Medical Specialties Commons^™

Outcomes Of Catheter Ablation For Supraventricular Tachycardia In Adult Patients With Congenital Heart Disease, Lohit Garg Md, Sahil Agrawal Md, Manyoo Agarwal Md, Brijesh Patel Md, Mahek Shah Md, Aakash Garg Md, Sudip Nanda Md, Facp, Talha Nazir Md, Raman Dusaj Md

Department of Medicine

Background: Supraventricular tachyarrhythmias (SVT) are common in adult patients with congenital heart disease (CHD). There is paucity of data regarding the safety and outcomes associated with catheter ablation in these patients.

Methods: We queried the National Inpatient Sample (NIS) to identify all adults patients > 18 years with CHD undergoing catheter ablation for SVT.

Results: Between 2003-2013, 5,966 patients with CHD underwent catheter ablation for SVT. Of these 4,769 were performed for atrial fibrillation or atrial flutter and rest for other SVTs. The mean age of these patient was 47+/- 15 years, 59.9% were males. 18% of patients experienced procedure related …

Obesity Is Not Associated With A Differential Outcome Following Coronary Artery Bypass Surgery, Lohit Garg Md, Sahil Agrawal Md, Amitoj Singh, Raman Dusaj, Jamshid Shirani

Department of Medicine

Background: Conflicting data exists regarding the impact of obesity on mortality and morbidity following coronary artery bypass graft (CABG) surgery with some suggesting a paradoxical reduction in adverse outcomes. We aimed to compare the in-hospital outcomes of CABG in obese and non-obese subjects.

Methods: The Nationwide Inpatient Sample for years 2003- 2014 was used to identify adults (age ≥18 years) who underwent isolated CABG.

Results: A total of 2,297,932 patients underwent CABG of which 554,857 (28.2%) surgeries were for acute coronary syndrome (ACS) and 1,743075 (74.2%) were elective. Obese patients in either group were younger, were more likely to be …

Type Ii Brugada Syndrome Syncopal Seizure: A Diagnostic Dilemma, Syed Rafay Ali Sabzwari, Nghia Hoang

Department of Medicine

Background: Type II Brugada syndrome is a rare entity that can present as syncope, sudden cardiac death, palpitations and nocturnal agonal respiration as a manifestation of ventricular tachyarrythmia. Although patients can experience a syncopal seizure, the dilemma between epileptic seizure and syncopal seizure due to type II Brugada syndrome is rarely encountered and reported in literature.

Case: 45 years old caucasian male with history of bicuspid aortic valve and no family history of sudden cardiac death or arrhythmia presented with generalized body shaking, unresponsiveness, mouth frothing and rolling of eyes for 4 minutes during sleep followed by 30 minutes of …

Cardiac Amyloidosis Masquerading As Hypertrophic Obstructive Cardiomyopathy, Lohit Garg Md, Naveen Sablani, Amy Ahnert, Bruce Feldman Do

Department of Medicine

Background: Cardiac amyloidosis (CA) remains a diagnostic challenge and is associated with significant morbidity and mortality.

Case: A 67-year old male was referred for septal myomectomy for hypertrophic obstructive cardiomyopathy (HOCM) due to worsening symptoms despite medical therapy. His medical history included chronic diastolic heart failure, and atrial fibrillation post pulmonary vein isolation. His examination revealed mid peaking crescendo-decrescendo systolic murmur, worse on Valsalva. An electrocardiogram revealed normal sinus rhythm and normal voltage. Transthoracic and transesophageal echocardiogram revealed asymmetric septal hypertrophy, chordal systolic anterior motion (SAM), and left ventricular (LV) obstruction with a peak gradient of 40 mmHg at rest. …

Risk Scores-Medical Derivatives., Ronald S. Freudenberger Md

Department of Medicine

No abstract provided.

