Internal Medicine Commons^™

Case And Commentary: How Should Clinicians' Performance Be Assessed When Health Care Organizations Implement Behavioral Architecture That Generates Negative Consequences?, S. Richardson

Journal Articles

© 2020 American Medical Association. All rights reserved. Behavioral interventions have been shown to have powerful effects on human behavior both outside of and within the context of health care. As organizations increasingly adopt behavioral architecture, care must be taken to consider its potential negative consequences. An evidencedbased approach is best, whereby interventions that might have a significant deleterious effect on patients' health outcomes are first tested and rigorously evaluated before being systematically rolled out. In the case of clinical decision support, brief and thorough instructions should be provided for use. Physician performance when using these systems is best measured …

Anticoagulant Reversal Strategies In The Emergency Department Setting: Recommendations Of A Multidisciplinary Expert Panel, C. W. Baugh, M. Levine, D. Cornutt, J. W. Wilson, R. Kwun, C. E. Mahan, C. V. Pollack, E. G. Marcolini, A. C. Spyropoulos, J. Williams

Journal Articles

No abstract provided.

Utility Of D-Dimer In Predicting Venous Thromboembolism In Non-Mechanically Ventilated Covid-19 Survivors., P. C. Nauka, S. W. Baron, A. Assa, L. Mohrmann, S. Jindal, E. Oran, G. Glazman-Kuczaj, W. N. Southern, S. Chekuri

Journal Articles

No abstract provided.

An Approach To Predicting Patient Experience Through Machine Learning And Social Network Analysis., V. Bari, J. S. Hirsch, J. Narvaez, R. Sardinia, K. R. Bock, M. I. Oppenheim, M. Meytlis

Journal Articles

OBJECTIVE:Improving the patient experience has become an essential component of any healthcare system's performance metrics portfolio. In this study, we developed a machine learning model to predict a patient's response to the Hospital Consumer Assessment of Healthcare Providers and Systems survey's "Doctor Communications" domain questions while simultaneously identifying most impactful providers in a network. MATERIALS AND METHODS:This is an observational study of patients admitted to a single tertiary care hospital between 2016 and 2020. Using machine learning algorithms, electronic health record data were used to predict patient responses to Hospital Consumer Assessment of Healthcare Providers and Systems survey questions in …

Covid-19 And Thrombotic Or Thromboembolic Disease: Implications For Prevention, Antithrombotic Therapy, And Follow-Up: Jacc State-Of-The-Art Review, B. Bikdeli, M. V. Madhavan, D. Jimenez, T. Chuich, I. Dreyfus, E. Driggin, C. D. Nigoghossian, W. Ageno, A. C. Spyropoulos, G. Y. Lip, +10 Additional Authors

Journal Articles

© 2020 American College of Cardiology Foundation Coronavirus disease-2019 (COVID-19), a viral respiratory illness caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), may predispose patients to thrombotic disease, both in the venous and arterial circulations, because of excessive inflammation, platelet activation, endothelial dysfunction, and stasis. In addition, many patients receiving antithrombotic therapy for thrombotic disease may develop COVID-19, which can have implications for choice, dosing, and laboratory monitoring of antithrombotic therapy. Moreover, during a time with much focus on COVID-19, it is critical to consider how to optimize the available technology to care for patients without COVID-19 who have thrombotic …

Famotidine Use And Quantitative Symptom Tracking For Covid-19 In Non-Hospitalised Patients: A Case Series., T Janowitz, E Gablenz, D Pattinson, Tc Wang, J Conigliaro, K Tracey, D Tuveson

Journal Articles

No abstract provided.

The Underrecognized Prothrombotic Vascular Disease Of Covid-19., Kp Cohoon, G Mahé, Ac Spyropoulos

Journal Articles

No abstract provided.

Acute Limb Ischemia In Covid-19 Disease: A Mysterious Coagulopathy., S. Anwar, S. Acharya, S. Shabih, A. Khabut

Journal Articles

Severe coronavirus disease 2019 (COVID-19) as a respiratory tract infection has been noted to be a causative agent for acute respiratory distress syndrome, shock, and multiple organ failure. It is also being suggested that COVID-19 results in serious systemic coagulopathies similar to disseminated intravascular coagulation. We describe a case of severe arterial thrombosis induced by COVID-19 infection along with its pathological implications.

Knowledge, Attitudes, And Interactions With Chaplains And Nursing Northwell Health Outcomes: A Survey Study, T. Liberman, A. Kozikowski, M. Carney, M. Kline, A. Axelrud, A. Ofer, M. Rossetti, R. Pekmezaris

Journal Articles

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. We conducted a cross-sectional survey of nursing Northwell Health (n = 51) in an academic hospital finding a significant inverse relationship between the frequency of chaplaincy interaction and perceived stress (r = − 0.27, p = 0.05). We also found a significant positive relationship between rated importance of having a chaplain at the hospital and secondary trauma (r = 0.30, p = 0.03). There was a significant positive relationship between religiosity and rated importance for having a chaplain (r = 0.30, p = 0.03) and rated helpfulness of chaplains (r …

New Paradigms Of Extended Thromboprophylaxis In Medically Ill Patients, K. Macdougall, A. C. Spyropoulos

Journal Articles

No abstract provided.

