From the Editors

We are delighted to present you with the 21st annual edition of The Medicine Forum.Here in the birthplace of our nation, we like to think of The Medicine Forum as being of the housestaff, by the housestaff and for the housestaff. Undeniably, this publication would not be possible without the countless hours dedicated by our residents, students, fellows and faculty

Anatomic location and mortality of pancreatic adenocarcinoma: A single institution study

In pancreatic adenocarcinoma, it is believed that patients with proximal tumors (head) have earlier diagnosis and higher survival due to anatomic location compared to patients with distal tumors (body/tail). We hypothesized that differences in tumor biology would contribute to poorer survival in body/tail tumors compared to head tumors when diagnosed at the same stage. We performed a retrospective chart review on 324 patients with pancreatic adenocarcinoma (236 head and 88 body/tail) diagnosed from 2011-2017. We gathered electronic health records from a single center with a high volume of pancreatic cancer directed surgery. We compared median patient survival from onset of diagnosis based on cancer staging and tumor location. The overall body/tail cancer survival was significantly less than pancreatic head cancer (11.2 months body/tail compared to 16 months head, p=0.015). When broken down individually by stage at diagnosis or surgery, the survival for body/tail cases was not statistically significant to pancreatic head cases (p\u3e0.05). After adjusting for both stage and surgery, the hazard ratio of body/tail reduced from 1.42 to 0.96. The overall survival of pancreatic head cancer was significantly higher than that of the body/tail cancer, which was attributed to the head group being diagnosed earlier and/or underwent surgery. The head group’s survival advantage diminishes when corrected by stage and surgery and has a similar survival to the body/tail cancer. This result less likely supports a difference in tumor biology on survival

A Case of Left Ventricular Myocardial Calcification in a Patient with Severe Sepsis

Introduction Sepsis is an important source of morbidity and mortality among patients admitted to the Intensive Care Unit (ICU) and can cause critical damage to all organ systems. Regarding cardiac complications, sepsis can acutely result in cardiomyopathy characterized by ventricular dilatation and a depressed ejection fraction.1 Myocardial calcification is a more rare, delayed cardiac complication of severe sepsis that has been reported in literature.1-6 Herein we report a case of a patient with Acute Myeloid Leukemia (AML) admitted to the TJUH ICU requiring prolonged vasopressor support for severe sepsis whose clinical course was complicated by left ventricular myocardial calcification

Analysis of Alert Based Intervention on Management of Hospital-Acquired Acute Kidney Injury: A Prospective Study

Introduction The development of acute kidney injury (AKI) during hospitalizations has become a widespread problem that leads to prolonged hospital stays and an increased risk of the development of renal failure. Several national prospective studies have been conducted to identify the most common causes of hospital acquired acute kidney injury (HAAKI) including contrast-induced, drug-induced, sepsis with hypotension, and comorbid organ dysfunction. To attempt to reduce HAAKI and its long-term consequences both to patients and the healthcare system, our study aimed to review creatinine changes among patients admitted to five general medicine teams. Our study goal was to see whether spreading awareness of the common causes of HAAKI through an alert-intervention to providers decreased the rate of occurrence of HAAKI in our hospital system.https://jdc.jefferson.edu/patientsafetyposters/1124/thumbnail.jp