Triple Pancreatic Walled-Off Fluid Collections Treated Simultaneously With Endoscopic Transmural Drainage., Sameen Khalid, Aamer Abbass, Eric Nellis Md, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

Pancreatic pseudocysts and walled-off pancreatic necrosis arise as a complication of pancreatitis. Multiple fluid collections are seen in 5-20% of the patients who have walled-off peripancreatic fluid collections. There is a paucity of data regarding the role of endoscopic transmural drainage in the management of multiple pancreatic fluid collections. In this case report, we present the case of a 72-year-old male with three walled-off pancreatic fluid collections in the setting of acute necrotizing pancreatitis. The patient underwent simultaneous endoscopic ultrasound-assisted cyst gastrostomy and cyst duodenostomy and aggressive irrigation without index endoscopic necrosectomy of the three peripancreatic fluid collections. Significant improvement …

Perception And Practice Among Emergency Medicine Health Care Providers Regarding Discharging Patients After Opioid Administration, Ryan M. Surmaitis Do, Alexandra Amaducci Do, Kathryn Henry Do, Michael Jong Md, Emily A. Kiernan Do, Hope Kincaid Mph, Cph, Lindsa Houck Msn, Rn, Nea-Bc, Cen, Cpen, Phrn, Sandra Sabbatini Bsn, Rn, Marna R. Greenberg Do, Mph, Facep, Kenneth D. Katz Md

Department of Emergency Medicine

Abstract

Purpose

This study aimed to determine the current attitudes, perceptions, and practices of emergency medicine providers and nurses (RNs) regarding the discharge of adult patients from the emergency department (ED) after administration of opioid analgesics.

Methods

A cross-sectional survey was administered at 3 hospital sites with a combined annual ED census of >180,000 visits per year. All 59 attending emergency physicians (EPs), 233 RNs, and 23 advanced practice clinicians (APCs) who worked at these sites were eligible to participate.

Findings

Thirty-five EPs (59.3%), 88 RNs (37.8%), and 14 APCs (60.9%) completed the survey for an overall response rate of …

Women And The Experience Of Pain And Opioid Use Disorder: A Literature-Based Commentary, Andrew L. Koons, Marna R. Greenberg Do, Mph, Facep, Robert D. Cannon Do, Gillian A. Beauchamp Md

Department of Emergency Medicine

It is generally understood that pain experience and opioid abuse have relied on male-dominated models. However, sex and gender play a role in both pain experience and opioid use disorder.

Using the previously validated Texas Tech University Health Sciences Center Sex and Gender Specific Health PubMed Advanced Search Tool, the authors used pertinent literature to develop this literature-based commentary on sex and gender differences in pain experience and opioid use disorder. Women report their experience of pain more frequently, have increased rates of diagnoses related to pain, have increased pain sensitivity, and have a variable response to pain and analgesia. …

Sex Differences In Prevalence Of Emergency Department Patient Substance Use, Robert D. Cannon Do, Gillian A. Beauchamp Md, Paige Roth Lsw, Jennifer Stephens Do, David B. Burmeister Do, Facep, Cpe, David M. Richardson Md, Alanna Balbi Bs, Tennessee Park Ba, Stephen W. Dusza Drph, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

Purpose

Substance use and misuse is prevalent in emergency department (ED) populations. While the prevalence of substance use and misuse is reported, sex-specific trends in ED populations have not been documented. We set out to determine the sex-specific prevalence of ED patient substance use during this current epidemic.

