Internal Medicine Commons^™

Contact And Sars-Cov-2 Infections Among College Football Athletes In The Southeastern Conference During The Covid-19 Pandemic, Benika C. Dixon, Rebecca S.B. Fischer, Hongwei Zhao, Catherine S. O'Neal, James R. Clugston, Shawn G. Gibbs

School of Medicine Faculty Publications

No abstract provided.

Androgen Receptor Signaling In Prostate Cancer And Therapeutic Strategies, Aasems Jacob, Rishi Raj, Derek B. Allison, Zin W. Myint

Markey Cancer Center Faculty Publications

Understanding of the molecular mechanisms of prostate cancer has led to development of therapeutic strategies targeting androgen receptor (AR). These androgen-receptor signaling inhibitors (ARSI) include androgen synthesis inhibitor-abiraterone and androgen receptor antagonists-enzalutamide, apalutamide, and darolutamide. Although these medications provide significant improvement in survival among men with prostate cancer, drug resistance develops in nearly all patients with time. This could be through androgen-dependent or androgen-independent mechanisms. Even weaker signals and non-canonical steroid ligands can activate AR in the presence of truncated AR-splice variants, AR overexpression, or activating mutations in AR. AR splice variant, AR-V7 is the most studied among these and …

The Impact Of Outpatient Laboratory Alerting Mechanisms In Patients With Aki, Nicole V Tolan, Salman Ahmed, Tolumofe Terebo, Zain M Virk, Athena K Petrides, Jaime R Ransohoff, Christiana A Demetriou, Yvelynne P Kelly, Stacy E F Melanson, Mallika L Mendu

Faculty, Staff and Students Publications

BACKGROUND: AKI is an abrupt decrease in kidney function associated with significant morbidity and mortality. Electronic notifications of AKI have been utilized in patients who are hospitalized, but their efficacy in the outpatient setting is unclear.

METHODS: We evaluated the effect of two outpatient interventions: an automated comment on increasing creatinine results (intervention I; 6 months;

RESULTS: Providers were more likely to document AKI in interventions I (

CONCLUSIONS: An automated comment was associated with improved documented recognition of AKI and the additive intervention of an email alert was associated with increased discontinuation of nephrotoxins, but neither improved clinical outcomes. …

The Compounding Effect Of Rurality On Health Disparities Among Black Patients With Covid-19, Jessica E. Johnson, Ruchi Bhandari, Allison Lastinger, Rebecca Reece

Journal of Appalachian Health

Background: West Virginia had garnered national attention for its vaccination rollout against coronavirus 2019 (COVID-19). Outcomes of this mostly rural population, however, have been underreported. As the pandemic continues, identifying high risk populations remains important to further epidemiologic information and target vaccines.

Purpose: The objective of this study is to examine the effects of COVID-19 and the influence of race and rurality on hospitalization and outcomes in Appalachians.

Methods: In this retrospective study, data from patients who tested positive and were admitted for COVID-19 and seen within the state’s largest health system (West Virginia University Health System) between March …

A Rare Case Of Acute Hepatitis C Causing Coagulopathy And Severe Transaminitis, Timothy Kuchera, Md, Muyi Li, Md, Corey O'Brien, Md

Department of Medicine Posters

• Although Hepatitis C (HCV) is extremely common, diagnosis of acute HCV is as rare as it is typically asymptomatic.
• The following is an uncommon presentation of symptomatic acute HCV resulting in sepsis, transaminitis, jaundice, and coagulopathy.

Hyperckemia : Psychosis-Induced Non-Traumatic Rhabdomyolysis, Mackenzie Kramer, Joann Butkus, Vincent Chan, Nathaniel Rosal, Stephanie Tzarnas, Eunha Kim

Abington Jefferson Health Posters

Rhabdomyolysis is a clinical syndrome that results from skeletal muscle breakdown and the release of intracellular enzymes into systemic circulation. We present a case of transaminitis and serum Creatinine Kinase (CK) levels exceeding 590,000 U/L without myoglobinuria or subsequent Acute Kidney Injury (AKI) after an acute psychotic episode. Case reports regarding such extreme serum CK elevations without myoglobinuria or ensuing renal failure in a non-traumatic case of rhabdomyolysis are minimal.

Clinical Challenges In The Diagnosis And Treatment In Neurosarcoidosis And Neurosyphilis, Mackenzie Kramer, Melissa Margolis, Neelima Manda, Rehan Saeed, Stephanie Tzarnas, Nathaniel R. Rosal, Daniel Puga, Rebecca Fallis

Abington Jefferson Health Posters

Syphilis and sarcoidosis, both known as the "great mimickers," cause a wide range of symptoms making clinical differentiation between the two difficult.

