Medicine and Health Sciences Commons^™

Diffuse Alveolar Hemorrhage Due To Hydralazine-Induced Lupus, P Boshara, E Calvo-Ayala

Conference Presentation Abstracts

Introduction: Hydralazine is a known cause of drug-induced lupus. Rarely, it’s been reported to cause major organ-threatening complications, manifesting as kidney disease and CNS involvement. It’s also been associated with ANCA-positive vasculitis primarily involving the kidney, with uncommon pulmonary complications. We report a unique case of hydralazine-induced lupus presenting as diffuse alveolar hemorrhage (DAH) in the absence of renal disease or ANCA-positive vasculitis, which was successfully treated with systemic steroid monotherapy. Case description: The patient is an 86 year-old female with a history of chronic immune thrombocytopenia who presented to the hospital due to one week of dyspnea and hemoptysis. …

Impact Of Serum Igg Levels Against Sars-Cov-2 On Clinical Outcomes For Hopitalized Covid Patient, Bipin Ghimire, Bijaya Thapa, Nishant Aggarwal, Luai Madanat, Melinda Sager, Daniel O'Connor, Alexandra Halalau

Conference Presentation Abstracts

BACKGROUND: The SAR-CoV-2 pandemic continues to negatively impact the healthcare system globally with over 800,000 deaths in the United States and millions more worldwide. The cases are rising despite availability of vaccines. For most immunocompetent patients these vaccines will generate a humoral response and also a memory T-cell response. Few if any studies have reported data that measure anti-spike IgG titers and also correlate those titers with clinical outcomes in the instance of breakthrough infection.

METHODS: We conducted a pilot prospective observational clinical study enrolling 30 immunocompetent patients who were admitted with a positive SARS-CoV-2 PCR. Leftover blood from admission …

The Competitive Edge: Improving Absite Scores Through A Team-Based Approach, Sean Masters, Kathryn Howard, Darci Foote, Diane Studzinski, Rose E. Callahan, Felicia Ivascu, Begum Akay

Conference Presentation Abstracts

Introduction: A competitive team-based approach to encourage self-studying and didactic participation is a novel method of American Board of Surgery In-Training Examination (ABSITE) preparation. We aimed to determine if this method significantly improves residents’ percentile performances on the ABSITE. Methods: We reviewed ABSITE performance and preparation from general surgery residents for the last ten years. Percentile scores were compared before and after implementation of a purchased online question bank (TrueLearn LLC, Mooresville, NC), a team-based competition, and a virtual format of the team-based competition. Statistical analysis was performed with ANOVA Kruskal-Wallis and Mann Whitney tests where appropriate. Results: 378 ABSITE …

Spontaneous Pneumomediastinum In Children Is Not Associated With Esophageal Perforation, Kevin Roby, Catherine Barkach, Diane Studzinsk, Nathan M. Novotny, Begum Akay, Pavan Brahmamdam

Conference Presentation Abstracts

Purpose: We hypothesized that esophageal perforation is not a common etiology for spontaneous pneumomediastinum (SPM), and that SPM is a self-limited disease not requiring routine admission. Methods: We performed a retrospective review of patients, ages 0 to 21 years, diagnosed with SPM in one hospital system (five hospitals) from 2009 – 2019. Cases were identified using ICD9 and 10 codes and confirmed through chart review. Cases were excluded for trauma, severe infections, or subsequent development of SPM after admission for a separate diagnosis. Data regarding patient characteristics, diagnostic tests, and outcomes were collected, and summary statistics were performed. Results: We …

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, …

Pulmonary Cement Emboli: An Underreported Phenomenon Or Rare Kyphoplasty Complication, A Cimino, A Alchakaki

Conference Presentation Abstracts

Kyphoplasty is an intervention to treat and stabilize painful vertebral compression fractures by injecting Polymethymethacrylate (PMMA) cement in the vertebral cavity. It has become increasingly important procedure in pathologic compression fracture treatment. Pulmonary cement embolism (PCE) happens by leakage of cement through the venous plexus or retrograde migration in the arterial vessels to aorta. It was reported as a rare complication of this procedure (3.5%) but others have suggested that because of paucity in symptoms, PCE is often overlooked and can happen in up to 28.6% of kyphoplasty patients. PCE cause a wide spectrum of symptoms ranging from asymptomatic to …