Methods

A retrospective electronic data abstraction tool, developed for quality-improvement purposes, was used to assess ED visits in 3 hospitals in northeastern Pennsylvania. All patients with ED diagnosis codes for substance use F10.000 through F 19.999 (excluding F17 codes for nicotine) were abstracted for network ED visits at all 3 hospitals. Data …

Central Hypoventilation: A Rare Complication Of Wallenberg Syndrome, Keithan Sivakumar Md, Mba, Manveer Garcha, Dev Mehta, Megan Leary Md, Hussam A. Yacoub Md

Department of Medicine

Central alveolar hypoventilation disorders denote conditions resulting from underlying neurologic disorders affecting the sensors, the central controller, or the integration of those signals leading to insufficient ventilation and reduction in partial pressures of oxygen. We report a patient who presented with a left lateral medullary ischemic stroke after aneurysm repair who subsequently developed a rare complication of CAH. Increased awareness of this condition’s clinical manifestations is crucial to make an accurate diagnosis and understand its complications and prognosis.

Just Another Fever And Rash? A Broad Differential Leading To A Relatively Uncommon Condition In Adult Still's Disease., Nathan Brewster Do, Jaimin Patel Do, Rachel Kinney Do

Department of Medicine

No abstract provided.

A Reversible Cause Of Complete Heart Block Causing Chest Pain And Syncope., Syed Rafay Ali Sabzwari, Zoltan Varga, Khurram Butt, Nimra Khan

Department of Medicine

Vasospastic angina (VSA), also known as variant or Prinzmetal's angina, is a relatively uncommon cause of retrosternal chest pain with transient ST segment elevation, mainly due to vasospasm in the coronary arteries. This is a case of 37-year-old female who presented with chest pain and syncope. Her initial workup, including echocardiogram, was negative. Subsequently, she was sent home with an event monitor. During the next two weeks, she continued to have recurrent episodes of similar chest pains and presented to her cardiology appointment with a heart rate of 45 bpm and blood pressure of 100/60 mmHg and was taken to …

Implementing 5s Methodology To Maximize Flow And Efficiency In Shelter-Based Student Clinic., Seth Vanzant, Andre Lee, Lauren Walheim, Anne Laverty, Preethi Rajan, Aleksandra Bacewicz, Elizabeth Beaty, Cristina Calogero, Amy B. Smith Phd, Susan E. Hansen Ma, Marna R. Greenberg Do, Mph, Facep

USF-LVHN SELECT

No abstract provided.

Burnout: Where The Rubber Meets The Road., Deb Bren Do, Frank Sperrazza Do, Grant M. Greenberg M.D., M.H.S.A., M.A., Kevin Cowell Do

Department of Family Medicine

No abstract provided.

Characterization Of Antibiotic Use Within Pediatric Patients With Cystic Fibrosis., Elizabeth Shober Pharmd, Kristin M. Held Wheatley Pharmd, Bcop

Department of Pharmacy

No abstract provided.

Increasing Colorectal Cancer Screening Among Hispanic Primary Care Patients: Re-Aim Analysis., Beth Careyva M.D., Melanie B. Johnson Mpa, Randa D. Sifri Md, Melissa Dicarlo Mph, Ms, Kyle Shaak Bs, Alicia Rivera, Liselly Diaz, Andrea Barsevick, Rosa Anderson-Deortiz, Evelyn T. Gonzalez Ma, Amy Leader Drph, Mph, Anett Petrich Rn, Msn, Anna Quinn Mph, Ryt, Brian Stello Md, Ronald E. Myers Phd

Department of Family Medicine

Context: Hispanic adults experience disparities in rates of colorectal cancer (CRC) screening. This RE-AIM analysis encompassed a multilevel decision support and navigation intervention (DSNI) for CRC screening. Interim findings were previously presented; we now aim to share the final analysis, particularly for effectiveness and implementation. Objective: Apply RE-AIM framework to a completed randomized controlled trial of a CRC screening intervention for Hispanic adults Setting: Five primary care practices Patients or Other Participants: Potential participants included a sampling frame of 2,720 screening-eligible patients, ages 50-75, Hispanic ethnicity, without history of CRC and polyps. 400 participants were enrolled. Intervention/Instrument: Decision support and …

Repeat Crc Screening After Standard And Decision Support And Navigation Interventions Among Hispanic Primary Care Patients., Melanie B. Johnson Mpa, Beth Careyva M.D., Melissa Dicarlo Mph, Ms, Kyle Shaak Bs, Sarah Hegarty Mphil, Evelyn T. Gonzalez Ma, Anna Quinn Mph, Ryt, Randa Sifri Md, Brian Stello Md, Ronald E. Myers Phd

Department of Family Medicine

No abstract provided.

