Try a new search

Format these results:

Searched for:

department:Medicine. General Internal Medicine

recentyears:2

school:SOM

Total Results:

14494


An Exploratory Study of Goals of Care Conversations Initiated with Seriously Ill Veterans in the Emergency Room

Foglia, Mary Beth; Cohen, Jennifer H; Batten, Adam; Alfandre, David
PMID: 33170071
ISSN: 1557-7740
CID: 4675912

Informed Consent by Any Other Name: Consent Processes for Emergency Use Authorization

Weaver, Meaghann S; Alfandre, David J
PMID: 33645658
ISSN: 1552-4604
CID: 4825832

Mineralocorticoid Receptor Antagonists and Cardiovascular Health with Kidney Failure [Editorial]

Soomro, Qandeel H; Charytan, David M
PMID: 34117077
ISSN: 1555-905x
CID: 4900872

Morbid obesity but not obesity is associated with increased mortality in patients undergoing endoscopic retrograde cholangiopancreatography: A national cohort study

Chen, Bing; Yo, Chia-Hung; Patel, Ramya; Liu, Bolun; Su, Ke-Ying; Hsu, Wan-Ting; Lee, Chien-Chang
BACKGROUND:The relationship between body weight and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) is unclear. OBJECTIVES:This study aimed to investigate the impact of obesity and morbid obesity on mortality and ERCP-related complications in patients who underwent ERCP. METHODS:We conducted a US population-based retrospective cohort study using the Nationwide Readmissions Databases (2013-2014). A total of 159,264 eligible patients who underwent ERCP were identified, of which 137,158 (86.12%) were normal weight, 12,522 (7.86%) were obese, and 9584 (6.02%) were morbidly obese. The primary outcome was in-hospital mortality. The secondary outcomes were the length of stay, total cost, and ERCP-related complications. Multivariate analysis and propensity score (PS) matching analysis were performed. The analysis was repeated in a restricted cohort to eliminate confounders. RESULTS:Patients with morbid obesity, as compared to normal-weight patients, were associated with a significantly higher in-hospital mortality (hazard ratio [HR]: 5.54; 95% confidence interval [CI]: 1.23-25.04). Obese patients were not associated with significantly different mortality comparing to normal weight (HR: 1.00; 95% CI: 0.14-7.12). Patients with morbid obesity were also found to have an increased length of hospital stay and total cost. The rate of ERCP-related complications was comparable among the three groups except for a higher cholecystitis rate after ERCP in obese patients. CONCLUSIONS:Morbid obesity but not obesity was associated with increased mortality, length of stay, and total cost in patients undergoing ERCP.
PMCID:8259364
PMID: 33951338
ISSN: 2050-6414
CID: 5046132

Mapping the Clinical Experience of a New York City Residency Program During the COVID-19 Pandemic

Rhee, David W; Pendse, Jay; Chan, Hing; Stern, David T; Sartori, Daniel J
The COVID-19 pandemic has dramatically disrupted the educational experience of medical trainees. However, a detailed characterization of exactly how trainees' clinical experiences have been affected is lacking. Here, we profile residents' inpatient clinical experiences across the four training hospitals of NYU's Internal Medicine Residency Program during the pandemic's first wave. We mined ICD-10 principal diagnosis codes attributed to residents from February 1, 2020, to May 31, 2020. We translated these codes into discrete medical content areas using a newly developed "crosswalk tool." Residents' clinical exposure was enriched in infectious diseases (ID) and cardiovascular disease content at baseline. During the pandemic's surge, ID became the dominant content area. Exposure to other content was dramatically reduced, with clinical diversity repopulating only toward the end of the study period. Such characterization can be leveraged to provide effective practice habits feedback, guide didactic and self-directed learning, and potentially predict competency-based outcomes for trainees in the COVID era.
PMCID:8191765
PMID: 34129487
ISSN: 1553-5606
CID: 4911612

Linoleic acid (LA) and α-linolenic acid (ALA) inhibit conjugative transfer of an IncX4 plasmid carrying mcr-1

Li, Gong; Xia, Li-Juan; Zhou, Shi-Ying; Wang, Xi-Ran; Cui, Cao-Yue; He, Yu-Zhang; Diao, Xiao-Yuan; Liu, Ming; Lian, Xin-Lei; Kreiswirth, Barry N; Liu, Ya-Hong; Liao, Xiao-Ping; Chen, Liang; Sun, Jian
AIMS/OBJECTIVE:The aim at this study was to determine the effects of unsaturated fatty acids on clinical plasmids. METHODS AND RESULTS/RESULTS:, respectively, were used to assess the effects on conjugative transfer of a mcr-1-harboring plasmid pCSZ4 (IncX4) in conjugation experiment. The inhibitory mechanisms were analyzed by molecular docking and the gene expression of virB11 was quantitated by qRT-PCR. Target plasmid diversity was carried out by TrwD/VirB11 homology protein sequence prediction analysis. Our results showed that LA and ALA inhibit plasmid pCSZ4 transfer by binding to the amino acid residues (Phe124 and Thr125) of VirB11 with dose-dependent effects. The expression levels of virB11 gene were also significantly inhibited by LA and ALA treatment. Protein homology analysis revealed a wide distribution of TrwD/VirB11-like genes among over 37 classes of plasmids originated from both Gram-negative and Gram-positive bacteria, CONCLUSIONS: This study demonstrates representing a diversity of plasmids that may be potentially inhibited by unsaturated fatty acids. SIGNIFICANCE AND IMPACT OF STUDY/CONCLUSIONS:Our work reported here provides additional support for application of curbing the spread of multiple plasmids by unsaturated fatty acids.
PMID: 33034112
ISSN: 1365-2672
CID: 4627262