Identifying Novel Subphenotypes In Covid-19 Using Protein Biomarkers, A Spicer, P A. Verhoef, C Lopez-Espina, A Bhargava, L Schmalz, M Sims, A V. Palagiri, K V. Iyer, M J. Crisp, A Halalau, N Maddens, A Espinosa

Conference Presentation Abstracts

RATIONALE: COVID-19 is widely heterogeneous in presentation, even across patients with similar demographics and medical history. Identification of subphenotypes based on host immune responses that are biologically discrete and predict outcomes may enable personalized COVID-19 therapies. Accordingly, using a composite of electronic health record (EHR) data and 36 research biomarkers, we sought to compare COVID-19 immune responses across patients of varying disease severity, identify subphenotypes within hospitalized COVID-19 patients, and test for heterogeneity of treatment effect (HTE) to intravenous corticosteroids across these subphenotypes. METHODS: In this multicenter retrospective analysis of prospectively collected data, patients presenting to three medical centers from …

Pneumothorax Ex Vacuo As Initial Presentation Of Endobronchial Tuberculosis By Mycobacterium Bovis, Olga Romina Gomez Rojas, Matthew Weatherhead, Matthew Hicks, Christopher Dado, Abdulgadir Adam

Conference Presentation Abstracts

INTRODUCTION: Mycobacterium bovis infection in humans is an extremely rare entity. M. tuberculosis and M. bovis are clinically and radiographically indistinguishable, hence, genotype-based identification is required. Management and outcomes of M. bovis infection are not well described. We present the first case of endobronchial tuberculosis secondary to M. bovis in an immunocompetent host. DESCRIPTION: A 19 year old woman without past medical history presented to the emergency department for sudden onset left-side chest pain and dry cough. A preoccupational evaluation noted a positive tuberculin skin test with normal chest-xray. Physical exam significant for absent breathing sounds in the left upper …

Hex Of The Dex: Dexmedetomidine Induced Malignant Hyperthermia In Myotonic Dystrophy, K Almerico, T Salimnia, S Dogra

Conference Presentation Abstracts

Dexmedetomidine is an alpha2 agonist that has been shown to have anxiolytic, analgesic, and sedative properties making it a popular medication in the intensive care unit. Over the years, its use has become more widespread. Thus, there have been more adverse events, most notably hypotension and bradycardia. Over the past few years the side effect of hyperthermia has grown to recognition with various case reports being documented. We report a case of dexmedetomidine induced malignant hyperthermia (MH) up to 42.2 degrees Celsius in a patient with underlying myotonic dystrophy that resolved within 24 hours of discontinuing the medication. The patient …

A Study To Compare Baseline Functional Residual Capacity And Forced Vital Capacity As A Predictor Of Mortality And Hospitalization In A Cohort Of Mild To Moderate Interstitial Lung Disease, O R. Gomez Rojas, E Naeem, F Ionescu, E Castillo, G B. Nair

Conference Presentation Abstracts

Background Forced Vital Capacity (FVC) is a common parameter used to assess disease progression in patients with Interstitial lung disease (ILD) and acts as a surrogate for mortality. Previous studies suggest Functional Residual Capacity (FRC) may be an earlier predictor of disease progression in ILD. In this study, we compared ability of baseline FRC to FVC to predict one-year-mortality and respiratory related hospitalization in patients with mild to moderate ILD. Methods We retrospectively analyzed a prospective cohort of ILD patients attending a multidisciplinary ILD program from Jan 2017 to Oct 2021 at a large Health care system. Patients who had …

Evaluation Of Vancomycin Based On Risk Factors In Emergent And Critically Ill Patients, Morgan Ragsdale, Lisa Hal Zimmerman, Elizabeth Messana, Derek Volgyi

Conference Presentation Abstracts

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with prolonged hospital length of stay and mortality rates up to 20%. Risk factors for MRSA and presumed type of infection often guide vancomycin prescribing. This study evaluated the presence of MRSA risk factors in emergent and critically ill patients who received vancomycin therapy. METHODS: This retrospective study evaluated emergent and critically ill patients who received vancomycin for at least 24 hours for a presumed infection from 1/2020—3/2020. Patients were excluded if vancomycin was administered for surgical prophylaxis. Patients were divided into groups: MRSA Risk (MRSA-R) vs MRSA No Risk (MRSA-NR). MRSA …