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Dive into the research topics where Camelia Arsene is active.

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Featured researches published by Camelia Arsene.


Annals of Thoracic Medicine | 2016

Suboptimal implementation of diagnostic algorithms and overuse of computed tomography-pulmonary angiography in patients with suspected pulmonary embolism

Sulaiman Alhassan; Alaa Abu Sayf; Camelia Arsene; Hicham Krayem

Background: Majority of our computed tomography-pulmonary angiography (CTPA) scans report negative findings. We hypothesized that suboptimal reliance on diagnostic algorithms contributes to apparent overuse of this test. Methods: A retrospective review was performed on 2031 CTPA cases in a large hospital system. Investigators retrospectively calculated pretest probability (PTP). Use of CTPA was considered as inappropriate when it was ordered for patients with low PTP without checking D-dimer (DD) or following negative DD. Results: Among the 2031 cases, pulmonary embolism (PE) was found in 7.4% (151 cases). About 1784 patients (88%) were considered “PE unlikely” based on Wells score. Out of those patients, 1084 cases (61%) did not have DD test prior to CTPA. In addition, 78 patients with negative DD underwent unnecessary CTPA; none of them had PE. Conclusions: The suboptimal implementation of PTP assessment tools can result in the overuse of CTPA, contributing to ineffective utilization of hospital resources, increased cost, and potential harm to patients.


Journal of Graduate Medical Education | 2016

Successful Resident Engagement in Quality Improvement: The Detroit Medical Center Story

Syed Hussain; Camelia Arsene; Corinne Hamstra; Tess H. Woehrlen; Wilhelmine Wiese-Rometsch; Suzanne White

Background In 2014, the Detroit Medical Center launched a new program to engage residents and fellows in a strategy to deliver optimal care within 1 year, focusing on quality at an earlier stage of their careers and preparing them for working posttraining. Methods Residents from clinically relevant residency and fellowships programs were selected to be Resident Quality Directors. The project involved development of an interactive electronic health record (EHR) checklist to visually depict real time gaps in 40 process measures, while focusing on 14 areas related to stroke and venous thromboembolism (VTE) prophylaxis. We also implemented an incentive approach, using a pay-for-performance (P4P) model. Results The project included 800 residents led by 14 resident quality directors. We were able to achieve 100% resident participation. Prior compliance with VTE quality measures 6 months was 88.5%, with performance increasing to 94.2% (P < .006) at 6 months and 100% at 12 months (P < .005) after the intervention. The VTE prophylaxis score improved from the 89.7% to 92.9% range at inception to 100% by 12 months. A similar steady improvement of stroke process measures was observed, with a 100% compliance within 12 months. The institution made 4 incentive payments to trainees (ranging from


Case reports in gastrointestinal medicine | 2018

Acute Hepatitis due to Garcinia Cambogia Extract, an Herbal Weight Loss Supplement

Akshay Sharma; Elisa Akagi; Aji Njie; Sachin Goyal; Camelia Arsene; Geetha Krishnamoorthy; Murray Ehrinpreis

300 to


Case Reports | 2018

Recurrent hospitalisations in a rare case of hemicorporectomy: a challenging case for medical management

Ajit Thakur; Brittney Elliott; Rohan Naik; Nabeel Khan; Shayna McQuaid; Camelia Arsene

4,000 per year). The remaining 26 process measures remained at goal with above 95% compliance. Conclusions This quality improvement initiative was associated with system-wide quality performance on VTE prevention and stroke care process measures, which was facilitated by a interactive EHR-based checklist and linkage to P4P incentive payments.


Journal of The National Medical Association | 2017

Impact of Autologous Stem Cell Transplantation on Blood Pressure and Renal Function in Multiple Myeloma Patients

Leah Balsam; Chadi Saad; Camelia Arsene; Joshua Fogel

The Drug Induced Liver Injury Network reports dietary supplements as one of the most important causes of drug induced hepatotoxicity, yet millions of people use these supplements without being aware of their potential life-threatening side effects. Garcinia cambogia (GC) extract is an herbal weight loss supplement, reported to cause fulminant hepatic failure. We present a case of a 57-year-old female with no previous history of liver disease, who presented with acute hepatitis due to GC extract taken for weight loss, which resolved after stopping it and got reaggravated on retaking it. Obtaining a history of herbal supplement use is critical in the evaluation of acute hepatitis.


