Internal Medicine Commons^™

The Association Of Hyponatremia With Race, Ethnicity, And Gender In Patients Admitted For Acute Decompensated Heart Failure Diagnoses, Vikas Sunder, Md, Rene Alvarez, Md, Evan Carabelli, Md

Division of Internal Medicine Faculty Papers & Presentations

Background: Hyponatremia, defined by a serum sodium concentration less than 135 mEq/L, is seen in approximately 25% of patients admitted with congestive heart failure (CHF). Hyponatremia on admission has been shown to increase in-hospital mortality and to be an independent predictor of 6month mortality. Prior work has shown that CHF patients with hyponatremia on admission are more likely to be Caucasian. Given its prognostic significance, hyponatremia and its association with patient characteristics warrants further study.

Methods: We queried for unique admissions to Temple University Hospital between 2011 and 2015 with a DRG code of "291-293" to represent a …

The Impact Of Schizophrenia On Copd Readmission Rate Among Hospitalized South Carolinians, Emilienne Y. Watonsi

DNP Research Projects

Due to elevated readmission costs, the Affordable Care Act established the Hospital Readmission Reduction Program in 2012 to curb the 30-day readmission rates. COPD and schizophrenia are two very expensive diseases, COPD national medical costs is projected to be $49.0 billion in 2020; the cost of schizophrenia was 155.7 billion in 2013. The main objective of this study was to determine if schizophrenia is a significant predictor of 30-day readmission following hospitalization for acute exacerbation of COPD after adjusting for age, gender, anxiety, smoking status, T2DM, chronic ischemic heart disease, and GERD. Methods: A retrospective cohort design was used to …

Evaluation Outcomes Of A Modified Early Warning System For Early Identification Of Sepsis In The Adult Population Requiring Acute Care, Gavin M. Turpin

DNP Projects

Objectives: To examine the use of a Modified Early Warning System (MEWS) for sepsis identification and evaluate its effects on treatment and outcomes for those patients diagnosed with sepsis after admission, during their stay at an acute care facility.

Design: A retrospective chart audit was conducted on the electronic medical records (EMRs) of patients who developed, and were diagnosed with, sepsis post admission. Specifically, a retrospective separate sample pretest posttest design was used to examine the accuracy of the MEWS, differences in outcomes (ICU days, length of hospital stay, qSOFA Score and mortality rates), and treatment initiation time (fluid resuscitation, …

Prevalence Of Hla-B*5701 In A Kenyan Population With Hiv Infection, Reena Shah, H. Nabiswa, Nancy Okinda, Gunturu Revathi, Mark Hawken, Nelson M.

Internal Medicine, East Africa

We read with interest the article published in your Journal entitled “Real-world persistence with antiretroviral therapy for HIV in the United Kingdom: a multicentre retrospective cohort study”1 which concluded that treatment discontinuation attributable to toxicity profile is not an uncommon event. They also acknowledged lack of data collection on HLA-B*5701 status, which would heavily influence initial ART regimen and the choice to discontinue medication. Of the 25.6 million living with Human Immunodeficiency Virus (HIV) in Africa, an estimated 1.6 million people live in Kenya.2 With an HIV prevalence of 5.6%, Kenya has upscaled HIV treatment and care in the past …

Pulmonary Mucormycosis In Chronic Lymphocytic Leukemia And Neutropenia., Izza Mir, Sijan Basnet, David Ellsworth, Elan Mohanty

Reading Hospital Internal Medicine Residency

Pulmonary mucormycosis is a rare life-threatening fungal infection associated with high mortality. We present the case of a 61-year-old man with history of chronic lymphocytic leukemia who presented with fever and cough, eventually diagnosed with pulmonary mucormycosis after right lung video-assisted thoracoscopic surgery. The patient was successfully treated with amphotericin B and right lung pneumonectomy; however, he later died from left lung pneumonia.

The Association Between Asymptomatic And Mild Neurocognitive Impairment And Adherence To Antiretroviral Therapy Among People Living With Human Immunodeficiency Virus, Violet Awori, Peter Mativo, Gerald Yonga, Reena Shah

Internal Medicine, East Africa

Background: Asymptomatic cognitive impairment in human immunodeficiency virus (HIV)-infected patients has recently been recognised as part of HIV-associated neurocognitive disorders. This has been implicated as one of the causes of poor adherence to antiretroviral therapy (ART).

Objective: To assess the association between neurocognitive impairment (asymptomatic and mild forms) and adherence to ART.

Methods: This was a cross-sectional survey involving 218 participants consecutively sampled from those attending the HIV treatment clinic at Aga Khan University Hospital in Nairobi. Data collected included quantitative primary data on pre-defined baseline characteristics, neurocognitive assessment by Montreal Cognitive Assessment (MoCA) tool (Appendix 1), instrumental …

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 …

Vitamin E Status Is Inversely Associated With Risk Of Incident Tuberculosis Disease Among Household Contacts, Omowunmi Aibana, Molly F Franke, Chuan-Chin Huang, Jerome T Galea, Roger Calderon, Zibiao Zhang, Mercedes C Becerra, Emily R Smith, Carmen Contreras, Rosa Yataco, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression.

OBJECTIVE: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk.

METHODS: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on …

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.