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The discovery of new understanding of pathological conditions and treatment is essential to advancement in human health. As such, it is the expectation that each fellow will design or participate in a scholarly activity during the training period. Clinical research is of several varieties, each important to this advancement.

Clinical research is divided into:

  1. Pathophysiological investigation-understanding the mechanisms of disease or therapies in cohorts of patients with the same condition.
  2. Outcomes or data mining research-using clinical data bases (local, regional, or national) to address observational associations that can lead to future mechanistic research.
  3. Non-parametric or behavioral research (including educational research).
  4. Translational research-collaborative investigation with basic scientists to extend basic science understanding to human disease states.
  5. Drug-company sponsored clinical trials.

The Division of Nephrology and Hypertension has been, or is, active in each of these arenas.

  1. Determination of the renin to BNP ratio as a marker of volume expansion from CHF in patients with ESRD-S. Bhayana and R. Beach.
  2. Regulation of renin secretion by AP-1 transactivating factor in humans-R. Beach
  3. Outcomes on cardiovascular disease with treatment of hyperuricemia with xanthineoxidase inhibitors-C. Takkar and R. Beach
  4. Regulation of calcitropic hormones in African-Americans with hypertension-R. Beach. Poster presentation at NKF meeting.
  1. Case report on renal recovery in a young patient with multiple myeloma-H. Salameh, A. Ahmad, T. Kochar. Poster presentation at NKF meeting.
  2. Utilization of the HOMA test with simultaneous kidney and pancreas transplantation-G. Osuchukwu, T. Kochar, H. Adrogue. Oral presentation at AST meeting.
  3. Use of urinary pO2 to determine risk of AKI in critically ill patients-N. Mastouri and R. Beach
  4. Incidence and relationship to urine flow rates of acquired cystic disease of the kidneys in patients on peritoneal dialysis, home hemodialysis, and in-center hemodialysis-C. Takkar, T. Kochar, and R. Beach.
  5. Comparison of effectiveness of natriuresis with combination diuretics in refractory ascites in cirrhosis-S. Mittal and R. Beach.
  6. A Multi-Center, Randomized, Placebo-Controlled, Double-Blind Study to Confirm the Reversal of Hepatorenal Syndrome Type I with Lucassin (Terlipressin)- K. Crudo and H. Duchini.

The department of internal medicine is developing evidence based clinical protocols which will be available in EPIC (as order sets) for use when admitting patients with these diagnoses. Their AIM is to standardize care and decrease length of stay and readmission rates.

Currently available protocols are:
  • CAP - Community Acquired Pneumonia Order set
  • Congestive Heart Failure (CHF)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Diabetic Ketoacidosis Adult, ICU
  • General Medicine Admission
  • Immunodeficiency Flow Panel
  • MICU/CCU Admission Order Set
  • Oral Analgesic Medications
  • Parenteral Opioids
  • Sepsis, Adult ICU
  • 111 - Stroke Alert
  • 112 - Stroke Activation
  • 300086 - Stroke Floor Admission
  • 3000000001 -  Stroke Critical care without tPA
  • 300088 Stroke - Transfer from Critical care to floor
  • 3004002 - Stroke Discharge

All protocols can be found in the EPIC order set section.

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The department of Internal Medicine has a large role in the Meaningful Use Initiative. Our participation is key for the success of the initiative. Please visit the meaningful use website for important communication and updates from the Meaningful Use Initiative.

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