Journal of the American College of Cardiology | 2012

OUTCOME OF CATHETER BASED REVASCULARIZATION FOR PERIPHERAL ARTERIAL DISEASE: MULTI VESSEL VS. SINGLE VESSEL INVOLVEMENT

Malitha Samanthika Hettiarachchi; Anas Alani; Tamam Mohamad; David Rustom; Hamza Aurakzai; Adnan kassier; Camelia Arsene; Mahir Elder

Hemicorporectomy, or translumbar amputation, is a radical surgery involving the dissection of the body at the waist and is usually reserved for complex medical conditions including locally invasive malignancy and terminal pelvic osteomyelitis. Only 71 cases have previously been reported. We present a rare case of hemicorporectomy in a 53-year-old patient with terminal pelvic osteomyelitis which occurred after he suffered a gunshot wound at T6 causing paraplegia at the age of 31. Unfortunately, this patient continued to suffer recurrent hospitalisations and sepsis events secondary to chronic, non-healing advanced pressure ulcers and complicated urinary tract infections despite repeated courses of broad-spectrum intravenous antibiotics and surgical debridements. In light of his diminished quality of life and poor prognosis, the patient’s family chose to manage his condition conservatively with home hospice. This case illustrates the significant challenges in the medical and surgical management of hemicorporectomy patients.


Critical Care Medicine | 2018

1446: CLINICAL OUTCOMES OF WEIGHT-BASED VERSUS NON-WEIGHT-BASED NOREPINEPHRINE DOSING IN SEPTIC SHOCK

Aditya Kotecha; Nabeel Haider; Prabhash Kakarla; Rushi Surati; Robert Sherwin; Camelia Arsene; Geetha Krishnamoorthy; Hicham Krayem

BACKGROUND Autologous stem cell transplantation (ASCT) reverses kidney failure in one-third of multiple myeloma (MM) patients, which may lead to blood pressure (BP) improvement. We evaluate the long term impact of ASCT on BP and renal function in MM patients. METHODS We studied 192 MM patients that underwent ASCT. We compared BP readings and glomerular filtration rate (GFR) at 4 weeks before ASCT, on day of ASCT and post-ASCT at 30, 100 and 180 days. RESULTS Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) on day of ASCT and at both 30 and 100 days post-ASCT was significantly lower as compared to pre-ASCT SBP and DBP. There was a significantly higher mean GFR at day of ASCT and 30 days post-ASCT and significantly lower mean GFR at 180 days post-ASCT as compared to pre-ASCT. White patients had similar patterns to the total group for SBP, DBP, and GFR except for SBP which was still significantly lower and GFR which was not significantly different at 180 days. African-American patients showed no significant reductions in the mean values of SBP and DBP and no significant increases for GFR in follow-up after day of ASCT. Furthermore, the mean value of GFR was significantly lower at 180 days post-ASCT. CONCLUSIONS ASCT in MM patients had a positive impact on SBP and DBP and GFR but the impact was minimal for African-American patients. We recommend that clinicians consider closer follow-up of BP and kidney function and more intense therapy in African-Americans with MM.


Chest | 2018

AN UNUSUAL CAUSE OF ENCEPHALOPATHY: STEROID RESPONSIVE ENCEPHALOPATHY ASSOCIATED WITH AUTOIMMUNE THYROIDITIS (SREAT)

Parker Latshaw; Maxwell Cretcher; Katherine Kelley; Sidrah Najam; Udorji Ogochukwu; Aditya Kotecha; Christina Rose; Camelia Arsene; E.M. Malitha S. Hettiarachchi


Neurology | 2015

Engaging Residents in Stroke Quality Measures with Financial Incentives and Electronic Checklist (S11.007)

Marissa Dean; Salman Rashid; Wilhelmine Wiese-Rometsch; Camelia Arsene; Corinne Hamstra; Suzanne White; Syed Hussain


Chest | 2014

Institutional Validation of Currently Used D-Dimer Cutoff Value in the Workup of Pulmonary Embolism, Quality Improvement Initiative

Sulaiman Alhassan; Alaa Abu Sayf; Hicham Krayem; Rajika L. Munasinghe; Camelia Arsene; John Flack

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