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Detroit medical center

Pascal Kingah, Muhammad Alam, Karan Chugh, John Kamholz, Lobelia Samavati
BACKGROUND: Neurosarcoidosis is a serious extra pulmonary manifestation of sarcoidosis. Its presentation ranges from peripheral or cranial neuropathy to central nervous system dysfunction. It can mimic stroke or multiple sclerosis. Due to the variation in clinical presentation, diagnosis is difficult and often delayed. OBJECTIVE: Determine the proportion of patients with neurosarcoidosis who have positive findings on chest CT, lung biopsy or lymph node biopsy. METHODS: Retrospective study at the Sarcoidosis and Interstitial Lung Disease Center at Wayne State University-Detroit Medical Center in Detroit, MI...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Robert P Lisak, Suhayl Dhib-Jalbut
No abstract text is available yet for this article.
October 2016: Multiple Sclerosis: Clinical and Laboratory Research
Michael W Wandling, Avery B Nathens, Michael B Shapiro, Elliott R Haut
BACKGROUND: Rapid transport to definitive care ("scoop and run") versus field stabilization in trauma remains a topic of debate and has resulted in variability in prehospital policy. We aimed to identify trauma systems frequently using a true "scoop and run" police transport approach and to compare mortality rates between police and ground emergency medical services (EMS) transport. METHODS: Using the National Trauma Databank (NTDB), we identified adult gunshot and stab wound patients presenting to Level 1 or 2 trauma centers from 2010 to 2012...
November 2016: Journal of Trauma and Acute Care Surgery
Syed Ahmed Hussain, Camelia Arsene, Corinne Hamstra, Tess H Woehrlen, Wilhelmine Wiese-Rometsch, Suzanne R White
Background In 2014, the Detroit Medical Center launched a new program to engage residents and fellows in a strategy to deliver optimal care within 1 year, focusing on quality at an earlier stage of their careers and preparing them for working posttraining. Methods Residents from clinically relevant residency and fellowships programs were selected to be Resident Quality Directors. The project involved development of an interactive electronic health record (EHR) checklist to visually depict real time gaps in 40 process measures, while focusing on 14 areas related to stroke and venous thromboembolism (VTE) prophylaxis...
May 2016: Journal of Graduate Medical Education
Serge P Marinkovic, Brandi Miller, Scott Hughes, Christina Marinkovic, Lisa Gillen
BACKGROUND: A Drum Dock Manager in an auto manufacturing company suffers a pelvic fracture, severing the bulbar urethra and completely fracturing the right side of his pelvis. He is unable to void without catheterization but has a complete sensation to void. Can neuromodulation help him achieve spontaneous voiding? CASE PRESENTATION: We reviewed the electronic medical record of Mr. M.E. from Detroit Medical Center following his 2012 forklift accident and subsequent orthopedic surgeries...
2015: BMC Urology
Yasamean Zamani-Hank
The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these life-saving medications...
August 2016: Population Health Management
Tsilia Lazarovitch, Keren Amity, Joseph R Coyle, Benjamin Ackerman, Ruthy Tal-Jasper, Hadas Ofer-Friedman, Kayoko Hayakawa, Christopher Bogan, Paul R Lephart, Tamir Kaplansky, Moran Maskit, Tal Azouri, Ronit Zaidenstein, Federico Perez, Robert A Bonomo, Keith S Kaye, Dror Marchaim
BACKGROUND: The pandemic of carbapenem-resistant Enterobacteriaceae (CRE) was primarily due to clonal spread of bla KPC producing Klebsiella pneumoniae. Thus, thoroughly studied CRE cohorts have consisted mostly of K. pneumoniae. OBJECTIVE: To conduct an extensive epidemiologic analysis of carbapenem-resistant Enterobacter spp. (CREn) from 2 endemic and geographically distinct centers. METHODS: CREn were investigated at an Israeli center (Assaf Harofeh Medical Center, January 2007 to July 2012) and at a US center (Detroit Medical Center, September 2008 to September 2009)...
November 2015: Infection Control and Hospital Epidemiology
Mili Thakur, Bernard Gonik, Navleen Gill, Awoniyi O Awonuga, Frederico G Rocha, Juan M Gonzalez
OBJECTIVES: Development of a validated triaging system that can be used by obstetric providers to identify obstetric patients at risk of developing severe morbidity during an admission is urgently required. Maternal Critical Care Working Group (MCCWG) recommended a "level of care" strategy that based patient acuity needs on number of individual organ systems requiring support. The objective of this study was to apply the MCCWG level of support for critical care (MCCWG LOC) scoring to pregnant women admitted to an intensive care unit (ICU) to predict maternal outcomes and to compare it to the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system...