In-Hospital 30-Day Survival Among Young Adults With Coronavirus Disease 2019: A Cohort Study

Richardson, Safiya; Gitlin, Jordan; Kozel, Zachary; Levy, Sera; Rahman, Husneara; Hirsch, Jamie S; McGinn, Thomas; Diefenbach, Michael A
Background/UNASSIGNED:Our objective was to characterize young adult patients hospitalized with coronavirus disease 2019 (COVID-19) and identify predictors of survival at 30 days. Methods/UNASSIGNED:This retrospective cohort study took place at 12 acute care hospitals in the New York City area. Patients aged 18-39 hospitalized with confirmed COVID-19 between March 1 and April 27, 2020 were included in the study. Demographic, clinical, and outcome data were extracted from electronic health record reports. Results/UNASSIGNED:= .002) were independent predictors of in-hospital 30-day mortality. Conclusions/UNASSIGNED:Obesity was identified as the strongest negative predictor of 30-day in-hospital survival in young adults with COVID-19.
PMCID:8135976
PMID: 34183983
ISSN: 2328-8957
CID: 4996232

Response to Mindfulness-Based Cognitive Therapy Differs Between Chronic and Episodic Migraine

Seng, Elizabeth K; Conway, Alexandra B; Grinberg, Amy S; Patel, Zarine S; Marzouk, Maya; Rosenberg, Lauren; Metts, Christopher; Day, Melissa A; Minen, Mia T; Buse, Dawn C; Lipton, Richard B
Objective/UNASSIGNED:Evaluate whether the benefits of Mindfulness-Based Cognitive Therapy for Migraine (MBCT-M) on headache disability differs among people with episodic and chronic migraine (CM). Methods/UNASSIGNED:This is a planned secondary analysis of a randomized clinical trial. After a 30-day baseline, participants were stratified by episodic (6-14 d/mo) and CM (15-30 d/mo) and randomized to 8 weekly individual sessions of MBCT-M or wait list/treatment as usual (WL/TAU). Primary outcomes (Headache Disability Inventory; Severe Migraine Disability Assessment Scale [scores ≥ 21]) were assessed at months 0, 1, 2, and 4. Mixed models for repeated measures tested moderation with fixed effects of treatment, time, CM, and all interactions. Planned subgroup analyses evaluated treatment*time in episodic and CM. Results/UNASSIGNED:= 0.268). Conclusions/UNASSIGNED:MBCT-M is a promising treatment for reducing headache-related disability, with greater benefits in episodic than CM. Trial Registration Information/UNASSIGNED:ClinicalTrials.gov Identifier: NCT02443519. Classification of Evidence/UNASSIGNED:This study provides Class III evidence that MBCT-M reduces headache disability to a greater extent in people with episodic than CM.
PMCID:8382359
PMID: 34484887
ISSN: 2163-0402
CID: 5069652

Systems-Level Reforms to the US Resident Selection Process: A Scoping Review

Zastrow, Ryley K; Burk-Rafel, Jesse; London, Daniel A
Background/UNASSIGNED:Calls to reform the US resident selection process are growing, given increasing competition and inefficiencies of the current system. Though numerous reforms have been proposed, they have not been comprehensively cataloged. Objective/UNASSIGNED:This scoping review was conducted to characterize and categorize literature proposing systems-level reforms to the resident selection process. Methods/UNASSIGNED:Following Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, searches of Embase, MEDLINE, Scopus, and Web of Science databases were performed for references published from January 2005 to February 2020. Articles were included if they proposed reforms that were applicable or generalizable to all applicants, medical schools, or residency programs. An inductive approach to qualitative content analysis was used to generate codes and higher-order categories. Results/UNASSIGNED:Of 10 407 unique references screened, 116 met our inclusion criteria. Qualitative analysis generated 34 codes that were grouped into 14 categories according to the broad stages of resident selection: application submission, application review, interviews, and the Match. The most commonly proposed reforms were implementation of an application cap (n = 28), creation of a standardized program database (n = 21), utilization of standardized letters of evaluation (n = 20), and pre-interview screening (n = 13). Conclusions/UNASSIGNED:This scoping review collated and categorized proposed reforms to the resident selection process, developing a common language and framework to facilitate national conversations and change.
PMCID:8207920
PMID: 34178261
ISSN: 1949-8357
CID: 4964962

Assessment of quantitative [18F]Sodium fluoride PET measures of knee subchondral bone perfusion and mineralization in osteoarthritic and healthy subjects

Watkins, L; MacKay, J; Haddock, B; Mazzoli, V; Uhlrich, S; Gold, G; Kogan, F
OBJECTIVE:F]NaF uptake in subchondral bone of individuals with and without knee osteoarthritis (OA). METHODS:) were evaluated using the Hawkins 3-compartment model. Measures were compared between structurally normal-appearing bone regions and those with structural findings. RESULTS:, and extraction fraction were significantly different between Healthy subjects and subjects with OA. Between-group differences in metabolic parameters were observed both in regions where the OA group had degenerative changes as well as in regions that appeared structurally normal. CONCLUSIONS:F]NaF PET imaging can complement assessments of structural abnormalities observed on MRI.
PMCID:8159876
PMID: 33639259
ISSN: 1522-9653
CID: 5579182