Mayank Mittal

University of Missouri | Mizzou · Department of Internal Medicine

Chronic congestive heart failure (CHF) and acute decompensated heart failure (ADHF) refractory to medical therapy represent therapeutic challenges. In such patients, attempts to reduce pulmonary and systemic congestion frequently produce deterioration of renal function. In studies of patients with chronic severe CHF refractory to medical therapy (i...

Objectives: Left ventricular ejection fraction can be measured by a variety of invasive and non-invasive cardiac techniques. This study assesses the relation of three diagnostic modalities to each other in the measurement of left ventricular ejection fraction: invasive contrast left ventriculography, two-dimensional echocardiography, and quantitati...

Cardiovascular disease is the major cause of morbidity and mortality in chronic kidney disease patients. Because of a higher occurrence of asymptomatic coronary artery disease and increased perioperative cardiovascular mortality in kidney transplant patients, screening for coronary artery disease before transplant surgery is essential. Various stud...

Cardiovascular disease (CVD) occurs commonly in patients with chronic kidney disease (CKD) including those treated with hemodialysis (HD), and is associated with poor outcomes in this population. Pharmacologic management of hypertension, dyslipidemia, acute and chronic coronary artery disease, and atrial fibrillation in the general population is su...

Patients with advanced chronic kidney disease (CKD), including those treated with dialysis, are at high risk for the development of cardiovascular disease (CVD). CVD accounts for 45-50% of deaths among dialysis patients. Therapy of acute and chronic coronary heart disease (CHD) that is effective in the general population is frequently less effectiv...

Contrast induced nephropathy (CIN) is an iatrogenic form of acute kidney injury (AKI) with variable but growing prevalence secondary to increased need for contrast administration during medical investigations such as coronary angiography. The mechanism of CIN is complex and poorly understood but is believed to be secondary to renal medullary hypoxi...

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and approximately 18-45% of AF patients have concomitant coronary artery disease (CAD). Several studies have demonstrated that oral anticoagulation is the mainstay of therapy for stroke prevention in AF. Similarly, antiplatelet therapy including aspirin and P2Y12 inhibitor is recomme...

Abstract: Stroke prevention is a crucial step in the management of atrial fibrillation (AF). The assessment of stroke risk associated with AF varies, depending on the presence of various clinical risk factors (older age, congestive heart failure, diabetes mellitus, hypertension, history of stroke or transient ischemic attack, female sex, or periphe...

Background: The internet can provide evidence-based patient education to overcome time constraints of busy ambulatory practices. Health information prescriptions (HIPs) can be effectively integrated into clinic workflow, but compliance to visit health information sites such as MedlinePlus is limited. Objective: Compare the efficacy of paper (pHI...

3-Hydroxy-3-methyl-glutarylCoA reductase inhibitors, or statins, are a mainstay in the treatment of patients with established coronary artery disease (CAD) because of their proven efficacy in reducing cardiovascular death, myocardial infarction, and coronary revascularization procedures in this patient population. Statin therapy has also proven suc...

Increased patient awareness, duty hour restrictions, escalating costs, and time constraints in the operating room have revolutionized surgery education. Although simulation and skills laboratories are emerging as promising alternatives for skills training, their integration into graduate surgical education is inconsistent, erratic, and often on a v...

Medical student procedural training has become increasingly limited amid concerns for patient safety. Because simulation education has been shown to be effective for early skills training, we used germ simulation for teaching hand hygiene principles and aseptic technique in urinary catheterization (UC). We hypothesized that posttraining, students w...

In2001,wedevelopedasurgicalskillscurriculumtoenhancecognitive and procedural skills training for our surgical resi-dents and health care providers. This was initially delivered attheWilliamsT.FittsSurgicalEducationCenter.Thesuccessfulimplementation of simulation rotation and the growing popu-larity of our educational program highlighted the need to...

Endothelial progenitor cells (EPCs) are a heterogeneous population of cells that are provided by the bone marrow and other adult tissue in both animals and humans. They express both hematopoietic and endothelial surface markers, which challenge the classic dogma that the presumed differentiation of cells into angioblasts and subsequent endothelial...

Surgical trainees routinely participate in percutaneous endoscopic gastrostomy (PEG) tube placement. Although simulation has gained widespread acceptance, novice trainees continue learning this procedure on real patients. We designed a novel hands-on training model for practicing PEG tube placement with minimal monetary investment (cost<$10). Our p...

Physician-patient email communication is gaining popularity. However, a formal assessment of physicians' email communication skills has not been described. We hypothesized that the email communication skills of rheumatology fellows can be measured in an objective structured clinical examination (OSCE) setting using a novel email content analysis in...

Heart failure (HF) is a leading cause of morbidity and mortality. Appropriate medical therapy using angiotensin converting enzyme inhibitors and beta-blockers improves outcomes in HF, whereas the role of digoxin is still not clearly defined. Digoxin is currently recommended for patients with HF who are symptomatic despite standard therapy and for c...

The article by Barsuk et al1 demonstrated that simulation-based training reduces catheter-related bloodstream infections (CRBSIs) associated with central venous line (CVL) placement by trainees. We know that educational intervention can reduce CRBSIs associated with CVL placement.2,3 In a multicenter study, Warren et al3 demonstrated a significant...