January 2016: Maternal and Child Health Journal
Gustavo Vilchez, Laura Londra, Luis R Hoyos, Robert Sokol, Ray Bahado-Singh
OBJECTIVE: To determine whether intrapartum mean platelet volume (MPV) can predict new-onset delayed postpartum pre-eclampsia. METHODS: In a retrospective study, data were obtained for women with delayed postpartum pre-eclampsia (≥48 hours after delivery) who attended the Detroit Medical Center, Detroit, MI, USA, between January 2002 and July 2010. Patients were divided into two subgroups: new-onset delayed postpartum pre-eclampsia (no history of hypertensive disorder before 48 hours after delivery) and other late-onset/delayed postpartum pre-eclampsia (history of hypertensive disorders)...
October 2015: International Journal of Gynaecology and Obstetrics
Tal Mann, Joseph Ellsworth, Najia Huda, Anupama Neelakanta, Thomas Chevalier, Kristin L Sims, Sorabh Dhar, Mary E Robinson, Keith S Kaye
OBJECTIVE: To develop an automated method for ventilator-associated condition (VAC) surveillance and to compare its accuracy and efficiency with manual VAC surveillance SETTING: The intensive care units (ICUs) of 4 hospitals METHODS: This study was conducted at Detroit Medical Center, a tertiary care center in metropolitan Detroit. A total of 128 ICU beds in 4 acute care hospitals were included during the study period from August to October 2013...
September 2015: Infection Control and Hospital Epidemiology
Kimberly C Claeys, Abdalhamid M Lagnf, Trishna B Patel, Manu G Jacob, Susan L Davis, Michael J Rybak
INTRODUCTION: Acute bacterial skin and skin structure infections (ABSSSIs) are frequently treated in emergency departments (EDs) or observation units (OUs) initially with intravenous (IV) antibiotics before discharge on oral therapy. This study aims to describe ABSSSI patients discharged directly from EDs/OUs. METHODS: This is a retrospective cohort study of patients with ABSSSIs treated in EDs/OUs of the Detroit Medical Center from 2012 to 2014. Adults with less than 24 h of IV antibiotics without hospital admission were included...
June 2015: Infectious Diseases and Therapy
Violet Leibman, Emily T Martin, Ruthy Tal-Jasper, Leonti Grin, Kayoko Hayakawa, Coral Shefler, Tal Azouri, Tamir Kaplansky, Moran Maskit, Tsilia Lazarovitch, Ronit Zaidenstein, Keith S Kaye, Dror Marchaim
BACKGROUND: Epidemiological characteristics of patients with bloodstream infections (BSI) due to extended-spectrum β-lactamase producing (ESBL) and carbapenem-resistant (CRE) strains are often similar. Mortality rates for CRE BSI are 70%, and mean time to initiation of appropriate therapy is ~5 days. A bedside score was developed to differentiate CRE-BSIs from ESBL-BSIs, in order to help decrease the time to initiation of appropriate therapy for CRE and mortality rates. FINDINGS: Score was developed based of data (2007-2010) abstracted from charts of adult patients from Assaf Harofeh Medical Center (AHMC, Zeriffin, Israel), and validated on a cohort of patients from Detroit Medical Center (DMC, MI, USA)...
2015: Annals of Clinical Microbiology and Antimicrobials
Joshua N Raub, Taylor M Thurston, Anna D Fiorvento, Ryan P Mynatt, Suprat S Wilson
PURPOSE: The implementation and outcomes of a pharmacy residency mentorship program are described. SUMMARY: The mentorship program at the Detroit Medical Center was formally implemented during the residency orientation period in 2013. Residents had up to two months after the start of the residency to choose a mentor, which we believed was an adequate amount of time to meet all members of the department of pharmacy. One year after implementation of the mentorship program, an anonymous survey was administered to all 16 residents to gather feedback about the mentorship program...
June 1, 2015: American Journal of Health-system Pharmacy: AJHP
Teena Chopra, Dror Marchaim, Paul C Johnson, Indu K Chalana, Zeinab Tamam, Mazin Mohammed, Shatha Alkatib, Ryan Tansek, Khawar Chaudhry, Jing J Zhao, Jason M Pogue, Keith S Kaye
BACKGROUND: Extended-spectrum β-lactamase (ESBL)-producing pathogens represent increasing challenges to physicians because of rising prevalence, high mortality, and challenging treatment. Identifying high risks and early appropriate therapy is critical to favorable outcomes. METHODS: This is a 5-year retrospective case-case-control study performed at the Detroit Medical Center on adult patients with bloodstream infection (BSI) caused by ESBL-producing and non-ESBL-producing Escherichia coli or Klebsiella pneumoniae, each compared with uninfected controls...
