Discoveries & Impact (July 2021)

Discoveries & Impact highlights some publications by section in the Department of Internal Medicine.

Cardiovascular medicine

Compared with second-generation drug-eluting stents, devices with ultrafine spacers were associated with a 19% reduction in target lesion failure at three years, a long-term meta-analysis of 18 publications from of 10 trials published in the journal Catheterization and cardiovascular procedures suggests.

Hussein Y, Gaston S, Kluger J, Shah T, Yang y, Tirziu D, Lansky A. Long-term results of ultra-thin drug-eluting stents versus standard thickness stents: meta-analysis of randomized trials. Cardiovasc Interv Catheter. July 8, 2021. doi: 10.1002 / ccd.29866. Epub ahead of print. PMID: 34236755.

Digestive diseases

In the United States, acute hemorrhage is the most common gastrointestinal (GI) diagnosis requiring hospitalization, but existing risk stratification scores are not used in real time. In “Early Identification of Patients with Acute Gastrointestinal Bleeding Using Natural Language Processing and Decision Rules,” the authors created EHR phenotypes using decision rules to identify patients with of real-time gastrointestinal bleeding and compared them to other phenotypes derived using natural language processing and neural function. networks. Learn more about the study here.

Shung D, Tsay C, Wool L, Chang D, Li F, Thomas P, Partridge C, Simonov M, Hsiao A, Tay JK, Taylor A. Early identification of patients with acute gastrointestinal bleeding using processing rules and language decisions natural. J Gastroenterol Hepatol. 2021 Jun; 36 (6): 1590-1597. doi: 10.1111 / jgh.15313. PMID: 33105045.

Endocrinology & Metabolism

In their JAMA Internal Medicine research letter, the authors performed a retrospective analysis of new prescriptions for levothyroxine between 2008 and 2018. They found that levothyroxine was commonly prescribed for patients with slightly increased thyrotropin levels, inconsistent with guidelines. clinical practice, as 60% had subclinical hypothyroidism. and 30% normal thyroid function. Learn more.

Brito JP, Ross JS, El Kawkgi OM, Maraka S, Deng Y, Shah ND, Lipska KJ. Levothyroxine use in the United States, 2008-2018. JAMA Med Intern. June 21, 2021: e212686. doi: 10.1001 / jamainternmed.2021.2686. PMID: 34152370; PMCID: PMC8218227.

General internal medicine

Research suggests that female trainees are penalized on assessments of non-gendered behavior during medical training. Studies of appraisals and performance scores reflect a gender bias, although the studies vary in methodology and the results have not been consistent. Using natural language processing (NLP), we examined differences in word use, skill themes, and length of written assessments of internal medicine residents, taking into account the impact of gender. teachers and residents. See our conclusions in Medical education.

Andrews J, Chartash D, Hay S. Gender bias in resident assessments: natural language processing and skills assessment. Med Educ. July 5, 2021. doi: 10.1111 / medu.14593. Epub ahead of print. PMID: 34224606.

Geriatrics

In “A Controlled Pilot Study of the Wish Outcome Obstacle Plan Strategy for Spouses of Persons with Early-Stage Dementia,” researchers investigated the use of the Wish Outcome Obstacle Plan (WOOP) tool for spouses of people with dementia . Through this randomized controlled trial, the team found significant effects on the perceived stress of caregivers, but suggested other trials.

Monin JK, Oettingen G, Laws H, David D, DeMatteo L, Marottoli R. A controlled pilot study of Wish’s Obstacle Plan strategy results for spouses of people with early stage dementia. J Gerontol B Psychol Sci Soc Sci. June 25, 2021: gbab115. doi: 10.1093 / geronb / gbab115. PMID: 34171086.

Hematology

In this new publication, Yale clinicians describe the transition from clinical infusions to home treatment with intravenous immunoglobulin (IVIG) for patients with hypogammaglobulinemia. Learn more about the successful transition to American Journal of Health-System Pharmacy.

