Medical Specialties Commons^™

Understanding The Significance Of Virtual Support During Global Pandemic In Young Adults Diagnosed With Hepatitis C, Veronika Arkhipova

Master's Projects and Capstones

Hepatitis C is a viral infection that attacks the liver and leads to inflammation. In recent years, the prevalence of hepatitis C infections among 20 and 30 years of age has increased by 300 percent, and between 30 and 39 years by 400 percent. Due to the global coronavirus pandemic, people diagnosed with Hepatitis C have lost access to mental health services and resources, including in-person meetings with support groups. Since most states enforced stay-at-home order, many community centers, non-profit organizations that work with Hepatitis C patients and the affected population provide limited to no access to support group meetings …

Trend Analysis Of Lab Tests Requisitions Of Covid-19 Prognostic Biomarkers At A Clinical Chemistry Reference Laboratory-An Observational Study, Sibtain Ahmed, Farooq Ghani

Department of Pathology and Laboratory Medicine

Background: Biochemical parameters, such as C-reactive protein (C-RP), Procalcitonin (PCT), Lactate dehydrogenase (LDH) and Ferritin are associated with COVID-19 severity and prognosis. This trend analysis of COVID-19 prognostic biomarker requisitions is aimed at providing a reflection of the clinical practices adopted amidst the peak of the pandemic. This knowledge of the prognostic biomarkers utilized, will further aid to classify patients based on their risk, for optimal resource allocation and improve outcomes.
Material & methods: This cross-sectional study was conducted at the clinical chemistry laboratory at the Aga Khan University Hospital (AKUH), Karachi Pakistan. A team consisting of two clinical chemistry …

Safety And Effectiveness Of Hydroxychloroquine And Azithromycin Combination Therapy For Treatment Of Hospitalized Patients With Covid-19: A Propensity-Matched Study, Henry D Huang, Hani Jneid, Mariam Aziz, Venkatesh Ravi, Parikshit S Sharma, Timothy Larsen, Neal Chatterjee, Basil Saour, Zaid Aziz, Hemal Nayak, Richard G Trohman, Kousik Krishnan

Faculty, Staff and Students Publications

INTRODUCTION: We sought to determine the effectiveness and safety of hydroxychloroquine-azithromycin (HCQ-AZM) therapy in hospitalized patients with COVID-19.

METHODS: This was a retrospective cohort study of 613 patients hospitalized (integrated health system involving three hospitals) for RT-PCR-confirmed COVID-19 infection between March 1, 2020 and April 25, 2020. Intervention was treatment with HCQ-AZM in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Outcomes of interest were in-hospital all-cause mortality, cardiovascular mortality, pulseless electrical activity (PEA) arrest, non-lethal arrhythmias, and length of hospital stay. Secondary measures included in-hospital corrected QT (QTc) interval parameters and serum biomarkers levels.

RESULTS: Propensity-matched …

Cutaneous Manifestations Of Covid-19: Case Report And Discussion, Abigail Russell, Gary Gross, Vashist Nobbee

HCA Healthcare Journal of Medicine

Introduction: Various cutaneous manifestations of COVID-19 have been described and awareness of these findings is beneficial for clinicians for an accurate diagnosis.

Clinical Findings: We present a case of skin findings consistent with acral microthrombi induced changes in an elderly gentleman who was positive for COVID-19.

Outcomes: The patient had a mild course of COVID-19. Cutaneous findings resolved after one week from presentation with supportive care.

Conclusions: This case highlights the importance of awareness of manifestations of COVID-19, which may assist in timely diagnosis and prevention of transmission.

Covid Intensive Care Unit Through The Eyes Of Ophthalmologists, Laura Drayer Turner, Dharshana Ramanathan, Sneha Melmane, Geeta Menon

HCA Healthcare Journal of Medicine

The disproportionate impact of COVID on the mortality and morbidity of people of black, Asian and minority ethnic (BAME) backgrounds has been recognised and is under investigation. Here we present a different impact: that on the psyche. As three doctors of BAME heritage, we shared an experience of being redeployed from ophthalmology to the COVID Intensive Care Unit. We share our reflections on the experience and lessons learned.

