Internal Medicine Commons^™

Hubungan Tingkat Stres, Kecemasan, Dan Depresi Dengan Konstipasi Fungsional Pada Mahasiswa Kedokteran, Khafifah Z, Wilson Wilson, Agustina Arundina Triharja Tejoyuwono

Jurnal Penyakit Dalam Indonesia

Introduction. Stress, anxiety, and depression are factors associated with functional constipation that affect students’ quality of life. Stress, anxiety, and depression are often experienced by first-year medical students, but studies assessing these three variables with functional constipation are still limited.

Methods. This study used a cross-sectional analytical design. Study was carried out in July 2023 involving 88 first-year medical students from the Tanjungpura University Medical Study Program. Analysis of relationship tests was carried out using Kendall’s Tau-B tests.

Results. Most students were in the normal category of stress, anxiety and depression levels, however 21 students were in …

Infark Ventrikel Kanan Dengan Blok Atrioventrikular: Laporan Kasus Dengan Tinjauan Pustaka, Naomi Niari Dalimunthe, Refli Hasan, Herwindo Ahmad, Rahmad Isnanta, T Realsyah, Zainal Safri

Jurnal Penyakit Dalam Indonesia

Inferior myocardial infarction is frequently accompanied by right ventricular infarction. This report presents two cases of right ventricular infarction accompanied by hemodynamic disorder and atrioventricular block complications. These patients were diagnosed with right ventricular infarction based on history, clinical presentations, and electrocardiography findings. The management approach for these patients involved optimizing volume and fluid status, using temporary pacemakers, and urgent percutaneous coronary intervention. This report highlights the need to promptly identify right ventricular involvement in inferior myocardial infarction, as the treatment strategies for right ventricular infarction are different from left ventricular infarction.

Hubungan Rasio Neutrofil Limfosit Terhadap Komplikasi Kardiovaskular Pada Pasien Penyakit Ginjal Kronik Hemodialisis, Thariq Hikmatul Akmal, Agung Susanto, Ratih Tri Kusuma Dewi, Agus Jati Sunggoro

Jurnal Penyakit Dalam Indonesia

Introduction. The neutrophil-to-lymphocyte ratio (NLR) is a simple parameter to assess the inflammatory status, especially in chronic kidney disease (CKD) patients experiencing capillary damage due to increased glomerular capillary pressure. In a state of vascular endothelial inflammation, there is a higher tendency to form atherosclerotic plaques and calcification that can induce cardiovascular events such as heart failure, coronary heart disease, and stroke. This study aimed to determine the relationship between the NLR and cardiovascular complications in CKD patients undergoing hemodialysis.

Methods. An analytical observational study with cross-sectional approach was conducted among 119 CKD patients undergoing hemodialysis at Dr …

Evaluasi Pengukuran Kekakuan Limpa Dalam Memprediksi Perdarahan Varises Esofagus Berulang Pada Pasien Sirosis Hati, Andi Cahaya Tahir, Juferdy Kurniawan, Marcellus Simadibrata, Aulia Rizka, Hamzah Shatri, Cosmas Rinaldi A. Lesmana, Nadia Ayu Mulansari

Jurnal Penyakit Dalam Indonesia

Introduction. Esophageal variceal bleeding is one of the complications caused by an increase in pressure within the portal vein blood vessels. The gold standard examination for portal pressure is the hepatic venous pressure gradient (HVPG), but HVPG examination is invasive, involving transjugular catheterization of the hepatic vein. Currently, non-invasive methods for measuring portal hypertension are being developed to predict esophageal varices and esophageal variceal bleeding using spleen stiffness measurements. This study aimed to evaluate the accuracy of spleen stiffness measurement in predicting recurrent esophageal variceal bleeding in patients with liver cirrhosis.

