SVOA Medical Research最新文献

{"title":"Broken Heart! Surprised to Know Why!","authors":"Sumon Kumar Nag, Iyare Nehikhare, Surojit Bose","doi":"10.58624/svoamr.2024.02.010","DOIUrl":"https://doi.org/10.58624/svoamr.2024.02.010","url":null,"abstract":"A 70-year-old female attended the emergency department with cardiac sounding chest pain, cough, new concerning ECG changes and recent history of long flight. Her cardiac enzymes were elevated raising the suspicion of Acute Coronary syndrome. She was taken for urgent percutaneous coronary intervention which did not reveal any significant obstructive coronary artery disease however, ventriculogram revealed severe left ventricular systolic dysfunction (LVSD) with typical apical akinesis resembling takatsubo. A transthoracic echocardiogram confirmed severely reduced left ventricular ejection fraction. In addition, she was also treated for pneumonia which was the possible trigger of the event.","PeriodicalId":345295,"journal":{"name":"SVOA Medical Research","volume":"15 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140375804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure Changes During the Normal Menstrual Cycle in Adolescent Females","authors":"Dixa B Thakrar","doi":"10.58624/svoamr.2024.02.009","DOIUrl":"https://doi.org/10.58624/svoamr.2024.02.009","url":null,"abstract":"Study Objective: The objective of this study was to investigate blood pressure (BP) changes during the menstrual cycle in adolescents. Methods: Prospective primary data collection study. Systolic (SBP) and diastolic (DBP) pressures were measured from 22 female and 5 control male adolescents, daily for eight weeks. Readings taken on and after the onset of the first menstruation contributed to the primary analysis. Readings taken before this, in their previous cycle, were used to investigate consistency in trends observed in the primary analysis. BP was compared between different phases of the cycle. Results: The primary analysis revealed that adjusted SBP was non-significantly higher in the luteal phase than follicular by 0.61mmHg (95%CI: -1.29to3.51; P=0.53). There was no statistical difference in DBP between the phases -0.07 (-1.62to1.48; P=0.93). In the previous cycle, however, SBP and DBP were higher during the follicular phase than the luteal (P=0.02 for both). This finding may be due to greater stress response, as these measurements were taken earlier in the experiment. Stress response is likely to affect the follicular phase more, as it is the first phase. This phenomenon was also observed in the male controls. Conclusions: BP does not change during the menstrual cycle in adolescents. This has potential clinical implications. Physicians cannot attribute BP variations in adolescent females to their menstrual cycle and therefore may warrant further investigation. Another finding is that researchers investigating BP should consider a long familiarization period, between subjects and the experimental environment, to minimize stress response.","PeriodicalId":345295,"journal":{"name":"SVOA Medical Research","volume":"131 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival in Newly Created Hospital Units in Response to COVID 19 Pandemic Crisis","authors":"M. Cao, K. Bridges, P. Vemulapalli, Jaime Sexton, B. Gilchrist","doi":"10.58624/svoamr.2023.01.006","DOIUrl":"https://doi.org/10.58624/svoamr.2023.01.006","url":null,"abstract":"Importance: New York City (NYC) was the first major US city struck by the novel Coronavirus (COVID-19) with significant infection rates, mechanical intubations, and subsequent mortality. New hospital units were created to accommodate the surge of pandemic patients. Objective: The objective of this study is to examine the outcomes of COVID-19 patients admitted to a community teaching NYC hospital with newly created units and compare them to outcomes of patients admitted to established hospital units to determine if there is a mortality difference. Design: We retrospectively collected data on patients hospitalized with laboratory-confirmed COVID-19 infection between March 8, 2020 and April 7, 2020. Included were patient demographics, comorbidities, risk factors, clinical factors, laboratory data, imaging studies, hospital course, and outcomes obtained from our electronic medical records. Data were analyzed between two cohorts: new hospital units (NHU) and established hospital units (EHU) to determine if a mortality difference existed. Setting: The study is based on a 454-bed community teaching hospital in NYC at a location that serves an ethnically diverse population using population-based data. Participants: All patients included in our study were 17 years or greater in age. The study endpoint was defined as either patient discharge or death, and pregnant women and patients who died in the Emergency Department before admission were excluded from the analysis. Results: Of the 1288 screened patients, 351 confirmed COVID-19 hospitalized patients were included in our