Internal Medicine Commons^™

Cva In Patient With Systemic Sclerosis On Aspirin Therapy: A Case Report, Rahyan Mahmud, Bianna Koutsenko, Kenneth Goich, Usaid Hasan

Rowan-Virtua Research Day

Introduction

Systemic sclerosis is an autoimmune disorder characterized by microvascular damage and multiorgan fibrosis. These patients have a higher risk of cerebrovascular events, but it is difficult to develop strategies for prevention due to limited understanding of underlying pathophysiology.

Case Presentation

A 76-year-old female with a history of systemic sclerosis presented to the emergency department with acute onset slurred speech, facial droop, and left arm pain with a National Institutes of Health (NIH) Stroke Scale of 1. She was outside the thrombolytic window. Other history includes hypertension and hyperlipidemia; both were well controlled. MRI confirmed right frontal lobe ischemic stroke …

Community-Acquired Pneumonia: A Us Perspective On The Guideline Gap, Maricar Malinis, Lilian Abbo, Jose A Vazquez, Luis Ostrosky-Zeichner

Faculty, Staff and Student Publications

Community-acquired pneumonia continues to be one of the most common causes of morbidity and mortality due to infectious disease. The aetiologies, clinical presentations, diagnostic modalities and therapeutic options are changing and outpacing the creation of management guidelines. This educational article summarizes a roundtable activity sponsored by an unrestricted educational grant by Paratek that included US experts discussing these changes and identifying gaps in the current guidelines.

Outcomes Of Mechanical Circulatory Support In Stemi Patients With Cardiogenic Shock: Insights From The National Inpatient Sample, Rahul Gupta, Chukwuemeka Umeh, Priya Hotwani Md, Gagan Kaur, Raghav Dhawan, Benson Eghreriniovo, Tamanna Mohta, Payaam Mahdavian, Eseosa Sanwo, Sabina Kumar, Mark A. Zainea, Jay Mohan

Internal Medicine Residency

Background

Methods

Results

Nationwide Outcomes In Intermediate To High-Risk Pulmonary Embolism Treated With Catheter-Based Therapies, Chukwuemeka Umeh, Rahul Gupta, Priya Hotwani Md, Sabina Kumar, Mark A. Zainea, Jay Mohan

Internal Medicine Residency

Background

Methods

In-Hospital Outcomes Of Patients With Lung Cancer With And Without Superior Vena Cava Thrombosis: A Nationwide Analysis., Ankushi Sanghvi, Dhairya Nanavaty, Sagar Patel, Bhavyakumar Vachhani, Mrunanjali Gaddam, Manasa Ginjupalli, Jayalekshmi Jayakumar, Nawaraj Adhikari, Rishav Sinha, Vikash Kumar, Priya Hotwani Md, Ahmed Nadeem

Internal Medicine Residency

Meeting Abstract: 2024 ASCO Annual Meeting

Background: Malignant superior vena cava syndrome (SVCS) is a clinical problem that results from the obstruction of blood flow in the superior vena cava by an underlying malignancy. It may be caused by external compression or internal obstruction due to a thrombus or direct invasion by tumor cells. Though lung malignancy is the most common cause of SVCS, there is a lack of data on in-hospital outcomes in these patients. Methods: We queried the National Inpatient Sample 2018-2020 to identify hospitalizations with lung cancer including both small cell and non small cell lung cancer. …

Intravascular Ultrasound In Percutaneous Coronary Interventions: A Nationwide Overview Of Its Use And Outcomes, Priya Hotwani Md, Chukwuemeka Umeh Md, Rahul Gupta, Gagan Kaur Md, Raghav Dhawan, Benson Eghreriniovo, Tamanna Mohta, Payaam Mahdavian Md, Jessica Ekomerei Obi, Eseosa Sanwo, Sabina Kumar Do, Mark A. Zainea Md Fscai, Jay Mohan Do Fscai

Internal Medicine Residency

Background

Methods

Results

Gender Disparities In Outcomes Of Left Atrial Appendage Occlusion Device Placement, Manoj Kumar, Shafaqat Ali, Faryal Farooq, Priya Hotwani Md, Sanjay Kumar

Internal Medicine Residency

Background

Objective

Methods

Propensity Matched In-Hospital Outcomes Of Acute St Elevation Myocardial Infarction Of Left Anterior Descending (Lad) Coronary Artery In Patients With & Without Chronic Total Occlusion Of Coronaries, Manoj Kumar, Shafaqat Ali, Faryal Farroq, Sanchit Duhan, Priya Hotwani Md, Bijeta Keisham, Sanjay Kumar, Mahin R. Khan

