Internal Medicine Commons^™

The Intersection Of Financial Toxicity And Family Building In Young Adult Cancer Survivors, B. Thom, C. Benedict, D. N. Friedman, J. F. Kelvin

Journal Articles

No abstract provided.

Disparities In Potentially Preventable Hospitalizations: Near-National Estimates For Hispanics, C. Feng, M. K. Paasche-Orlow, N. R. Kressin, J. E. Rosen, L. López, E. J. Kim, M. Y. Lin, A. D. Hanchate

Journal Articles

© Health Research and Educational Trust Objective: To obtain near-national rates of potentially preventable hospitalization (PPH)—a marker of barriers to outpatient care access—for Hispanics; to examine their differences from other race-ethnic groups and by Hispanic national origin; and to identify key mediating factors. Data Sources/Study Setting: Data from all-payer inpatient discharge databases for 15 states accounting for 85 percent of Hispanics nationally. Study Design: Combining counts of inpatient discharges with census population for adults aged 18 and older, we estimated age-sex-adjusted PPH rates. We examined county-level variation in race-ethnic disparities in these rates to identify the mediating role of area-level …

A Computerized Method For Measuring Computed Tomography Pulmonary Angiography Yield In The Emergency Department: Validation Study., S. Richardson, P. Solomon, A. O'Connell, S. Khan, J. Gong, A. Makhnevich, G. Qiu, M. Zhang, T. Mcginn

Journal Articles

BACKGROUND:Use of computed tomography pulmonary angiography (CTPA) in the assessment of pulmonary embolism (PE) has markedly increased over the past two decades. While this technology has improved the accuracy of radiological testing for PE, CTPA also carries the risk of substantial iatrogenic harm. Each CTPA carries a 14% risk of contrast-induced nephropathy and a lifetime malignancy risk that can be as high as 2.76%. The appropriate use of CTPA can be estimated by monitoring the CTPA yield, the percentage of tests positive for PE. This is the first study to propose and validate a computerized method for measuring the CTPA …

Improvement In Parameters Of Hematologic And Immunologic Function And Patient Well-Being In The Phase Iii Resonate Study Of Ibrutinib Versus Ofatumumab In Patients With Previously Treated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma., J. C. Barrientos, S. O'Brien, J. R. Brown, N. E. Kay, N. M. Reddy, S. Coutre, C. Tam, S. Mulligan, U. Jaeger, P. Hillmen, +18 Additional Authors

Journal Articles

BACKGROUND: Ibrutinib compared with ofatumumab significantly improves progression-free and overall survival in patients with previously treated chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).

PATIENTS AND METHODS: Measures of well-being were assessed in RESONATE, where previously treated patients with CLL/SLL were randomized to receive ibrutinib 420 mg/day (n = 195) or ofatumumab (n = 196) for up to 24 weeks. Endpoints included hematologic function, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), disease-related symptoms, European Organization for Research and Treatment of Cancer Quality of Life Questionnaires Core 30 (EORTC QLQ-C30), and medical resource utilization.

RESULTS: With up to 24 months' follow-up (median, 16.4 …

Postthrombotic Syndrome In Patients Treated With Rivaroxaban Or Warfarin For Venous Thromboembolism., C. I. Coleman, J. Beyer-Westendorf, T. J. Bunz, C. E. Mahan, A. C. Spyropoulos

Journal Articles

Postthrombotic syndrome (PTS) is a frequent complication of venous thromboembolism (VTE). Using MarketScan claims data from January 2012 to June 2015, we identified adults with a primary diagnosis code for VTE during a hospitalization/emergency department visit, ≥6 months of insurance coverage prior to the index event and newly started on rivaroxaban or warfarin within 30 days of the index VTE. Patients with

Young Adult Female Cancer Survivors' Concerns About Future Children's Health And Genetic Risk, N. J. Raghunathan, C. Benedict, B. Thom, D. N. Friedman, J. F. Kelvin

Journal Articles

No abstract provided.

