Ebubechukwu Ezeh

Marshall University

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Iatrogenic Pituitary Shutdown: A Rare Adverse Event of Programmed Cell Death-Ligand 1 Inhibitor

JCEM Case Reports (2023)

Mohammed Al-Hiari Anthony Workman Ebubechukwu Ezeh Samson Teka

Abstract Immune checkpoint inhibitors (ICIs) are one of the novel treatment strategies for malignancies, and their wide use has led to the emergence of immune-related adverse events (irAEs). Most of them have been reported in patients taking cytotoxic T lymphocyte-associated protein 4 inhibitors and are rarely reported among those taking programmed cell death-ligand protein 1 inhibitors. Here is a 74-year-old man who underwent treatment with atezolizumab for 33 weeks for hepatocellular carcinoma before presenting with chronic symptoms and laboratory results consistent with central adrenal insufficiency. Brain imaging did not show a possible culprit. He was incidentally found to have low thyrotropin (TSH) and low thyroxine prior to his presentation and began replacement with no further workup prior. We advocate keeping a low threshold for the diagnosis of adrenal insufficiency among patients taking ICIs and monitoring their pituitary hormones on a regular basis. Also, it is crucial to rule out pituitary hormonal deficiency among patients with central hypothyroidism prior to initiating replacement.

Culprit

10.1210/jcemcr/luad157

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IN-HOSPITAL CARDIOVASCULAR OUTCOMES OF HYPOGONADIC MALES ON TESTOSTERONE REPLACEMENT THERAPY: A PROPENSITY MATCHED ANALYSIS FROM A NATIONALLY REPRESENTATIVE DATABASE

Journal of the American College of Cardiology (2024)

Endurance O Evbayekha Ebubechukwu Ezeh Olubadewa A. Fatunde Olakanmi Olagoke Rohan Goswami

Testosterone replacement

10.1016/s0735-1097(24)03144-9

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Opioid-Induced Hyperalgesia in a Cancer Patient on High-Dose Methadone Maintenance Therapy: A Case for Subspecialty Opioid Use Disorder Primary Care

Cureus (2020)

Ebubechukwu Ezeh Davinder Singh Varun Dobariya Esiemoghie Akhigbe Christine Gilkerson

As opioid use disorder (OUD) reaches epidemic levels in the United States, medication-assisted treatment (MAT) plays a central role in its treatment. Methadone, a long-acting mu-opioid receptor agonist has been shown to be effective in managing OUD. It is also known that chronic opioid therapy may have the paradoxical effect of increased sensitivity to pain, a phenomenon called opioid-induced hyperalgesia (OIH). This presents a conundrum when a patient such as ours, on MAT presents with acute pain and OIH. This case report illustrates the current challenges health care providers encounter when treating patients on chronic MAT for non-opioid-related conditions. As this patient population ages, these encounters will become more common. These patients will need appropriate health care screening and chronic care management. This case serves two purposes; to highlight the difficulty in treating acute pain in patients on long-term high-dose methadone coupled with the missed opportunity for primary care for OUD patient population, and proposes that education reforms in this area be implemented now.

Subspecialty

Methadone maintenance

10.7759/cureus.12345

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Sa1467 FACTORS ASSOCIATED WITH VARICES IN PRIMARY SCLEROSING CHOLANGITIS HOSPITALIZATIONS: A NATION-WIDE SAMPLE STUDY.

Gastroenterology (2023)

Onyinye Ugonabo Olubunmi Oladunjoye Pramod Pantangi Olachi J. Egbo Ebubechukwu Ezeh

Primary Sclerosing Cholangitis

Sample (material)

10.1016/s0016-5085(23)01916-9

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THE JAILED SINOATRIAL NODE: SINUS ARREST-INDUCED CARDIOGENIC SHOCK FOLLOWING PERCUTANEOUS INTERVENTION

Journal of the American College of Cardiology (2022)

Ebubechukwu Ezeh Esiemoghie J. Akhigbe Mohammad Amro Ebad Ur Rahman Salem Omar

Sinus (botany)

10.1016/s0735-1097(22)03778-0

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Role Of Right Ventricular Index Of Myocardial Performance (RIMP) In The Diagnosis Of Right Ventricular Dysfunction In Heart Failure Patients; A Sub-sahara African Teaching Hospital Experience

Journal of Cardiac Failure (2024)

Chigozie Chukwuocha Chikodili Nebuwa Ebubechukwu Ezeh Onyedika J. Ilonze Patricia Rodriguez Lozano

Ventricular Function

10.1016/j.cardfail.2023.10.374

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AN UNDER-RECOGNIZED MOLECULAR MIMICRY: ACUTE NON-RHEUMATIC STREPTOCOCCAL MYOPERICARDITIS MIMICKING ST ELEVATION MYOCARDIAL INFARCTION IN A HEALTHY MALE