Methods. This study used a retrospective cohort …

Faktor-Faktor Yang Memengaruhi Kualitas Hidup Pasien Gagal Jantung Kronik Fraksi Ejeksi Terjaga (Hfpef) Rawat Jalan Di Rsupn Dr. Cipto Mangunkusumo, Derin Anugrah Pratama, Sally Aman Nasution, Muhadi Muhadi, Arif Mansjoer, Idrus Alwi, Dyah Purnamasari, Aida Lydia, Dicky Levenus Tahapary

Jurnal Penyakit Dalam Indonesia

Introduction. The prevalence of heart failure in Indonesian adults is 1.5%, at least half of which categorized as heart failure with preserved ejection fraction (HFpEF). Quality of life assessment plays an important role in the management of heart failure, one of the tools widely used is the Minnesota Living with Heart Failure (MLHF) questionnaire. In Indonesia, there is still no data regarding risk factors that affect the quality of life of HFpEF patients. This study aimed to determine the quality of life profile of HFpEF patients and the relationship between the risk factors (age, hypertension, DM, smoking, and obesity) …

Gambaran Klinis Pasien Terduga Tuberkulosis Paru Resisten Obat (Tb-Ro) Dengan Kolonisasi Candida Sp. Di Rumah Sakit Hasan Sadikin Bandung, Hasna Rafifah Zahira Zalfa, Iceu Dimas Kulsum, Hendarsyah Suryadinata, Chrysanti Chrysanti, Intan Mauli Warma Dewi

Jurnal Penyakit Dalam Indonesia

Introduction. Candida sp. is a fungus that lives as a commensal in human body, but may cause infection upon immune suppression. The decrease in immunity due to TB infection and long-term use of antibiotics in TB patients may increase the risk of the Candida sp. colonization in patient. Data regarding the prevalence of Candida sp. colonization in TB patients and its impact has not been widely reported. This study was conducted to determine the prevalence and clinical characteristics of presumptive drug-resistance TB patients with Candida sp. colonization.

Methods. A cross-sectional study was conducted using secondary data from a …

Program Multidisiplin Pasien Gagal Jantung Kronik Untuk Menurunkan Angka Perawatan Ulang Rumah Sakit, Lusiani Lusiani, Nurhayati Adnan

Jurnal Penyakit Dalam Indonesia

Heart failure is a complex disease caused by abnormalities in the structure or function of the heart resulting in decreased cardiac output. The complexity of heart failure causes an increasing burden of mortality and morbidity. This has further exacerbated the burden of treatment costs as well as the high rate of hospital readmissions. Readmission rate in patients with heart failure within 30 days post-hospitalization can reach 17.5%. In order to reduce re-hospitalization rates, multidisciplinary programs were introduced. The program involves collaboration of cardiologists, specialty nurses, pharmacists, nutritionists, and social workers using home or clinic-based models. Studies show that special management …

Etika Publikasi Di Bidang Kedokteran, Chyntia Olivia Murine Jasirwan, Edward Faisal, Evy Yunihastuti

Jurnal Penyakit Dalam Indonesia

Publikasi ilmiah merupakan penjelasan sistematis mengenai hipotesis, bukti, dan kesimpulan dari sebuah penelitian yang dimaksudkan untuk mengedukasi masyarakat. Publikasi merupakan tujuan utama dari penelitian, dan peer-review dilakukan untuk memverifikasi temuan dan meningkatkan kepercayaan penulis untuk evaluasi penelitian yang dipublikasi. Publikasi merupakan salah satu persyaratan khusus dalam suatu institusi akademik dan dapat mendukung promosi ke jabatan akademis. Publikasi (nasional dan internasional) telah menjadi norma yang dapat dikatakan wajib dalam dunia pendidikan. Berbagai pelanggaran etika banyak terjadi dan kita temukan, seperti plagiarisme, tata bahasa yang tidak pantas, dan praktik pengelolaan data yang meragukan. Kurangnya pemahaman tentang etika penelitian seringkali menjadi akar dari …

Efektivitas Terapi Antituberkulosis Empirik Pada Pasien Dengan Penyakit Hiv Stadium Lanjut: Sebuah Laporan Kasus Berbasis Bukti, Natasha Chandra, Dina Elita, Evy Yunihastuti

Jurnal Penyakit Dalam Indonesia

Patients with advanced human immunodeficiency virus (HIV) disease have a high risk of mortality, with tuberculosis (TB) being one of the leading causes. Empiric antituberculosis therapy could be considered as a strategy to reduced mortality although there is no strong evidence. This study aims to review the efficacy of empiric antituberculosis therapy in patient with advanced HIV disease compared to isoniazid prophylaxis therapy and assessed with mortality as outcome. A 46- year old male patient with advanced HIV disease on antiretroviral therapy (ARV) and liver cirrhosis was admitted to hospital due to difficulties in sleeping and walking. During hospitalization he …