Perreault S, Schiffer M, Clinchy-Jarmoszko V, Bocchetta N, Barbarotta L, Abdelghany O, Foss F, Huntington S, Seropian S, Isufi I. Mitigate the risk of exposure to COVID-19 by switching from a clinical immunoglobulin infusion to a home infusion. Am J Health Syst Pharm. 2021 Jun 7; 78 (12): 1112-11717. doi: 10.1093 / ajhp / zxab072. PMID: 33617630; PMCID: PMC7929449.

Infectious diseases

In a recent PNAS research paper, Yale researchers explain that SARS-CoV-2 is able to stop host protein synthesis, including antiviral protein synthesis, and that the non-structural protein of the SARS-CoV-2 NSP14 performs this activity. Understanding the strategies used by SARS-CoV-2 to subvert host immune responses is essential for the design of next-generation antivirals and for preparing for future emerging viral pathogens.

Hsu JC, Laurent-Rolle M, Pawlak JB, Wilen CB, Cresswell P. Translational arrest and evasion of the innate immune response by the SARS-CoV-2 NSP14 protein. Proc Natl Acad Sci US A. 2021 Jun 15; 118 (24): e2101161118. doi: 10.1073 / pnas.2101161118. PMID: 34045361.

Medical oncology

In “Analysis of Survival Among Adults With Early-Onset Colorectal Cancer in the National Cancer Database,” the authors designed a cohort study evaluating 769,871 colorectal cancer (CRC) patients to determine if there was a difference in survival. for those diagnosed with an early onset. CRC (

Cheng E, Blackburn HN, Ng K, Spiegelman D, Irwin ML, Ma X, Raw CP, Tabung FK, Giovannucci EL, Kunz PL, Llor X, Billingsley K, Meyerhardt JA, Ahuja N, Fuchs CS. Analysis of survival in adults with early-onset colorectal cancer in the National Cancer Database. JAMA Netw Open. 2021 Jun 1; 4 (6): e2112539. doi: 10.1001 / jamanetworkopen.2021.12539. PMID: 34132794; PMCID: PMC8209612.

Nephrology

A recent study in the European Journal of Heart Failure Significantly adds to the discussion of the relationship between incomplete decongestion and improved kidney function (IRF), Jeffrey M. Turner, MD, and Jeffrey M. Testani, MD, write in an editorial commentary in the journal.

Turner JM, Cox ZL, Testani JM. Improving renal function during diuresis: useful information or just noise? Eur J Heart Fail. June 11, 2021. doi: 10.1002 / ejhf.2267. PMID: 34117684.

Pulmonology, intensive care and sleep medicine

Untreated obstructive sleep apnea (OSA) is associated with adverse outcomes in patients with coronary artery disease (CAD). Continuous positive airway pressure (CPAP) is the most common treatment, but only 1 in 2 patients use CPAP long term. They sought to determine whether the physiological traits that cause OSA can also predict which patients may adhere to long-term CPAP and help improve the precision of therapeutic approaches to OSA. Read the study in the American Journal of Respiratory and Critical Care Medicine.

Zinchuk AV, Chu JH, Liang J, Celik Y, Op de Beeck S, Redeker NS, Wellman A, Yaggi HK, Peker Y, Sands SA. Physiological characteristics and treatment adherence for sleep apnea in people with coronary artery disease. Am J Respir Crit Care Med. June 22, 2021. doi: 10.1164 / rccm.202101-0055OC. Epub ahead of print. PMID: 34156917.

Rheumatology, Allergy & Immunology

Can research advances in translational approaches, data generation and sharing, and computational techniques be harnessed to advance our understanding of the aging process and its role in disease? An “elegant and informative” study in Nature Aging that uses big data to disentangle aging and COVID-19 proves we can, says Ruth R. Montgomery in News & Views, co-authored by Hanno Steen.

Montgomery, RR., Steen, H. Using “Big Data” to Untangle Aging and COVID-19. Aging Nat 1, 496-497 (2021). https://doi.org/10.1038/s43587-021-00078-8


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