Medical Specialties Commons^™

Point-Of-Care Hpv Molecular Diagnostics For A Test-And-Treat Model In High-Risk Hiv Populations, Shahin Sayed, Michael Chung, Marleen Temmerman

Pathology, East Africa

Strategies for cervical cancer prevention and control in low-income and middle-income countries (LMICs) require concerted efforts to improve screening and access to treatment, especially in high-risk HIV populations. LMICs bear the largest burden of HIV infection, human papillomavirus (HPV) infection is common among HIV-infected women, risk of cervical cancer is increased in women with HIV/AIDS, and HIV clinics provide opportunities to screen and treat for cervical cancer in this population.

Everolimus-Induced Pneumonitis: A Diagnostic Challenge, Andrew Gulde, Elshad Hasanov, Kayla Krug, Gus W Krucke

Faculty, Staff and Student Publications

No abstract provided.

Ablation Of Refractory Papillary Muscle Ventricular Tachycardia Warranting Multiple Adjunctive Ablation Techniques: A Combined Approach For Success, Mark Pollet, Ben Jenny, Adwait Mehta, Austin Howard, Nilesh Mathuria

Faculty, Staff and Student Publications

A 27-year-old male presented to our institution with recurrent unifocal premature ventricular contraction/nonsustained ventricular tachycardia (VT) with associated cardiomyopathy. The patient had undergone three prior ablation procedures with continued arrhythmia. Mapping led to identification of the VT arising from the basal aspect of the left ventricular anterolateral papillary muscle. Conventional ablation techniques were unsuccessful. We incorporated adjunctive ablation techniques in this case that ultimately led to a successful outcome. The present discussion covers the roles of intracardiac echocardiography, induced apnea, and low-ionic irrigation.

Diagnostic Criteria For Detection Of Retinal Nerve Fibre Layer Thickness And Neuroretinal Rim Width Abnormalities In Glaucoma, Feihui Zheng, Marco Yu, Christopher Kai-Shun Leung

Faculty, Staff and Student Publications

BACKGROUND/AIMS: Although measurements of the Bruch's membrane opening minimum rim width (BMO-MRW) and retinal nerve fibre layer thickness (RNFLT) with optical coherence tomography (OCT) have been widely adopted in the diagnostic evaluation of glaucoma, there is no consensus on the diagnostic criteria to define BMO-MRW and RNFLT abnormalities. This study investigated the sensitivities and specificities of different diagnostic criteria based on the OCT classification reports for detection of glaucoma.

METHODS: 340 eyes of 137 patients with glaucoma and 87 healthy individuals, all with axial length ≤26mm, had global and sectoral BMO-MRW and RNFLT measured with Spectralis OCT (Heidelberg Engineering). Six …

Modern Ventilator Management In Surgical/Trauma Patients, Errington C. Thompson

Marshall Journal of Medicine

Physicians have a lot to consider when they place a patient on the ventilator. This article reviews the literature and provides the physician with a clear guide to managing the ventilator in the ICU. This manuscript is meant to be a practical guide to managing the ventilator at the patient's bedside.

Angioimmunoblastic T Cell Lymphoma: A Diagnostic Dilemma, Nishanth Thalambedu, Md, Seema Sethi, Do, Herbert Auerbach, Do

Abington Jefferson Health Posters

Angioimmunoblastic T cell lymphoma(AITL) is one of the rarest T cell lymphomas. Diagnosing the type of lymphoma is crucial, as the management differs depending on the type. We present a case of a sixty-one-year-old woman who presented with generalized lymphadenopathy and how we unfolded the diagnosis.

Listening To The Patient: A Typology Of Contextual Red Flags In Disease Management Encounters, Amy E. Binns-Calvey, Gunjan Sharma, Naomi Ashley, Brendan Kelly, Frances M. Weaver, Saul J. Weiner

Journal of Patient-Centered Research and Reviews

Purpose: Patients send clues, often unwittingly, when they are grappling with a life challenge that complicates their care. For instance, a patient may lose control of a previously well-managed chronic condition or start missing appointments. When explored, these clues help clinicians uncover the life circumstance impacting the individual’s ability to manage their health and health care. Such clues are termed “contextual red flags.” Effective care requires recognizing them, asking about them, and customizing the care plan where feasible. We sought to develop a typology of contextual red flags by analyzing audio recordings along with the medical records of encounters between …

A Five Chambered Heart, George Hanna, Javad Savoj, Syed Iftikhar, Scott Kubomoto, Patrick Hu

Internal Medicine

No abstract provided.

Catch 22 : To Anticoagulate Or Not To Anticoagulate, Muhammad Madkour, Patrick Hu

Internal Medicine

No abstract provided.

