Medical Specialties Commons^™

Emergency Departments And Care For Marginalized Populations, Irvin B. Harrell

Institute for the Humanities Theses

Healthcare providers in emergency departments (EDs) face a daunting daily task: providing health care in a triage setting to a diverse group of patients many with complex medical issues. Many patients rely on ED services out of financial necessity, when their healthcare issues could be better suited for care from a primary care physician. Many of these already vulnerable patients – minorities, those health illiterate, low-income, uninsured and those with language barriers – must also deal with ED overcrowding and staffing conditions. In some cases, patients leave without being seen while others face bed shortages. This study explores healthcare provider …

The Value Of Quick Sepsis-Related Organ Failure Assessment Scores In Patients With Acute Pancreatitis Who Present To Emergency Departments: A Three-Year Cohort Study., Alexander Hallac, Nishant Puri, David Applebury, Kurt Myers, Parag Dhumal, Ashish Thatte, Wichit Srikureja

Articles, Abstracts, and Reports

Background: Distinguishing sepsis from other inflammatory syndromes continues to be a clinical challenge. The goal of risk stratification tools is to differentiate sepsis from other conditions. We compare the ability of quick sepsis-related organ failure assessment (qSOFA) and systemic inflammatory responses syndrome (SIRS) scores to predict prolonged length of stay (LOS) among patients who presented to the emergency department and hospital ward with acute pancreatitis (AP).

Methods: We compiled a retrospective database of all adult patients hospitalized for AP during 2015 - 2018 at a single tertiary care center. Independent

Results: The sensitivity and specificity of an SIRS score of …

Identification Of Inadvertent Azygous Vein Cannulation Using Transthoracic Echocardiography During Venoarterial Extracorporeal Membrane Oxygenation Initiation., Bethany Runkel, Jason D. Fraser, John Daniel, Karina M. Carlson

Manuscripts, Articles, Book Chapters and Other Papers

It is well known that optimal cannula positioning during initiation of venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is directly related to ECMO circuit function. Malpositioned cannulae can have deleterious effects on clinical outcomes, and inadvertent cannulation of the azygous vein during initiation of ECMO is a rare but potentially devastating complication that has been reported only a few times in the literature. Here we report a case of azygous vein cannulation in a neonate that was not identified on chest radiography but was recognized and corrected expeditiously with the use of transthoracic echocardiography.

Inotuzumab Ozogamicin In Pediatric Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia., Deepa Bhojwani, Richard Sposto, Nirali N. Shah, Vilmarie Rodriguez, Constance Yuan, Maryalice Stetler-Stevenson, Maureen M. O'Brien, Jennifer L. Mcneer, Amrana Quereshi, Aurelie Cabannes, Paul Schlegel, Claudia Rossig, Luciano Dalla-Pozza, Keith August, Sarah Alexander, Jean-Pierre Bourquin, Michel Zwaan, Elizabeth A. Raetz, Mignon L. Loh, Susan R. Rheingold

Manuscripts, Articles, Book Chapters and Other Papers

Although inotuzumab ozogamicin (InO) is recognized as an effective agent in relapsed acute lymphoblastic leukemia (ALL) in adults, data on safety and efficacy in pediatric patients are scarce. We report the use of InO in 51 children with relapsed/refractory ALL treated in the compassionate use program. In this heavily pretreated cohort, complete remission was achieved in 67% of patients with overt marrow disease. The majority (71%) of responders were negative for minimal residual disease. Responses were observed irrespective of cytogenetic subtype or number or type of prior treatment regimens. InO was well-tolerated; grade 3 hepatic transaminitis or hyperbilirubinemia were noted …

Opinions Of Academic Em Society Members On The New Acgme Common Program Requirements, Shawn M. Quinn Do, Bryan G. Kane Md, Marna R. Greenberg Do, Mph, Facep, Terrence E. Goyke, Steven Bird Md, Megan Schagrin Mba, Gavin C. Barr Jr. Md

Department of Emergency Medicine

No abstract provided.

