COVID-19 Outcomes in a US Cohort of Persons Living with HIV (PLWH).

Reported coronavirus disease 2019 (COVID-19) outcomes in persons living with HIV (PLWH) vary across cohorts. We examined clinical characteristics and outcomes of PLWH with COVID-19 compared with a matched HIV-seronegative cohort in a mid-Atlantic US healthcare system. Multivariate logistic regression was used to explore factors associated with hospitalization and death/mechanical ventilation among PLWH.

HCV universal EHR prompt successfully increases screening, highlights potential disparities.

Background & Objectives: Screening for hepatitis C virus is the first critical decision point for preventing morbidity and mortality from HCV cirrhosis and hepatocellular carcinoma and will ultimately contribute to global elimination of a curable disease. This study aims to portray the changes over time in HCV screening rates and the screened population characteristics following the 2020 implementation of an electronic health record (EHR) alert for universal screening in the outpatient setting in a large healthcare system in the US mid-Atlantic region.

Methods: Data was abstracted from the EHR on all outpatients from 1/1/2017 through 10/31/2021, including individual demographics and their HCV antibody (Ab) screening dates.

Alcohol-associated liver disease predicts increased post-liver transplant opioid use.

Background: Alcohol-associated liver disease (ALD) is a rising indication for liver transplantation (LT). Prolonged opioid use after LT leads to increased graft loss and mortality. The aim is to determine if patients transplanted with a primary diagnosis of ALD had higher risk of post-LT opioid use (p-LTOU) compared to non-ALD patients.

Thrombotic and Clinical Outcomes in Patients with Hematologic Malignancy and COVID-19.

Background: Venous thromboembolism (VTE) is a common complication in acute COVID-19 and those with hematologic malignancy (HM) may be at an even higher risk. We performed a retrospective analysis of patients with history of HM and acute COVID-19 to evaluate thrombotic and clinical outcomes.

Methods: Patients with COVID-19 were identified by positive SARS-CoV-2 PCR test.

Risk factors for bleeding hepatocellular adenoma in a United States cohort.

Background & Aims: Known risk factors for hepatocellular adenoma (HCA) bleeding are size >5 cm, growth rate, visible vascularity, exophytic lesions, β-catenin and Sonic Hedgehog activated HCAs. Most studies are based on European cohorts. The objective of this study is to identify additional risk factors for HCA bleeding in a US cohort.

Oral Prescription Opioids as a High-Risk Indicator for Hepatitis C Infection: Another Step Toward HCV Elimination.

Background: The opioid epidemic across the U.S. poses an array of public health concerns, especially HCV transmission.

HIV testing in patients who are HCV positive: Compliance with CDC guidelines in a large healthcare system.

Background: There are approximately 300,000 people in the United States who are co-infected with HIV and HCV. Several organizations recommend that individuals who are HCV infected, as well as persons over the age of 13, should be HIV tested. Comorbidities associated with HCV can be reduced with early identification of HIV.

Early mortality benefit with COVID-19 convalescent plasma: a matched control study.

Convalescent plasma can provide passive immunity during viral outbreaks, but the benefit is uncertain for the treatment of novel coronavirus disease 2019 (COVID-19). Our goal is to assess the efficacy of COVID-19 convalescent plasma (CCP). In all, 526 hospitalized patients with laboratory-confirmed SARS-CoV-2 at an academic health system were analyzed.

Facial Pressure Injuries from Prone Positioning in the COVID-19 Era.

Objective/hypothesis: This study aimed to determine the incidence of facial pressure injuries associated with prone positioning for COVID-19 patients as well as to characterize the location of injuries and treatments provided.

Methods: This was a retrospective chart review of 263 COVID-19 positive patients requiring intubation in the intensive care units at MedStar Georgetown University Hospital and MedStar Washington Hospital Center between March 1st and July 26th, 2020. Information regarding proning status, duration of proning, presence, or absence of facial pressure injuries and interventions were collected.