analysis. Specifically, the racial demographics for African Americans were similar between both units (p=0.139). Factors such as elevated BUN, ferritin, lactate dehydrogenase, and troponin were found to be similar in both cohorts. Overall survival was higher for patients in EHU compared to NHU (p=.012). The mortality rate was most striking in the NHU ICU where the mortality, especially in patients on mechanical ventilation (MV), was higher than in EHU ICU units (p = <.004). Conclusion: Our analysis revealed that patients admitted to newly created hospital units had a significantly lower overall survival rate compared to those admitted to established units, particularly in the NHU ICUs, especially for MV patients. These findings highlight the need for better planning, including the development of protocols that encompass trained providers' assignment, competency, proper orientation to the new unit, team cohesion, familiarity with the equipment, and critically ill patients' allocation. Such measures can help mitigate the survivorship disadvantage observed during surges in hospitalizations, particularly when NHU, especially new ICUs, need to be created.","PeriodicalId":345295,"journal":{"name":"SVOA Medical Research","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122836097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mysterious Presentation of Small Bowel Stricture","authors":"M. Cao, Kristen Bridges, P. Vemulapalli, Jaime Sexton, Justin Cleveland, B. Gilchrist","doi":"10.58624/svoamr.2023.01.002","DOIUrl":"https://doi.org/10.58624/svoamr.2023.01.002","url":null,"abstract":"Small bowel adenocarcinoma is a rare malignancy that accounts for a small percentage of gastrointestinal cancers. Diagnosis and management of small bowel adenocarcinoma can be challenging due to its rarity and nonspecific presentation. We present a case of a 51-year-old male with a history of intravenous drug use who presented with worsening abdominal pain and was found to have a small bowel obstruction. Exploratory laparotomy revealed a stricture in the jejunum caused by an intraluminal mass, which was resected. Pathological examination confirmed the diagnosis of intestinal type, moderately differentiated adenocarcinoma. This case highlights the importance of considering small bowel adenocarcinoma as a possible etiology in patients presenting with small bowel obstruction, particularly in high-risk individuals. Early diagnosis and complete resection remain the mainstays of treatment for improved outcomes in small bowel adenocarcinoma.","PeriodicalId":345295,"journal":{"name":"SVOA Medical Research","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127608910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First Ever Described Transhepatic Gallbladder","authors":"Kristen Bridges, P. Vemulapalli, K. O'driscoll, Jamie Han, Jaime Sexton, B. Gilchrist","doi":"10.58624/svoamr.2023.01.003","DOIUrl":"https://doi.org/10.58624/svoamr.2023.01.003","url":null,"abstract":"A transhepatic gallbladder is an exceedingly rare finding that presents unique challenges for the general surgeon who often encounters it unexpectedly. A sonogram will not demonstrate it. A gallbladder that wholly penetrates the right lobe of the liver and is clearly visible on the anterior surface is an enigma. We describe an incidental finding at the time of elective surgery of such a phenomenon. This presented the author with a unique problem - how to remove the entire gallbladder without leaving a hole in the right lobe of the liver through which bowel could herniate. A novel technique was utilized which left a small bridge of cauterized gallbladder fundus wall. This article delves into the embryology of the hepatobiliary system in order to surmise how this could have occurred during development. This transhepatic gallbladder also contained a septum, dividing the gallbladder transversely into unequal parts. We hope that our findings and operative description will assist future surgeons that encounter a similar anatomic problem.","PeriodicalId":345295,"journal":{"name":"SVOA Medical Research","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122744366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should Patients with Low Body Mass Index and Hypoalbuminemia on Chemoradiation Be Prescribed Prophylactic Proton Pump Inhibitors?","authors":"M. Cao, Kristen Bridges, P. Vemulapalli, Jaime Sexton, B. Gilchrist","doi":"10.58624/svoamr.2023.01.005","DOIUrl":"https://doi.org/10.58624/svoamr.2023.01.005","url":null,"abstract":"Introduction: The common causes of peptic ulcer disease are H. pylori infection and NSAIDs. Other factors such as physiological stress, smoking, steroid use, and previous history of PUD also increase the risk for developing gastric ulcers. Medical therapy has become more effective and accessible, leading to a decrease in the risk of complications by 2 -3% per year and a decline of 30-40% in the USA from 1993 to 2006. However, chemoradiation, which is