacy And Benefit, Scott Sabbagh, Alyssa Heintschel, Patrick Herndon, Michael Moussa, Ruth Lerman

Posters

INTRODUCTION
Studies suggest that healthcare-affiliated populations are at an increased risk of experiencing chronic stress and burnout. Mindfulness meditation has become an established method to address and alleviate their effects, though it has not been extensively studied in the medical student population. The primary goals of this study are to assess the feasibility and efficacy of an 8-week, 30 contact hour MBSR course for first and second year medical students, and to assess its impact on their reported levels of stress, burnout, fear of compassion, and mindfulness.

Comparison Of Collaborative Goal Setting With Enhanced Education For Managing Diabetes-Associated Distress And Hemoglobin A1c Levels: A Randomized Clinical Trial, Lechauncy Woodard, Amber B Amspoker, Natalie E Hundt, Howard S Gordon, Brian Hertz, Edward Odom, Anne Utech, Javad Razjouyan, Suja S Rajan, Nipa Kamdar, Jasmin Lindo, Lea Kiefer, Praveen Mehta, Aanand D Naik

Journal Articles

IMPORTANCE: Type 2 diabetes is a prevalent and morbid condition. Poor engagement with self-management can contribute to diabetes-associated distress and hinder diabetes control.

OBJECTIVE: To evaluate the implementation and effectiveness of Empowering Patients in Chronic Care (EPICC), an evidence-based intervention to improve diabetes-associated distress and hemoglobin A1c (HbA1c) levels after the intervention and after 6-month maintenance.

DESIGN, SETTING, AND PARTICIPANTS: This hybrid (implementation-effectiveness) randomized clinical trial was performed in Veterans Affairs clinics across Illinois, Indiana, and Texas from July 1, 2015, to June 30, 2017. Participants included adults with uncontrolled type 2 diabetes (HbA1c level >8.0%) who received primary care …

Improving Utilization Of Buprenorphine In A Residency Program, Christopher Bender, Amy Dechet

Providence Portland Medical Center Internal Medicine 2022

No abstract provided.

Wearing An Applea Day Won’T Keep The Doctor Away: Diagnosing Wolff-Parkinson-White Syndrome With An Apple Watch, Grace Judd, Jason Heino

Providence Portland Medical Center Internal Medicine 2022

No abstract provided.

Small Vessel, Large Problems: An Unusual Cause Of Heart Failure In An Elderly Female., Nicholas Pettit, Jason Bensch

Providence Portland Medical Center Internal Medicine 2022

No abstract provided.

Diagnostic Utility Of Red Cell Indices In Relation To Serum Iron Indices For Evaluation Of Iron Deficiency In Heart Failure, Larry Wangai Mburu

Theses & Dissertations

Background: Iron deficiency (ID) in heart failure (HF) causes poorer outcomes, and evaluation using ferritin and transferrin saturation (TSAT) in our setting is hampered by cost and availability. Though the red cell indices (RCIs), routinely used for assessment of ID anaemia, have shown utility in predicting outcomes in HF, they have not been evaluated in this population for prediction of ID relative to the iron indices. A combination of the RCIs, the combined cell index (CCI), may be more accurate. Validating the diagnostic accuracy of the RCIs would improve evaluation of ID in low-resource settings and improve uptake of iron …

Dysglycemia In Patients Presenting With Stroke And Acute Coronary Syndrome At Aga Khan University Hospital, Nairobi, Beverly Yongo Owino

Theses & Dissertations

Background: Dysglycemia is often diagnosed late in sub-Saharan Africa with a significant number of patients presenting with complications. Data is needed to expand knowledge on the impact diabetes has on major adverse cardiovascular outcomes.

Objective: We aimed to determine the prevalence of dysglycemia in patients with stroke and Acute Coronary Syndrome (ACS) and define characteristics of the patients with dysglycemia.