Niemann-Pick Type C Disease, Sameh Morkous Md, Faan

Department of Pediatrics

No abstract provided.

Diverticulitis Resulting In Brain Abscess: A Case Report (Poster)., Sean J. Wallace Md, David Deisher Do, Thomas Daniel Harrison Do

Department of Surgery

No abstract provided.

Extra-Pleural Dermal Solitary Fibrous Tumor On The Posterior Shoulder: A Case Report., Sean J. Wallace Md, Robert Teixeira Md, Nathan F. Miller, Hina A. Sheikh, Genevieve Guzman, Rohit Sharma Md

Department of Surgery

No abstract provided.

Moving Primary Care Forward To Meet The Complex Care Needs Of Older Adults., Lynn M. Wilson Do, Nyann Biery Ms, Laura J. Benner Rn, Bsn, Acm-Rn, Ccctm, Julie Dostal Md, Brenda Frutos Mph

Department of Family Medicine

No abstract provided.

Cancer Survivorship In Primary Care - A Mixed Methods Comparative Study Of Environmental And Contextual Features Of Care Across Three States., Autumn Kieber-Emmons Md, Mph, William L. Miller Md, Ma, Benjamin F. Crabtree Phd, Jenna Howard Phd

Department of Family Medicine

No abstract provided.

Effect Of Team-Based Communication Post An Er Visit., Madalyn Schaefgen Md, Barbara Sikora Lpn, Colleen Poehler, Kyle Shaak Mph

Department of Family Medicine

No abstract provided.

Integrating Disability: Evaluating The Usefulness Of "My Health Report" And Its Effect On Doctor-Patient Communication., Seth Vanzant, Sweety Jain Md, Elizabeth Perkins

Department of Family Medicine

No abstract provided.

Retrospective Review Of Biofires Filmarray Gastrointestinal Panels Detection Of Multiple Pathogens In Adults Patients., Patrick Hickey Do, Eric Nellis Md, Anastasia Shnitser Md, Amy Slenker Md

Department of Medicine

No abstract provided.

Six Month Av Fistulae Outcomes Following Local Perianastomotic Delivery Of Sirolimuspreliminary Report From A Us Phase 3 Clinical Trial (Access Trial), Sriram Iyer, Nelson Kopyt Do, Fasn, Facp, Joseph J. Lee, Osman Khawar, Thomas Wooldridge, Nirav Gandhi, Robert I. Lynn, William Paulson, Maria Devita

Department of Medicine

No abstract provided.

Effect Of Baseline Serum Calcium On Responses To Extended-Release Calcifediol (Erc) In Stage 3 - 4 Ckd, Nelson Kopyt Do, Fasn, Facp, Stephen A. Strugnell, Akhtar Ashfaq, Martin Petkovich, Charles W. Bishop

Department of Medicine

No abstract provided.

Let's Talk! Engaging The Community In Advance Care Planning Through Games., Seth Vanzant, Aleksandra Bacewicz, Alexandria Holmes, Priscilla Shen, Lora Bojilova, Robert Levy, Nicole Defenbaugh Phd, Robert Motley Md

Department of Family Medicine

No abstract provided.

A Seemingly Innocuous Headache Heralding Onset Of Rare Autoimmune Disorder., Thomas Quinn Do, Noor Salam Md

Department of Medicine

No abstract provided.

Ampa-R Antibody Positive Autoimmune Encephalitis: An Under Recognized Cause Of Acute Mental Status Changes., Joseph Moran Do, George Prousi Md, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.