Innovative Conservation Of Inhaled Medication Devices During The Covid-19 Pandemic Through A Canister Reassignment Process, Mandelin K. Cooper, L. Hayley Burgess, Karla Miller, Theresa Baltz, Julia Moody, Elizabeth Wiggins, Jeffrey Guy

HCA Healthcare Journal of Medicine

Background: The ideal practice for patients requiring metered-dose inhalers (MDI) with coronavirus disease 2019 (COVID-19) is to use patient specific MDIs. However, this practice may not be possible during a time of increased usage throughout the country and limited availability of the medication. Nebulized medications are a concern due to the potential for aerosolized virus and increased exposure for health care workers. An alternative program of canister reassignment is proposed to address concerns for infection prevention, cross-contamination of MDI canisters and the shortage of MDI’s due to the COVID-19 pandemic.

Methods: A comprehensive MDI canister reassignment process was developed for …

Universal Testing Of Covid-19 Infection On A New Orleans, La Labor And Delivery Unit, Vidda Moussavi, Tiffany C. Chang, Alison M. Key, Minmin Luo, Alice S. Tong, Chi Dola

HCA Healthcare Journal of Medicine

Background: The greater New Orleans area emerged as an early epicenter of the COVID-19 pandemic, with one of the highest infection and death rates per capita in the United States. The first case of COVID-19 in an obstetric patient at Tulane Lakeside Hospital occurred on March 22, 2020. Given increasing concern for asymptomatic carriers, the labor and delivery unit implemented universal testing of all patients and their support partners starting on April 1, 2020.

Methods: A retrospective chart review of all obstetric encounters was performed to determine the incidence of COVID-19, characterize the natural history of COVID-19 and evaluate obstetric …

Covid-19 Needs Assessment And Support For Primary Care Practices In Western North Carolina, Sheri Denslow, Jill Fromewick, Kacey Scott, Jesse Bossingham, Brian Cass, Bryan Hodge, Erica L. Richman, Tammy Garrity, Kathleen Mottus, Jacqueline R. Halladay

HCA Healthcare Journal of Medicine

Background: It is critical to ensure that Primary Care Providers (PCPs) have adequate personal protective equipment (PPE), supplies, training, staffing, and contingency planning during pandemics, particularly in rural areas. In March 2020, during the onset of the COVID-19 pandemic, the Mountain Area Health Education Center (MAHEC), in collaboration with the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, rapidly created and conducted a needs assessment of PCPs in western North Carolina (WNC).

Methods: A group of twenty volunteers conducted a telephone survey of PCPs in a 16 county region of WNC. Practices were asked about their …

Acute Ischemic Stroke As The Presenting Feature Of Covid-19 In The Young And Pregnant, Nermila A. Ballmick, Jiri F. Kubac, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction: Coronavirus disease (COVID-19) is an emerging and rapidly evolving public health issue that has become globally widespread and an overwhelming pandemic. Clinical manifestations of the disease include asymptomatic carrier states, acute respiratory distress syndrome, and even multiorgan dysfunction. Here, we present a unique and rare case of an acute ischemic stroke (AIS) in an asymptomatic pregnant woman with no predisposing medical illnesses.

Discussion: An 18-year-old G2P1 African American woman at 7 weeks gestational age with no significant medical or family history presenting to the Emergency Department during the initial phases of the pandemic with complaints of new onset left …

Neuropsychiatric Presentation Of Covid-19: A Case Report Of Disinhibition In An Acute Sars-Cov-2 Infection, I. Jack Abramson, Kristy A. Fisher, Clara V. Alvarez, Jacqueline Horan Fisher