The Relationship Of Physical Performance And Osteoporosis Prevention With Vitamin D In Older African Americans (Poda), R. Dhaliwal, M. Mikhail, G. Usera, A. Stolberg, S. Islam, L. Ragolia, J. F. Aloia

Journal Articles

© 2017 Elsevier Inc. Rationale Vitamin D deficiency is associated with bone loss, poor muscle strength, falls and fracture. This information in older African Americans (AAs) is sparse. Objective The study of the relationship of Physical performance, Osteoporosis prevention with vitamin D in older African Americans (PODA) is a randomized, double-blind, placebo-controlled 3-year trial examining the effect of vitamin D on bone loss and physical performance in older AA women. Methods 260 healthy AA women aged > 60 years were assigned to receive placebo or vitamin D3. Initial vitamin D3dose was determined by the baseline serum 25OHD level, and adjusted further …

Mycobacterium Tuberculosis Infection In The Setting Of Interstitial Lung Disease: Coincidence Or Bad Luck?, Christian Wong, Sonu Sahni, Muhammad Azaz I. Cheema, Asma Iftikhar

Touro College of Osteopathic Medicine (New York) Publications and Research

Mycobacterium tuberculosis (MTB) infection is the ninth leading cause of death worldwide, with many individuals with undiagnosed active or latent disease. The presence of parenchymal lung disease, such as interstitial lung disease (ILD), has been suggested to increase the risk of pulmonary tuberculosis (TB). In the clinical setting of ILD, the diagnosis of an underlying MTB infection may be challenging due to the interstitial process and underlying fibrosis, which may mask the infection. An atypical presentation and misleading radiological patterns may delay the diagnosis of the underlying MTB infection. Herein, we describe a unique case of ILD complicated by active …

Successful Pulmonary Thromboendarterectomy In A Patient With Sickle Cell Disease And Associated Resolution Of A Leg Ulcer, A. Agrawal, R. Shah, M. D. Bacchetta, A. Talwar

Journal Articles

© 2017 Indian Chest Society | Published by Wolters Kluwer -Medknow. Pulmonary hypertension (PH) is a relatively frequent and severe complication of sickle cell disease (SCD). PH associated with SCD is classified as Group 5 PH. The exact pathogenesis of PH in SCD in not known. There are also very limited treatment options available at this time for such patients with Group 5 PH. Patients with SCD are predisposed to a hypercoagulable state and thus can also suffer from chronic thromboembolism. These patients can have associated chronic thromboembolic pulmonary hypertension (CTEPH), thus being classified as Group 4 PH. We present …

Prostate Cancer Patients’ Understanding Of The Gleason Scoring System: Implications For Shared Decision-Making, E. K. Tagai, S. M. Miller, A. Kutikov, M. A. Diefenbach, R. A. Gor, T. Al-Saleem, D. Y. Chen, S. Fleszar, G. Roy

Journal Articles

© 2018 American Association for Cancer Education The Gleason scoring system is a key component of a prostate cancer diagnosis, since it indicates disease aggressiveness. It also serves as a risk communication tool that facilitates shared treatment decision-making. However, the system is highly complex and therefore difficult to communicate: factors which have been shown to undermine well-informed and high-quality shared treatment decision-making. To systematically explore prostate cancer patients’ understanding of the Gleason scoring system (GSS), we assessed knowledge and perceived importance among men who had completed treatment (N = 50). Patients were administered a survey that assessed patient knowledge and …

Reduction In Social Activities Mediates The Relationship Between Diarrhea And Distress In Rectal/Anal Cancer Survivors, C. Benedict, K. Duhamel, C. J. Nelson

Journal Articles

No abstract provided.

Streptococcus Intermedius Brain And Diverticular Abscesses After Dental Manipulation: A Case Report., H. Al Moussawi, M. Krzyzak, Z. Awada, J. M. Chalhoub

Journal Articles

A brain abscess is defined as a focal intracerebral infection consisting of an encapsulated collection of pus, which can be a life-threatening complication of infections, trauma, or surgery. While immunocompromised patients can have a wide array of causative organisms, bacterial species represent the most common etiology in immunocompetent individuals. The incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000, with a high predisposition among immunocompromised patients and in those with disruption of the blood-brain barrier. The most common causative organisms found were Streptococcus species, particularly S. viridians and S. pneumonia, Enterococcus, and Staphylococcus species, mainly S. aurieus and …

Alk-Negative Anaplastic Large Cell Lymphoma Presenting As Disseminated Intravascular Coagulation And Hemophagocytic Lymphohistiocytosis: A Potentially Fatal Presentation., U. Ibrahim, A. Saqib, M. Rehan, J. P. Atallah

