Dietary Habits of Patients with Chronic Medical Conditions During COVID-19

Over the past two years, the COVID-19 pandemic has forced drastic changes in various aspects of normal life for millions world-wide. As of April 2022, there have been over reported 80.8 million cases and 989,000 reported deaths. At the start of the COVID-19 pandemic, there were numerous societal changes occurred such as social distancing protocols, mask recommendations and restrictions in public spaces. With such drastic changes to normal life, investigators began examining how dietary habits in the general population could have been affected, but not investigated the impacts on patients with chronic medical conditions (CMC). Prior to major vaccination efforts, in February of 2021, the CDC noted that of the 548,971 confirmed deaths, 96.1% of those deaths where among individuals with pre-existing chronic medical conditions. Patients with chronic medical conditions, have strict regimented dietary patterns and nutritional needs. GOAL: Gather information and use it to help address the needs of patients with chronic medical conditions and address factors that can influence dietary habits

Effects of Wearable Devices on a Person’s Lifestyle

Lifestyle of the general population is a genuine concern currently due to processed foods and sedentary lifestyles. Also, technology has geared the new generation towards introversion but, not all technology is bad. If used in the correct way, technology can be helpful in transitioning from an unhealthy lifestyle to a healthy lifestyle. Through the Summer Medical Research Fellowship (SMRF) research program, it addressed whether or not wearable devices have an effect on lifestyle. During SMRF, everyone above the age of 18 was targeted. The hypothesis was to address if devices have an effect on lifestyle. During the first week of the study, a survey was developed to assess the lifestyle choices of patients in the Rowan Medicine Offices. The survey was administered to 225 people. The results of the study were not significant. The sample number of patients that actually utilized fitness devices was too small for any analysis. In the future, the goal would be to conduct this study with a greater sample. Ultimately, this study was good to lay foundations in regards to assessing lifestyle choices but it needs to be furthered

Consequence of Patient Education on Health Habits

Hypothesis: Patients who participate in an specific health habit do so due to a lack of knowledge about the consequences of that choice. Goal: Correlate patient participation in specific health habits with their knowledge of the consequences of these choices. Understand why patients continue to participate in specific habits and what influences their decision. The end goal of my project is to provide insight to encourage physicians to evaluate patient’s health education and get physicians to try to apply consequences of these habits on the patient’s life to help them understand health outcomes. Conclusion: This study showed more correlations between health habits related to diet compared to other habits. It may suggest that educating a patient on nutrition may be beneficial in altering their dietary behaviors. However, the study was unable to conclude a correlation in the knowledge of the consequence of a habit with smoking, excessive alcohol consumption, and exercise

The Effect of Perceived Weight Status and BMI on Food Attitudes and Food Relationships

The findings of this study have shed light on the intricate relationship that exists between perceived weight status from a “non-obese/obese” perspective and attitudes towards food and the overconsumption of particular food items. Participants who perceived their weight status as “obese” despite having a calculated BMI below the CDC threshold and classification for “obesity” had poorer relationships with food, consumption behaviors, and on average consumed food items that were detrimental to overall health. Comprehending a patient’s weight status perception and conducting a thorough history of their food intake could play a crucial role in addressing the patient’s overall health and medically managing this population

Pneumocystis Carinii Pneumonia: A Rare Cause of Granulomatous Hypercalcemia

Pneumocystis Carinii pneumonia (PCP) is a well-known complication of immunosuppression. Scattered case reports have linked PCP and its ability to induce a granulomatous response to hypercalcemia. PCP related hypercalcemia appears to be resistant to standard therapy. We report a case of hypercalcemia that preceded PCP and continued to worsen during the course of infection. A 63y man with renal transplant for polycystic kidney disease one year prior, presented with a three week history of fatigue, cough and chills. Patient was hypoxic and CT of the thorax revealed diffuse ground glass opacities. He was started on empiric therapy for PCP with intravenous methylprednisolone, clindamycin, and primaquine. Laboratory studies revealed a serum calcium of 12 mg/dl (baseline 9.2mg/dl, reference range 8.6-10.4 mg/dl) and creatinine of 3.23 mg/dl, which rose from a baseline value of 1.6 mg /dl. The patient’s bronchoalveolar lavage confirmed PCP. Endocrinology was consulted for evaluation of hypercalcemia. Further investigations revealed a suppressed PTH of 15 pg/ml from a baseline of 97 pg/ml (reference range 15-65pg/ml) post-transplant, 25-hydroxyvitamin D level of 30 ng/ml (reference range \u3e20 ng/ml ), and 1,25-dihydroxyvitamin D(1,25D) level was elevated (\u3e156 pg/ml; reference range 20-79 pg/ml). A diagnosis of 1,25D mediated hypercalcemia was made, intravenous fluids started and high dose steroids continued. Serum calcium levels improved transiently but subsequently rose to a peak level of 13.5 mg/dl. Ketoconazole 200 mg every 8hrs was started to reduce 1,25D production. Serum calcium remained high despite a reduction in 1,25D level (33 pg/ml). Bisphosphonates therapy was considered unsafe because of decreased GFR. Therefore, denosumab 30mg was administered, which resulted in decrease in serum calcium level to 10.3 mg/dl by day 19. Improvement of hypercalcemia correlated with improvement of PCP and renal function. Patient was discharged home after completing the 21 day course of treatment for PCP. Five weeks later, serum calcium stayed normal with an elevated PTH of 153 pg/ml and 1,25D level of 20 pg/ml.Hypercalcemia heralding PCP infection has been reported in the literature. Elevated calcium of 10.6 mg/dl was present one month prior to our patient’s hospitalization around the time of onset of his symptoms. Of the 19 cases of hypercalcemia due to PCP infection, 5 had hypercalcemia that preceded PCP infection by few weeks. The gold standard for diagnosis of PCP involves identification of the organism in induced sputum or bronchoalveolar lavage specimen. Measurement of serum 1,3-β-d-Glucan, which has high sensitivity, may be used as a screening tool in the right clinical setting such as our patient with immunosuppression and hypercalcemia to diagnose PCP at an earlier stage. We believe that hypercalcemia in a patient with immunosuppression should alert the possibility of PCP infection.https://scholarlycommons.henryford.com/merf2019caserpt/1027/thumbnail.jp