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Full-Text Articles in Medicine and Health Sciences

An Unexpected Case Of Non-Uremic Calciphylaxis In A Patient With Multiple Risk Factors, Shannon Nugent, Fred Karaisz, Maisa Elbadawi, Andrew Touati, Neda Nikbakht, Jason B. Lee, Hasan Arif Dec 2022

An Unexpected Case Of Non-Uremic Calciphylaxis In A Patient With Multiple Risk Factors, Shannon Nugent, Fred Karaisz, Maisa Elbadawi, Andrew Touati, Neda Nikbakht, Jason B. Lee, Hasan Arif

Division of Internal Medicine Faculty Papers & Presentations

A 58-year-old woman with a history of morbid obesity, asthma, and prior warfarin use presented to the hospital with shortness of breath and a three-month history of painful, ulcerated ulcers with retiform purpura of her bilateral distal extremities. A punch biopsy specimen demonstrated focal necrosis and hyalinization of the adipose tissue with subtle arteriolar calcium deposition, findings consistent with calciphylaxis. We discuss the presentation of non-uremic calciphylaxis and review the risk factors, pathophysiology, and interdisciplinary management approach of this rare disease.


Risk Prevention And Health Promotion For Non-Alcoholic Fatty Liver Diseases (Nafld), Adnan Khan, Do, Heather Ross, Natali Salinas, Sarah Chen, Kashyap Chauhan, Makala Wang, Brian Yan, Ba, John Magagna, Jacob Beiriger, Yash Shah, Taha Shahzad, Dina Halegoua-De Marzio, Md Oct 2022

Risk Prevention And Health Promotion For Non-Alcoholic Fatty Liver Diseases (Nafld), Adnan Khan, Do, Heather Ross, Natali Salinas, Sarah Chen, Kashyap Chauhan, Makala Wang, Brian Yan, Ba, John Magagna, Jacob Beiriger, Yash Shah, Taha Shahzad, Dina Halegoua-De Marzio, Md

Division of Internal Medicine Faculty Papers & Presentations

Non-alcoholic fatty liver disease (NAFLD) is a serious clinicopathological condition that is recognized as the most frequent chronic liver disease, affecting 14%-30% of the world’s population. The prevalence of NAFLD has rapidly grown and is correlated with the growth in obesity and type 2 diabetes, among other factors. NAFLD often results in long-term complications including cardiovascular disease, liver cirrhosis, and liver fibrosis. This paper provides an updated overview of NAFLD with a focus on epidemiology, etiology, pathophysiology, screening, complications, and pharmacological therapies to identify effective risk prevention and health promotion.


Interobserver Variability Among Expert Readers Quantifying Plaque Volume And Plaque Characteristics On Coronary Ct Angiography: A Clarify Trial Sub-Study, Rebecca Jonas, Shaneke Weerakoon, Rebecca Fisher, William F Griffin, Vishak Kumar, Habib Rahban, Hugo Marques, Ronald P Karlsberg, Robert S Jennings, Tami R Crabtree, Andrew D Choi, James P Earls Aug 2022

Interobserver Variability Among Expert Readers Quantifying Plaque Volume And Plaque Characteristics On Coronary Ct Angiography: A Clarify Trial Sub-Study, Rebecca Jonas, Shaneke Weerakoon, Rebecca Fisher, William F Griffin, Vishak Kumar, Habib Rahban, Hugo Marques, Ronald P Karlsberg, Robert S Jennings, Tami R Crabtree, Andrew D Choi, James P Earls

Division of Internal Medicine Faculty Papers & Presentations

Background: The difference between expert level (L3) reader and artificial intelligence (AI) performance for quantifying coronary plaque and plaque components is unknown.

Objective: This study evaluates the interobserver variability among expert readers for quantifying the volume of coronary plaque and plaque components on coronary computed tomographic angiography (CCTA) using an artificial intelligence enabled quantitative CCTA analysis software as a reference (AI-QCT).