Transcriptional Responses Of Different Brain Cell Types To Oxygen Decline, Camille Ravel-Godreuil, Ethan R Roy, Srinivas N Puttapaka, Sanming Li, Yanyu Wang, Xiaoyi Yuan, Holger K Eltzschig, Wei Cao

Journal Articles

Brain hypoxia is associated with a wide range of physiological and clinical conditions. Although oxygen is an essential constituent of maintaining brain functions, our understanding of how specific brain cell types globally respond and adapt to decreasing oxygen conditions is incomplete. In this study, we exposed mouse primary neurons, astrocytes, and microglia to normoxia and two hypoxic conditions and obtained genome-wide transcriptional profiles of the treated cells. Analysis of differentially expressed genes under conditions of reduced oxygen revealed a canonical hypoxic response shared among different brain cell types. In addition, we observed a higher sensitivity of neurons to oxygen decline, …

Gut Microbiota And Blood Metabolites Related To Fiber Intake And Type 2 Diabetes, Zheng Wang, Brandilyn A Peters, Bing Yu, Megan L Grove, Tao Wang, Xiaonan Xue, Bharat Thyagarajan, Martha L Daviglus, Eric Boerwinkle, Gang Hu, Yasmin Mossavar-Rahmani, Carmen R Isasi, Rob Knight, Robert D Burk, Robert C Kaplan, Qibin Qi

Journal Articles

BACKGROUND: Consistent evidence suggests diabetes-protective effects of dietary fiber intake. However, the underlying mechanisms, particularly the role of gut microbiota and host circulating metabolites, are not fully understood. We aimed to investigate gut microbiota and circulating metabolites associated with dietary fiber intake and their relationships with type 2 diabetes (T2D).

METHODS: This study included up to 11 394 participants from the HCHS/SOL (Hispanic Community Health Study/Study of Latinos). Diet was assessed with two 24-hour dietary recalls at baseline. We examined associations of dietary fiber intake with gut microbiome measured by shotgun metagenomics (350 species/85 genera and 1958 enzymes; n=2992 at …

Hypermetabolic Lymphadenopathy Following The Administration Of Covid-19 Vaccine And Immunotherapy In A Lung Cancer Patient: A Case Report, Shreya Tripathy, Nathaniel Alvarez, Shubham Jaiswal, Ryan Williams, Munaf Al-Khadimi, Sarah Hackman, William Phillips, Supreet Kaur, Sherri Cervantez, William Kelly, Josephine Taverna

Research Symposium

Background: Given the current climate of the pandemic, lung cancer patients are especially vulnerable to complications from severe acute respiratory syndrome coronavirus 2 infection. As a high-risk population group, these patients are strongly advised to receive coronavirus disease 2019 vaccination in accordance with Center for Disease Control and Prevention guidelines to minimize morbidity and mortality. In recent years, immunotherapy has taken a preeminent role in the treatment of non-small cell lung cancer with dramatic improvement in overall survival. Reactive lymphadenopathy following the administration of a coronavirus disease 2019 vaccination can confound the radiographic interpretation of positron emission tomography-computed tomography or …

New Onset Dyspnea In A Patient With Pacemaker, What Does The Ecg Tracing Show?, Jakob Nypaver, Robert Libera Do, Arun Kundra, Ravi Choxi

Transformative Medicine (T-Med)

Dual chamber pacemakers are programmed to allow for AV synchrony. Whenever a patient with a dual chamber pacemaker with underlying sinus rhythm presents with AV dissociation, the lack of AV synchrony should be questioned. The authors present a case of new onset dyspnea diagnosed as pacemaker syndrome. The diagnosis was initially delayed due to underlying ventricular paced rhythm as misidentified as normal pacemaker behavior.

