Medical Specialties Commons^™

Association Of Anticoagulation Dose And Survival In Hospitalized Covid-19 Patients: A Retrospective Propensity Score-Weighted Analysis, F. Ionescu, I. Jaiyesimi, I. Petrescu, P. R. Lawler, E. Castillo, Y. Munoz-Maldonado, Z. Imam, M. Narasimhan, A. E. Abbas, G. B. Nair, +1 Additional Author

Journal Articles

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Background: Hypercoagulability may contribute to COVID-19 pathogenicity. The role of anticoagulation (AC) at therapeutic (tAC) or prophylactic doses (pAC) is unclear. Objectives: We evaluated the impact on survival of different AC doses in COVID-19 patients. Methods: Retrospective, multi-center cohort study of consecutive COVID-19 patients hospitalized between March 13 and May 5, 2020. Results: A total of 3480 patients were included (mean age, 64.5 years [17.0]; 51.5% female; 52.1% black and 40.6% white). 18.5% (n = 642) required intensive care unit (ICU) stay. 60.9% received pAC (n …

Pathophysiology And Pathology Of Acute Kidney Injury In Patients With Covid-19, J. H. Ng, V. Bijol, M. A. Sparks, M. E. Sise, H. Izzedine, K. D. Jhaveri

Journal Articles

© 2020 National Kidney Foundation, Inc. Acute kidney injury (AKI) is common among hospitalized patients with Coronavirus Infectious Disease 2019 (COVID-19), with the occurrence of AKI ranging from 0.5% to 80%. The variability in the occurrence of AKI has been attributed to the difference in geographic locations, race/ethnicity, and severity of illness. AKI among hospitalized patients is associated with increased length of stay and in-hospital deaths. Even patients with AKI who survive to hospital discharge are at risk of developing chronic kidney disease or end-stage kidney disease. An improved knowledge of the pathophysiology of AKI in COVID-19 is crucial to …

Estimating The Predictive Value Of Negative Sars-Cov-2 Results: A Prospective Study, D. Hirschwerk, M. Foley, M. Lesser, B. Farber, J. M. Crawford, K. W. Davidson, G. J. Berry, E. Smith, C. Kast, T. Mcginn, +1 Additional Author

Journal Articles

© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved. We performed a prospective study of 501 patients, regardless of symptoms, admitted to the hospital, to estimate the predictive value of a negative Nasopharyngeal swab for SARS-CoV-2. At a positivity rate of 10.2%, the estimated Negative Predictive Value (NPV) was 97.2% and NPV rose as prevalence decreased during the study.

Characteristics And Risk Factors Associated With Critical Illness In Pediatric Covid-19, G. Fisler, S. M. Izard, S. Shah, D. Lewis, M. K. Kainth, S. H. F. Hagmann, J. A. Belfer, L. M. Feld, F. Mastroianni, C. L. Kvasnovsky, C. A. Capone, J. Schneider, T. Sweberg, C. Schleien, M. D. Taylor

Journal Articles

© 2020, The Author(s). Background: While much has been reported regarding the clinical course of COVID-19 in children, little is known regarding factors associated with organ dysfunction in pediatric COVID-19. We describe critical illness in pediatric patients with active COVID-19 and identify factors associated with PICU admission and organ dysfunction. This is a retrospective chart review of 77 pediatric patients age 1 day to 21 years admitted to two New York City pediatric hospitals within the Northwell Health system between February 1 and April 24, 2020 with PCR + SARS-CoV-2. Descriptive statistics were used to describe the hospital course and …

Patient Attitudes Toward Telepsychiatry During The Covid-19 Pandemic: A Nationwide, Multisite Survey., D. Guinart, P. Marcy, M. Hauser, M. Dwyer, J. M. Kane

Journal Articles

Background

The COVID-19 pandemic and its associated movement restrictions forced a rapid and massive transition to telepsychiatry to successfully maintain care continuity.

Objective

The aim of this study is to examine a large number of patients' experiences of, use of, and attitudes toward telepsychiatry.