HCA Healthcare Journal of Medicine

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) viral infection is notable for a high degree of symptom diversity. Emerging evidence suggests viral invasion of the central nervous system; therefore, serious neurological and psychiatric manifestations are anticipated. We present the case of a 67-year-old male physician with a history of stable Bipolar Disorder for decades, hospitalized for persistent COVID-19 symptoms with documented positive serology, who presented with new and acute onset neuropsychiatric symptoms of disinhibition proximate the viral infection. We postulate neuroinvasion as the putative origin of the patient’s psychiatric instability. Further investigation is needed to expand upon our understanding of the …

Pulmonary Embolism And Giant Cavitary Lesion Developing After Covid-19 Pneumonia, Ahmet Vural, Ahmet Nedim Kahraman

HCA Healthcare Journal of Medicine

Introduction: The clinical manifestations of the worldwide pandemic, which began in mainland China in December 2019, were very similar to viral pneumonia and defined as Coronavirus disease 2019 (COVID-19). Complications such as acute respiratory distress syndrome (ARDS), acute cardiac tissue damage, secondary infections, isolated coagulopathy and pulmonary embolism have been reported with COVID-19 disease.

Clinical Findings: A 79-year-old woman admitted to the emergency room (ER) had complaints of fever and cough. The patient was admitted to the ER with the suspicion of COVID-19. Samples were collected with a nasopharyngeal swab and confirmed as COVID-19. In addition, a chest CT examination …

Extracorporeal Membrane Oxygenation For Covid-19 Treatment In A Community Hospital, Daniel I. Loube, Kashif Z. Hassan, Sang H. Lee

HCA Healthcare Journal of Medicine

Coronavirus disease 2019 (COVID-19) may result in severe acute respiratory disease syndrome (ARDS) and death. For COVID-19 patients failing mechanical ventilation, extra corporeal membrane oxygenation (ECMO) has been used with varying efficacy in academic medical centers and quaternary referral centers. We report the successful use of veno-venous (VV) ECMO to treat refractory ARDS due to COVID-19 in a community hospital setting with a survival to discharge rate of 71% over a 3 month period. In a community hospital with adequate resources, VV ECMO can be an effective rescue therapy for selected COVID-19 patients who fail all other available treatments.

Covid-19 And Arrhythmias: A Review Of Cardiac Electrophysiology Associated With Sars-Cov-2, Kashmala Khan, Francis Dimtri, Carlos Vargas, Thomas Alexander

HCA Healthcare Journal of Medicine

Coronavirus infectious disease 2019 (COVID-19) has become one of the most recognized viral illnesses to date. Most people infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have a benign clinical course, but there have also been catastrophic outcomes. Although, notoriously known to affect the respiratory system, extra-pulmonary manifestations have also been established. An increasing number of people have been reported to present with cardiac manifestations, which include but are not limited to arrhythmias. The cardiac conduction system can be damaged by various mechanisms in patients infected with SARS-CoV-2. In this review, we will attempt to briefly describe the arrhythmogenic …

An Obstetrics And Gynecology Residency Program’S Approach To The Covid-19 Pandemic, Tiffany C. Chang, Brenda Nguyen, Chi Dola

HCA Healthcare Journal of Medicine

Background: The impact of COVID-19 on residency training nationwide has been substantial, and adapting to this unprecedented event has proven challenging for program directors throughout the United States. Here, the authors presented their initial experiences with restructuring an obstetrics and gynecology residency program during the pandemic. The authors outlined their strategies to maximize resident safety and address clinical care in outpatient and inpatient settings, resident education curriculum, resident wellness and consider the ethical dilemmas of health care providers during a pandemic.

Conclusion: With perspectives from other residency programs, the authors hope this review will serve as an initial building block …

Research Amidst The Pandemic, Howard Burris

HCA Healthcare Journal of Medicine

Cancer patients need access to promising investigational therapies, available only through clinical trials, and the emergence of COVID-19 and the resulting pandemic became an emerging threat to fulfilling that need. Many academic medical centers were pausing their clinical research programs, diverting their resources and sheltering their teams. Sarah Cannon, the Cancer Institute of HCA Healthcare, made the decision to stay safe, but stay the course.