We present a case in which both neurosarcoidosis and neurosyphilis were considered in the differential diagnosis, posing a unique challenge in decision making.

Metastatic Choriocarcinoma In A Young Woman Presenting As Thyroid Storm: A Case Report, Muhammad Saleem, Sher Sethi, Abrar Ali, Zareen Kiran,

Department of Medicine

Background: Thyroid storm is an endocrine emergency and life-threatening condition discovered in 1926. There is no specific laboratory parameter that can differentiate or distinguish between thyroid storm and primary hyperthyroidism. Diagnosis is made on a clinical scoring system, including the Burch-Wartofsky point scale and Japanese Thyroid Association scoring system. The management is early diagnosis, immediate initiation of anti-thyroid medications, intensive care monitoring, and prevention of multiorgan failure.
Case presentation: A 30-year-old Pakistani female presented with complaint of headache, vomiting, and generalized weakness for 3 weeks. She had an episode of seizure-like activity at home, and so was rushed to the …

Patient And Clinician Characteristics That Predict Breast Cancer Screening Behavior In 40–49-Year-Old Women, Sarina Schrager, Claudia Evaristo, Terry Little, Lori Dubenske, Elizabeth S. Burnside

Journal of Patient-Centered Research and Reviews

Guidelines recommend that clinicians practice shared decision-making (SDM) with women in their 40s to discuss breast cancer screening. Traditionally, SDM includes discussion of values and preferences to help determine a decision that is congruent with what the patient desires. We analyzed 54 women’s breast cancer screening decisions after a SDM conversation with their clinician. We looked at both patient and clinician characteristics that predicted whether or not a woman would get a screening mammogram. Women with a family history of breast cancer or who had a previous abnormal mammogram had higher rates of screening. Screening rates also varied widely between …

Increasing Breast, Cervical, And Colorectal Cancer Screenings: A Qualitative Assessment Of Barriers And Promoters In Safety-Net Practices, Laura A. Brady, Laurene M. Tumiel-Berhalter, Laura A. Schad, Alexandrea Bentham, Karen Vitale, Amanda Norton, Gary Noronha, Carlos Swanger, Christopher P. Morley

Journal of Patient-Centered Research and Reviews

Purpose: Breast, cervical, and colorectal cancer screening rates are suboptimal in underserved populations. A 7-year quality improvement (QI) project implemented academic detailing and practice facilitation in safety-net primary care practices to increase cancer screening rates. This manuscript assesses barriers and promoters.

Methods: Primary care practices providing care to underserved patients were recruited in New York cities Buffalo, Rochester, and Syracuse. Enrollment totaled 31 practices, with 12 practices participating throughout. Annually, each practice received 6 months of practice facilitation support for development and implementation of evidence-based interventions to increase screening rates for the three cancer types. At the end of each …

Improving Cancer Screening Rates In Primary Care Via Practice Facilitation And Academic Detailing: A Multi-Pbrn Quality Improvement Project, Christopher P. Morley, Laura A. Schad, Laurene M. Tumiel-Berhalter, Laura A. Brady, Alexandrea Bentham, Karen Vitale, Amanda Norton, Gary Noronha, Carlos Swanger

Journal of Patient-Centered Research and Reviews

Purpose: In the United States, cancer screening rates are often below national targets. This project implemented practice facilitation and academic detailing aimed at increasing breast, cervical, and colorectal cancer screening rates in safety-net primary care practices.

Methods: Three practice-based research networks across western and central New York State partnered to provide quality improvement strategies on breast, cervical, and colorectal cancer screening. Pre/postintervention screening rates for all participating practices were collected annually, as were means across all practices over 7 years. Simple ordinary least squares linear regression was used to calculate the trend for each cancer type and test for statistical …

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.

Assessment Of Macronutrients Consumption In The Diet Of Adolescent School Children In Four Seasons: A Longitudinal Study From An Urban City In Pakistan, Syed Hasan Raza Abidi, Aysha Almas, Abdul Ghani, Sania Sabir, Romaina Iqbal

Medical College Documents

Background: A healthy diet in the adolescence period is essential for physical, mental, and immunological development. We aimed to assess macronutrient consumption in the diet of adolescent school children using 24 h recalls in four seasons of the year.
Method: This was a longitudinal study conducted from February 2014 to June 2015. The study population included 155 school children aged 7-14 years from an urban school in Karachi. 24HR recall was conducted on 4 random days of the 4 main seasons. A food composition table was developed where the weight, calories, carbohydrate, fat, and protein content of the food items …

Exploring Perceived Importance Of A Novel Emergency Food Program During Covid-19 And Program Recipient Characteristics, Makenzie L. Barr, Kendra Oonorasak, Kristin Hughes, Lauren Batey, Kaela Jackson, Haley Marshall, Tammy Stephenson

