Journal of community hospital internal medicine perspectives
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J Community Hosp Intern Med Perspect · Oct 2020
Hematological parameters predicting severity and mortality in COVID-19 patients of Pakistan: a retrospective comparative analysis.
COVID-19 is a global pandemic. In our study, we aimed to utilize the hematological parameters in predicting the prognosis and mortality in COVID-19 patients. ⋯ The inflammatory markers and hematological indices are a good guide for predicting the severity and disease outcome of coronavirus disease. NLR and PLR are elevated in severe disease while LMR and LCR are inversely correlating with disease severity.
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J Community Hosp Intern Med Perspect · Oct 2020
Clinical characteristics and outcomes of critically ill patients with COVID-19 in a tertiary community hospital in upstate New York.
Background: There are limited reports describing critically ill COVID-19 patients in the state of New York. Methods: We conducted a retrospective analysis of 32 adult critically ill patients admitted to a community hospital in upstate New York, between 14 March and 12 April 2020. We collected demographic, laboratory, ventilator and treatment data, which were analyzed and clinical outcomes tabulated. ⋯ Conclusion: Majority of patients were of older age and with medical comorbidities. With adequate resource utilization, mortality of critically ill COVID-19 patients may not be as high as previously suggested. Abbreviations: ACE-i: Angiotensin converting enzyme inhibitor; ARB: Angiotensin receptor blocker; ARDS: Acute Respiratory Distress Syndrome; BiPAP: Bilevel positive airway pressure; CABG: Coronary artery bypass graft; CFR: Case fatality rate; COVID-19: Coronavirus disease 19; CPAP: Continuous positive airway pressure; CRP: C - Reactive Protein; CT: Computed tomography; DVT: Deep vein thrombosis; ECMO: Extra Corporeal Membrane Oxygenation; ESICM: European Society of Intensive Care Medicine; FiO2: Fraction of inspired O2; HFNC: High Flow Nasal Cannula; HITF: Hypoxia-Inducible Transcription Factor; IBM: International Business Machines; ICU: Intensive Care Unit; IL: Interleukin; IMV: Invasive Mechanical Ventilation; IQR: Interquartile Range; ISTH: International Society of Thrombosis Hemostasis; NIV: Non Invasive Ventilation; NY: New York; PAI: Plasminogen activator inhibitor; PaO2: partial pressure of arterial oxygen; PCV: Pressure Control Ventilation; PEEP: Positive End Expiratory Pressure; RGH: Rochester General Hospital; RRH: Rochester Regional Health; RT-PCR: Reverse transcriptase polymerase chain reaction; RSV: Respiratory Syncytial virus; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; SD: Standard Deviation; STEMI: ST segment elevation myocardial infarction; TNF: Tumor necrosis factor; USA: USA; VTE: Venous thromboembolism.
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J Community Hosp Intern Med Perspect · Sep 2020
Predictability of CRP and D-Dimer levels for in-hospital outcomes and mortality of COVID-19.
Systemic inflammation elicited by a cytokine storm is considered a hallmark of coronavirus disease 2019 (COVID-19). This study aims to assess the clinical utility of the C-reactive protein (CRP) and D-Dimer levels for predicting in-hospital outcomes in COVID-19. ⋯ CRP value greater than 100 mg/dL and D-dimer levels higher than 500 ng/ml during hospitalization might predict higher odds of in-hospital mortality. Higher levels at presentation might indicate impending clinical deterioration and the need for IMV.
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J Community Hosp Intern Med Perspect · Sep 2020
Internal medicine resident perspectives on scoring USMLE as pass/fail.
The scoring rubric on the USMLE Step 1 examination will be changing to pass/fail in January 2022. This study elicits internal medicine resident perspectives on USMLE pass/fail scoring at the national level. ⋯ Our results suggest that a majority of internal medicine residents, currently training in the USA prefer that USMLE numerical scoring is retained and not changed to pass/fail.
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J Community Hosp Intern Med Perspect · Sep 2020
Patients' reasons for missing scheduled clinic appointments and their solutions at a major urban-based academic medical center.
Patients that do not show up for scheduled clinic appointments affect the quality of healthcare provided. This study aimed to recognize the reasons behind missing scheduled appointments and understand possible solutions from the patient's perspective. ⋯ The patients should be aware of different appointment reminders options and have the freedom to choose a suitable reminder. Patients should be educated about the importance of calling to cancel the appointment since some of the reasons for no show are unpreventable.