Journal Articles

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder that can be familial in etiology or a result of infections, malignancy, and autoimmune or inflammatory disorders. Disseminated intravascular coagulation (DIC) is common in patients admitted to intensive care units and can confound and delay the diagnosis of HLH. We present a case of a 69-year-old female who presented with dyspnea and malaise. Her condition declined rapidly with laboratory parameters consistent with DIC. In addition, she had a ferritin of 32,522 ng/mL, low haptoglobin, and elevated LDH, and bone marrow biopsy showed hemophagocytic lymphohistiocytes. She was started on HLH-directed therapy, and later, a …

Indwelling Pleural Catheters: Complications And Management Strategies, M. Chalhoub, A. Saqib, M. Castellano

Journal Articles

©Journal of Thoracic Disease. Indwelling pleural catheters (IPCs) are increasingly being used for patients with recurrent malignant pleural effusions. They are simple to place and can be done on an outpatient basis under local anesthesia. IPCs uniformly relieve dyspnea and improve quality of life of patients with malignant pleural effusions. In some patients with recurrent non-malignant pleural effusions, IPCs proved to be effective as well. With increasing use of IPCs, physicians and patients are faced with complications related to the presence of an indwelling catheter for extended periods of time. The purpose of this review is to describe the various …

Computerized Cognitive Training In Prostate Cancer Patients On Androgen Deprivation Therapy: A Pilot Study, L. M. Wu, A. Amidi, M. L. Tanenbaum, G. Winkel, W. A. Gordon, S. J. Hall, K. Bovbjerg, M. A. Diefenbach

Journal Articles

© 2017, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Prostate cancer patients who have undergone androgen deprivation therapy (ADT) may experience cognitive impairment, yet there is an unmet need for nonpharmacological interventions to address cognitive impairment in this population. This study examines the feasibility, acceptability, and preliminary efficacy of a home-based computerized cognitive training (CCT) program to treat cancer-related cognitive impairment. Methods: Sixty men who had received ≥ 3 months of ADT were screened for at least mild cognitive or neurobehavioral impairment and randomized to 8 weeks of CCT or usual care. Follow-up assessments occurred immediately post-intervention or equivalent …

Examining The Impact Of A Multimedia Intervention On Treatment Decision-Making Among Newly Diagnosed Prostate Cancer Patients: Results From A Nationwide Rct., M. A. Diefenbach, C. Benedict, S. M. Miller, A. L. Stanton, M. E. Ropka, K. Wen, N. E. Mohamed, S. J. Hall

Journal Articles

Men diagnosed with early stage prostate cancer face multiple treatment options, each with distinctive side effects that have significant implications for post-treatment quality of life. Healing Choices for Men with Prostate Cancer is a multimedia educational and decision aid program. This nation-wide randomized controlled trial evaluated the impact of Healing Choices on reducing decisional conflict and distress. Eligible prostate cancer patients who called the National Cancer Institute's Cancer Information Service (CIS) were invited to participate. After a baseline interview, participants were randomized to usual personalized consultation with a CIS specialist (comparison condition) or CIS personalized consultation plus the Healing Choices …

Racial And Ethnic Disparities In Diagnosis Of Chronic Medical Conditions In The Usa, E. J. Kim, T. Kim, J. Conigliaro, J. M. Liebschutz, M. K. Paasche-Orlow, A. D. Hanchate

Journal Articles

No abstract provided.

Is 30-Day Posthospitalization Mortality Lower Among Racial/Ethnic Minorities?: A Reexamination, M. Lin, N. R. Kressin, M. K. Paasche-Orlow, E. J. Kim, L. Lopez, J. E. Rosen, A. D. Hanchate

Journal Articles

No abstract provided.

Nephrocutaneous Fistula Due To Xanthogranulomatous Pyelonephritis, Simcha Weissman, Madeeha Ghaffar, Dana Safavian, Sharma Rubal, Anthony Khabut, Mohammad G. Maruf, Michael Krzyzak

Touro College of Osteopathic Medicine (New York) Publications and Research

While the development of a fistulous tract from the kidney to the proximal adjacent organs is relatively common, a tract leading to the skin is a rare occurrence. The primary cause of a fistula is prior surgical intervention or malignancy leading to abscess formation. Our case involves Xanthogranulomatous pyelonephritis (XGP) causing a longstanding lobulated abscess, ultimately leading to the formation of a fistulous tract.

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 …