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  1. Article: Human Papillomavirus Positive Squamous Cell Carcinoma of the Rectum.

    Makadia, Shraddhadevi / Patel, Ishan / Abusaada, Khalid

    Cureus

    2020  Volume 12, Issue 7, Page(s) e9022

    Abstract: Squamous cell carcinoma (SCC) is most commonly seen in the esophagus and anal canal in the gastrointestinal tract. The incidence of SCC of the rectum is infrequent with no clear etiology. There have been limited reported cases of SCC of the rectum caused ...

    Abstract Squamous cell carcinoma (SCC) is most commonly seen in the esophagus and anal canal in the gastrointestinal tract. The incidence of SCC of the rectum is infrequent with no clear etiology. There have been limited reported cases of SCC of the rectum caused by human papillomavirus (HPV). Due to the rarity of carcinoma, the management of SCC of the rectum is not standardized. We report a case of a 51-year-old female with an insignificant medical history presenting with hematochezia and weight loss and was found to have HPV-positive SCC of the rectum. This case report emphasizes the importance of work-up, usefulness of HPV testing for high-risk patients, and clinical management of SCC of the rectum.
    Language English
    Publishing date 2020-07-06
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.9022
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  2. Article: Renin-Angiotensin-Aldosterone System Blockers Prior to Hospitalization and Their Association With Clinical Outcomes in Coronavirus Disease 2019 (COVID-19).

    Banwait, Ranjit / Singh, Devina / Blanco, Anamarys / Rastogi, Vaibhav / Abusaada, Khalid

    Cureus

    2021  Volume 13, Issue 2, Page(s) e13429

    Abstract: Objective: To determine the effect of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) use prior to hospitalization on clinical outcomes in coronavirus disease 2019 (COVID-19) patients.: Design: An ... ...

    Abstract Objective: To determine the effect of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) use prior to hospitalization on clinical outcomes in coronavirus disease 2019 (COVID-19) patients.
    Design: An observational retrospective cohort study from 178 hospitals from a large health system across the United States.  Patient population: Hospitalized patients (n=2726) with confirmed COVID-19 between January 1, 2020, and April 1, 2020. Main outcome(s) and measure(s): Outcomes during hospitalization, including disease severity by level of care, intensive care unit (ICU) admission, mechanical ventilator (MV) use, hospital length of stay, and in-hospital death. Patient demographics and comorbidities were also recorded.
    Results: A total of 2,726 patients were included in the analysis. Three hundred ninety-eight (14.6%) patients were taking an ACEI, while 352 (12.9%) patients were taking an ARB prior to hospitalization. After adjusting for comorbidities, age, renal function, and severity of illness based on level of care, ACEI prior to admission was independently associated with decreased need for MV (odds ratio [OR] 0.56, p value 0.003) and mortality (OR 0.45, p value <0.001). Similarly, patients who took ARBs were less likely to require MV when compared to the non-renin-angiotensin-aldosterone system blockade (RAASb) group (7.4% vs 12.2%, p value 0.009, respectively). ARB prior to admission was also independently associated with decreased need for MV (OR 0.46, p value 0.001) and mortality (OR 0.66, p value 0.017) compared to the non-RAASb group.
    Conclusion: Taking ACEIs and ARBs prior to admission for COVID-19 was independently associated with decreased need for mechanical ventilation and in-hospital mortality.
    Language English
    Publishing date 2021-02-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.13429
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  3. Article: Characteristics and outcomes of diabetic patients with acute exacerbation of COPD.

    Monsour, Elio / Rodriguez, Lyd-Marie / Abdelmasih, Randa / Tuna, Kubra / Abusaada, Khalid

    Journal of diabetes and metabolic disorders

    2021  Volume 20, Issue 1, Page(s) 461–466

    Abstract: Rationale aims and objectives: Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and diabetes mellitus form a special population due to an increased risk of hyperglycemia from the use of corticosteroids. There is limited ...