Methods: This study uses CCTA imaging obtained from 232 patients enrolled in the CLARIFY (CT EvaLuation by ARtificial Intelligence For Atherosclerosis, Stenosis and Vascular MorphologY) study. Readers quantified overall plaque volume and the % breakdown of noncalcified plaque (NCP) …


Echocardiographic Predictors Of Symptomatic Cardiotoxicity Among Patients Undergoing Chemotherapy: A Systematic Review And Meta-Analysis, Muhammad Umer Siddiqui, Youssef Yaacoub, Heidi-Anne Hanson, Joey Junarta, Ahmed K Pasha, Mahek Shah Jul 2022

Echocardiographic Predictors Of Symptomatic Cardiotoxicity Among Patients Undergoing Chemotherapy: A Systematic Review And Meta-Analysis, Muhammad Umer Siddiqui, Youssef Yaacoub, Heidi-Anne Hanson, Joey Junarta, Ahmed K Pasha, Mahek Shah

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Chemotherapeutic agents have been associated with cardiotoxicity; thus, they require close monitoring. Several echocardiographic variables have been investigated as early predictors of symptomatic cardiotoxicity in patients undergoing chemotherapy.

OBJECTIVE: To identify if global longitudinal strain (GLS) is a better predictor of symptomatic cardiotoxicity compared to left ventricular ejection fraction (LVEF) in patients receiving chemotherapy.

METHODS: MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials were searched from inception through December 2020. Adults who developed symptomatic cardiotoxicity (New York Heart Association [NYHA] Class III-IV heart failure, cardiac arrest, or cardiac death) after undergoing chemotherapy with pre- and postchemotherapy echocardiographic measures …


Feasible Stenting Of A Large Septal Perforator Providing A Sizeable Coronary Collaterals, Hussam Al Hennawi, Mohammad F. Mathbout,, Abdulrahman Taftafa, Christopher D. Nielsen Jun 2022

Feasible Stenting Of A Large Septal Perforator Providing A Sizeable Coronary Collaterals, Hussam Al Hennawi, Mohammad F. Mathbout,, Abdulrahman Taftafa, Christopher D. Nielsen

Division of Internal Medicine Faculty Papers & Presentations

While coronary artery disease involving the septal perforator branches presents similar to diseases of major coronary arteries, management can present a challenge. Owing to their relatively small size, performing interventional procedures is often impractical in terms of selecting appropriate devices. Although larger septal perforator branches have been managed percutaneously, similar to major vessels, long-term sequelae and clinical effectiveness have been indeterminate. We present our experience in managing a patient with a stenosed septal perforator branch and challenging comorbidities.


The Overestimation Of Concentric Hypertrophy In Patients With Hfpef As Determined By 2d-Echocardiography, Mohammad F. Mathbout, Hussam Al Hennawi, Anwar Khedr, Gaurang N. Vaidya, Marcus Stoddard Jun 2022

The Overestimation Of Concentric Hypertrophy In Patients With Hfpef As Determined By 2d-Echocardiography, Mohammad F. Mathbout, Hussam Al Hennawi, Anwar Khedr, Gaurang N. Vaidya, Marcus Stoddard

Division of Internal Medicine Faculty Papers & Presentations

Background: Heart failure with preserved ejection fraction continues to pose multiple challenges in terms of accurate diagnosis, treatment, and associated morbidity. Accurate left ventricular (LV) mass calculation yields essential prognostic information relating to structural heart disease. Two-dimensional (2D) echocardiography-based calculations are solely limited to LV geometric assumptions of symmetry, whereas three-dimensional (3D) echocardiography could overcome these limitations. This study aims to compare the performance of 2D and 3D LV mass calculations. Methods: A prospective review of echocardiography findings at the University of Louisville, Kentucky, was conducted and assessed. Normal ejection fraction (EF) was defined as >=52% in males and >=54% …


Smartphone Apps For Diabetes Medication Adherence: Systematic Review, Sheikh Mohammed Shariful Islam, Vinaytosh Mishra, Muhammad U Siddiqui, Jeban Chandir Moses, Sasan Adibi, Lemai Nguyen, Nilmini Wickramasinghe Jun 2022