Internal Medicine Residency

Background

Methods

Results

Early Vs Late Extracorporeal Membrane Oxygenation (Ecmo) For Mechanical Circulatory Support, Manoj Kumar, Shafaqat Ali, Sanchit Duhan, Nomesh Kumar, Priya Hotwani Md, Sanjay Kumar, Fnu Bawna, Faryal Farooq, Muhammad Sultan, Muhammad Sohaib Afzal, M Chadi Alraies

Internal Medicine Residency

Background

Methods

Results

Assessing Impact Of Image-Based Immunization Education On Pediatric Vaccine Uptake Within Families Of Low English Literacy, Ahmed Ali, Mariam Bassalious, Sharfaa Chowdhury, Coral Hufnagel, Salwa Bajjey, Amaal Haimout, Nelia Afonso, Raouf Seifeldin

Posters

• Vaccinations have been hailed as the most effective public health strategy in mitigating infectious diseases. Since the advent of vaccines at the end of the 18th century, the incidence, prevalence, and mortality of vaccine-preventable diseases have markedly decreased.
• Vaccine hesitancy has been increasing within the last decade due to various reasons including misinformation and a lack of understanding. 2 This is especially true amongst patients with limited literacy skills as traditional vaccine education material is not optimal for their understanding.
• Several studies across various healthcare disciplines have shown that the use of picture-based health education for patients with limited literacy …

Ectopic Pregnancy Located At Pelvic Wall And Liver: Two Uncommon Case Reports From Vietnam And Mini-Review Literature, Thanh Hai Pham, Van Hoang Bui, Van Hung Nguyen, Phuc Nhon Nguyen

Faculty, Staff and Student Publications

INTRODUCTION AND IMPORTANCE: Abdominal ectopic pregnancy (AEP) located at hepatic region and pelvic-wall ectopic pregnancy (EP) are rare entities, that provoking a potentially life-threatening condition. Due to insufficient data, a proper management of non-specific types remains a challenge for all gynecologists worldwide.

CASE PRESENTATION: Two child-bearing age women were hospitalized due to delayed menstruation and a urine pregnancy test was positive without a determination of intrauterine pregnancy. The first EP case was located at the pelvic wall which identified incidentally during laparoscopy for a presumed tubal ectopic pregnancy on ultrasonography throughout. The second EP case was found at the hepatic …

A Multimodal Approach To Decreasing Hesitancy Of The Influenza Vaccine In The Family Care Setting, Carley J. Ellenberger

Evidence-Based Practice Project Reports

The uptake of the influenza vaccine is the most effective and proactive action an individual can take to defend themselves against the influenza outbreak each season; therefore, it is recommended that everyone at least six months of age and older should receive the annual flu vaccine (CDC, 2022; WHO, 2023). Unfortunately, influenza vaccine hesitancy is demonstrated on a global level affecting the uptake compliance annually each influenza season despite the millions of people that experience influenza symptoms annually (CDC, 2022, WHO, n.d.; Healthy People 2030, n.d.). The PICOT question for this project was in adults, over the age of 18, …

The Internist's Post V.1 N.3, The University Of Texas Rio Grande Valley. School Of Medicine, Eunbee Cho, Jian Garcia Cruz, Diana Othon Martinez, Edgar Dorsey Trevino, Ramon Elizondo Romo, Roque Mifuji, Martha Solis

School of Medicine Publications

No abstract provided.

Guidance For Assessment Of The Inflammation Etiologic Criterion For The Glim Diagnosis Of Malnutrition: A Modified Delphi Approach., Tommy Cederholm, Gordon L Jensen, Maria D Ballesteros-Pomar, Renee Blaauw, M Isabel T D Correia, Cristina Cuerda, David C Evans, Ryoji Fukushima, Juan Bernardo Ochoa Gautier, M Cristina Gonzalez, Andre Van Gossum, Leah Gramlich, Joseph Hartono, Steven B Heymsfield, Harriët Jager-Wittenaar, Renuka Jayatissa, Heather Keller, Ainsley Malone, William Manzanares, M Molly Mcmahon, Yolanda Mendez, Kris M Mogensen, Naoharu Mori, Maurizio Muscaritoli, Guillermo Contreras Nogales, Ibolya Nyulasi, Wendy Phillips, Matthias Pirlich, Veeradej Pisprasert, Elisabet Rothenberg, Marian De Van Der Schueren, Han Ping Shi, Alison Steiber, Marion F Winkler, Rocco Barazzoni, Charlene Compher

Ambulatory and Primary Care Articles

BACKGROUND & AIMS: The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation in support of the …

Natural Language Processing Of Clinical Notes Enables Early Inborn Error Of Immunity Risk Ascertainment, Kirk Roberts, Aaron T Chin, Klaus Loewy, Lisa Pompeii, Harold Shin, Nicholas L Rider

Faculty, Staff and Student Publications

BACKGROUND: There are now approximately 450 discrete inborn errors of immunity (IEI) described; however, diagnostic rates remain suboptimal. Use of structured health record data has proven useful for patient detection but may be augmented by natural language processing (NLP). Here we present a machine learning model that can distinguish patients from controls significantly in advance of ultimate diagnosis date.