    Abstract Rationale aims and objectives: Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and diabetes mellitus form a special population due to an increased risk of hyperglycemia from the use of corticosteroids. There is limited data regarding specific outcomes in diabetic patients with AECOPD.
    Methods: A retrospective data analysis of adult patients admitted to North Florida Division of the Hospital Corporation of America (HCA Healthcare) with a primary or secondary diagnosis of AECOPD from January 1, 2018, to December 31, 2018. We excluded patients who needed intensive care unit (ICU) care on day 0. Outcomes assessed included length of stay, mortality, and need for ICU transfer after 48 h from admission. Characteristics included age, sex, and race, comorbidities such as diabetes mellitus, chronic kidney disease, acute kidney injury, congestive heart failure, and anemia were analyzed. Comparisons were analyzed via binary and multivariate logistic regression models.
    Results: A total of 3788 patients admitted for AECOPD were included; amongst them, 1356 patients (~36%) had diabetes mellitus. This subset of patients had higher rates of comorbidities. A significant portion of diabetic patients (72%) received intravenous rather than oral steroids, similar to non-diabetic patients. In addition, diabetic patients were more likely to develop acute kidney injury (14.2% vs 8.0%,
    Conclusion: Diabetes mellitus is independently associated with increased ICU transfers amongst patients hospitalized with AECOPD. The use of oral steroids rather than intravenous steroids was independently associated with decreased length of stay in diabetic and non-diabetic patients. Despite no difference in intravenous vs. oral corticosteroids demonstrated in previous COPD trials, a significant portion of diabetic patients continue to receive intravenous corticosteroids. Further investigation is required to explore these findings.
    Language English
    Publishing date 2021-04-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2680289-2
    ISSN 2251-6581
    ISSN 2251-6581
    DOI 10.1007/s40200-021-00766-7
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  4. Article: A Rare Case of Severe Hypercalcemia Secondary to Atypical Parathyroid Cystic Adenoma with Negative Sestamibi Scan.

    Monsour, Elio P / Rifai, Faysal / Chacko, Jay / Hamza, Alan / Abusaada, Khalid

    Cureus

    2020  Volume 12, Issue 1, Page(s) e6830

    Abstract: The two types of parathyroid cysts are functional and non-functional cysts. Cystic parathyroid lesions are a rare cause of hypercalcemia and often pose a diagnostic challenge due to the reduced detection on preoperative imaging studies. We, herein, ... ...

    Abstract The two types of parathyroid cysts are functional and non-functional cysts. Cystic parathyroid lesions are a rare cause of hypercalcemia and often pose a diagnostic challenge due to the reduced detection on preoperative imaging studies. We, herein, present a rare case of an elderly female presenting to the emergency department with altered mental status associated with hypercalcemic crisis and a negative sestamibi scan. Following surgical resection, pathology revealed the diagnosis of cystic parathyroid adenoma and normalization of serum calcium levels.
    Language English
    Publishing date 2020-01-31
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.6830
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  5. Article ; Online: A Rare Case of an Immunocompetent Male With Zoster Meningitis.

    Faluk, Mohammed Ali / Makadia, Shraddhadevi / Abdelmaseih, Ramy / Hasan, S Mustajab / Abusaada, Khalid

    Journal of investigative medicine high impact case reports

    2020  Volume 8, Page(s) 2324709620952212

    Abstract: Varicella zoster meningitis is an uncommon complication of herpes zoster, especially in immunocompetent patients. We report a case of a healthy 45-year-old male who developed aseptic meningitis as a result of reactivated varicella zoster virus infection. ...

    Abstract Varicella zoster meningitis is an uncommon complication of herpes zoster, especially in immunocompetent patients. We report a case of a healthy 45-year-old male who developed aseptic meningitis as a result of reactivated varicella zoster virus infection. This case highlights the importance of remaining cognizant of varicella zoster virus as a cause of meningitis in not only the elderly or immunocompromised patients but also in patients who are healthy.
    MeSH term(s) Acyclovir/therapeutic use ; Antiviral Agents/therapeutic use ; Exanthema/virology ; Herpes Zoster/complications ; Herpes Zoster/diagnosis ; Herpesvirus 3, Human/isolation & purification ; Humans ; Immunocompetence ; Male ; Meningitis, Aseptic/diagnosis ; Meningitis, Aseptic/drug therapy ; Meningitis, Viral/diagnosis ; Meningitis, Viral/drug therapy ; Middle Aged
    Chemical Substances Antiviral Agents ; Acyclovir (X4HES1O11F)
    Language English
    Publishing date 2020-05-18
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2710326-2
    ISSN 2324-7096 ; 2324-7096
    ISSN (online) 2324-7096
    ISSN 2324-7096
    DOI 10.1177/2324709620952212
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  6. Article ; Online: Performance of a pre-procedural Mehran score to predict acute kidney injury after percutaneous coronary intervention.