Methods

An anonymous 11-question survey was delivered electronically to 14,000 patients receiving telepsychiatry care at 18 participating centers across 11 US states between the months of April and June 2020, including questions about their age and length of service use, as well as experience and satisfaction with telepsychiatry on a 5-point Likert scale. Descriptive statistics were …

Alterations In Plasma Membrane Ion Channel Structures Stimulate Nlrp3 Inflammasome Activation In Apol1 Risk Milieu, A. Jha, V. Kumar, S. Haque, K. Ayasolla, S. Saha, X. Lan, A. Malhotra, M. A. Saleem, K. Skorecki, P. C. Singhal

Journal Articles

© 2019 Federation of European Biochemical Societies We evaluated alterations in the structural configurations of channels and activation of nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3) inflammasome formation in apolipoprotein L1 (APOL1) risk and nonrisk milieus. APOL1G1- and APOL1G2-expressing podocytes (PD) displayed enhanced K+ efflux, induction of pyroptosis, and escalated transcription of interleukin (IL)-1β and IL-18. APOL1G1- and APOL1G2-expressing PD promoted the transcription as well as translation of proteins involved in the formation of inflammasomes. Since glyburide (a specific inhibitor of K+ efflux channels) inhibited the transcription of NLRP3, IL-1β, and IL-18, the role of K+ efflux in the activation …

The Relationship Between Medication Discrepancies And Hospitalization Risk Among Patients With Advanced Ckd, V. Sakhiya, J. James, K. D. Jhaveri, M. Zhang, J. H. Ng, C. Halinski Np, J. Tomanguillo-Chumbe, S. Fishbane

Journal Articles

No abstract provided.

'Whatsapp (R)' Ening In Nephrology Training, K. D. Jhaveri, B. Pascarelli, A. Hasan, A. Kozikowski, S. Fishbane, R. Pekmezaris

Journal Articles

No abstract provided.

Morphea (Localized Scleroderma) Presenting With Recurrent Skin And Soft Tissue Infections: A Diagnostic Dilemma., A. M. Khatri, M. Mclemore, P. Malhotra

Journal Articles

Morphea or localized scleroderma is reported to be triggered through diverse stimuli. We present a case of morphea that presented as a non-healing wound with superimposed methicillin-sensitive Staphylococcus aureus (MSSA) infection. In our case, morphea was thought to have been potentially triggered by a post-surgical infection. We discuss the potential infectious triggers and common infections that may confound the diagnosis.

Management Of Barrett's Esophagus With Dysplasia Refractory To Radiofrequency Ablation, K. L. Raphael, A. J. Trindade

Journal Articles

No abstract provided.

Bevacizumab-Induced Pneumonitis In A Patient With Metastatic Colon Cancer: A Case Report, S. Pervaiz, S. Homsy, N. Narula, S. Ngu, D. Elsayegh

Journal Articles

© The Author(s) 2020. Bevacizumab is a vascular endothelial growth factor–directed humanized monoclonal antibody used to treat many types of cancer and some eye diseases. Due to inhibition of angiogenesis, many adverse reactions such as bowel necrosis, nasal septal perforation, and renal thrombotic microangiopathy have been described. However, its association with interstitial pneumonitis is scarcely reported in the literature. We report a case of a 79-year-old woman with metastatic colon cancer who presented with cough and dyspnea on exertion the day after initiation of bevacizumab. She was found to have bilateral airspace opacities on imaging. Infectious and cardiogenic etiologies of …

Do Not Fall To The Vape Trap!, S. Acharya, S. I. Ali, S. Anwar, A. Glaser

Journal Articles

© 2020 The Author(s) Introduction: Whilst the use of combustible tobacco products continues to decline in the United States, the use of e-cigarettes has seen an explosive rise in recent years. In 2019 an outbreak on EVALI was seen across the country, highlighting the fact that e-cigarettes may not be as harmless as previously perceived. Case description: A 22-year-old male came to the emergency department complaining of vomiting and shortness of breath. Patient reported using a “pod” a day of a “JUUL” e-cigarette. Patient's oxygen requirement continued to increase and was eventually shifted to the intensive care unit and mechanically …

Isolated Pulmonary Valve Endocarditis., S. Acharya, S. Anwar, M. Iannuzzi, V. Anugu, F. Ghavami