Journal of the American College of Cardiology (2023)

Ebubechukwu Ezeh Olalekan Olanipekun Esiemoghie J. Akhigbe Mohamed Suliman Isimenmen Okekumata

Myopericarditis

Molecular mimicry

10.1016/s0735-1097(23)04230-4

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Citations (1)

Life's essential eight as targets for cardiometabolic risk reduction among non-Hispanic black adults: A primary care approach

Journal of the National Medical Association (2023)

Ebubechukwu Ezeh Onyedika J. Ilonze Maddie Perdoncin Archana Ramalingam Gurleen Kaur

Cardiovascular diseases remain the leading cause of death in the United States. Several studies have shown racial disparities in the cardiovascular outcomes. When compared to their Non-Hispanic White (NHW) counterparts, non-Hispanic Black (NHB) individuals have higher prevalence of cardiovascular risk factors and thus, increased mortality from atherosclerotic cardiovascular diseases. This is evidenced by lower scoring in the indices of the American Heart Association's Life Essential 8 among NHB individuals. NHB individuals score lower in blood pressure, blood lipids, nicotine exposure, sleep, physical activity level, glycemic control, weight, and diet when compared to NHW individuals. Measures to improve these indices at the primary care level may potentially hold the key in mitigating the health care disparities in cardiovascular health experienced by NHB individuals.

Cardiovascular Health

10.1016/j.jnma.2023.11.003

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The Slower, the Better: Wide Complex Tachycardia Triggered by Flecainide in an Elderly Female

Case Reports in Cardiology (2022)

Ebubechukwu Ezeh Maddie Perdoncin Morgan K. Moroi Mohammad Amro Mohammed Ruzieh

Class IC antiarrhythmics are generally considered a safe means of treating many common arrhythmias such as atrial fibrillation (a-fib), atrial flutter (a-flutter), and paroxysmal supraventricular tachycardia (PSVT). Essentially, flecainide works by binding and blocking sodium channels more effectively at higher heart rates. However, this class of drugs is known to exhibit use dependence which could predispose patients to the development of malignant arrhythmias during episodes of tachycardia. In this case, we present a patient who was being treated with flecainide for a-fib who ultimately developed a wide complex tachycardia after her metoprolol was held.

Flecainide

Supraventricular Tachycardia

Atrial tachycardia

Fibrillation

10.1155/2022/1409498

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Abstract 11699: In Hospital Outcomes of Acute Coronary Artery Dissection and Obesity

Circulation (2022)

Richard Orji Kelechukwu U. Okoro Favour Markson Ebubechukwu Ezeh Muftawu-Deen Iddrisu

Introduction: Coronary artery dissection is an emergency condition due to a tear in the coronary arterial wall, and it’s an uncommon cause of acute coronary syndrome. The Effect of Obesity on the outcome of acute coronary artery dissection is poorly documented. Hence, our study sought to estimate the impact of Obesity on clinical outcomes of hospitalizations of patients with acute Coronary artery dissection using the national database. Methods: We queried the National Inpatient Sample (NIS) database from 2016 to 2019. The NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalization of adult patients with acute Coronary artery dissection as a principal diagnosis with and without Obesity as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality. The secondary results were Acute kidney injury (AKI), Cardiogenic shock (CS), Cardiac arrest (CA), Total hospital charge (THC), and length of stay (LOS). Multivariate logistic and linear regression analyses were used accordingly to adjust for confounders. Results: About 2440 patients were admitted for acute Coronary artery dissection; 17.4% (425) had underlying obesity. Cohorts with obesity vs No obesity had a mean age of 52.9 years [CI 50.4 - 55.5] vs 55.9 years [CI 54.5 - 57.4]; male (20% vs 25.8%), female (80% vs 74.2%); white (71.3% vs 73.3%), black (21.3% vs 12.0%), and Hispanic (6.3% vs 7.8%). Compared to patients without obesity, patients admitted with coexisting obesity had similar inpatient mortality (7.1% vs 3.2%, AOR 3.22, 95% CI 0.74 - 13.88, P=0.118), AKI (15.3% vs 9.9%, P 0.357), CS (9.4% vs 11.2% P=0.098), CA (5.9% vs 5.0% P=0.530), THC (IRR 0.94, 95% CI 0.64 - 1.37, P=0.738), and LOS (IRR 0.79, 95% CI 0.59 - 1.05, P=0.107). Conclusions: Patients admitted primarily for acute Coronary artery dissection with co-existing Obesity had similar inpatient mortality, AKI, CS, CA, THC, and LOS compared to patients without Obesity.

10.1161/circ.146.suppl_1.11699

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