How Deep Is Too Deep?, Dietrich Schlueter Md, Asma Jamil Md, Ibrahim Talab, Samia Faiz, Scott Kubomoto Md

Internal Medicine

No abstract provided.

Cervical Osteomyelitis: Unique Presentation And Fatal Outcome, Asma Jamil Md, Ayesha Jamil Md, Scott Kubomoto Md, Liliana Crisan Md

Internal Medicine

No abstract provided.

Assessment Of Guideline Recommended Anti-Coagulation Rates For Atrial Fibrillation In An Outpatient Resident Clinic, Kanav Gupta Md, Emily Langnas Do, Zahra Khaled, Travis Tagami Do, Alexandra Halalau Md

Internal Medicine

No abstract provided.

Giant 75mm Intracranial Aneurysm Masquerading As Primary Malignancy, Andrew W. Hwang, Satvir Dhillon Md, Remus Popa

Internal Medicine

No abstract provided.

Always Remember To Floss... Or Else, Arunmozhi (Sankavi) Aravagiri Md, Muhammad Zain Md, Rajesh Gulati Md

Internal Medicine

No abstract provided.

Calcium Alkali Thiazide Syndrome, Mehboob A. Rehan Md, Asma Rashid Md, Reema Singh Md, Gabutti Cristina, Luma Mohsin Md, Tausha Allen Md, Paul Stanford Md, James Thomson Md

Internal Medicine

No abstract provided.

Menstrual-Related Headaches Among A Cohort Of African Adolescent Girls, Philip Adebayo, Folajimi M. Otubogun, Rufus O. Akinyemi

Internal Medicine, East Africa

Introduction: Migraine attacks associated with menstruation are generally perceived as more severe than attacks outside this period.

Aim and Objective: The study aimed at determining the frequency of menstrual-related headaches among a cohort of senior secondary school girls in Abeokuta, Nigeria. We also determined its burden among these school girls.

Methodology: This study was cross-sectional using a validated adolescent headache survey questionnaire. A self-administration of the instrument was done during a school visit. A headache was classified using the ICHD-II criteria.

Results: Of the 183 students interviewed, 123(67.2%) had recurrent headaches. Mean age ±SD, 16.18± 1.55 (range 12– …

Older Adults Hospitalized For Pneumonia In The United States: Incidence, Epidemiology, And Outcomes., Forest W. Arnold, Andrea Reyes-Vega, Vidyulata Salunkhe, Stephen P. Furmanek, Christian Furman, Laura Morton, Anna Johan Faul, Pam Yankeelov, Julio A. Ramirez

Faculty and Staff Scholarship

OBJECTIVES: To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN: This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. SETTING: The study took place in all nine acute care hospitals for adults in Louisville, …

A Phantom Of The Past: Withdrawal From Meprobamate Presenting With Focal Seizures., Thomas M. Zink, John E. Erickson

Journal of Maine Medical Center

Introduction: Meprobamate (Miltown, Equinil) is a sedative-hypnotic medication that first gained popularity as an anxiolytic and later as a muscle relaxant. It is a major metabolite of the more commonly used muscle relaxant carisoprodol (Soma). In vitro and electroencephalogram studies demonstrated that meprobamate modulates gama-aminobutyric acid (GABA) receptors, similar to barbiturates. Withdrawal from meprobamate manifests in symptoms ranging from mild anxiety to severe autonomic instability and death. Meprobamate is rarely prescribed, but is still given to a small subset of elderly patients.

Clinical findings: In this case of meprobamate withdrawal, the patient initially displayed altered mental status and recurrent seizures …

Famotidine Use Is Associated With Improved Clinical Outcomes In Hospitalized Covid-19 Patients: A Propensity Score Matched Retrospective Cohort Study., D. E. Freedberg, J. Conigliaro, T. C. Wang, K. J. Tracey, M. V. Callahan, J. A. Abrams, Famotidine Research Group Famotidine Research Grou, M. E. Sobieszczyk, D. D. Markowitz, A. Gupta, M. R. O'Donnell, J. Li, D. A. Tuveson, Z. Jin, W. C. Turner, D. W. Landry

Journal Articles

No abstract provided.

The Uses Of Overnight Pulse Oximetry, S. Singh, S. Khan, D. Singh, S. Verma, A. Talwar

Journal Articles

© 2020 Indian Chest Society Published by Wolters Kluwer - Medknow. Overnight pulse oximetry (OPO) has proven to be an effective and beneficial technique to determine the cardiorespiratory status of patients in both the inpatient and outpatient settings. It is a cheap, safe, reliable, simple, and accurate method of patient monitoring as compared to the expensive and labor-intensive method of multichannel polysomnography for detecting sleep-disordered breathing. It provides accurate information about patient's oxygenation status and also helps in monitoring the response to continuous positive airway pressure and in the surgical treatment of obstructive sleep apnea (OSA). Nocturnal hypoxemia portends a …

Covid-19: Magnifying The Effect Of Health Disparities, E. J. Kim, L. Marrast, J. Conigliaro

Journal Articles

No abstract provided.