Journal Articles

Infective endocarditis involving the right side of the heart is typically associated with IV drug abuse and chronic indwelling catheters which commonly involve the tricuspid valve. Isolated pulmonary valve endocarditis (PVE) is a rare clinical entity. We report a rare case of a young woman with a history of end-stage renal disease (ESRD) on hemodialysis through tunneled catheter presenting with persistent coagulase-negative staphylococcus (CoNS) epidermidis bacteremia despite being on appropriate treatment with IV vancomycin for two weeks. Because of the persistent bacteremia, a transesophageal echocardiogram was performed and it revealed a thickened pulmonary valve with 1.8 cm vegetation in the …

A Rare But Reversible Cause Of Lithium-Induced Bradycardia., B. Ataallah, R. Al-Zakhari, A. Sharma, M. Tofano, G. Haggerty

Journal Articles

Lithium is a well-known medication that has been used for many years to treat mood disorders. One of its side effects is cardiotoxicity, which usually occurs at serum lithium levels > 1.5 mEq/L but rarely occurs when therapeutic levels of lithium are used. Other causes of bradycardia should be eliminated by performing a detailed workup that includes calcium level, thyroid function, and cardiac workup, with consideration of any medication interactions. Lithium-induced bradycardia is reversible upon discontinuation of lithium, but irreversible sinus node can occur and may warrant permanent insertion of a pacemaker to maintain sinus rhythm when long-term lithium therapy is …

“Palliative Pandemic Plan,” Triage And Symptoms Algorithm As A Strategy To Decrease Providers’ Exposure, While Trying To Increase Teams Availability And Guidance For Goals Of Care (Goc) And Symptoms Control, S. Lopez, G. Decastro, K. M. Van Ogtrop, S. Weiss-Domis, S. R. Anandan, C. J. Magalee, R. Roofeh, T. A. Liberman

Journal Articles

No abstract provided.

Erratum: A Large Right Ventricle And Severe Hypoxemia. Use Of Bedside Transesophageal Echocardiography To Assess Cardiopulmonary Failure (Annals Of The American Thoracic Society (2020) 17 (112-115) Doi: 10.1513/Annalsats.201904-316cc), A. Agrawal, M. Frank, A. Tsegaye

Journal Articles

Copyright © 2020 by the American Thoracic Society. The authors would like to make a correction to the legends of Videos 1 and 3 in their article published in the January 2020 issue of AnnalsATS (1). The definition for the abbreviation TEE in these video legends should read "transesophageal echocardiogram." For the convenience of our readers, AnnalsATS is replacing the online version of the article with a corrected version; we apologize for the error.

Carbapenemase Producing Klebsiella Pneumoniae (Kpc) Meningitis From Chronic Otitis Media, S. Anwar, S. Acharya, S. Thapa, J. Rabadi, N. Mobarakai

Journal Articles

© 2020 The Authors Meningitis and brain abscess caused by carbapenemase-producing Klebsiella pneumoniae (KPC) is rarely described in the medical literature. Such infections have been described after neurosurgical medium or post-trauma. We describe an unusual case of KPC meningitis originating from with long term intravenous antibiotics.

Life Threatening Haemoptysis In Primary Lung Cancer-Signet Ring Cell Carcinoma, S. Anwar, S. Acharya, D. Elsayegh, A. Sokoloff, M. Rehan

Journal Articles

© 2020 The Author(s) Primary signet ring cell carcinoma of the lung is a rare non-small cell carcinoma of the lung with extremely aggressive features and poor prognosis. The diagnosis mainly required tissue biopsy with immunohistochemical analysis and gene mutation studies. We describe a unique case of primary signet ring cell carcinoma of the lung presenting with life threatening haemoptysis along with literature review of prognosis and management of this rare clinical entity.

A Case Of Wernicke's Encephalopathy In A Pregnant Woman With A History Of Sleeve Gastrectomy., H. Kandlakunta, D. Gurala, J. Philipose, A. Polavarapu, J. R. Abergel

Journal Articles

Wernicke's encephalopathy (WE) is a neurological complication of thiamine deficiency characterized by a triad of acute confusion, ataxia, and ophthalmoplegia. Even though it is most common in chronic alcoholism, an increase in prevalence has been reported recently due to the increased popularity of bariatric surgeries. WE is a known neurological complication after gastric bypass surgery but rarely reported after sleeve gastrectomy. We present a unique case of WE in pregnant women four months after sleeve gastrectomy.