Smartphone Apps For Diabetes Medication Adherence: Systematic Review, Sheikh Mohammed Shariful Islam, Vinaytosh Mishra, Muhammad U Siddiqui, Jeban Chandir Moses, Sasan Adibi, Lemai Nguyen, Nilmini Wickramasinghe

Division of Internal Medicine Faculty Papers & Presentations

Background: Diabetes is one of the leading noncommunicable chronic diseases globally. In people with diabetes, blood glucose levels need to be monitored regularly and managed adequately through healthy lifestyles and medications. However, various factors contribute to poor medication adherence. Smartphone apps can improve medication adherence in people with diabetes, but it is not clear which app features are most beneficial.

Objective: This study aims to systematically review and evaluate high-quality apps for diabetes medication adherence, which are freely available to the public in Android and Apple app stores and present the technical features of the apps.

Methods: We systematically searched …


Mortality After Transcatheter Aortic Valve Replacement For Aortic Stenosis Among Patients With Malignancy: A Systematic Review And Meta-Analysis, Muhammad U Siddiqui, Omar Yacob, Joey Junarta, Ahmed K Pasha, Farouk Mookadam, Mamas A Mamas, D L Fischman May 2022

Mortality After Transcatheter Aortic Valve Replacement For Aortic Stenosis Among Patients With Malignancy: A Systematic Review And Meta-Analysis, Muhammad U Siddiqui, Omar Yacob, Joey Junarta, Ahmed K Pasha, Farouk Mookadam, Mamas A Mamas, D L Fischman

Division of Internal Medicine Faculty Papers & Presentations

Background: With advancements in cancer treatment, the life expectancy of oncology patients has improved. Thus, transcatheter aortic valve replacement (TAVR) may be considered as a feasible option for oncology patients with severe symptomatic aortic stenosis (AS). We aim to evaluate the difference in short- and long-term all-cause mortality in cancer and non-cancer patients treated with TAVR for severe AS.

Methods: Medline, PubMed, and Cochrane Central Register of Controlled Trials were searched for relevant studies. Patients with cancer who underwent treatment with TAVR for severe AS were included and compared to an identical population without cancer. The primary endpoints were short- …


Hyperdynamic Left Ventricular Ejection Fraction Is Associated With Higher Mortality In Covid-19 Patients, Annas Rahman, Max Ruge, Md, Alex Hlepas, Batha Nair, Joanne Gomez, Jeanne Du Fey De Lavallaz, Setri Fugar, Nusrat Jahan, Annabelle Santos Volgman, Kim A. Williams, Anupama Rao, Karolina Marinescu, Tisha Suboc Apr 2022

Hyperdynamic Left Ventricular Ejection Fraction Is Associated With Higher Mortality In Covid-19 Patients, Annas Rahman, Max Ruge, Md, Alex Hlepas, Batha Nair, Joanne Gomez, Jeanne Du Fey De Lavallaz, Setri Fugar, Nusrat Jahan, Annabelle Santos Volgman, Kim A. Williams, Anupama Rao, Karolina Marinescu, Tisha Suboc

Division of Internal Medicine Faculty Papers & Presentations

Study objective: To compare the characteristics and outcomes of COVID-19 patients with a hyperdynamic LVEF (HDLVEF) to those with a normal or reduced LVEF.

Design: Retrospective study.

Setting: Rush University Medical Center.

Participants: Of the 1682 adult patients hospitalized with COVID-19, 419 had a transthoracic echocardiogram (TTE) during admission and met study inclusion criteria. Interventions: Participants were divided into reduced (LVEF < 50%), normal (≥50% and <70%), and hyper- dynamic (≥70%) LVEF groups.

Main outcome measures: LVEF was assessed as a predictor of 60-day mortality. Logistic regression was used to adjust for age and BMI.

