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Articles 271 - 300 of 14109
Full-Text Articles in Medical Education
Enhancing Gestational Diabetes Screening, Sataj Johnson, Daniel Ruegg
Enhancing Gestational Diabetes Screening, Sataj Johnson, Daniel Ruegg
Books, Presentations, Posters, Etc.
Background: Gestational diabetes mellitus (GDM) screening is recommended between 24–28 weeks of gestation to allow timely diagnosis and treatment and reduce adverse maternal and neonatal outcomes. The two-step glucose tolerance testing method is supported by ACOG, though completion can be delayed due to the need for multiple tests. In 2024 at Providence Milwaukie Family Medicine Clinic, incomplete GDM screening occurred in 23.1% of patients, and incomplete two-step screening occurred in 33.3%, with an average completion time of 12 days. Objective: To increase completion rates of two-step GDM screening and reduce time between abnormal 1-hour and diagnostic 3-hour glucose tolerance tests …
When Common Isn’T Typical: A Diagnostic Twist In Hyperparathyroidism, Connor Shortt, Do*, Laura Loertscher, Md*
When Common Isn’T Typical: A Diagnostic Twist In Hyperparathyroidism, Connor Shortt, Do*, Laura Loertscher, Md*
Books, Presentations, Posters, Etc.
Introduction: Primary hyperparathyroidism is the third most common endocrine disorder, following diabetes and thyroid disease. It is characterized by excess calcium and inappropriately elevated parathyroid (PTH) levels. Severe disease classically presents with a combination of nephrolithiasis, bone pain, osteoporosis, constipation, abdominal pain, anxiety, depression, or confusion. However, due to the availability of routine labs, most cases now present as asymptomatic hypercalcemia. Case Description: A 60-year-old female was evaluated for falls, generalized weakness, constipation, and brain fog. Her admission labs revealed a calcium of 19.6 mg/dL and subsequent PTH of 1,932 pg/mL. She was treated with intravenous fluids, pamidronate, and cinacalcet, …
An Atypical Presentation Of Metastatic Gastric Adenocarcinoma Due To Pulmonary Lymphangitic Carcinomatosis, Matthew Moritz, Omar Pandhair
An Atypical Presentation Of Metastatic Gastric Adenocarcinoma Due To Pulmonary Lymphangitic Carcinomatosis, Matthew Moritz, Omar Pandhair
Books, Presentations, Posters, Etc.
Pulmonary lymphangitic carcinomatosis (PLC) accounts for approximately 8% of pulmonary metastases and is primarily associated with breast, lung, and gastric cancers. Chest radiographs are often nonspecific and normal in approximately 50% of cases. We present a case of PLC as an initial presentation of metastatic gastric adenocarcinoma. A 57-year-old White woman with prior tobacco use, asthma, and multiple sclerosis on Natalizumab presented with three months of progressive dyspnea and cough. She was evaluated multiple times and treated with various antibiotics and inhalers for presumed bronchitis. Despite this, her symptoms worsened, prompting hospital evaluation. She was tachycardic and markedly hypoxemic on …
The Rash After The Remedy, Elaine Chen, Md
The Rash After The Remedy, Elaine Chen, Md
Books, Presentations, Posters, Etc.
Introduction: Trimethoprim/sulfamethoxazole (TMP/SMX) is a widely prescribed and generally well-tolerated antibiotic. Cutaneous reactions occur in up to 4% of patients, including morbilliform rash, urticaria, DRESS, Stevens-Johnson syndrome, and toxic epidermal necrolysis. More rarely, TMP/SMX can trigger leukocytoclastic vasculitis (LCV), a small-vessel vasculitis characterized by neutrophilic infiltration, fibrinoid necrosis, and leukocytoclasia. LCV typically manifests as palpable purpura on dependent areas. While often skin-limited, systemic involvement may occur. We present a case of TMP/SMX-induced LCV with multi-organ features. Case description: A 53-year-old healthy male presented to urgent care with dysuria. Urine culture grew pan-sensitive E. coli, and he completed a 7-day course …
Cloudy Consequences: Exploring Vaping-Induced Pulmonary Alveolar Proteinosis, Jennifer Wong, Do, Omar Pandhair, Abby Lindseth, Md, Cameron Miles Long, Md
Cloudy Consequences: Exploring Vaping-Induced Pulmonary Alveolar Proteinosis, Jennifer Wong, Do, Omar Pandhair, Abby Lindseth, Md, Cameron Miles Long, Md
Books, Presentations, Posters, Etc.
