Predicting severe COVID-19 using readily available admission indicators: SpO2/FiO2 ratio, comorbidity index, and gender.

The focus of this study was to identify risk factors for severe and critical COVID-19, evaluate local respiratory immune responses to SARS-CoV-2 infection, and develop a prognostic tool for COVID-19 severity using accessible early indicators. Using nasopharyngeal swab samples from hospitalized patients with COVID-19 of varying severity during the first wave of the pandemic from March to May 2020 in Louisiana, we evaluated the association between COVID-19 severity and viral load, respiratory immune mediators, and demographic/clinical factors. We found that the SpO/FiO ratio at triage, total comorbidity burden (represented by Charlson Comorbidity Index), and gender were significantly associated with COVID-19 severity.

Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, March 2020-August 2021.

Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021.

Integrating Problem-Based Learning Into an Internal Medicine Residency Curriculum.

Problem-based learning (PBL) is a form of constructivist learning that allows learners to use higher order thinking by promoting learners to construct their own knowledge and understanding. PBL is prevalent in medical school education, but literature on PBL in graduate medical education (GME) is lacking. Because of the limited amount of data on PBL curricula in GME and the need for young physicians to develop critical thinking, lifelong self-directed learning, and problem-solving skills, we sought to incorporate PBL into the curriculum for our internal medicine residency program in a university-based community hospital setting.

Impact on an Urgent Care Clinic of a New Freestanding Emergency Department in a Resource-Scarce Area.

Convenience clinics-such as urgent care centers (UCCs), retail clinics, and freestanding emergency departments (FSEDs)-where patients can receive treatment for a variety of medical conditions have increased in number and popularity. We quantify the impact an FSED had on UCC visits in an underserved area in North Baton Rouge, Louisiana. All FSED and UCC visits were abstracted from 2015 to 2020.

Risk factors among Black and White COVID-19 patients from a Louisiana Hospital System, March, 2020 - August, 2021.

Objectives: To investigate relationships between race and COVID-19 hospitalizations, intensive care unit (ICU) admissions, and mortality over time and which characteristics, may mediate COVID-19 associations.

Methods: We analyzed hospital admissions, ICU admissions, and mortality among positive COVID-19 cases within the ten-hospital Franciscan Ministries of Our Lady Health System around the Mississippi River Industrial Corridor in Louisiana over four waves of the pandemic from March 1, 2020 - August 31, 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race-outcome relationships.

Effectiveness of a Patient-Centered Dietary Educational Intervention.

A healthy diet is an important component of preventive medicine. With the changing landscape of medicine, physicians are encountering more challenges in educating patients about a healthy diet, so finding innovative ways to educate patients is imperative. This study investigated the effectiveness of an innovative educational intervention based on the United States Department of Agriculture-recommended MyPlate diet.

Effect of Medicaid Expansion on Visit Composition in a Louisiana Health Care System.

In 2016, Louisiana expanded Medicaid to low-income adults under the Patient Protection and Affordable Care Act. By 2020, the uninsured rate of adults in Louisiana had dropped from 22.7% to 8.

Retrospective identification of infection in the emergency department: A significant challenge in sepsis clinical trials.

Background: This study examined three methods for retrospectively identifying infection in emergency department (ED) patients: modified objective definitions of infection (MODI) from the CDC/NHSN, physician adjudication determination of infection, and ED treating physician behavior.

Methods: This study used a subset of data from a prospective sepsis trial. We used Fleiss's Kappa to compare agreement between two physicians retrospectively adjudicating infection based on the patient's medical record, modified infection definition from the CDC/NHSN, and ED treating physician behavior.

Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting.

Objective: Assess the IntelliSep Index (ISI) for risk stratification of patients presenting to the Emergency Department (ED) with respiratory symptoms suspected of COVID-19 during the pandemic.

Methods: An observational single-center study of prospective cohort of patients presenting to the ED during the early COVID-19 pandemic with respiratory symptoms and a CBC drawn within 4.5 hours of initial vital signs.

P009 Assessing the Status Quo: Ulcerative Colitis Monitoring in a Community GI Practice.

Background: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that is a life-long condition with a relapsing and remitting course. As with other chronic diseases, close monitoring of UC is essential to achieving desired outcomes. Given the progressive nature of IBD and its corresponding complexities of care, monitoring of these diseases can be optimized in a collaborative, IBD-focused care center.

Assessment of a Cellular Host Response Test as a Sepsis Diagnostic for Those With Suspected Infection in the Emergency Department.

Objectives: Sepsis is a common cause of morbidity and mortality. A reliable, rapid, and early indicator can help improve efficiency of care and outcomes. To assess the IntelliSep test, a novel in vitro diagnostic that quantifies the state of immune activation by measuring the biophysical properties of leukocytes, as a rapid diagnostic for sepsis and a measure of severity of illness, as defined by Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation-II scores and the need for hospitalization.

The impact of the COVID-19 pandemic and governor mandated stay at home order on emergency department super utilizers.

Background: Despite the trend of rising Emergency Department (ED) visits over the past decade, researchers have observed drastic declines in number of ED visits due to the COVID-19 pandemic. The purpose of the current study was to examine the impact of the COVID-19 pandemic and governor mandated Stay at Home Order on ED super utilizers.

Methods: This was a retrospective chart review of patients presenting to the 12 emergency departments of the Franciscan Mission of Our Lady Hospital System in Louisiana between January 1, 2018 and December 31, 2020.

The Relationship Between Grit and Resilience in Emergency Medical Service Personnel.

Emergency medical service (EMS) personnel are regularly exposed to traumatic incidents and experience higher rates of symptoms of posttraumatic stress disorder (PTSD) than the general population. Grit is a construct proposed to be associated with achievement, but it has demonstrated preliminary evidence of an association with resilience. The current study examined the relationship between grit and resilience among EMS workers.

Variability in Management of Patients With SJS/TEN: A Survey of Burn Unit Directors.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, type IV hypersensitivity reactions of the skin and mucosa. These reactions (SJS/TEN) are frequently managed in burn units; however, no standardized guidelines exist for the treatment and management of SJS/TEN. To gain insight into current SJS/TEN management practices, a survey on admission, diagnosis, and management, was conducted across accredited burn units in the United States.

Implementing a Narrative Medicine Curriculum During the Internship Year: An Internal Medicine Residency Program Experience.

Introduction: Narrative medicine develops professional and communication skills that align with Accreditation Council for Graduate Medical Education competencies. However, little is known about a narrative medicine curriculum's impact on physicians in training during residency. Implementing a narrative medicine curriculum during residency can be challenging because of time constraints and limited opportunity for nonclinical education.

Health Care Disparities Knowledge, Attitudes, and Behaviors in Resident Physicians.

Purpose: Health care disparities are an important but sometimes underrepresented topic in graduate medical education. In this study we measured the impact of educational and behavioral interventions on resident knowledge about and attitudes toward health care disparities.

Methods: Faculty from 6 residency programs designed and presented an hour-long educational intervention to emphasize the importance of and increase resident knowledge about health care disparities.

Adam22 is a major neuronal receptor for Lgi4-mediated Schwann cell signaling.

The segregation and myelination of axons in the developing PNS, results from a complex series of cellular and molecular interactions between Schwann cells and axons. Previously we identified the Lgi4 gene (leucine-rich glioma-inactivated4) as an important regulator of myelination in the PNS, and its dysfunction results in arthrogryposis as observed in claw paw mice. Lgi4 is a secreted protein and a member of a small family of proteins that are predominantly expressed in the nervous system.