Clearance of Hepatitis C Virus (HCV) Is Associated With Improved Outcomes in HCV-Associated Lymphoma.

Background: Improved hepatitis C virus (HCV) clearance due to directly acting antiviral agents has led to remarkably improved outcomes of indolent HCV-associated non-Hodgkin lymphoma (NHL). The impact of directly acting antivirals on the outcomes of aggressive NHL is still under investigation. Characteristics of HCV-associated NHL in black patients are not well characterized.

Identification of Risk Factors for Testing of Hepatitis C in Non-Birth Cohort Patients: Is Universal Screening Necessary?

Objectives: CDC reported that 45% of Hepatitis C (HCV) infected people denied known risk factors. Electronic health record RF-based, non-Birth Cohort (born outside of years 1945-1965) screening is challenging as risk factors are often input as nonsearchable data. Testing non-Birth Cohort patients solely based on risk factors has the potential to miss a substantial number of HCV infected patients.

Ethnicity and insurance status predict metastatic disease presentation in prostate, breast, and non-small cell lung cancer.

Background: Ethnicity and insurance status have been shown to impact odds of presenting with metastatic cancer, however, the interaction of these two predictors is not well understood. We evaluate the difference in odds of presenting with metastatic disease in minorities compared to white patients despite access to the same insurance across three common cancer types.

Methods: Using the National Cancer Database, a multilevel logistic regression model that estimated the odds of metastatic disease was fit, adjusting for covariates including year of diagnosis, ethnicity, insurance, income, and region.

Major acute cardiovascular events in patients with inflammatory bowel disease.

Background: Systemic inflammation and immune-mediated diseases have been associated with ischemic heart disease in addition to traditional risk factors. In this study, we investigate associations between inflammatory bowel disease (IBD) and acute cardiovascular events.

Methods: An observational study where patient data were extracted from our health system patient pool of 3 917 894.

Recruiting Control Participants into Stroke Biomarker Studies.

The number of scientists using -omics technologies to investigate biomarkers with the potential to gauge risk and aid in the diagnosis, treatment, and prognosis of stroke continues to rise, yet there are few resources to aid investigators in recruiting control participants. In this review, we describe two major strategies to match control participants to a stroke cohort-propensity score matching and one-to-one matching-including statistical approaches to gauge the balance between groups. We then explore the advantages and disadvantages of traditional recruitment methods including approaching spouses of enrolled stroke participants, direct recruitment from clinics, community outreach events, approaching retirement communities, and buying samples from a 3rd party vendor.

Redesigning ambulatory care management for uncontrolled type 2 diabetes: a prospective cohort study of the impact of a Boot Camp model on outcomes.

Objective: Type 2 diabetes care management (DCM) is challenging. Few studies report meaningful improvements in clinical care settings, warranting DCM redesign. We developed a Boot Camp to provide timely, patient-centered, technology-enabled DCM.

Leveraging the electronic health record to eliminate hepatitis C: Screening in a large integrated healthcare system.

Highly efficacious and tolerable treatments that cure hepatitis C viral (HCV) infection exist today, increasing the feasibility of disease elimination. However, large healthcare systems may not be fully prepared for supporting recommended actions due to knowledge gaps, inadequate infrastructure and uninformed policy direction. Additionally, the HCV cascade of care is complex, with many embedded barriers, and a significant number of patients do not progress through the cascade and are thus not cured.

Effectiveness of Early Laser Treatment in Surgical Scar Minimization: A Systematic Review and Meta-analysis.

Background: Studies investigating the efficacy of lasers to minimize early surgical scars are low powered and report variable results. To further examine the evidence, the authors performed a systemic review and meta-analysis.

Objective: To present the evidence of randomized controlled trials investigating the efficacy of laser modalities in minimizing surgical scars when applied <1 month after operation.

The impact of environmental ultraviolet exposure on the clinical course of mycosis fungoides.