Methods: A prospective cross-sectional study was conducted at Aga Khan University Hospital, Nairobi which is a tertiary facility. Consenting adults above 18 years (n=211) with stroke and acute coronary syndrome were recruited in the study in the period of April …

Intestinal Tuberculosis Presenting With Gastrointestinal Bleeding In Patient On Warfarin Therapy, Pascal Kuka, Joe Rakiro, Joseph Gatheru, Felix Riunga

Internal Medicine, East Africa

Background: Intestinal tuberculosis (ITB) constitutes less than 5% of overall cases of extrapulmonary disease and mostly affects the ileocecal region. The presentation and radiologic findings in enteric tuberculosis can mimic Crohn’s disease (CD).

Case Pre- sentation: We present a case report of an African woman who presented to a Kenyan hospital with lower gastrointestinal bleeding while on anticoagulation for valvular atrial fibrillation, and was diagnosed with intestinal tuberculosis after colonoscopy, biopsy, and positive staining for tuberculous bacilli.

Conclusion: Intestinal tuberculosis causing gastrointestinal bleeding is rare but should be suspected in patients living in TB endemic regions.

Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar

Nursing | Senior Theses

Background

Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.

Objective

To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …

Adolescent Connectedness: A Scoping Review Of Available Measures And Their Psychometric Properties, Ezra Too, Esther Chongwo, Adam Mabrouk, Amina Abubakar

Institute for Human Development

Introduction: Adolescent connectedness, a key component of positive youth development, is associated with various positive health outcomes. Several measures have been developed to assess this construct. However, no study has summarized data on the existing measures of adolescent connectedness. We conducted this scoping review to fill this gap. We specifically aimed to: (i) identify the existing measures of adolescent connectedness, (ii) determine the most frequently used measures among the identified measures, and (iii) summarize the psychometric properties of these measures with a keen interest in highlighting their cross-cultural utility and validity.

Methods: We searched CINAHL, Embase, PsycInfo, PubMed, …

Necrotizing Enterocolitis Rates In Preterm Infants, Alexis Howard

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breast milk and donor human milk is used in the prevention of necrotizing enterocolitis (NEC) in preterm infants born prior to 37 weeks gestation and those with very low birth weight. This process occurs through direct breast feeding and tube feeding. The aim of this study was to compare the use of breast milk and donor milk to the use of formula feed in preterm infants. A systematic review was conducted using articles collected from CINAHL and PubMed and was guided by PRISMA guidelines. A total of 15 studies that met criteria were analyzed by purpose, variables, study design, population …

Asymptomatic Chronic Sinusitis As An Atypical Presentation Of Meningitis, David Hwang, Laura Azzouz, Zeshan Choudhry, Benjamin Rossi

Posters

Introduction We present a unique case report of asymptomatic acute on chronic pansinusitis with parameningeal involvement as an atypical presentation of meningitis with associated pyrexia, nuchal rigidity, and headaches. Following initial admission, patient clinically deteriorated subsequently requiring emergent surgical debridement with ENT with cultures demonstrating fusobacterium nucleatum. This case presentation is of unique interest given long term neurological sequelae which can manifest as a result of delayed therapy, both medical and surgical, which includes but is not limited to permanent vision loss, ataxia, gait difficulty, and long standing sensorimotor deficits. We hope to provide additional educational resources given the lack …

Discrimination And Abuse Amongst Health Care Workers In A Tertiary Hospital In Kenya, Farah Alnoor Ebrahim

Theses & Dissertations

Background: Discrimination is defined as the unequal or disadvantageous treatment of an individual or a group of individuals. Discrimination in the health care setting can take many forms, including gender, race, verbal or emotional abuse, physical abuse, and sexual abuse. The prevalence of discrimination varies, with common forms being gender and racial discrimination as well as verbal and emotional abuse. Workplace discrimination often leads to a hostile environment for healthcare workers, resulting in significant mental strain. Patients, their relatives, and consultants are the foremost perpetrators of discrimination and abuse across the globe. Little is known about discrimination and abuse within …

Clinical Pathways Leading To Antibiotic Initiation In Patients With Suspected Infection And Their Association With Delays And Mortality, X Han, C Lopez-Espina, P A. Verhoef, A Spicer, A Bhargava, L Schmalz, Matthew Sims, Alexandra Halalau, Nicholas Maddens, Aimee Espinosa