Results: There was no difference in 60-day mortality between patients in the reduced LVEF and normal LVEF …


The Effect Of Scan And Patient Parameters On The Diagnostic Performance Of Ai For Detecting Coronary Stenosis On Coronary Ct Angiography, Rebecca Jonas, Emil Barkovich, Andrew D Choi, William F Griffin, Joanna Riess, Hugo Marques, Hyuk-Jae Chang, Jung Hyun Choi, Joon-Hyung Doh, Ae-Young Her, Bon-Kwon Koo, Chang-Wook Nam, Hyung-Bok Park, Sang-Hoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang Gao, Faisal Nabi, Ryo Nakazato, U Joseph Schoepf, Roel S Driessen, Michiel J Bom, Randall C Thompson, James J Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Généreux, Paul Knaapen, Guus A De Waard, Gianluca Pontone, Daniele Andreini, Marco Guglielmo, Mouaz H Al-Mallah, Robert S Jennings, Tami R Crabtree, James P Earls Apr 2022

The Effect Of Scan And Patient Parameters On The Diagnostic Performance Of Ai For Detecting Coronary Stenosis On Coronary Ct Angiography, Rebecca Jonas, Emil Barkovich, Andrew D Choi, William F Griffin, Joanna Riess, Hugo Marques, Hyuk-Jae Chang, Jung Hyun Choi, Joon-Hyung Doh, Ae-Young Her, Bon-Kwon Koo, Chang-Wook Nam, Hyung-Bok Park, Sang-Hoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang Gao, Faisal Nabi, Ryo Nakazato, U Joseph Schoepf, Roel S Driessen, Michiel J Bom, Randall C Thompson, James J Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Généreux, Paul Knaapen, Guus A De Waard, Gianluca Pontone, Daniele Andreini, Marco Guglielmo, Mouaz H Al-Mallah, Robert S Jennings, Tami R Crabtree, James P Earls

Division of Internal Medicine Faculty Papers & Presentations

Objectives: To determine whether coronary computed tomography angiography (CCTA) scanning, scan preparation, contrast, and patient based parameters influence the diagnostic performance of an artificial intelligence (AI) based analysis software for identifying coronary lesions with ≥50% stenosis.

Background: CCTA is a noninvasive imaging modality that provides diagnostic and prognostic benefit to patients with coronary artery disease (CAD). The use of AI enabled quantitative CCTA (AI-QCT) analysis software enhances our diagnostic and prognostic ability, however, it is currently unclear whether software performance is influenced by CCTA scanning parameters.

Methods: CCTA and quantitative coronary CT (QCT) data from 303 stable patients (64 ± …


A Comprehensive Review On The Risk Of Metabolic Syndrome And Cardiovascular Disease After Liver Transplantation, Kashyap Chauhan, Adnan Khan, Salil Chowdhury, Heather Ross, Natali Salinas, Dina Halegoua-De Marzio Apr 2022

A Comprehensive Review On The Risk Of Metabolic Syndrome And Cardiovascular Disease After Liver Transplantation, Kashyap Chauhan, Adnan Khan, Salil Chowdhury, Heather Ross, Natali Salinas, Dina Halegoua-De Marzio

Division of Internal Medicine Faculty Papers & Presentations

Survival rates after liver transplantation have increased dramatically over the past 20 years. Cardiovascular disease is the most common extra-hepatic cause of mortality in the long-term post liver transplant. This is intimately linked with both the higher pre-existing rates of metabolic syndrome in these patients as well as increased propensity to develop de novo metabolic syndrome post-transplant. This unfavorable metabolic profile that contributes to cardiovascular disease is multifactorial and largely preventable. This review explores metabolic syndrome and cardiovascular disease and their contributory factors post liver transplantation to highlight areas for potential intervention and thus reduce the significant morbidity and mortality …


Prognostic Value Of H2fpef Score In Covid-19, Priya Patel, Max Ruge, Joanne Michelle D. Gomez, Jeanne Du Fay De Lavallaz, Anupama Rao, Kim A. Williams, Annabelle Santos Volgman, Maria Rosa R. Costanzo, Tisha Suboc, Karolina Marinescu Mar 2022

Prognostic Value Of H2fpef Score In Covid-19, Priya Patel, Max Ruge, Joanne Michelle D. Gomez, Jeanne Du Fay De Lavallaz, Anupama Rao, Kim A. Williams, Annabelle Santos Volgman, Maria Rosa R. Costanzo, Tisha Suboc, Karolina Marinescu

Division of Internal Medicine Faculty Papers & Presentations

Study objective: This study sought to assess the predictive value of H2FPEF score in patients with COVID-19.