A 69-year-old female with a past medical history of 2:1 atrioventricular block status post dual-chamber pacemaker implant presented with complaints of new onset shortness of breath and dyspnea. The ECG showed a ventricular rate of 66 …

Too Yellow: An Idiopathic Case Of Autoimmune Hemolytic Anemia, Shreel Patel, Kashif Ali, Donnel Dockery-Joseph, Eunbee Cho, Sriharsha Koneru, Taha Al Hassan, Aramide Tijani, Elimar Gonzalez Morales

Research Symposium

Background: Autoimmune hemolytic anemia is caused by autoantibodies that react with self red blood cells and cause them to be destroyed. Warm AIHA, due to antibodies that are active at body temperature, is the most common type of the AIHA. It is mostly caused by the underlying disease like infections, autoimmune disorders, lymphoproliferative disorders, immunodeficiency or physiologic state like pregnancy. Rarely it happens that there is no underlying cause. Therefore, here we present a case of idiopathic autoimmune hemolytic anemia without any underlying cause.

Case Discussion: A 77 year old lady with known history of the diabetes mellitus type 2, …

Spontaneous Tumor Lysis Syndrome In A Patient With Recent Diagnosis Of Multiple Myeloma — An Unusual Presentation, Taha Al Hassan, Olga G. Cantu-Rodriguez, Eunbee Cho, Edgar G. Dorsey Trevino

Research Symposium

Background: Tumor lysis syndrome (TLS) is an oncologic emergency that surfaces as a constellation of metabolic imbalances due to the rapid destruction of cancer cells and subsequent dissemination of their contents. However, a markedly rare subtype of TLS, known as spontaneous TLS (STLS), occurs without an evident trigger, such as cytotoxic therapy, and carries a similar mortality risk. It is paramount to recognize high-risk cases early and implement therapeutic measures to prevent complications of STLS.

Case Presentation: We present the case of a 74-year-old gentleman with a recent diagnosis of Kappa-restricted multiple myeloma who presented with worsening weakness, tremors, ataxia, …

Little Bit About Liddle: Big Improvement In Blood Pressure, Shreel Patel, Roy Kondapavuluru, Eunbee Cho, Fatimah Bello, Jian Garcia Cruz

Research Symposium

Background: Liddle syndrome is a rare autosomal dominant disorder associated with abnormalities in function of the collecting tubule sodium channel, also called the epithelial sodium channel (ENaC). ENaC function is increased in the Liddle’s syndrome leading to the manifestations of mineralocorticoid excess symptoms, such as hypertension, hypokalemia, and metabolic alkalosis. The diagnosis is made when these features are seen with low renin and low plasma or urinary aldosterone. Genetic testing is not required for the diagnosis of Liddle syndrome. Liddle's syndrome has an excellent response to amiloride.

Case Presentation: A 56-year-old gentleman, with longstanding uncontrolled hypertension was seen for functional …

Pilot Study To Assess The Effectiveness Of The Sustainable Culturally Adaptive Nutrition Program (Scan) To Improve Adherence To The National Diabetes Prevention Program, William B Perkison, Pierre Fwelo, Fernanda Velasco-Huerta, Natalia I Heredia, James J Yang, Sidra S Beg, Belinda M Reininger, Serena A Rodriguez, Maha Almohamad, Catherine Pulicken, Ella Garza, Grace E White, Maria E Fernandez

Journal Articles

PURPOSE: The Sustainable Culturally Adapted Nutrition Program (SCAN) is a novel adaptation to the National Diabetes Prevention Program (NDPP) that aims to improve attendance and effectiveness. This paper presents its feasibility and impact through the initial 6-month outcomes.

DESIGN: A pragmatic quasi-experimental pilot study with intervention (DPP plus SCAN) and control (DPP only) groups.

SAMPLES AND INCLUSION CRITERIA: Sustainable Culturally Adapted Nutrition Program participants were recruited from federally qualified health center (FQHC) clinic patients enrolled in a NDPP in Houston, Texas. Participants needed to be (1) ≥18 years old, (2) body mass index >25, (3) no prior diagnosis of diabetes, …

Cd69 Signaling In Eosinophils Induces Il-10 Production And Apoptosis Via The Erk1/2 And Jnk Pathways, Respectively, Dan Van Bui, Linh Manh Nguyen, Akira Kanda, Hanh Hong Chu, Nhi Kieu Thi Le, Yasutaka Yun, Yoshiki Kobayashi, Kensuke Suzuki, Akitoshi Mitani, Akihiro Shimamura, Kenta Fukui, Shunsuke Sawada, David Dombrowicz, Hiroshi Iwai

Journal Articles

INTRODUCTION: Eosinophils contribute to the pathogenesis of allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis. We previously reported that human tissue eosinophils have high CD69 expression compared to blood eosinophils, and its expression is correlated with disease severity and the number of infiltrated eosinophils. However, biological CD69 signaling activity in eosinophils remains unclear.