    Blanco, Anamarys / Rahim, Faisal / Nguyen, Michelle / Quach, Steven / Guduru, Sai / Makadia, Shraddha / Abusaada, Khalid

    Nephrology (Carlton, Vic.)

    2020  Volume 26, Issue 1, Page(s) 23–29

    Abstract: Aim: Acute kidney injury (AKI) is a known complication of patients undergoing cardiac catheterization or percutaneous coronary interventions (PCI).The Mehran score was developed to identify patients at risk for AKI after cardiac catheterization or PCI, ... ...

    Abstract Aim: Acute kidney injury (AKI) is a known complication of patients undergoing cardiac catheterization or percutaneous coronary interventions (PCI).The Mehran score was developed to identify patients at risk for AKI after cardiac catheterization or PCI, but its use of contrast volume as part of the score calculation limits its application prior to the procedure. In this study, we evaluated the utility of a modified Mehran score that utilizes only pre-procedural data by excluding contrast volume.
    Methods: This was done in a retrospective fashion using data from patients who received PCI at our institution between July 2015 and December 2017 by evaluating the discriminative ability of the scoring systems for predicting outcomes through a receiver-operator characteristic curve analysis.
    Results: One thousand five hundred and seven patients were included in the study. A total of 70 (4.6%) patients developed AKI. The removal of contrast volume from the Mehran score resulted in a small loss of discrimination with AUROC 0.73 vs 0.74, P = .01 for the pre-procedural Mehran and the original Mehran, respectively. When compared to the original score, the pre-procedural Mehran score had a four-category net discrimination index (NRI) of -0.10 and an integrated discrimination index (IDI) for of -0.12.
    Conclusion: Despite a small loss in discrimination, there was no difference in the four-category net discrimination index between the two scores. The pre-procedural modified Mehran score is a useful clinical predictor of the risk of AKI in patients undergoing PCI.
    MeSH term(s) Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/prevention & control ; Aged ; Cardiac Catheterization/adverse effects ; Cardiac Catheterization/methods ; Contrast Media/administration & dosage ; Contrast Media/adverse effects ; Female ; Humans ; Male ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/methods ; Predictive Value of Tests ; Preoperative Care/methods ; Research Design ; Retrospective Studies ; Risk Assessment/methods ; Risk Factors ; United States/epidemiology
    Chemical Substances Contrast Media
    Language English
    Publishing date 2020-09-09
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1303661-0
    ISSN 1440-1797 ; 1320-5358
    ISSN (online) 1440-1797
    ISSN 1320-5358
    DOI 10.1111/nep.13769
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  7. Article ; Online: Impact of Consultation on Hospital Outcomes and Resource Utilization for Patients with Acute Congestive Heart Failure.

    Varga, Zoltan / Sabzwari, Syed Ali Rafay / Abusaada, Khalid

    Southern medical journal

    2017  Volume 110, Issue 7, Page(s) 452–456

    Abstract: Objectives: Consultation is an important tool for acquiring subspecialty support when managing patients with acute congestive heart failure (CHF). The effect of consultation on hospital outcomes and resource utilization in CHF is unknown. The objectives ...

    Abstract Objectives: Consultation is an important tool for acquiring subspecialty support when managing patients with acute congestive heart failure (CHF). The effect of consultation on hospital outcomes and resource utilization in CHF is unknown. The objectives of our study were to determine the effect of consultation on outcomes in CHF and to evaluate factors affecting the frequency of consultation.
    Methods: Our study was a retrospective cohort study of patients admitted to Florida Hospital Orlando for CHF between January 1, 2011 and December 31, 2013. Data on demographics, number of consultations, length of stay (LOS), readmissions within 30 days, cost of care, and mortality were compared according to the number of consultations. For statistical analysis, analysis of variance, the χ
    Results: A total of 1554 patients were included; 103 (6.6%) patients received no consultation; 482 (31%) received 1; 365 (23.5%) received 2; 229 (14%) received 3; and 375 (24%) received ≥4. Teaching service, age, and African American race were associated with decreased consultation (
    Conclusions: Increased consultation with patients with CHF is associated with increased costs and LOS without improved mortality or readmission rate. Decreased utilization of consultations by the teaching service suggests that there is an opportunity to decrease utilization of healthcare resources by streamlining the utilization of consultations.
    MeSH term(s) Acute Disease ; Aged ; Cohort Studies ; Diagnosis-Related Groups ; Female ; Florida ; Health Resources/economics ; Health Resources/utilization ; Heart Failure/economics ; Heart Failure/therapy ; Hospitalization ; Humans ; Interdisciplinary Communication ; Intersectoral Collaboration ; Length of Stay/economics ; Male ; Middle Aged ; Patient Readmission ; Referral and Consultation/economics ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 185329-6
    ISSN 1541-8243 ; 0038-4348
    ISSN (online) 1541-8243
    ISSN 0038-4348
    DOI 10.14423/SMJ.0000000000000668
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  8. Article: Successful Treatment of Human Monocytic Ehrlichiosis with Rifampin.