Design: Retrospective study.

Setting: Rush University Medical Center.

Participants: A total of 1682 patients had an echocardiogram in the year preceding their COVID-19 admission with a preserved ejection fraction (≥50%). A total of 156 patients met inclusion criteria. Interventions: Patients were divided into H2FPEF into low (0–2), intermediate (3–5), and high (6–9) score H2FPEF groups and outcomes were compared.

Main outcome measures: Adjusted multivariable logistic regression models evaluated the association between H2FPEF score group and a composite outcome for severe COVID-19 infection consisting …


Acute Left Atrial Compression After Ventricular Assist Device Placement, Max Rug Ruge, Tal Zivan, Ron Leong, Eric Feduska, Mahek Shah, J. Eduardo Rame, Howard Massey, René J Alvarez, Yevgeniy Brailvosky, Indranee Rajapreyar Feb 2022

Acute Left Atrial Compression After Ventricular Assist Device Placement, Max Rug Ruge, Tal Zivan, Ron Leong, Eric Feduska, Mahek Shah, J. Eduardo Rame, Howard Massey, René J Alvarez, Yevgeniy Brailvosky, Indranee Rajapreyar

Division of Internal Medicine Faculty Papers & Presentations

Highlights:

  • Pump thrombosis commonly presents with hemolysis and device parameter fluctuations.
  • Left atrial compression presents similarly to pump thrombosis but with no device fluctuations.
  • Reference standard imaging test for ventricular device thrombus is contrast-enhanced CT.


Successful Treatment With Daptomycin Of Mrsa Empyema Complicated By Right-Sided Loculated Pleural Effusion Refractory To Vancomycin, Ava Torjani, Dylan Selbst, Joshua Hamsher, Sahaj Mujumdar, Andie Belkoff, Luis Taboada Feb 2022

Successful Treatment With Daptomycin Of Mrsa Empyema Complicated By Right-Sided Loculated Pleural Effusion Refractory To Vancomycin, Ava Torjani, Dylan Selbst, Joshua Hamsher, Sahaj Mujumdar, Andie Belkoff, Luis Taboada

Division of Internal Medicine Faculty Papers & Presentations

Empyema is a serious complication of pneumonia and has been reported to have a mortality rate of 8.7%. For methicillin-resistant Staphylococcus aureus (MRSA) empyema, treatment includes drainage and specific antibiotics such as vancomycin and linezolid. Strikingly, there are increasing incidences of empyema refractory to vancomycin and linezolid. Despite being inactivated in the lung parenchyma by pulmonary surfactant, daptomycin can penetrate the pleural space and may be better at treating MRSA empyema than vancomycin and linezolid. Some case reports have shown that daptomycin has been used to successfully treat MRSA empyema refractory to linezolid and vancomycin-resistant enterococcus (VRE) empyema. Here, we …


Clinical Factors Implicated In Antibiotic Resistance In Helicobacter Pylori Patients, Brian White, Maria Winte, Joshua Desipio, Sangita Phadtare Jan 2022

Clinical Factors Implicated In Antibiotic Resistance In Helicobacter Pylori Patients, Brian White, Maria Winte, Joshua Desipio, Sangita Phadtare

Division of Internal Medicine Faculty Papers & Presentations

Helicobacter pylori is a common gastric pathogen associated with multiple clinical syndromes, including cancer. Eradication rates of H. pylori remain suboptimal despite the progress made in the past few decades in improving treatment strategies. The low eradication rates are mainly driven by antibiotic resistance of H. pylori. Non-invasive molecular testing to identify patients with antibiotic-resistant H. py-lori represents a promising therapeutic avenue, however this technology currently remains limited by availability, costs, and lack of robust validation. Moreover, there is insufficient evidence to demonstrate that resistance-testing-based treatment approaches are superior to appropriately designed empiric strat-egies. Consensus guidelines recommend use of proven …