Abstract: Pulmonary alveolar proteinosis (PAP) is a rare disease caused by abnormal accumulation of surfactant within alveoli. Vaping of electronic cigarette smoke has recently been described as a cause of pulmonary alveolar proteinosis in two case reports. We add to this rare literature by describing a case of pulmonary alveolar proteinosis induced from vaping in a young woman with confirmed granulocyte/macrophage colony-stimulating factor (GM-CSF) autoantibodies as the proposed mechanism. Introduction: Pulmonary alveolar proteinosis (PAP) results from inappropriate accumulation of pulmonary alveolar surfactant due to dysregulated granulocyte/ macrophage colony-stimulating factor (GM-CSF) signaling.1 Its incidence is approximately 0.2 cases per million with …
Ecmo As A Bridge To Lung Transplant For Refractory Rapidly Progressive Interstitial Lung Disease, Matthew Moritz, Omar Pandhair
Ecmo As A Bridge To Lung Transplant For Refractory Rapidly Progressive Interstitial Lung Disease, Matthew Moritz, Omar Pandhair
Books, Presentations, Posters, Etc.
Anti-melanoma differentiation-associated gene 5 (MDA-5) antibody is most frequently associated with dermatomyositis with various degrees of clinical manifestations including rapidly progressive interstitial lung disease (RP-ILD), inflammatory arthritis, vasculopathy, and other cutaneous findings. Clinically amyopathic dermatomyositis (CADM) is frequently associated with RP-ILD and has high mortality rates. Here we present a case of anti-MDA5 associated RPILD but without other features of dermatomyositis that did not respond to standard immunosuppressive therapy. A 41-year-old woman with recently diagnosed interstitial lung disease and polyarthritis previously on methotrexate presented with progressive dyspnea and worsening hypoxemic respiratory failure. She was previously admitted for respiratory failure two …
Increasing Structured Inpatient Teaching In A Family Medicine Residency, Eric Waelbroeck, Mh Choe
Increasing Structured Inpatient Teaching In A Family Medicine Residency, Eric Waelbroeck, Mh Choe
Books, Presentations, Posters, Etc.
Background: What is not measured cannot be improved. Residents at Providence Milwaukie Family Medicine Residency identified a need to increase structured teaching on inpatient rotations. Other projects aimed at increasing structured teaching during family medicine training have demonstrated improvements in resident confidence in key areas of practice, licensing exam performance, and resident satisfaction with their training. However, without a system of measurement, the number of teaching opportunities cannot be reliably improved. Objectives: Develop a method of documenting structured inpatient teaching that occurs at Providence Milwaukie Hospital. Then, implement interventions using a quality improvement model to increase structured teaching over time. …
Evaluating The Interrater Reliability For The Intern Selection Process Done At Providence Medical Group Psychology Training Program, Vanoosheh Ferdousian, M.A., Teresa Davigo, Luke Dowling
Evaluating The Interrater Reliability For The Intern Selection Process Done At Providence Medical Group Psychology Training Program, Vanoosheh Ferdousian, M.A., Teresa Davigo, Luke Dowling
Books, Presentations, Posters, Etc.
Interrater reliability (IRR) is an important component of evaluation processes that involve subjective judgments, as it reflects the degree of consistency among multiple raters. In training and hiring contexts, establishing adequate IRR helps ensure that applicant evaluations are fair, systematic, and minimally influenced by individual bias. The present program evaluation examines the interrater reliability of the intern selection process at the Providence Medical Group Psychology Training Program. Specifically, this project evaluates the consistency of raters’ scores assigned to internship applicants using the program’s standardized application rating forms. Numerical ratings from multiple reviewers were collected for each applicant and analyzed using …
Hypercalcemic Crisis After Open Mitral Valve Replacement, Andrew Sunwood, Do, Jason Heino
Hypercalcemic Crisis After Open Mitral Valve Replacement, Andrew Sunwood, Do, Jason Heino
Books, Presentations, Posters, Etc.