METHODS: CD69 expression on lung tissue eosinophils obtained from mice with ovalbumin-induced asthma was measured using flow cytometry. CD69 crosslinking was performed on eosinophils purified from the spleen of IL-5 transgenic mice to investigate CD69 signaling and its function in eosinophils. Then, qPCR, Western blot, enzyme-linked …

Using Protein Language Models For Protein Interaction Hot Spot Prediction With Limited Data, Karen Sargsyan, Carmay Lim

Journal Articles

BACKGROUND: Protein language models, inspired by the success of large language models in deciphering human language, have emerged as powerful tools for unraveling the intricate code of life inscribed within protein sequences. They have gained significant attention for their promising applications across various areas, including the sequence-based prediction of secondary and tertiary protein structure, the discovery of new functional protein sequences/folds, and the assessment of mutational impact on protein fitness. However, their utility in learning to predict protein residue properties based on scant datasets, such as protein-protein interaction (PPI)-hotspots whose mutations significantly impair PPIs, remained unclear. Here, we explore the …

Effect Of Neutralizing Monoclonal Antibody Treatment On Early Trajectories Of Virologic And Immunologic Biomarkers In Patients Hospitalized With Covid-19, Tomas O Jensen, Greg A Grandits, Mamta K Jain, Thomas A Murray, Birgit Grund, Kathryn Shaw-Saliba, Michael A Matthay, Mahsa Abassi, Magdalena Ardelt, Jason V Baker, Peter Chen, Robin L Dewar, Anna L Goodman, Timothy J Hatlen, Helene C Highbarger, Mark Holodniy, Perrine Lallemand, Sylvain Laverdure, Bradley G Leshnower, David Looney, Charalampos D Moschopoulos, Henry Mugerwa, Daniel D Murray, Eleftherios Mylonakis, Stephanie Nagy-Agren, M Tauseef Rehman, Adam Rupert, Randy A Stevens, Stuart Turville, Amy Weintrob, Katherine Wick, Jens Lundgren, Emily R Ko

Journal Articles

BACKGROUND: Neutralizing monoclonal antibodies (nmAbs) failed to show clear benefit for hospitalized patients with coronavirus disease 2019 (COVID-19). Dynamics of virologic and immunologic biomarkers remain poorly understood.

METHODS: Participants enrolled in the Therapeutics for Inpatients with COVID-19 trials were randomized to nmAb versus placebo. Longitudinal differences between treatment and placebo groups in levels of plasma nucleocapsid antigen (N-Ag), anti-nucleocapsid antibody, C-reactive protein, interleukin-6, and D-dimer at enrollment, day 1, 3, and 5 were estimated using linear mixed models. A 7-point pulmonary ordinal scale assessed at day 5 was compared using proportional odds models.

RESULTS: Analysis included 2149 participants enrolled between …

Lifestyle Medicine For The Prevention And Treatment Of Pancreatitis And Pancreatic Cancer, Sruthi Kapliyil Subramanian, Bhaumik Brahmbhatt, Jennifer M Bailey-Lundberg, Nirav C Thosani, Pritesh Mutha

Journal Articles

The incidence of pancreatitis and pancreatic cancer is on the upswing in the USA. These conditions often lead to higher healthcare costs due to the complex nature of diagnosis and the need for specialized medical interventions, surgical procedures, and prolonged medical management. The economic ramification encompasses direct healthcare expenses and indirect costs related to productivity losses, disability, and potential long-term care requirements. Increasing evidence underscores the importance of a healthy lifestyle in preventing and managing these conditions. Lifestyle medicine employs evidence-based interventions to promote health through six key pillars: embracing a whole-food, plant-predominant dietary pattern; regular physical activity; ensuring restorative …