Applications Of Non-Invasive Neuromodulation For The Management Of Disorders Related To Covid-19, Abrahão Fontes Baptista, Adriana Baltar, Alexandre Hideki Okano, Alexandre Moreira, Ana Carolina Pinheiro Campos, Ana Mércia Fernandes, André Russowsky Brunoni, Bashar W. Badran, Clarice Tanaka, Daniel Ciampi De Andrade, Daniel Gomes Da Silva Machado, Edgard Morya, Eduardo Trujillo, Jaiti K. Swami, Joan A. Camprodon, Katia Monte-Silva, Katia Nunes Sá, Isadora Nunes, Juliana Barbosa Goulardins, Marom Bikson, Pedro Sudbrack-Oliveira, Priscila De Carvalho, Rafael Jardim Duarte-Moreira, Rosana Lima Pagano, Samuel Katsuyuki Shinjo, Yossi Zana

Publications and Research

Background: Novel coronavirus disease (COVID-19) morbidity is not restricted to the respiratory system, but also affects the nervous system. Non-invasive neuromodulation may be useful in the treatment of the disorders associated with COVID-19.

Objective: To describe the rationale and empirical basis of the use of non-invasive neuromodulation in the management of patients with COVID-10 and related disorders.

Methods: We summarize COVID-19 pathophysiology with emphasis of direct neuroinvasiveness, neuroimmune response and inflammation, autonomic balance and neurological, musculoskeletal and neuropsychiatric sequela. This supports the development of a framework for advancing applications of non-invasive neuromodulation in the management COVID-19 and related disorders.

Results: …

Extended Cable For Left Ventricular Assist Devices For Monitoring Isolated Patients During The Covid-19 Pandemic, Neal A. Waxali, James M. Kenward, Laurie P. Loza, Yasser Varona, Arvind Bhimaraj

The VAD Journal

We present a method to create an extended cable for patients who are supported by left ventricular assist devices (LVADs) while infected with SARS-CoV-2. The arrangement described facilitates the LVAD monitor console’s positioning outside of the patient’s room to minimize exposure of the mechanical circulatory support team to the novel coronavirus.

Ua12/2/1 College Heights Herald, Vol. 96, No. 13, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Burned Out – COVID-19
• Payne, Michael. 15 Years with the Bagel Brothers – Sandra Hurley
• Hargrove, Matthew. Hilltoppers Get in the Win Column, Home Finale Up Next - Football
• Kieser, Nick. All Eyes on the Spring – Basketball, Softball, Soccer, Baseball
• Leboutier, Addison. Little Flock of Jesus Christ Fellowship Comes Home – Clarence Tapp
• Cox, Alex. Editorial Cartoon re: Kamala Harris
• What a Kamala Harris Vice Presidency Means for Young People of Color
• Lattimer, Jacob. Student Government Association Sustainability Committee Looks to Make an Impact …

Conduct Of Clinical Trials In The Era Of Covid-19: Jacc Scientific Expert Panel., Mitchell A. Psotka, William T. Abraham, Mona Fiuzat, Gerasimos Filippatos, Joann Lindenfeld, Tariq Ahmad, Ankeet S. Bhatt, Peter E. Carson, John G.F. Cleland, G. Michael Felker, James L. Januzzi, Dalane W. Kitzman, Eric S. Leifer, Eldrin F. Lewis, John J.V. Mcmurray, Robert J. Mentz, Scott D. Solomon, Norman Stockbridge, John R. Teerlink, Muthiah Vaduganathan, Orly Vardeny, David J. Whellan, Janet Wittes, Stefan D. Anker, Christopher M. O'Connor

Department of Medicine Faculty Papers

The coronavirus disease-2019 (COVID-19) pandemic has profoundly changed clinical care and research, including the conduct of clinical trials, and the clinical research ecosystem will need to adapt to this transformed environment. The Heart Failure Academic Research Consortium is a partnership between the Heart Failure Collaboratory and the Academic Research Consortium, composed of academic investigators from the United States and Europe, patients, the U.S. Food and Drug Administration, the National Institutes of Health, and industry members. A series of meetings were convened to address the challenges caused by the COVID-19 pandemic, review options for maintaining or altering best practices, and establish …