59. Hypercalcemic Crisis After Open Mitral Valve Replacement Andrew Sunwood, DO Background: Hypercalcemic crisis is a rare manifestation of primary hyperparathyroidism characterized by a sudden increase in serum calcium levels to >14 mg/dL with symptoms of hypercalcemia including adverse gastrointestinal symptoms, abdominal pain, and even predisposition to cardiac arrhythmias. There is only one other documented case of hypercalcemic crisis occurring after open heart surgery. Case information: 69-year-old female with a history of primary osteoporosis on alendronate and valvular heart failure presented for mitral valve replacement. Preoperative lab work did not show evidence of electrolyte abnormalities. She under- went open bioprosthetic …
Pulmonary Prelude: Ild As The Only Manifestation Of Rheumatoid Arthritis, Matthew Moritz, Md, Benjamin Hackett
Pulmonary Prelude: Ild As The Only Manifestation Of Rheumatoid Arthritis, Matthew Moritz, Md, Benjamin Hackett
Books, Presentations, Posters, Etc.
Abstract: Rheumatoid arthritis (RA), a systemic autoimmune disorder, classically presents with joint pain and prolonged morning stiffness. Extra-articular pulmonary manifestations are frequently observed but can be the primary initial presentation. We present a case of a women with chronic RA in remission who presented with shortness of breath and was found to have new RA-associated interstitial lung disease (RA-ILD). A 74-year-old female with a history of rheumatoid arthritis in remission, chronic obstructive pulmonary disease, and recent admission for septic shock presented with progressive dyspnea and hypoxia. Initial vitals noted an oxygen saturation in the low 80s. CT pulmonary angiography excluded …
Breakthroughs In Cervical Cancer Screening: Hpv Self-Collection At Pmg Milwaukie Family Medicine Clinic, Brandon Bartlett, Sataj Johnson, Emily Miyasako, Rachel Gallagher, Daniel Ruegg
Breakthroughs In Cervical Cancer Screening: Hpv Self-Collection At Pmg Milwaukie Family Medicine Clinic, Brandon Bartlett, Sataj Johnson, Emily Miyasako, Rachel Gallagher, Daniel Ruegg
Books, Presentations, Posters, Etc.
Background: Cervical cancer screening is a cornerstone of preventative healthcare and cancer screening in primary care. Based on data from the CDC, in the US alone, the rate of new cervical cancers each year is ~13,000, accounts for ~4,000 deaths annually, and disproportionally effects people of color and people of low SES (CDC, 2025). In our clinic (PMG Milwaukie), the rate of cervical cancer screening has remained around 70% for years, which is below the national average of ~75% (Healthy People, 2021). Primary HPV screening with self-collected swabs has been used successfully for years outside of the US, improving screening …
An Exploration Of Drivers Of Sepsis Outcomes In Racial And Ethnic Minority Populations, Matthew Moritz, Omar Pandhair, Shelley Schoepflin Sanders
An Exploration Of Drivers Of Sepsis Outcomes In Racial And Ethnic Minority Populations, Matthew Moritz, Omar Pandhair, Shelley Schoepflin Sanders
Books, Presentations, Posters, Etc.
RATIONALE: Race and ethnicity affect sepsis outcomes in unclear ways. Existing data is conflicting, with some studies suggesting minority patients do worse, while others did not show a difference in outcomes between these groups. We sought to investigate whether inequalities exist in sepsis outcomes for different racial and ethnic groups in our large hospital system and to characterize how they may manifest. METHODS: We performed a retrospective cohort study of adults diagnosed with sepsis and discharged from any of Providence’s 52 hospitals between January 1 and December 31, 2023. We grouped patients into ten different race/ethnicity groups including White, Black, …
A Case Of Pembrolizumab Associated Sjs/Ten Spectrum Reaction, Lauryn Orsillo, Do, Alex Zhu, Md, Linh Tang Taylor, Md
A Case Of Pembrolizumab Associated Sjs/Ten Spectrum Reaction, Lauryn Orsillo, Do, Alex Zhu, Md, Linh Tang Taylor, Md
Books, Presentations, Posters, Etc.