increasingly used in the management of cancer patients, can cause mucosal injuries and other complications. Although there is no established support for prophylactic PPIs for cancer patients undergoing chemoradiation, a subset of patients with risk factors for systemic chemotoxicity and vulnerability to stress ulcers should be carefully evaluated and prescribed short-term PPIs to reduce complications and avoid unnecessary hospitalization. Method: No IRB approval was obtained: Two case reports of cancer patients with gastrointestinal tumors who presented to the Emergency Room with abdominal pain shortly after receiving chemoradiation are described. Both patients were not prescribed PPIs prior to their chemoradiation therapy and were found to have gastric perforation, requiring exploratory laparotomy with Graham patch and prolonged hospitalization. Results: According to studies, chemoradiation increases the risk of mucosal injuries and consequently the risk of developing stress gastric ulcers. Patients with borderline low BMI (<18.5) and hypoalbuminemia (<3.5dg/L) who undergo such treatment have a higher risk of developing stress mucosal injuries compared to average patients. Conclusion: These case reports highlight that low BMI and hypoalbuminemia increase the risk of developing stress gastric ulcers in patients undergoing chemoradiation due to mucosal toxicity. Therefore, this specific patient population should be carefully evaluated and prescribed short-term PPIs prophylactically to prevent gastric ulcers, thereby reducing the risk of emergent surgical intervention and unnecessary hospitalization.","PeriodicalId":345295,"journal":{"name":"SVOA Medical Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131031518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Acute Intrathoracic Sleeve Migration with Partial Volvulus after Laparoscopic Sleeve Gastrectomy and Hiatal Hernia Repair","authors":"M. Cao, Kristen Bridges, P. Vemulapalli, Jaime Sexton, B. Gilchrist","doi":"10.58624/svoamr.2023.01.004","DOIUrl":"https://doi.org/10.58624/svoamr.2023.01.004","url":null,"abstract":"Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the United States and is widely accepted due to its technical ease and effectiveness. Concomitant hiatal hernia repair, if detected during an LSG, is recommended. Intrathoracic sleeve migration (ITSM), a sliding hiatal hernia that develops after LSG, is a rare complication of this procedure. This report presents an early case of ITSM due to intermittent retching, resulting in postoperative incarceration of the proximal sleeve. The patient is a 28-year-old female who underwent concomitant LSG and hiatal hernia repair and was readmitted for acute entrapment of the proximal portion of the sleeve. The patient underwent re-operation with reduction of the proximal sleeve, and omentopexy was performed for stabilization. Intraoperative esophagogastroduodenoscopy was performed to ensure the detorsion and patency of the sleeve before the surgery. No additional hiatal hernia repair was attempted. ITSM with incarceration is an interesting phenomenon that is underrecognized and underreported. It can present postoperatively with reflux symptoms and poor oral tolerance. Failure to make an accurate diagnosis and intervene can result in prolonged hospitalization and poor patient outcomes.","PeriodicalId":345295,"journal":{"name":"SVOA Medical Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130372336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Metformin on Adipose Tissue Degeneration During Obesity","authors":"Cesar Elpidio Rodríguez Cervantes, Clara Alba Betancourt","doi":"10.58624/svoamr.2023.01.001","DOIUrl":"https://doi.org/10.58624/svoamr.2023.01.001","url":null,"abstract":"Obesity is associated with an increased inflammation involved in the development of atherosclerosis and insulin resistance. Macrophages are key in the genesis of these processes. Obesity induces macrophage accumulation in adipose tissue, they produce many of the inflammatory molecules secreted by adipose tissue like TNF-α, interleukins (IL-1β, IL-6, IL-8), as well as acute phase proteins such as haptoglobin (Hp), PAI-1 and C-reactive protein. The presence of these molecules in obesity relates this pathology to various inflammation degrees.The analysis of histological sections obtained from rabbit adipose tissue biopsy samples and processed by the hematoxylin-eosin and immunohistochemistry, showed the effect of metformin, a molecule which acts on the insulin metabolism, by the degeneration of this tissue during obesity. Metformin and its effects on metabolism are such that decreases the inflammation process suffered by adipose tissue, which is reflected by morphological changes in the distribution and migration of cells in the histological structure.","PeriodicalId":345295,"journal":{"name":"SVOA Medical Research","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127105722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}