Dietetics and Human Nutrition Faculty Publications

Following rising unemployment rates and consequent loss of income due to COVID-19, many people have been seeking meal assistance. This study examines the impact of a community-based free meal distribution program during the pandemic in Kentucky, reviewing characteristics of recipients of the program. Demographics, health behaviors, food insecure classification, and rating of importance of the meal program were collected. Qualitative feedback on the impact of the program was collected via open response. Of the 92 participants using the meal service, the cohort was female, Black, 43 years of age (43.5 ± 15.0 years), with a household income under 30,000 USD …

A Novel Combination Chemotherapy Targeting Extramedullary Disease In Multiple Myeloma Following First-Line Treatment Failure, Ruaa M. Elteriefi, Nourelhuda Abbas Hamed, Omar Nasser Rahal, Faisal Musa

Conference Presentation Abstracts

Introduction:

Multiple Myeloma (MM), a plasma cell neoplasm that resides in the bone marrow’s intramedullary space.

Extramedullary disease (EMD) occurs when plasma cells extend through the bone cortex or via hematogenous spread to different organs.

This case of EMD of MM didn’t respond to the first line RVD regimen per NCCN guidelines which includes Lenalidomide (Revlimid), Bortezomib (Velcade), and Dexamethasone (Decadron). Therefore, new combination chemotherapy including Daratumumab, and Carfilzomib was initiated with excellent response.

Case description:

62-year-old female presenting to the oncologist for progressive right hip pain for 4 weeks. Initial hip x-ray and bone scan suspected malignancy. MRI showed …

Hypercalcaemia Caused By Sunflower Seeds And Calcium Carbonate Supplements, Iqra Patoli, Mehrunissa Kazim, Saad Bin Jamil, Syed Hassan Abbas

Department of Medicine Faculty Papers

INTRODUCTION: Hypercalcaemia is commonly associated with malignancy or endocrinological disorders. However, sometimes it can occur due to increased oral intake of calcium. We present an interesting case of hypercalcaemia due to ingestion of sunflower seeds and calcium carbonate supplements.

CASE DESCRIPTION: We present the case of a 53-year-old man with history of T-cell lymphoma and gastroesophageal reflux disease who was brought to the emergency room due to altered mental status, nausea, vomiting and abdominal pain. His calcium level was 3.30 mmol/l (normal value 2.23-2.58 mmol/l). Imaging studies were unremarkable. The patient was hydrated with normal saline and calcium levels improved. …

Neuroimaging Referral For Reassurance In Evaluation Of Headache With Low-Risk Features, Omar E. Fernandez

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Howard L, Wessely S, Leese M, et al. Are investigations anxiolytic or anxiogenic? A randomised controlled trial of neuroimaging to provide reassurance in chronic daily headache. J Neurol Neurosurg Psychiatry. 2005;76(11):1558-1564. https://doi.org/10.1136/jnnp.2004.057851

for a patient with daily headache.

Peritoneal Dialysis Vs. Hemodialysis: The Choice Of Modality Of Dialysis May Drastically Affect The Quality Of Life Of Patients Initiating Dialysis, Deepa Daryani

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Jung HY, Jeon Y, Park Y, et al. Better Quality of Life of Peritoneal Dialysis compared to Hemodialysis over a Two-year Period after Dialysis Initiation. Sci Rep. Jul 16 2019;9(1):10266. https://doi.org/10.1038/s41598-019-46744-1

for a young patient initiating dialysis.

Using A Single Tablet Regimen Of Darunavir, Cobicistat, Emcitrabine, And Tenofovir Alafenamide In Virally Suppressed Hiv-1 Patients Is An Adequate Treatment Option For Controlling Hiv, Priya Kathuria

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Orkin C, Molina JM, Negredo E, et al. Efficacy and safety of switching from boosted protease inhibitors plus emtricitabine and tenofovir disoproxil fumarate regimens to single-tablet darunavir, cobicistat, emtricitabine, and tenofovir alafenamide at 48 weeks in adults with virologically suppressed HIV-1 (EMERALD): a phase 3, randomised, non-inferiority trial. Lancet HIV. 2018;5(1):e23-e34. https://doi.org/10.1016/S2352-3018(17)30179-0

for a patient with viriologically suppressed HIV-1.

Remdesivir Has Questionable Efficacy In Patients With Severe Covid-19 Receiving High-Flow Oxygen, Gabriel Burdick

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the Treatment of Covid-19 — Final Report. N Engl J Med. 2020;383:1813-1826. https://doi.org/10.1056/NEJMoa2007764

for a patient with severe COVID-19.