Introduction: Immune checkpoint inhibitors (ICIs), such as pembrolizumab, are becoming increasingly more common.1 They are associated with a variety of cutaneous immune-related adverse events which can range from drug eruptions to life-threatening Stevens–Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) spectrum reactions.2 As use of these ICIs and PD1 inhibitors expands, the incidence of severe dermatologic toxicity can be expected to rise. Early recognition is critical, as SJS/TEN spectrum reactions carry substantial morbidity and mortality compared with drug eruptions. Case report: An 80-year-old female with a history of triple-negative breast cancer on pembrolizumab presented to the ED for evaluation of a …
A Fatal ‘Sepsis’: Intravascular Large B-Cell Lymphoma In Disguise, Jennifer L. Wong, Do1, Jared A. Shipley, Md2, Christine Johnson, Md3
A Fatal ‘Sepsis’: Intravascular Large B-Cell Lymphoma In Disguise, Jennifer L. Wong, Do1, Jared A. Shipley, Md2, Christine Johnson, Md3
Books, Presentations, Posters, Etc.
Introduction: Intravascular large B-cell lymphoma (IVLBCL) is a rare, aggressive subtype of non-Hodgkin lymphoma characterized by selective proliferation of neoplastic cells within small vessel lumina. Cases in Western countries more commonly involve the central nervous system or skin, whereas patients in Eastern regions often present with hemophagocytic syndrome or medullary disease. The absence of lymphadenopathy, low circulating tumor burden, and subtlety of morphologic clues contribute to delays in diagnosis. By presentation, most have advanced disease, and a substantial proportion are diagnosed only at autopsy. We report a unique case with mixed features who manifested respiratory involvement and ultimately suffered cardiovascular …
A Rare And Fatal Complication Of Herpes Simplex Virus (Hsv) Infection, Natalie Bolton, Jeffrey Youker
A Rare And Fatal Complication Of Herpes Simplex Virus (Hsv) Infection, Natalie Bolton, Jeffrey Youker
Books, Presentations, Posters, Etc.
Introduction: Hemophagocytic Lymphohistiocytosis (HLH) is a rare syndrome characterized by overactive immune activation, cytokine storm, and uncontrolled hemophagocytosis. Primary HLH is familial and most often seen in infants, whereas secondary HLH occurs more frequently in adults and is triggered by infections, malignancies, or autoimmune disorders. Clinically, secondary HLH often mimics sepsis but fails to respond to standard therapies, contributing to delayed diagnosis and treatment. Without timely intervention, HLH can result in extensive tissue damage, multiorgan failure, and death. In rare cases, central nervous system (CNS) involvement may occur, manifesting as histiocytic infiltration that can be misinterpreted as malignancy or infection. …
Closing The Gap: Standardizing Sepsis Management To Address Racial Disparities Across Oregon Providence Hospitals, Jennifer Wong, Do, Shelley Schoepflin Sanders, Md, Facp
Closing The Gap: Standardizing Sepsis Management To Address Racial Disparities Across Oregon Providence Hospitals, Jennifer Wong, Do, Shelley Schoepflin Sanders, Md, Facp
Books, Presentations, Posters, Etc.
Introduction: Sepsis is a time-sensitive, life-threatening medical emergency affecting approximately 1.7 million adults annually in the United States, contributing to nearly 270,000 deaths and over $24 billion in healthcare expenditures. Delays in recognition and initiation of treatment can significantly increase mortality. Previous studies have identified persistent racial disparities in sepsis care, including lower rates of recognition as the principal diagnosis and delayed antibiotic initiation for Black patients compared with White patients. In alignment with Providence’s mission to provide compassionate, equitable care, Oregon Providence hospitals implemented a standardized “Sepsis Order Set” in all Emergency Departments (ED) to reduce treatment delays and …
Eosinophilic Fasciitis Masquerading As Myositis: A Diagnostic Challenge, Jennifer L. Wong, Do, Elizabeth S. Ballner, Do, Mary Elizabeth Swift-Taylor
Eosinophilic Fasciitis Masquerading As Myositis: A Diagnostic Challenge, Jennifer L. Wong, Do, Elizabeth S. Ballner, Do, Mary Elizabeth Swift-Taylor
Books, Presentations, Posters, Etc.