Update On The Use Of Transcranial Electrical Brain Stimulation To Manage Acute And Chronic Covid-19 Symptoms, Giuseppina Pilloni, Marom Bikson, Bashar W. Badran, Mark S. George, Steven A. Kautz, Alexandre Hideki Okano, Abrahão Fontes Baptista, Leigh E. Charvet

Publications and Research

The coronavirus disease 19 (COVID-19) pandemic has resulted in the urgent need to develop and deploy treatment approaches that can minimize mortality and morbidity. As infection, resulting illness, and the often prolonged recovery period continue to be characterized, therapeutic roles for transcranial electrical stimulation (tES) have emerged as promising non-pharmacological interventions. tES techniques have established therapeutic potential for managing a range of conditions relevant to COVID-19 illness and recovery, and may further be relevant for the general management of increased mental health problems during this time. Furthermore, these tES techniques can be inexpensive, portable, and allow for trained self-administration. Here, …

Risk Factors For Intensive Care Unit Admission And Mortality In Hospitalized Covid-19 Patients, Ahmed Ayaz, Ainan Arshad, Hajra Malik, Haris Ali, Erfan Hussain, Bushra Jamil

Medical College Documents

Background: This study investigated the clinical features and outcome of hospitalized coronavirus disease 2019 (COVID-19) patients admitted to our quaternary care hospital.
Methods: In this retrospective cohort study, we included all adult patients with COVID-19 infection admitted to a quaternary care hospital in Pakistan from March 1 to April 15, 2020. The extracted variables included demographics, comorbidities, presenting symptoms, laboratory tests and radiological findings during admission. Outcome measures included in-hospital mortality and length of stay.
Results: Sixty-six COVID-19 patients were hospitalized during the study period. Sixty-one percent were male and 39% female; mean age was 50.6±19.1 years. Fever and cough …

Severe Acute Respiratory Syndrome Coronavirus 2 Infections In Children: Multicenter Surveillance, United States, January-March 2020., Brian Rha, Joana Y. Lively, Janet A. Englund, Mary A. Staat, Geoffrey A. Weinberg, Rangaraj Selvarangan, Natasha B. Halasa, John V. Williams, Julie A. Boom, Leila C. Sahni, Marian G. Michaels, Laura S. Stewart, Christopher J. Harrison, Peter G. Szilagyi, Monica M. Mcneal, Eileen J. Klein, Bonnie Strelitz, Kirsten Lacombe, Elizabeth Schlaudecker, Mary Moffatt, Jennifer E. Schuster, Barbara A. Pahud, Gina Weddle, Robert W. Hickey, Vasanthi Avadhanula, Mary E. Wikswo, Aron J. Hall, Aaron T. Curns, Susan I. Gerber, Gayle Langley

Manuscripts, Articles, Book Chapters and Other Papers

Previous reports of coronavirus disease 2019 among children in the United States have been based on health jurisdiction reporting. We performed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing on children enrolled in active, prospective, multicenter surveillance during January-March 2020. Among 3187 children, only 4 (0.1%) SARS-CoV-2-positive cases were identified March 20-31 despite evidence of rising community circulation.

Ua12/2/1 College Heights Herald, Vol. 96, No. 12, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Kieser, Nick. Boyce Store, 1869 to COVID-19
• Bertucci, Leo. Barren River COVID-19 Data Still Delayed
• Frazier, Keilen. Joe Biden Their Time
• Extending the Withdrawal Date Is Not Enough – Pass / D / Fail Option
• Reynolds, Easton. WKU Extends the Deadline to Withdraw a Class
• Mallon, Sam. WKU, Barren River Area Child Advocacy Center Initiative Aims to Curb Child Abuse, Neglect – Child Welfare Education
• Hargrove, Matthew. Hilltoppers Drop Game at Florida Atlantic University, Southern Mississippi Visits the Hill Saturday – Football
• Gaylord, Kaden. Time …

FacebookʼS Latest Attempt To Address Vaccine Misinformation — And Why ItʼS Not Enough, Ana Santos Rutschman

All Faculty Scholarship

On October 13, 2020 Facebook announced the adoption of a series of measures to promote vaccine trust “while prohibiting ads with misinformation that could harm public health efforts.” In the post written by Kang-Xing Jin (head of health) and Rob Leathern (director of product management), the company explained that the new measures were designed with an emphasis on encouraging widespread use of this yearʼs flu vaccine, as well as in anticipation of potential COVID-19 vaccines becoming available in the near future.