Scientific And Standardization Committee Communication: Clinical Guidance On The Diagnosis, Prevention And Treatment Of Venous Thromboembolism In Hospitalized Patients With Covid-19., A. C. Spyropoulos, J. H. Levy, W. Ageno, J. M. Connors, B. J. Hunt, T. Iba, M. Levi, C. M. Samama, D. Giannis, +2 Additional Authors

Journal Articles

The novel coronavirus disease of 2019 (COVID-19) pandemic, as declared by the World Health Organization, is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Cardiovascular disease and, in particular, venous thromboembolism (VTE) has emerged as an important consideration in the management of hospitalized patients with COVID-19. The diagnosis of VTE using standardized objective testing is problematic in these patients, given the risk of infecting non-COVID-19 hospitalized patients and hospital personnel, coupled with the usual challenges of performing diagnostic testing in critically-ill patients. Early reports suggest a high incidence of VTE in hospitalized COVID-19 patients, particularly those with severe …

Management Of Iron-Deficiency Anemia On Inpatients And Appropriate Discharge And Follow-Up., K. Patel, Z. Memon, R. Mazurkiewicz

Journal Articles

Background:The aims of the study were to identify appropriate supplementation of iron for inpatients and to identify factors involved in appropriate discharge documentation and follow-up. Methods:This was a retrospective analysis of 103 patients at a community hospital in New York City. Results:A total of 57 (57/103, 55.3%) patients were admitted due to symptomatic anemia. Twenty (20/103, 19.4%) of those with iron-deficiency anemia had either esophagogastroduodenoscopy or colonoscopy. Gastroenterologist or hematologist was consulted for 45/103 (43.7%). Inpatient iron supplementation was given for 62/103 (60.2%) of patients; and 43/103 (41.7%) had blood transfusion. Upon discharge, 50/103 (48.5%) had appropriate documentation of iron-deficiency …

Eikenella Corrodens And Streptococcus Anginosus Co-Infection Causing Skull Base Osteomyelitis And Internal Carotid Artery Lesion, K. Patel, C. Park, Z. Memon, N. Ilyas

Journal Articles

© 2020 The Author(s) A 35-year-old male presented with headaches and fevers. MRI of his head showed skull-based infection of the clivus extended to the right internal carotid artery. Blood and sinus cultures were positive for Eikenella corrodens and Streptococcus anginosus. He had intravenous antibiotics and sinus washout. The patient had full neurological recovery following this.

Prognostic Factors For Vte And Bleeding In Hospitalized Medical Patients: A Systematic Review And Meta-Analysis, A. J. Darzi, S. G. Karam, R. Charide, I. Etxeandia-Ikobaltzeta, M. Cushman, M. K. Gould, L. Mbuagbaw, F. A. Spencer, A. C. Spyropoulos, H. J. Schunemann, +9 Additional Authors

Journal Articles

No abstract provided.

Arterial Thromboembolic Complications In Covid-19 In Low-Risk Patients Despite Prophylaxis, D. O. Griffin, A. Jensen, M. Khan, J. Chin, K. Chin, R. Parnell, C. Awwad, D. Patel

Journal Articles

No abstract provided.

Cll Intraclonal Fractions Exhibit Established And Recently Acquired Patterns Of Dna Methylation, B. A. Bartholdy, X. Wang, X. Yan, M. Pascual, M. Fan, J. Barrientos, S. L. Allen, K. R. Rai, N. Chiorazzi, S. Roa, +2 Additional Authors

Journal Articles

No abstract provided.

Society Of Behavior Medicine (Sbm) Urges Congress To Ensure Affordable Care Act Coverage Of Prostate Cancer Screening Support Services For High-Risk Men, K. Watson, J. Buscemi, M. Fitzgibbon, M. Murray, A. Murphy, M. Abern, P. Gann, J. B. Levi, M. Diefenbach, R. A. Winn, +1 Additional Author

Journal Articles

© Society of Behavioral Medicine 2019. All rights reserved. For permissions, please e-mail: [email protected]. Prostate cancer (PCa) disproportionately affects African American men. Early detection reduces risk of mortality. The United States Preventive Services Task Force (USPSTF) issued an updated recommendation statement on serum Prostate Specific Antigen (PSA)-based screening for PCa. Specifically, in 2012, the USPSTF recommended against PSA-based screening due to risk for overdiagnosis and overtreatment. However, the updated 2018 guidelines recommend consideration of screening for certain at risk men and revised the recommendation rating from "D" to "C." This new guideline recommends providers to educate high-risk men on the …

Covid-19 Induced Myocarditis: A Rare Cause Of Heart Failure., Q. Z. Iqbal, M. A. Haider, S. B. A. Sattar, M. Hanif, I. Javid