Introduction: Eosinophilic fasciitis (EF), or Shulman’s disease, is a rare disorder of unknown etiology and poorly understood pathogenesis. It is characterized by fibroblast activation and interleukin-driven eosinophilia. Early clinical features include limb or trunk erythema, non-pitting edema, and progressive fascial thickening, often producing an “orange peel” appearance. Eosinophilia is a prominent laboratory finding in the early phase, but diagnosis often requires a full-thickness skin-to-muscle biopsy. Systemic corticosteroids are first-line therapy, with methotrexate as the steroid -sparing agent for refractory disease. We present a unique and diagnostically challenging case of EF confirmed by histopathology. Case Presentation: A 56-year-old man presented with …
Evaluating Outcomes Of Long-Acting Injectable Antiretrovirals For Hiv Treatment And Pre-Exposure Prophylaxis In A Pharmacist-Managed Clinic Setting, Kaitlin Repass, Pharmd, Melissa Yokoyama, Pharmd, Farnaz Khoshnahad, Pharmd, Bcacp, Char Hunt, Pharmd, Ms, Bcacp
Evaluating Outcomes Of Long-Acting Injectable Antiretrovirals For Hiv Treatment And Pre-Exposure Prophylaxis In A Pharmacist-Managed Clinic Setting, Kaitlin Repass, Pharmd, Melissa Yokoyama, Pharmd, Farnaz Khoshnahad, Pharmd, Bcacp, Char Hunt, Pharmd, Ms, Bcacp
Books, Presentations, Posters, Etc.
No abstract provided.
Extracorporeal Membrane Oxygenation (Ecmo) In Acute Chest Syndrome, Natalie Bolton, Md, Omar Pandhair
Extracorporeal Membrane Oxygenation (Ecmo) In Acute Chest Syndrome, Natalie Bolton, Md, Omar Pandhair
Books, Presentations, Posters, Etc.
Introduction: Acute chest syndrome (ACS) is a severe complication of sickle cell disease. Rarely, it may progress to acute respiratory distress syndrome (ARDS). Inability to oxygenate despite mechanical ventilation necessitates consideration of extracorporeal membrane oxygenation (ECMO). Case Summary: A 31-year-old man with sickle cell disease presented with low back pain similar to prior pain crises. Vital signs were normal, and his hemoglobin level was 10.2 g/dL, with a reticulocyte index of 0.05. He was admitted for pain control and rehydration. That night, he developed fever, tachypnea, and hypoxemia with imaging showing a right lower lobe infiltrate, consistent with ACS. He …
Looking Past The Portal: A Hidden Origin Of Ascites, Paige Ruh, Do, Claudia Leonard, Md
Looking Past The Portal: A Hidden Origin Of Ascites, Paige Ruh, Do, Claudia Leonard, Md
Books, Presentations, Posters, Etc.
Introduction: The most common cause of ascites is portal hypertension secondary to cirrhosis and accounts for nearly 75% of cases. In contrast, pancreatic ascites is a rare presentation of ascites and occurs in less than 1% of patients. Because of its low prevalence, pancreatic ascites is often excluded from the initial differential diagnosis and rarely assessed in ascitic fluid analysis. This is a case in which pancreatic ascites was considered and ultimately confirmed based on the overall clinical picture, challenging the initial assumption of portal hypertension and cirrhosis. Case Presentation: A 47-year-old man with ongoing alcohol use disorder presented to …
Gent-Le Dosing: Evaluating The Safety Of Gentamicin At Higher Doses For Late Preterm And Term Neonates, Jason Hector, D. Erin Wilson, Aiyana Ooki-Knutson, Jennifer Conley
Gent-Le Dosing: Evaluating The Safety Of Gentamicin At Higher Doses For Late Preterm And Term Neonates, Jason Hector, D. Erin Wilson, Aiyana Ooki-Knutson, Jennifer Conley
Books, Presentations, Posters, Etc.
Abstract: In June 2024, Providence St Joseph Health updated the standard gentamicin dose in the Pediatric and Neonatal Aminoglycoside protocol from 4 mg/kg to 5 mg/kg every 24 hours for late preterm and term neonates. This project aims to evaluate late preterm and term neonatal patients who received gentamicin for empiric sepsis coverage within the first seven days of life, at 4 mg/kg/dose or 5 mg/kg/dose, to assess the safety of the standardized 5 mg/kg dosing for late preterm and term neonates after the protocol change. This study is a multicenter retrospective pre-/post-intervention analysis at a multistate health system spanning …
Hepatic Schistosomiasis: An Unexpected Culprit Behind The Hepatic Mass, Jin Yun Do, Udip Dahal Md, Kenneth Flora, Md
Hepatic Schistosomiasis: An Unexpected Culprit Behind The Hepatic Mass, Jin Yun Do, Udip Dahal Md, Kenneth Flora, Md
Books, Presentations, Posters, Etc.