Detection Of Acute Brain Injury In Intensive Care Unit Patients On Ecmo Support Using Ultra-Low-Field Portable Mri: A Retrospective Analysis Compared To Head Ct, Sung-Min Cho, Shivalika Khanduja, Jiah Kim, Jin Kook Kang, Jessica Briscoe, Lori R Arlinghaus, Kha Dinh, Bo Soo Kim, Haris I Sair, Audrey-Carelle N Wandji, Elena Moreno, Glenda Torres, Jose Gavito-Higuera, Huimahn A Choi, John Pitts, Aaron M Gusdon, Glenn J Whitman

Journal Articles

Early detection of acute brain injury (ABI) is critical to intensive care unit (ICU) patient management and intervention to decrease major complications. Head CT (HCT) is the standard of care for the assessment of ABI in ICU patients; however, it has limited sensitivity compared to MRI. We retrospectively compared the ability of ultra-low-field portable MR (ULF-pMR) and head HCT, acquired within 24 h of each other, to detect ABI in ICU patients supported on extracorporeal membrane oxygenation (ECMO). A total of 17 adult patients (median age 55 years; 47% male) were included in the analysis. Of the 17 patients assessed, …

Metabolomic Profiles In Jamaican Children With And Without Autism Spectrum Disorder, Akram Yazdani, Maureen Samms-Vaughan, Sepideh Saroukhani, Jan Bressler, Manouchehr Hessabi, Amirali Tahanan, Megan L Grove, Tanja Gangnus, Vasanta Putluri, Abu Hena Mostafa Kamal, Nagireddy Putluri, Katherine A Loveland, Mohammad H Rahbar

Journal Articles

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with a wide range of behavioral and cognitive impairments. While genetic and environmental factors are known to contribute to its etiology, the underlying metabolic perturbations associated with ASD which can potentially connect genetic and environmental factors, remain poorly understood. Therefore, we conducted a metabolomic case-control study and performed a comprehensive analysis to identify significant alterations in metabolite profiles between children with ASD and typically developing (TD) controls.

OBJECTIVE: To elucidate potential metabolomic signatures associated with ASD in children and identify specific metabolites that may serve as biomarkers for the disorder. …

Methodological Advances In Patient-Centered Rare Disease Research: The Uthealth Houston Turner Syndrome Society Of The United States Research Registry, Sara Mansoorshahi, Cindy Scurlock, Scientific Advisory Board Of The Turner Syndrome Society Of The United States Research Registry, Siddharth K Prakash

Journal Articles

BACKGROUND: Many different clinical specialists provide care to patients with Turner syndrome (TS), who have highly variable clinical manifestations. Therefore, a national TS registry is essential to inform a cohesive approach to healthcare and research. In 2015, the Turner Syndrome Society of the United States (TSSUS) created the Turner Syndrome Research Registry (TSRR) to engage directly with community participants who voluntarily provide longitudinal data about their experiences with TS. TSRR projects are collaborative partnerships between people with TS, TSSUS, and researchers.

RESULTS: To ensure that registry workflows conform to the data privacy choices of participants, TSSUS collaborated with UTHealth Houston …

Case Of Rosai Dorfman Disease In A Patient With Newly Diagnosed Hodgkin Lymphoma, Liza Salloum, Jennifer Rojas Huen, Ricardo Serna, Alisha Valdez

Research Symposium

Background: Rosai Dorfman Disease (RDD, also known as sinus histiocytosis with massive lymphadenopathy) is a rare non-Langerhans cell histiocytosis, classified into nodal (classic) and extranodal disease. Most patients present with non-tender cervical lymphadenopathy, although other sites including the inguinal and axillary regions have been reported. Extranodal disease (~43% of cases) can involve any organ system. RDD is more common in children, but cases have been reported in patients in their 70s. The prognosis of nodal RDD can correlate with the number of nodal groups involved. Many cases can be managed only with observation, although surgery, chemotherapy, corticosteroids, and immunomodulators have …

An Unusual Presentation Of The Severe Hypothyroidism Presenting As Shortness Of Breath, Shreel H. Patel, Kashif Ali, Eunbee Cho, Fatimah Bello, Andres Suarez Parraga, Alcibiades Fleires