La Inhalers For Copd: Perceptions/Reality Of Abcd Gold Tool Use., V. Boryushkina, V. Kumar, M. Barnes, S. Nabeel, T. Le, H. Siddique, G. Haggerty, J. Ng, A. Kaell

Journal Articles

BACKGROUND:The Global Initiative for Chronic Obstructive Lung Disease (GOLD) created an ABCD tool to assess staging and severity of COPD subgroups that respond to LAMA or LABA with improved quality of life and reduced exacerbations. Our study assesses perception of physicians at five community hospitals towards LAMA use for patients admitted with COPD exacerbations according to the GOLD guidelines and describes the experience at our hospital. METHODS:Electronic survey forms regarding LAMA use and the GOLD criteria ABCD for COPD treating physicians were sent to five hospitals. A one-year chart review at our hospital determined prevalent use of a maintenance LAMA …

Glycosylated Hemoglobin, But Not Advanced Glycation End Products, Predicts Severity Of Coronary Artery Disease In Patients With Or Without Diabetes., C. Basman, S. L. Fishman, D. Avtanski, U. Rashid, A. Kodra, M. Lesser, D. Inlall, K. Ziskovich, V. Singh, L. Poretsky, +3 Additional Authors

Journal Articles

Background:The association between coronary artery disease (CAD) and diabetes mellitus (DM) is strong but the physiologic mechanisms responsible for this association remain unclear. Patients with DM exhibit high circulating levels of glycated proteins and lipoproteins called advanced glycation end products (AGEs) which have been implicated in the development of oxidative damage to vascular endothelium. We examined the relationships between the presence and extent of CAD and AGEs in patients undergoing elective coronary artery catheterization in an urban teaching hospital. Methods:Patients with possible CAD (n = 364) were recruited prior to elective cardiac catheterization (52% male, 48% diabetic). Regression and correlation …

A Case Report On Metformin-Associated Lactic Acidosis., H. K. Rai, P. Patel, K. Reddy

Journal Articles

Metformin is the first-line therapy for patients with type 2 diabetes, and its most common adverse effects are gastrointestinal. Lactic acidosis associated with metformin use is rare. Here, we report the case of a 77-year-old man with a medical history of diabetes (treated with metformin), hypertension, chronic alcohol abuse, and prostate and bladder cancer, who presented with abdominal pain, nausea, vomiting, and diarrhea for five days. He was admitted with severe metabolic acidosis due to metformin toxicity (metformin-associated lactic acidosis) with metformin level 23 mcg/mL (therapeutic range approximately 1-2 mcg/mL) in the setting of acute kidney failure due to acute …

Optimizing Telehealth Experience Design Through Usability Testing In Hispanic American And African American Patient Populations: Observational Study., D. King, S. Khan, J. Polo, J. Solomon, R. Pekmezaris, N. Hajizadeh

Journal Articles

BACKGROUND:Telehealth-delivered pulmonary rehabilitation (telePR) has been shown to be as effective as standard pulmonary rehabilitation (PR) at improving the quality of life in patients living with chronic obstructive pulmonary disease (COPD). However, it is not known how effective telePR may prove to be among low-income, urban Hispanic American and African American patient populations. To address this question, a collaborative team at Northwell Health developed a telePR intervention and assessed its efficacy among low-income Hispanic American and African American patient populations. The telePR intervention system components included an ergonomic recumbent bike, a tablet with a built-in camera, and wireless monitoring devices. …

Optimizing Tissue Use: A Step-Wise Approach To Diagnosing Squamous Cell Lung Carcinoma On Small Biopsies, C. Olazagasti, I. Preeshagul, M. Aziz, N. Seetharamu

Journal Articles

© The Author(s) 2020. Background: Histologic subtyping of lung cancer has significant implications for treatment planning. Accurate diagnosis based on cytology/small biopsy specimens is challenging and frequently determined by morphology, as material is often not sufficient for immunohistochemical studies (IHC). We investigated the concordance between the rates of diagnosis from cytology/small biopsies compared with surgical specimens in patients with squamous cell lung cancer (SCC) and the utility of IHC for diagnostic precision in lung cancer subtyping. Methods: We conducted a 5-year retrospective analysis identifying cases of SCC diagnosed on cytology/small biopsies ± IHC and compared them with subsequent surgical specimens …