Journal Articles

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing lung injury has been well documented in the literature recently. They do so primarily by binding to the membrane-bound form of angiotensin-converting enzyme 2 (ACE-2) receptors. However, since these receptors are also expressed in the heart and blood vessels, coronavirus can also cause damage to these organs by binding to the ACE-2 receptors. A typical case of coronavirus disease 2019 (COVID-19) usually presents with respiratory symptoms like cough and shortness of breath accompanied by fever. The literature regarding this pandemic has been growing and now we know very well that the effect …

Physiologic Response To Angiotensin Ii Treatment For Coronavirus Disease 2019-Induced Vasodilatory Shock: A Retrospective Matched Cohort Study., D. E. Leisman, F. Mastroianni, G. Fisler, S. Shah, Z. Hasan, M. Narasimhan, M. D. Taylor, C. S. Deutschman

Journal Articles

Objectives:To assess the early physiologic response to angiotensin-II treatment in patients with coronavirus disease 2019-induced respiratory failure and distributive shock. Design:Retrospective consecutive-sample cohort study. Setting:Three medical ICUs in New York during the coronavirus disease 2019 outbreak. Patients:All patients were admitted to the ICU with respiratory failure and were receiving norepinephrine for distributive shock. Interventions:The treatment groups were patients who received greater than or equal to 1 hour of angiotensin-II treatment. Time-zero was the time of angiotensin-II initiation. Controls were identified using a 2:1 hierarchical process that matched for 1) date and unit of admission; 2) specific organ support modalities; 3) …

Personal Preferences For Personalised Trials Among Patients With Chronic Diseases: An Empirical Bayesian Analysis Of A Conjoint Survey., Y.K. Cheung, D. Wood, K. Zhang, T. A. Ridenour, L. Derby, T. St Onge, N. Duan, J. Duer-Hefele, K. W. Davidson, N. Moise, +1 Additional Author

Journal Articles

OBJECTIVE: To describe individual patient preferences for Personalised Trials and to identify factors and conditions associated with patient preferences.

DESIGN: Each participant was presented with 18 conjoint questions via an online survey. Each question provided two choices of Personalised Trials that were defined by up to eight attributes, including treatment types, clinician involvement, study logistics and trial burden on a patient.

SETTING: Online survey of adults with at least two common chronic conditions in the USA.

PARTICIPANTS: A nationally representative sample of 501 individuals were recruited from the Chronic Illness Panel by Harris Poll Online. Participants were recruited from several …

Scientific And Standardization Committee Communication: Clinical Guidance On The Diagnosis, Prevention And Treatment Of Venous Thromboembolism In Hospitalized Patients With Covid-19., Ac Spyropoulos, Jh Levy, W Ageno, Jm Connors, Bj Hunt, T Iba, M Levi, Cm Samama, D Giannis, Jd Douketis, +1 Additional Author

Journal Articles

No abstract provided.

Implementation Of The Management Of Anticoagulation In The Periprocedural Period App Into An Electronic Health Record: A Prospective Cohort Study, A. C. Spyropoulos, D. Giannis, J. Cohen, S. John Np, A. Myrka, D. Inlall, M. Qiu, S. Akgul, R. J. Hyman, J. J. Wang

Journal Articles

No abstract provided.

Effect Of Direct Oral Anticoagulant, Patient, And Surgery Characteristics On Clinical Outcomes In The Perioperative Anticoagulation Use For Surgery Evaluation Study., K. Macdougall, J. D. Douketis, N. Li, N. P. Clark, A. Tafur, J. D'Astous, J. Duncan, S. Schulman, A. C. Spyropoulos

Journal Articles

Introduction  The Perioperative Anticoagulation Use for Surgery Evaluation (PAUSE) Study assessed a standardized perioperative management strategy in patients with atrial fibrillation who were taking a direct oral anticoagulant (DOAC) and required an elective surgery or procedure. The aim of this substudy is to analyze the safety of this management strategy across different patient subgroups, according to four presurgical variables: (1) DOAC type and dose, (2) surgery/procedure bleed risk, (3) patient renal function, and (4) age. Methods  Clinical outcomes analyzed included major bleeding (MB), arterial thromboembolism, any bleeding, and any thromboembolism. We used descriptive statistics to summarize clinical outcomes, where the …

Access And Continuity: A Multidisciplinary Education Workshop To Teach Patient-Centered Medical Home (Pcmh) Principles, L. Block, C. Petersen, D. J. Coletti, P. Yalakkishettar, N. Lavine

Journal Articles

No abstract provided.

Predictors Of Bleeding In The Perioperative Anticoagulant Use For Surgery Evaluation Study, A. J. Tafur, N. P. Clark, A. C. Spyropoulos, N. Li, E. Kaplovitch, K. Macdougall, S. Schulman, J. A. Caprini, J. Douketis

Journal Articles

No abstract provided.

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.

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 …

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 …

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.

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. …