scholarly journals Pleural Fluid Analysis in Chronic Hemothorax: A Mimicker of Infection

2015 ◽  
Vol 8 ◽  
pp. CCRep.S12404
Author(s):  
Matthew L. DiVietro ◽  
John Terrill Huggins ◽  
Lauren Brown Angotti ◽  
Carlos E. Kummerfeldt ◽  
Jennings E. Nestor ◽  
...  
Keyword(s):  
South Carolina ◽  
Pleural Fluid ◽  
Thoracoscopic Surgery ◽  
Clinical History ◽  
Pleural Space ◽  
University Of South Carolina ◽  
Fluid Analysis ◽  
Ph Range ◽  
Medical University ◽  
Time From Injury

Objectives Timing to video-assisted thoracoscopic surgery (VATS) in hemothorax is based on preventing acute and long-term complications of retained blood products in the pleural space, including pleural space infection. We propose that the persistence of blood in the pleural space induces a proinflammatory state, independent of active infection. Methods We identified six patients with a hemothorax by clinical history, radiographic imaging, and pleural fluid analysis from a database of 1133 patients undergoing thoracentesis from 2002 to 2010 at the Medical University of South Carolina. Results In four of the six patients identified, the time from injury to thoracentesis was one, four, four, and five days, respectively. The fluid pH range was 7.32–7.41. The lactate dehydrogenase (LDH) range was 210–884 IU/L (mean 547 IU/L), and the absolute neutrophil count (ANC) range was 1196–3631 cells/μL. In two patients, the time from injury to thoracentesis was 7 and 60 days. In these two patients, the pH was 7.18 and 6.91, LDH was 1679 and 961 IU/L, and the ANC was 8134 and 5943 cells/μL. Microbiology and pathology were negative in all patients. Conclusions The persistence of blood outside the vascular compartment, and within the pleural space, biochemically mirrors infection. We will explore the multiple mechanisms that account for development of pleural fluid acidosis, inflammation, and neutrophil recruitment.

scholarly journals Lessons Learned from the Medical University of South Carolina Transdisciplinary Collaborative Center (TCC) in Precision Medicine and Minority Men’s Health

2020 ◽  
Vol 14 (6) ◽  
pp. 155798832097923
Author(s):  
Chanita Hughes Halbert ◽  
Caitlin G. Allen ◽  
Melanie Jefferson ◽  
Gayenell S. Magwood ◽  
Cathy Melvin ◽  
...  
Keyword(s):  
South Carolina ◽  
Precision Medicine ◽  
Synergistic Effects ◽  
Men’S Health ◽  
Lessons Learned ◽  
Men's Health ◽  
Dissemination And Implementation ◽  
University Of South Carolina ◽  
Minority Men ◽  
Medical University

The Transdisciplinary Collaborative Center (TCC) in Precision Medicine for Minority Men’s Health was established at the Medical University of South Carolina (MUSC) in 2015 to address disparities in the translation of precision medicine approaches among racial minority groups. This regional consortium focuses on three primary areas: (1) the development of a consortium of regional and national partners, (2) conducting transdisciplinary research examining synergistic effects of biological, social, physiological, and clinical determinants of chronic disease risks and outcomes, and (3) dissemination and implementation of precision medicine approaches, with an emphasis on reducing disparities in health care and outcomes among minority men. Given consistent calls to better translate precision medicine approaches and the focus of this consortium on addressing disparities among minority men, we provide an overview of our experience in developing the MUSC TCC, including barriers and facilitators to conducting translational research on minority men’s health issues in the context of precision medicine. Lessons learned and areas for improvement include providing enough time to create consistent partnerships and community engagement to improve recruitment and retention, identifying unique ways to engage diverse partners from across the region and nation, and better approaches to dissemination and communication for large partnerships focusing on precision medicine.

THE MAKING OF A PHYSICIAN

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 268-268
Author(s):  
C. P. Darby
Keyword(s):  
New York ◽  
South Carolina ◽  
Educational Opportunity ◽  
State University ◽  
University Of South Carolina ◽  
Cultural Aspects ◽  
The Arts ◽  
Optimal Functioning ◽  
The Individual ◽  
Medical University

We must be aware that freedom from organic disease alone can not be our goal. The optimal functioning of the individual must be our aim, and that it occur in an environment conducive to a fuller life. We must be aware that man does not live by bread alone, nor by his antihypertensive pill alone. We must be citizens of the community, helping to make it a better place for the raising of our children, for a fuller educational opportunity, for the development of the arts and other cultural aspects which help raise man above the level of animal life. Thus, the making of a doctor almost begins at his mother's knee. Nurtured further by society and its educational and Cultural institutions, he is finally given a privilege by society, to act in a responsible way in furthering the health, both physical and mental, of those he calls his patients. (Delivered to medical students and faculty, School of Medicine, University of South Dakota, May 1976 by Mitchell I. Rubin, MD, Emeritus Professor of Pediatrics, State University of New York at Buffalo, and Consultant in Pediatrics, Medical University of South Carolina).

Economic Evaluation of Changes in Reimbursement for Medications Purchased Through the 340B Drug Pricing Program

2019 ◽  
pp. 001857871988890
Author(s):  
Lauren A. Endriukaitis ◽  
Genevieve L. Hayes ◽  
Jason Mills
Keyword(s):  
South Carolina ◽  
Final Analysis ◽  
Medicare Beneficiaries ◽  
Drug Pricing ◽  
University Of South Carolina ◽  
Fiscal Impact ◽  
Worst Case ◽  
Original Intent ◽  
Reimbursement Scheme ◽  
Medical University

Background: The Centers for Medicare and Medicaid Services (CMS) implemented changes to the reimbursement scheme for 340B-acquired medications on January 1, 2018, reducing payments by approximately 25%. It was recognized that these changes would have a significant fiscal impact to Medical University of South Carolina (MUSC) Health. The purpose of this assessment was to review the financial impact of changes in Medicare reimbursement for clinic-administered medications. Methods: This study was a single-center, retrospective, financial evaluation of closed outpatient encounters for Medicare beneficiaries in calendar year 2018. Actual reimbursement was calculated for 2018. To better characterize the margin obtained, exploratory analyses were completed to identify best- and worst-case reimbursement outcomes. This exploratory analysis was conducted for both the new (ASP-22.5%) and old (ASP+6%) reimbursement schemes. Results: Overall, 10 973 encounters were reviewed for inclusion. Ultimately, 8028 encounters were included in the final analysis. Of all encounters, 88 unique medications were administered. Most of the drugs (55%) were associated with oncologic indications. An unfavorable variance was found in 3761 encounters (47%). The actual reimbursement margin for 2018 was $3 193 525. Conclusion: Changes to reimbursement outlined by the CMS at the start of 2018 resulted in decreased reimbursement for 340B-eligible, clinic-administered medications. Most of the unfavorable variances were associated with 340B acquisition prices that exceeded reimbursement. Although the original intent of the 340B Drug Pricing Program was to stretch federal resources, decreased payments could reduce institutional ability to fund programs that support medically vulnerable populations.

scholarly journals Medical University of South Carolina College of Medicine

2020 ◽  
Vol 95 (9S) ◽  
pp. S461-S464
Author(s):  
Donna H. Kern ◽  
Angela R. Dempsey ◽  
Debra J. Hazen Martin
Keyword(s):  
South Carolina ◽  
University Of South Carolina ◽  
Medical University
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