January 2020, New England Osteopathic Heritage Center

New England Osteopathic Heritage Center Newsletter

New England Osteopathic Heritage Center's annual newsletter for January 2020

Surgical Gps Proof Of Concept For Scoliosis Surgery, Austin Tapp, Michel Audette

Computational Modeling & Simulation Engineering Faculty Publications

Scoliotic deformities may be addressed with either anterior or posterior approaches for scoliosis correction procedures. While typically quite invasive, the impact of these operations may be reduced through the use of computer-assisted surgery. A combination of physician-designated anatomical landmarks and surgical ontologies allows for real-time intraoperative guidance during computer-assisted surgical interventions. Predetermined landmarks are labeled on an identical patient model, which seeks to encompass vertebrae, intervertebral disks, ligaments, and other soft tissues. The inclusion of this anatomy permits the consideration of hypothetical forces that are previously not well characterized in a patient-specific manner. Updated ontologies then suggest procedural directions throughout …

Characterization Of A Speciese Adenovirus Vector As A Zika Virus Vaccine, Brianna L. Bullard, Brigette N. Corder, David N. Gordon, Theodore C. Pierson, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

The development of a safe and efficacious Zika virus (ZIKV) vaccine remains a global health priority. In our previous work, we developed an Adenovirus vectored ZIKV vaccine using a low-seroprevalent human Adenovirus type 4 (Ad4-prM-E) and compared it to an Ad5 vector (Ad5-prM-E). We found that vaccination with Ad4-prM-E leads to the development of a strong anti-ZIKV T-cell response without eliciting significant anti-ZIKV antibodies, while vaccination with Ad5-prM-E leads to the development of both anti-ZIKV antibody and T-cell responses in C57BL/6 mice. However, both vectors conferred protection against ZIKV infection in a lethal challenge model. Here we continued to characterize …

Comparison Of Low Carbohydrate Diets On Renal And Glucose Function In Subjects With Type 2 Diabetes: A Systematic Review And Meta-Analysis, Garrett A. Couch

Honors Undergraduate Theses

Background - Type 2 Diabetes Mellitus (T2DM) is a growing crisis that can lead to more problems if left untreated. One of these problems includes diabetic nephropathy or Chronic Kidney Disease (CKD). While there have been many advances in the field of treating CKD with medication, there are currently no medications with the capability of stopping the progression of or reversing diabetic nephropathy; however, recent studies have shown that diabetic nephropathy can be stopped and even reversed through dietary interventions. One of these studies went through the effects of a low protein diet on diabetic nephropathy and found very promising …

The Effects Of Modifiable And Non-Modifiable Risk Factors On The Severity Of Gastroparesis-Like Symptoms, Jonathon B. Nelson

Honors Undergraduate Theses

Gastroparesis (GP) is a clinical disorder recognized by measured delayed gastric emptying without mechanical obstruction, in addition to symptoms such as nausea, vomiting, chronic abdominal pain, heartburn, early satiety upon eating a regular-sized meal, and exaggerated postprandial fullness. While GP is considered a clinically rare disorder, there is much suspicion that a much larger number of patients experience GP-like symptoms without an official diagnosis. Furthermore, little work has been done to identify the causes and exacerbations of this gastrointestinal (GI) distress in the young adult population. This study's primary goal was to establish a relationship between modifiable and non-modifiable risk …

Risk Factors For Liposomal Bupivacaine Resistance After Total Hip Or Knee Arthroplasties: A Retrospective Observational Cohort In 237 Patients, Scott Buzin, Arianna L. Gianakos, Deborah Li, Anthony Viola, Sherif Elkattawy, David M. Keller, Richard S. Yoon, Frank A. Liporace

Orthopedic Surgery Resident Research

Purpose: Liposomal bupivacaine demonstrated promise decreasing postoperative pain in total hip and total knee arthroplasty (THA/TKA). Some randomized trials have shown non-superior results; however, confounding variables were not accounted for in such analyses. This study attempts to determine risk factors associated with failure of pain management in patients receiving liposomal bupivacaine.

Methods: Postoperative pain scores were collected following primary or revision arthroplasties between January 2016 and December 2017. Retrospective analysis of institutional total joint quality and outcomes registry was screened and patients undergoing primary or revision arthroplasties who completed a multi-modal pain management including liposomal bupivacaine were included in the …