    Abusaada, Khalid / Ajmal, Saira / Hughes, Laura

    Cureus

    2016  Volume 8, Issue 1, Page(s) e444

    Abstract: Currently recommended treatment regimens for human monocytic ehrlichiosis (HME) include doxycycline or tetracycline. Antibiotic susceptibility studies demonstrate that rifampin has in vitro bactericidal activity against Ehrlichia. Case reports have ... ...

    Abstract Currently recommended treatment regimens for human monocytic ehrlichiosis (HME) include doxycycline or tetracycline. Antibiotic susceptibility studies demonstrate that rifampin has in vitro bactericidal activity against Ehrlichia. Case reports have suggested clinical response with rifampin treatment of human granulocytic anaplasmosis (HGA). We report the first case of HME successfully treated with rifampin.
    Language English
    Publishing date 2016-01-01
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.444
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  9. Article: Pseudomembranous aspergillar tracheobronchitis in a non-neutropenic critically ill patient in the intensive care unit.

    Khalid, Sameen / -Rahman, Fnu Asad-Ur / Abbass, Aamer / Aldarondo, Sigfredo / Abusaada, Khalid

    Journal of community hospital internal medicine perspectives

    2017  Volume 7, Issue 1, Page(s) 43–45

    Abstract: Invasive aspergillosis is an important cause of morbidity and mortality among immunocompromised patients. Prolonged neutropenia is the most common risk factor. It has rarely been reported to occur in non-neutropenic critically ill patients in the ... ...

    Abstract Invasive aspergillosis is an important cause of morbidity and mortality among immunocompromised patients. Prolonged neutropenia is the most common risk factor. It has rarely been reported to occur in non-neutropenic critically ill patients in the intensive care unit setting. Mortality rate in this group has been reported to be as high as 92%. We report a case of tracheobronchial aspergillosis in a non-neutropenic critically ill patient to highlight the fact that critically ill patients admitted in the intensive care unit can develop opportunistic infections such as invasive aspergillosis even in the absence of classic risk factors and prior history of immunosuppression. Early diagnosis and prompt initiation of antifungal therapy may improve the outcome and decrease mortality rate.
    Language English
    Publishing date 2017-03-31
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2616884-4
    ISSN 2000-9666
    ISSN 2000-9666
    DOI 10.1080/20009666.2017.1287840
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  10. Article: A Rare Case of Hemophagocytic Lymphohistiocytosis Associated with Parvovirus B19 Infection.

    Yuan, Cai / Asad-Ur-Rahman, Fnu / Abusaada, Khalid

    Cureus

    2016  Volume 8, Issue 11, Page(s) e897

    Abstract: Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening syndrome resulting from excessive immune activation. Secondarily, HLH is often associated with autoimmune disease, infection, and malignancy. The most common infectious trigger is ... ...

    Abstract Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening syndrome resulting from excessive immune activation. Secondarily, HLH is often associated with autoimmune disease, infection, and malignancy. The most common infectious trigger is Epstein-Barr virus (EBV) infection. HLH is rarely triggered by parvovirus B19. We discuss a case of a 62-year-old male who presented with multi-organ failure with presumed septic shock who eventually was diagnosed with HLH, with positive parvovirus B19 deoxyribonucleic acid (DNA) polymerase chain reaction (PCR). Prompt treatment with dexamethasone resulted in significant clinical resolution.
    Language English
    Publishing date 2016-11-24
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.897
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