Introduction: Schistosomiasis is the second most common parasitic infection worldwide and is associated with significant morbidity and mortality. We present an unusual case of hepatic schistosomiasis presenting as a hepatic mass. Case Description: A 78-year-old male with no prior hepatobiliary disease with an incidental finding of a hepatic lesion on postoperative abdominal CT imaging after an endovascular aneurysm repair. He lived in China until immigrating to the United States over 50 years ago. Previously hospitalized for abdominal pain and diarrhea, at which time he was told he had an infection in his liver. Details of treatment are unknown. He has …
Hydroxocobalamin In Septic Shock Management – Should It Be Introduced Sooner?, Linh Tang Taylor, Md, Cameron Miles Long, Md, Omar Pandhair
Hydroxocobalamin In Septic Shock Management – Should It Be Introduced Sooner?, Linh Tang Taylor, Md, Cameron Miles Long, Md, Omar Pandhair
Books, Presentations, Posters, Etc.
Introduction: Treating sepsis involves timely antibiotics, adequate fluid resuscitation, and vasopressor support if shock develops. Plasma concentrations of nitric oxide and hydrogen sulfides are elevated in early sepsis, contributing to vasoplegia,1 a pathology that isn’t addressed by vasopressors. High-dose hydroxocobalamin (vitamin B12) does, and therefore, has long been explored as a potential adjunct to vasopressors, though no consensus or official guidelines for its use have been published. Case Report: A 26-year-old man who was diagnosed with acute myeloid leukemia a few months prior presented to the emergency room for fever, weakness, and emesis. He was found to be profoundly hypotensive …
Idiopathic Systemic Capillary Leak Syndrome With Shock And Compartment Syndrome Due To Influenza A, Jobe Ashby, Md, Katelyn Bobrowski, Do, Ryan Best, Md
Idiopathic Systemic Capillary Leak Syndrome With Shock And Compartment Syndrome Due To Influenza A, Jobe Ashby, Md, Katelyn Bobrowski, Do, Ryan Best, Md
Books, Presentations, Posters, Etc.
INTRODUCTION: Idiopathic systemic capillary leak syndrome (ISCLS) is a rare, poorly understood condition that leads to extreme pathology with severe but predictable complications. First described in 1960, ISCLS has been identified in about 260 case reports and is marked by a triad of hypotension, hypoalbuminemia, and hemoconcentration often preceded by upper respiratory tract infection. It is divided into distinct phases of prodrome, extravasation, and recovery. We present a case of a middle-aged woman who presented with influenza A infection and developed ISCLS needing ICU level care for shock and bilateral upper extremity compartment syndrome. DESCRIPTION: Our patient is a 49-year-old …
Implementation And Impact Of The Transition Series For Senior Residents In Internal Medicine Residency, Abby Lindseth, Md, Jeffrey Youker
Implementation And Impact Of The Transition Series For Senior Residents In Internal Medicine Residency, Abby Lindseth, Md, Jeffrey Youker
Books, Presentations, Posters, Etc.
The transition from medical student to intern is widely recognized as a challenging period, and numerous curricula have been developed to support this transition. However, the transition from intern to senior resident receives far less attention despite presenting its own unique challenges. Anecdotal feedback from internal medicine residents and emerging literature suggests that the transition to senior resident is associated with feeling emotionally overwhelmed from simultaneously being a learner, leader and educator.1,2 To address this gap, the Transition Series was developed as a novel curriculum to support internal medicine residents as they advance into their senior roles. Building on the …
Ofatumumab Associated Legionella Pneumonia In A Young Multiple Sclerosis Patient, Jobe Ashby, Omar Panhair
Ofatumumab Associated Legionella Pneumonia In A Young Multiple Sclerosis Patient, Jobe Ashby, Omar Panhair
Books, Presentations, Posters, Etc.