OBJECTIVE: We sought to create an NLP machine learning algorithm that could identify IEI patients early during the disease course and shorten the diagnostic odyssey.

METHODS: Our approach involved extracting a large corpus of IEI patient clinical-note text from a major …

Improvements In Appropriate Placement Of Dental Sealants After Implementation Of A Clinical Decision Support System, Joanna Mullins, Ryan Brandon, Nicholas Skourtes, Elsbeth Kalenderian, Muhammad Walji

Faculty, Staff and Student Publications

BACKGROUND: Dental sealants are effective for the prevention of caries in children at elevated risk levels, and increasing the proportion of children and adolescents who have dental sealants on 1 or more molars is a Healthy People 2030 objective. Electronic health record (EHR)-based clinical decision support systems (CDSSs) have the ability to improve patient care. A dental quality measure related to dental sealant placement for children at elevated risk of caries was targeted for improvement using a CDSS.

METHODS: A validated dental quality measure was adapted to assess a patient's need for dental sealant placement. A CDSS was implemented to …

Relationship Between Food Security, Nutrition Security, And Diabetes: The Role Of Supplemental Nutrition Assistance Program Participation, Maha Almohamad, Jayna M Dave, Eric E Calloway, Ruosha Li, Shreela Sharma

Faculty, Staff and Student Publications

BACKGROUND: Inadequate nutrition and poor diet quality are associated with a heightened risk of diabetes. The connection between food insecurity measures and diabetes has been established, with evidence indicating that Supplemental Nutrition Assistance Program (SNAP) participation contributes to reductions in food insecurity. Recently developed nutrition security measures, defined as the ability to acquire healthful foods to prevent diseases, and their association with diabetes and SNAP participation are not yet understood.

OBJECTIVES: This study aimed to assess the relationship between food security and nutrition security in relation to diabetes overall and by SNAP participation and nutrition security as potential modifiers.

METHODS: …

Establishing Kidney Transplantation In A Low-Income Country: A Case In Tanzania, Francis F. Furia, Jaqueline G. Shoo, Paschal Ruggajo, Jonathan W. Jonathan W. Mngumi, Valentine Valentine, Mahmoud A. Muhiddin, Kim Kim, Isaack Mlatie, Moses Mulungu, Namala Mkopi

Internal Medicine, East Africa

Background

Sub-Saharan African countries, including Tanzania, have a high burden of chronic kidney diseases (CKDs) and limited capacity for the provision of services. Tanzania and other countries in the region have made signifcant improvements in the provision of services for patients with CKD, including hemodialysis. Few countries are ofering kidney transplantation services, which is the defnitive treatment for patients with CKD and kidney failure. This study was conducted to review the steps taken by Muhimbili National Hospital (MNH) to establish a kidney transplantation service in Tanzania.

Methods

This study was based on the review of the activities that were undertaken …

Obstacles To Optimal Antenatal Corticosteroid Administration To Eligible Patients, Kara M Rood, Lynda G Ugwu, William A Grobman, Jennifer L Bailit, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Alan T N Tita, George R Saade, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa

Faculty, Staff and Student Publications

Background

Administration of antenatal corticosteroids (ANCS) is recommended for individuals expected to deliver between 24 and 34 weeks of gestation. Properly timed administration of ANCS achieves maximal benefit. However, more than 50% of individuals receive ANCS outside the recommended window.

Objective

To examine maternal and hospital factors associated with suboptimal receipt of ANCS among individuals who deliver between 24–34 weeks gestation.

Study Design

Secondary analysis of the Assessment of Perinatal Excellence (APEX), an observational study of births to 115,502 individuals at 25 hospitals in the US from March 2008–February 2011. Data from 3123 individuals who gave birth to a non-anomalous …

Coronary Pathophysiology Underlying The Obesity Paradox, Linh Bui, Monica Patel, K Lance Gould

Faculty, Staff and Student Publications

No abstract provided.