Obstructive Lung Disease Secondary To Compression Of The Bronchus By An Enlarged Pulmonary Artery, J. Panthappattu, V. Sharma, S. Verma, A. Talwar

Journal Articles

© 2020 Indian Chest Society Published by Wolters Kluwer - Medknow. In clinical practice, the presence of wheezing generally indicates an airway disease. In rare circumstances, adjacent mediastinal structures may compress the tracheobronchial tree leading to obstructive physiology. Compression of the tracheobronchial region by an enlarged pulmonary artery (PA) is exceedingly rare. We present here a case of pulmonary hypertension, where the enlarged PA resulted in obstructive lung physiology with a relevant review of the literature.

A Case Of Plasmodium Falciparum Malaria With A Prolonged Incubation Period Of Four Years., E. Sleiman, A. Upadhyaya, A. Glaser, M. Krzyzak

Journal Articles

With increased global travel, unique diseases from different parts of the world pose a new category of differential diagnosis, and an incubation period of different infectious diseases helps narrow differential diagnosis to point to one specific etiology. The normal incubation period of Plasmodium falciparum malariais 7-40 days. We report a case of symptomatic P. falciparum malaria that manifested four years after a visit to a malaria-endemic area in a 51-year-old female patient. Our case illustrates the importance of a broad differential with regard to infectious disease including remote travel history and raises questions of the survival of P. falciparum for …

External Validation Of A Venous Thromboembolic Risk Score For Cancer Outpatients With Solid Tumors: The Compass-Cat Venous Thromboembolism Risk Assessment Model, A. C. Spyropoulos, J. B. Eldredge, L. N. Anand, M. Zhang, M. Qiu, S. Nourabadi, D. J. Rosenberg

Journal Articles

No abstract provided.

Hospital-Based Use Of Thromboprophylaxis In Patients With Covid-19, A. C. Spyropoulos, W. Ageno, E. S. Barnathan

Journal Articles

No abstract provided.

Post-Discharge Prophylaxis With Rivaroxaban Reduces Fatal And Major Thromboembolic Events In Medically Ill Patients, A. C. Spyropoulos, W. Ageno, G. W. Albers, C. G. Elliott, J. L. Halperin, W. R. Hiatt, G. A. Maynard, P. G. Steg, J. I. Weitz, G. E. Raskob, +3 Additional Authors

Journal Articles

© 2020 The Authors Background: Hospitalized acutely ill medical patients are at risk for fatal and major thromboembolic events. Whether use of extended-duration primary thromboprophylaxis can prevent such events is unknown. Objectives: The purpose of this study was to evaluate whether extended-duration rivaroxaban reduces the risk of venous and arterial fatal and major thromboembolic events without significantly increasing major bleeding in acutely ill medical patients after discharge. Methods: MARINER (A Study of Rivaroxaban [JNJ-39039039] on the Venous Thromboembolic Risk in Post-Hospital Discharge Patients) studied acutely ill medical patients with additional risk factors for venous thromboembolism (VTE). Medically ill patients with …

Decreasing The Peril Of Antimicrobial Resistance Through Enhanced Health Literacy In Outpatient Settings: An Underrecognized Approach To Advance Antimicrobial Stewardship, E. D. Hermsen, E. L. Macgeorge, M. L. Andresen, L. M. Myers, C. J. Lillis, B. M. Rosof

Journal Articles

© 2020, The Author(s). Globally, antimicrobial resistance (AMR) is a serious problem causing 700,000 deaths annually. By 2050, AMR is expected to cause approximately 10 million deaths globally each year if allowed to increase at the present rate. Many individuals have limited knowledge regarding appropriate antibiotic use and AMR. Most antibiotic use occurs in the outpatient setting, with approximately 30% of antibiotics prescribed deemed unnecessary. Antimicrobial stewardship (AMS) is a means to reduce inappropriate antibiotic use and AMR. While existing AMS efforts generally focus on the inpatient setting, a significant gap is present in the outpatient setting. A common theme …

The Covid-19 Pandemic: Experiences Of A Geriatrician-Hospitalist Caring For Older Adults, L Sinvani

Journal Articles

No abstract provided.

Emergence Of Institutional Antithrombotic Protocols For Coronavirus 2019., Kp Cohoon, G Mahé, Aj Tafur, Ac Spyropoulos

Journal Articles

No abstract provided.

The Renin–Angiotensin System: An Integrated View Of Lung Disease And Coagulopathy In Covid-19 And Therapeutic Implications, B Diamond

Journal Articles

No abstract provided.