Ofatumumab is the only anti-CD20 IgG1κ human monoclonal antibody therapy for relapsing forms of multiple sclerosis (MS) that patients can self-administer subcutaneously. Anti-CD20 agents are biologic therapies that carry an increased risk of serious infections, but rarely Legionellosis. We present the case of a young man taking ofatumumab for his MS who developed Legionella pneumoniae pneumonia. A 30-year-old man with MS diagnosed two years prior, stable on ofatumumab, presented with fevers, cough, and hemoptysis. A week earlier, he developed fevers and myalgias after administering ofatumumab, but these symptoms persisted longer than usual. Though initial vital signs were normal, he appeared …
Pulmonary Pseudomyxoma Peritonei, Hannah Kirk, Do, Omar Pandhair
Pulmonary Pseudomyxoma Peritonei, Hannah Kirk, Do, Omar Pandhair
Books, Presentations, Posters, Etc.
Introduction: Pseudomyxoma peritonei (PMP) is an intra -abdominal cancer occurring in one to four out of one million patients. It begins as a mucinous adenocarcinoma of the appendix that implants on other peritoneal surfaces, spreading into gelatinous ascites. Treatment consists of hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS). Extra -abdominal metastases are rare. We present the case of a patient who underwent treatment for PMP and was found to have lung nodules over a decade later. Case Presentation: A 73 -year -old woman with pseudomyxoma peritonei presented to the emergency department with progressive dyspnea and unintentional weight loss. Twenty …
Puzzling Papules: Uncovering The Etiology Of A Rash In A Returning Traveler, Lisa Stampke, Md, Shahana Baig-Lewis, Md
Puzzling Papules: Uncovering The Etiology Of A Rash In A Returning Traveler, Lisa Stampke, Md, Shahana Baig-Lewis, Md
Books, Presentations, Posters, Etc.
Introduction: There are an estimated 1.8 billion people that travel internationally every year [1]. Approximately 22-64% of those acquire an infectious disease during or after returning home that is not endemic to their home country [1]. This is especially concerning in our current political climate and declining vaccination rates in the United States which places more patients at risk for preventable diseases [2]. These factors present a unique challenge in diagnosing and treating a symptomatic returning traveler. Case Description: A 25-year-old incompletely vaccinated male returned from Kenya after volunteering for 5-weeks in a rural hospital. He was in his usual …
Efficiency Rx: Emr Training For Resident Wellness, Calder Dorn, Do, Tom Chau, Md, Mba, Facp, Shelley Sanders, Md, Facp
Efficiency Rx: Emr Training For Resident Wellness, Calder Dorn, Do, Tom Chau, Md, Mba, Facp, Shelley Sanders, Md, Facp
Books, Presentations, Posters, Etc.
Introduction: Physician burnout affects nearly 60% of physicians during their careers, leading to increased medical errors, reduced care quality, higher turnover, and lower patient satisfaction. ii. The widespread use of Electronic Medical Records (EMRs) has been identified as a key contributor, with poor usability, inbox overload, and documentation burden reducing direct patient interaction among cited factors iii. Institutions like UCHealth, OHSU, CHOP, and Mayo Clinic have implemented strategies that improved EMR confidence and reduced burnout vi. While Providence offers training to all providers, there are no initiatives specifically targeted to internal medicine (IM) residents. Methods: Providence St. Vincent Medical Center …
Sepsis Transitional Care Management: A Phone Call To Reduce Readmission Health Inequity, Linh Tang Taylor, Md, Erica Leser, Ms, Alyssa Nelson, Michelle Schopeflin Sanders, Md
Sepsis Transitional Care Management: A Phone Call To Reduce Readmission Health Inequity, Linh Tang Taylor, Md, Erica Leser, Ms, Alyssa Nelson, Michelle Schopeflin Sanders, Md
Books, Presentations, Posters, Etc.
Introduction: Sepsis accounts for 52% of hospital admissions in the United States and is the leading cause of death among hospitalized patients1 . However, disparity exists among sepsis survivors with race being reported as a determinant of recovery2 . Such disparity exists in Providence Oregon 8 hospitals: Providence Black patients have higher sepsis readmission rates than White (12.93% vs 11.65%). Using modified community-based participatory research, data analysis, and stakeholder interviews, we identified one potential root cause of the disparity: Black patients being readmitted are not receiving our system's Transitional Care Management (TCM) services. We aim to eliminate the Black/White sepsis …