July 1, 2015: American Journal of Infection Control
Ting L Luo, Alexander H Rickard, Usha Srinivasan, Keith S Kaye, Betsy Foxman
OBJECTIVES: Acinetobacter baumannii is an emerging opportunistic nosocomial pathogen. Two factors that may enhance persistence in healthcare settings are antimicrobial resistance and biofilm-forming ability. The aim of this work was to determine whether A. baumannii isolates that persist in healthcare settings (endemic), can be differentiated from sporadic isolates based upon their ability to resist antibiotics and their biofilm-forming capability. METHODS: Two hundred and ninety A...
2015: Frontiers in Microbiology
Anthony M Casapao, Thomas P Lodise, Susan L Davis, Kimberly C Claeys, Ravina Kullar, Donald P Levine, Michael J Rybak
Given the critical importance of early appropriate therapy, a retrospective cohort (2002 to 2013) was performed at the Detroit Medical Center to evaluate the association between the day 1 vancomycin exposure profile and outcomes among patients with MRSA infective endocarditis (IE). The day 1 vancomycin area under the concentration-time curve (AUC0-24) and the minimum concentration at 24 h (Cmin 24) was estimated for each patient using the Bayesian procedure in ADAPT 5, an approach shown to accurately predict the vancomycin exposure with low bias and high precision with limited pharmacokinetic sampling...
2015: Antimicrobial Agents and Chemotherapy
Humberto C Gonzalez, Lois Lamerato, Craig G Rogers, Stuart C Gordon
BACKGROUND: Chronic hepatitis C virus (HCV) infection causes cirrhosis and hepatocellular carcinoma but is also etiologically linked to several extrahepatic medical conditions including renal disorders. HCV is also associated with extrahepatic malignancies and may be oncogenic. Whether HCV confers an increased risk of renal cell carcinoma (RCC) remains controversial. AIMS: Prospectively determine whether chronic HCV is associated with an increased risk of RCC. METHODS: At an integrated medical center in Detroit, Michigan, adult patients with suspected RCC or newly diagnosed colon cancer (controls) were screened for hepatitis C antibody (HCAB) and HCV RNA...
June 2015: Digestive Diseases and Sciences
Yanqing Ji, Hao Ying, John Tran, Peter Dews, Ayman Mansour, R Michael Massanari
Drug-drug interactions (DDIs) can result in serious consequences, including death. Existing methods for identifying potential DDIs in post-marketing surveillance primarily rely on the FDA's (Food and Drug Administration) spontaneous reporting system. However, this system suffers from severe underreporting, which makes it difficult to timely collect enough valid cases for statistical analysis. In this paper, we study how to signal potential DDIs using patient electronic health data. Specifically, we focus on discovery of potential DDIs by analyzing the temporal relationships between the concurrent use of two drugs of interest and the occurrences of various symptoms using novel temporal association mining techniques we developed...
2014: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Zachary P VandeGriend, Araz Hashemi, Mahdi Shkoukani
OBJECTIVE: The aim of this study was to determine whether the incidence of facial fractures has changed in the United States since 1990. STUDY DESIGN: This study is a retrospective review of all nonpediatric inpatient and outpatient facilities of the Detroit Medical Center from 1990 to 2011 and weighted national inpatient estimates from 1993 to 2010 using the National Inpatient Survey. METHODS: Facial fractures and surgical repairs were grouped according to fracture site and scaled to annual populations...
January 2015: Journal of Craniofacial Surgery
Jason M Pogue, Anupama Neelakanta, Ryan P Mynatt, Sarit Sharma, Paul Lephart, Keith S Kaye
In the era of carbapenem-resistance in Acinobacter baumannii and Enterobacteriaceae, there are limited treatment options for these pathogens. It is essential that clinicians fully assess all available therapeutic alternatives for these multidrug-resistant organisms. We herein describe the approach of the antimicrobial stewardship team at the Detroit Medical Center (DMC) for the evaluation and use of intravenous (IV) minocycline for the treatment of these resistant organisms, given potential advantages of IV minocycline over tigecycline and doxycycline...
December 1, 2014: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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