Browsing by Author "Desai, Hem"

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    Diffuse Alveolar Hemorrhage
    (Springer Nature, 2019-07-24) Desai, Hem; Smith, Joshua; Williams, Mark Daren; Medicine, School of Medicine
    Diffuse alveolar hemorrhage[DAH] is a serious condition that can be life threatening. It can be caused by a constellation of disorders which presents with hemoptysis, anemia, and diffuse alveolar infiltrates. Respiratory failure from DAH can be so severe that it has been called an ARDS mimic/imitator. Early recognition is crucial because prompt diagnosis and treatment are required for survival. DAH should be distinguished from other causes of pulmonary hemorrhage caused by localized pulmonary abnormalities and the bronchial circulation. Early bronchoscopy with bronchoalveolar lavage (BAL) is generally required to confirm the diagnosis of DAH and rule out infection. Progressively bloody bronchoalveolar lavage samples can distinguish DAH. Systemic vasculitis is one of the most common causes of DAH and can be pathologically defined by the presence of cellular inflammation, vessel destruction, tissue necrosis, and eventually, organ dysfunction. Corticosteroids and immunosuppressive agents remain the gold standard for the treatment. The following case illustrates a patient who was dependent on dialysis, then presented with hemoptysis. Bronchoscopy demonstrated progressively bloody bronchoalveolar lavage samples consistent with diffuse alveolar hemorrhage. Serologic testing was consistent with microscopic polyangiitis. The patient experienced a clinical remission with cyclophosphamide and corticosteroids.
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    In-hospital complications associated with total artificial heart implantation in the United States between 2004 to 2011
    (e-Century, 2022-10-15) Pasha, Ahmed K.; Lee, Justin Z.; Desai, Hem; Hashemzadeh, Mehrtash; Movahed, Mohammad Reza; Medicine, School of Medicine
    Objective: Total artificial heart (TAH) utilization has increased over the recent years. The goal of this study was to evaluate the trend of artificial hearts used in the USA with its associated morbidity and mortality based on a large in-hospital database. Materials and methods: Using a very large nationwide inpatient samples (NIS) database, we used ICD-9 code for a total artificial heart. We evaluated the utilization of this device over the years studied. Furthermore, we evaluated any associated complications and mortality in patients receiving this device. Results: From 2004 until 2011, the rate of total artificial heart implants increased over the years from 5 in 2004 to the highest of 26 in 2011 across the United State. TAH was insesrted in 75 patients. Death was reported in 22 patients (29.3%). Acute renal failure was the most common complication (69.3%). This is followed by post-operative infectious complications (28.0%), acute renal failure requiring dialysis (16%), bleeding complications requiring blood transfusion (14.7%) respiratory complications (6.7%), and stroke/TIA (4.0%). There was no post-operative deep vein thrmobosis or pulmonary embolism. Conclusions: The use of total artificial heart has increased in the United State steadily with substantial morbidity and mortality associated with this device.