The changes focus mainly on the establishment of a multiprong informational campaign about the seasonal flu vaccine, which includes …

Ua12/2/1 College Heights Herald, Vol. 96, No. 11, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Murray, Debra. Campaigning During COVID-19
• Stryker, Shane. Third Party Candidates Present Options Outside Democrats & Republicans
• WKU Young Democrats
• WKU College Republicans
• Serrano, Francisco. A Voice of Change for the Young Generation
• Thornton, Maggie. Kentucky’s 1^st Congressional District
• Holland, Kelley. Kentucky’s 2^nd Congressional District
• Latimer, Jacob. Senate Candidates on College-Level Issues – Mitch McConnell, Amy McGrath
• Collins, Michael. District 20 Candidates on the Issues – Patti Minter, Leanette Lopez
• Who’s Running for City Commission?

Can Charcoal Improve Outcomes In Covid-19 Infections?, Zeid J. Khitan, Imran Khawaja, Maurice A. Mufson, Juan R. Sanabria, Nader G. Abraham, Stephen J. Peterson, Uma Sundaram, Joseph I. Shapiro

Internal Medicine

COVID-19 infection causes considerable morbidity and mortality, especially to those who are aged, have impaired renal function and are obese. We propose to examine the potential utility of oral activated charcoal with the hypothesis that such treatment would lower absorption of microbiome derived toxins and ameliorate systemic oxidant stress and inflammation.

Donor And Transplant Candidate Selection For Solid Organ Transplantation During The Covid-19 Pandemic, N Thao N Galvan, Nicolas F Moreno, Jay E Garza, Susan Bourgeois, Marion Hemmersbach-Miller, Bhamidipati Murthy, Katherine Timmins, Christine A O'Mahony, James Anton, Andrew Civitello, Puneet Garcha, Gabe Loor, Kenneth Liao, Alexis Shaffi, John Vierling, Rise Stribling, Abbas Rana, John A Goss

Faculty, Staff and Students Publications

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a novel coronavirus responsible for a worldwide pandemic has forced drastic changes in medical practice in an alarmingly short period of time. Caregivers must modify their strategies as well as optimize the utilization of resources to ensure public and patient safety. For organ transplantation, in particular, the loss of lifesaving organs for transplantation could lead to increased waitlist mortality. The priority is to select uninfected donors to transplant uninfected recipients while maintaining safety for health care systems in the backdrop of a virulent pandemic. We do not yet have a standard approach to evaluating …

Tough Decisions During The Covid 19 Pandemic: A Frail Latino Patient, Irma Huayanay, Stephanie Luu

School of Medicine Publications

The pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had overwhelmed the healthcare system worldwide with multiple ethical dilemmas. Several tools have been used to assess risk factors in these patients. One of them, the Clinical Frailty scale, has shown good correlation between the patient functional status and hospital stay with overall mortality. We present a case were the Clinical Frailty Scale was used to assess patient management and goals of care.

Aerosol Generation With Common Rhinologic Devices: Cadaveric Study Conducted In A Surgical Suite, Bailey Leconte, Garren M I Low, Martin J Citardi, William C Yao, Arturo A Eguia, Amber U Luong

Faculty, Staff and Student Publications

No abstract provided.

Revisiting Child And Adolescent Health In The Context Of The Sustainable Development Goals, Zulfiqar Ahmed Bhutta, Kathryn M. Yount, Quique Bassat, Artur A. Arikainen

Woman and Child Health

No abstract provided.