Conference Presentation Abstracts

Rationale: Delayed antibiotic therapy is associated with increased mortality in patients hospitalized with infection. The decision toinitiate therapy in patients with suspected infection is influenced by a variety of information, such as vital signs, and laboratoryresults. Identifying different patterns of events that lead to initiation is necessary to discover factors that could serve as targets forinterventions to expedite this process. We aimed to identify the most common sequences of events that precede antibioticordering and to quantify the time intervals between each event that contribute to antibiotic delays. Methods: This was aretrospective study of adult patients hospitalized at 4 community hospitals …

Hiv Among Cancer Patients: Prevalence And Cancer Description By Hiv Status, Diana Wambui Muturi

Theses & Dissertations

Background: Antiretroviral therapy (ART) has resulted in a higher life expectancy of persons living with Human Immunodeficiency Virus (PLHIV) leading to an aging population at risk for non-AIDS defining cancers (NADCs) rather than AIDS-defining cancers (ADCs). Identification of HIV-cancer comorbidity through diagnostic HIV testing of patients presenting for cancer care is not offered routinely. The HIV prevalence among cancer patients in Kenya is undefined. In addition, the spectrum of malignancies in PLHIV has not been well characterized outside of ADCs.

Objective: Our primary objective was to determine the prevalence of HIV among patients with cancer. Secondary objectives were to determine …

Validation Of The Kiswahili Version Of The Migraine Disability Assessment Scale In Dar Es Salaam, Tanzania, Aliasger Nagri

Theses & Dissertations

Background: Migraine is a chronic paroxysmal neurological disorder characterized by multiphase attacks of head pain and many neurological symptoms. The MIDAS is a five (5) question-based questionnaire used in clinical practices to identify the disability caused by migraine at work, school, household or social life; with a score indicating little or no disability (0-5), mild disability (6-10), moderate disability (11-20), and severe disability (21+). Translated versions of the MIDAS scale in a number of languages has been validated. Translating and validating the Kiswahili version of the MIDAS questionnaire is essential and needed to ensure its comparability to the original English …

Feasibiity And Acceptability Of Tele-Neurology Services At A Regional Tertiary Referral Centre: A Prospective Study., Fazal Yakub

Theses & Dissertations

Background: Neurological diseases are a leading cause of morbidity and mortality worldwide with a great burden lying in Sub-Saharan Africa. The paucity of neurologists in the region makes neurological care disproportionately inaccessible. Utility of tele-medicine is low cost, time efficient, convenient, reducing the carbon footprint and ultimately increasing health care access.

Objective: We identified whether the concept of tele-neurology was feasible within our setup for patients with stable neurological diseases while establishing the cost effectiveness, efficiency, convenience and the carbon footprint burden.

Methods: We conducted a prospective cross-sectional study. New patients were triaged by the neurologist based on guidelines from …

From Head To Hilum: Angiosarcoma With Pulmonary Metastasis, Tanaz Salimnia, Lauren A. Abplanalp, Raashi Chawla, K Hughes, R Ghandchi, Matthew Weatherhead, Sanjay Dogra

Conference Presentation Abstracts

With an estimated five-year survival of less than 40 percent, angiosarcomas are rare and often misdiagnosed fataltumors originating from blood or lymphatic vessels with a predilection for the head and neck. They account for 1percent of all soft tissue sarcomas and are often mistaken for benign mimickers leading to the late-stage diagnosiswhen the body is already riddled with metastatic disease with the lung being the most common site of metastases.This case illustrates the myriad of pulmonary complications associated with this uncommon but fatal vasoformativemalignancy. The patient is a 73-year-old male diagnosed with angiosarcoma of the right scalp status post excision,reconstruction, …

Hemophilia A: Strategies For Improving Long-Term Holistic Management, Adherence, And Quality Of Life, Miguel A Escobar, Cindy Leissinger, Guy Young

Journal Articles

Hemophilia A is a rare inherited bleeding disorder characterized by a deficiency in factor VIII. The evolution of currently approved prophylaxis therapy in hemophilia A will be reviewed, including the clinical value of prophylaxis, real-world experience with prophylaxis, and patient quality-of-life factors that must be considered when choosing treatment options for these patients.