Research Symposium

Background: Hypothyroidism is defined as failure of the thyroid gland to produce sufficient thyroid hormone to meet the metabolic demands of the body. Untreated hypothyroidism can contribute to hypertension, dyslipidemia, infertility, cognitive impairment, and neuromuscular dysfunction. It may occur as a result of primary gland failure or insufficient thyroid gland stimulation by the hypothalamus or pituitary gland. Primary gland failure can result from the congenital abnormalities, autoimmune destruction, iodine deficiency, and infiltrative diseases. Patients can clinically present with weight gain, cold intolerance, depression, muscle fatigue, poor concentration, and menstrual irregularities. The best laboratory test for the thyroid assessment is serum …

A True Bloody Emergency: An Unusual Case Of Thrombotic Thrombocytopenic Purpura, Joshua M. Ninan

Research Symposium

Background: Thrombotic thrombocytopenic purpura (TTP) is a primary thrombotic microangiopathy that is classically characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). Although rare with an annual incidence of 3.7 cases per one million adults, it is considered a true hematological emergency due to its fatality rate of almost 100% if appropriate treatment is not initiated immediately. This makes it vitally important to identify and treat patients with TTP, a task that becomes unusually challenging in the absence of the disorder’s other characteristically diagnostic clinical features such as mucosal bleeding, fever, or presence of schistocytes.

Case Presentation: A 30-year-old gentleman with …

A Rare Encounter: Extracranial Meningioma Mimicking Musculoskeletal Neoplasms, Liza Salloum, Jennifer Rojas Huen, Ricardo Serna, Andrew Kolodziej

Research Symposium

Background: Meningiomas are the most common primary brain tumor in adults. While commonly encountered intracranially, 2% manifest extracranially. Although usually benign, 10% of meningiomas can become malignant. Despite their relatively high incidence, they are often difficult to diagnose due to long asymptomatic periods, often diagnosed after mass effect symptoms occur. This case explores the intricacies of diagnosing and managing an extracranial meningioma that mimicked musculoskeletal neoplasms.

Case Presentation: A 70-year-old female, with a history of hypertension and dyslipidemia, presented with diplopia, blurry vision, and intermittent right orbital pain. A recent CT had identified a slow-growing right temporal mass, yet she …

Development Of A Follow-Up Measure To Ensure Complete Screening For Colorectal Cancer, Elizabeth L Ciemins, Jeff T Mohl, Carlos A Moreno, Francis Colangelo, Robert A Smith, Mary Barton

Journal Articles

IMPORTANCE: The current quality performance measure for colorectal cancer (CRC) screening is limited to initial screening. Despite low rates, there is no measure for appropriate follow-up with colonoscopy after receipt of an abnormal result of a stool-based screening test (SBT) for CRC. A quality performance measure is needed.

OBJECTIVE: To develop and test a quality performance measure for follow-up colonoscopy within 6 months of an abnormal result of an SBT for CRC.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective quality improvement study examined data from January 1, 2016, to December 31, 2020, with 2018 plus 6 months of follow-up as the …

Outcomes Of Upper Gastrointestinal Bleeding In Hospitalized Covid-19 Patients In The United States: A Propensity-Score Matched Analysis Of A Large National Database, Moon Ryu, Mohammed Quazi, Niloy Ghosh, Karthik Gangu, Amir H Sohail, Asif Farooq, Babu Sriram , Maringanti, Aman Goyal, Anupa Patel, Muhammad Salman Khan, Abu Baker Sheikh

Journal of Community Hospital Internal Medicine Perspectives

Patients with cirrhosis that are hospitalized with COVID-19 infection have been found to have worse outcomes. No comparative study has been conducted between gastrointestinal (GI) bleeding in patients with cirrhosis who are diagnosed with COVID-19. We utilized the National Inpatient Sample (NIS) database to perform a retrospective analysis of 24, 050 patients diagnosed with cirrhosis and COVID-19. The identified patients were separated into variceal bleeding, nonvariceal bleeding, and no (or neither) GI bleeding groups. After performing propensity sample matching and multivariate analysis of mortality, we found no significant differences in mortality among the three groups. However, the variceal bleed group …