Background: As phototherapy plays an important role in the treatment of early-stage mycosis fungoides (MF), it is possible that environmental ultraviolet (UV) exposure affects the natural history of the disease.

Objective: To assess the impact of environmental UV exposure on the clinical course of MF.

Methods: The National Solar Radiation Database was used to identify the top and bottom registries for UV exposure from the Surveillance, Epidemiology, and End Results-18 database.

Hyponatremia Is Associated With Increased Osteoporosis and Bone Fractures in Patients With Diabetes With Matched Glycemic Control.

Context: Patients with diabetes mellitus are at increased risk for bone fragility fracture secondary to multiple mechanisms. Hyperglycemia can induce true dilutional hyponatremia. Hyponatremia is associated with gait instability, osteoporosis, and increased falls and bone fractures, and studies suggest that compromised bone quality with hyponatremia may be independent of plasma osmolality.

Hyponatremia and the risk of kidney stones: A matched case-control study in a large U.S. health system.

Kidney stones impose a large and increasing public health burden. Previous studies showed that hyponatremia is associated with an increased risk of osteoporosis and bone fractures, which are also known to be associated with kidney stones. However, the relation between hyponatremia and kidney stones is not known.

A Prognostic Model for Predicting Overall Survival in Patients with Peritoneal Surface Malignancy of an Appendiceal Origin Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

Introduction: Our aim was to develop a prognostic model for predicting overall survival following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with appendiceal adenocarcinoma and peritoneal metastasis.

Methods: A retrospective analysis of a prospectively maintained database for all patients treated for appendiceal adenocarcinoma with peritoneal metastasis from 1989 to 2012 was conducted.

Results: Overall, 734 (50.

Acute Kidney Injury and In-Hospital Mortality after Coronary Artery Bypass Graft versus Percutaneous Coronary Intervention: A Nationwide Study.

Background: Post-procedural acute kidney injury (AKI) is associated with significantly increased short- and long-term mortalities, and renal loss. Few studies have compared the incidence of post-procedural AKI and in-hospital mortality between 2 major modalities of revascularization - coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) - and results have been inconsistent.

Methods: We generated a propensity score-matched cohort that includes a total of 286,670 hospitalizations with multi-vessel coronary disease undergoing CABG or PCI (2004-2012) from the National Inpatient Sample database.

A comparison of the knowledge base and surgical skills of integrated versus independent vascular surgery trainees.

Objective: The purpose of this study was to compare the knowledge base and surgical skills of 0/5 integrated resident (IR) and 5/2 independent fellow (IF) vascular surgery trainees using milestones.

Methods: An anonymous survey, endorsed by the Association of Program Directors in Vascular Surgery, was sent to all program directors (PDs) of IR and IF training programs. The survey asked PDs to assess their trainees' milestones in postgraduate year (PGY) 4 to 7 pertinent to knowledge base and surgical skills using a 5-point Likert scale.

High rate of microbleed formation following primary intracerebral hemorrhage.

Background: We sought to investigate the frequency of microbleed development following intracerebral hemorrhage in a predominantly African-American population and to identify predictors of new microbleed formation.

Aims And/or Hypothesis: To investigate the frequency and predictors of new microbleeds following intracerebral hemorrhage.

Methods: The DECIPHER study was a prospective, longitudinal, magnetic resonance-based cohort study designed to evaluate racial/ethnic differences in risk factors for microbleeds and to evaluate the prognostic impact of microbleeds in this intracerebral hemorrhage population.

Hyponatremia Is Associated With Increased Osteoporosis and Bone Fractures in a Large US Health System Population.

Context: The significance of studies suggesting an increased risk of bone fragility fractures with hyponatremia through mechanisms of induced bone loss and increased falls has not been demonstrated in large patient populations with different types of hyponatremia.

Objective: This matched case-control study evaluated the effect of hyponatremia on osteoporosis and fragility fractures in a patient population of more than 2.9 million.