Profil Of Implementation Of Post Exposure Prophylaxis Of Hepatitis B, Hepatitis C And Human Immunodeficiency Virus To Health Care Worker In Cipto Mangunkusomo Hospital 2014-2016, Dewi Mira Ratih, Evy Yunihastuti, Regina Lestari, Andri Andri Sulaiman, Ikhwan Rinaldi

Jurnal Penyakit Dalam Indonesia

Introduction. Health care workers (HCW) have a high risk of infectious substance exposure. Hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) are some diseases transmitted by body fluid or body tissue. Cipto Mangunkusumo Hospital Jakarta has been implementing post-exposure prophylaxis (PEP)s towards HIV, hepatitis B, and hepatitis C. This study aimed to identify the implementation of post-exposure prophylaxis of HIV, Hepatitis B, and Hepatitis C among HCW in Cipto Mangunkusumo Hospital Jakarta. Methods. A cross-sectional study was conducted to exposed workers in Cipto Mangunkusumo Hospital Jakarta between 2014-2016 who had been recorded by report. Demographic data were collected through …

Emergency Department Skull Trephination For Management Of Acute Epidural Hematoma, Julie A. Fritzges Do

Department of Emergency Medicine

No abstract provided.

Invasive Candidiasis Prevalence Among Patients In Intensivecare Unit, Hasan Sadikin Hospital, Hafizh Ridwan Maulana, Uun Sumardi, Raspati C. Koesoemadinata

Jurnal Penyakit Dalam Indonesia

Introduction. Intensive care unit (ICU) patients have a high risk of invasive candidiasis (IC), which increase mortality and prolong length of stay in hospitals, resulting greater costs. This study aimed to determine the prevalence of IC and associated risk factors in ICU patients. Methods. A cross-sectional study was conducted including medical records of patients treated in ICU Hasan Sadikin Hospital Bandung admitted in June 2016-June 2017 whose blood sample were sent for culture. The prevalence of IC and corresponding 95% confidence interval (95% CI) was determined. A case-control study was done comparing the characteristics of patients with positive culture for …

Correlation Between The Severity Of Coronary Heart Disease Andqt Dispersion In Patients With Obstructive Sleep Apnea, Rasmijon Rasmijon, Muhammad Yamin, Syahrial M. Hutauruk, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Coronary heart disease (CHD) and obstructive sleep apnea (OSA) are common and complex clinical problems. Both have a high risk of sudden cardiac death (SCD). QT dispersion (QTd) in electrogram is a measure of heterogeneity of myocardial repolarization that can predict the occurrence of ventricular arrhythmias that cause SCD QTd is a predictor of ventricular arrhythmias and sudden cardiac death. So far, there is no publication about the severity relationship CHD with QTd in OSA patients in Indonesia. Methods. A cross-sectional study was conducted on twenty-nine CHD patients accompanied OSA in 2015 who had undergone coronary angiography and polysomnography …

Clinical Profile Of Cirrhotic Patient With Esophageal Varices Whoundergone Band Ligation In Cipto Mangunkusumo Hospital, Kemal Fariz Kalista, Cosmas Rinaldi Adithya Lesmana, Andri Sanityoso Sulaiman, Rino Alvani Gani, Irsan Hasan

Jurnal Penyakit Dalam Indonesia

Introduction. Liver cirrhosis (LC) is the end stage of chronic liver disease. One of the main complication caused by LC is esophageal varices (EV). Bleeding due to EV rupture is the main cause of mortality in patient with LC. EV band ligation can be used for primary or secondary prophylaxis to prevent bleeding. The purpose of this study was to know the clinical profile of LC patient with EV who underwent band ligation and who not underwent band ligation. Methods. A cross-sectional study was conducted in LC patients who underwent esophagogastroduodenoscopy (EGD) in Procedure Room Division of Hepatobiliary, Departement of …

A Case Series Hemichorea-Hemiballism Syndrome Related Tononketotic Hyperglycemia: A Challenge To Diagnostic Process, Laksmi Sasiarini, Rahmad Budianto, Ricky C. Tarigan

Jurnal Penyakit Dalam Indonesia

Diabetes mellitus is quite familiar to health-care personnel but occasionally presents with unusual manifestations. One of them is hemichorea-hemiballismus syndrome, a spectrum of involuntary, continuous non-patterned movement involving one side of the body which is related to nonketotic hyperglycemia in uncontrolled diabetes. Here we present two cases of nonketotic hyperglycemic diabetic patients who presented with the hemichorea-hemiballismus syndrome. First – a 57 years old woman was presented with involuntary, arrhythmic, and repetitive movement on the right arm and leg, accompanied by twitching on the right face for two weeks. She had an uncontrolled history of diabetes mellitus. The second- a …

Validation Of Ariscat Model Score To Predict Postoperativepulmonary Complications In Tertiary Referral Hospital Inindonesia, Muhammad Alkaff, Ceva Wicaksono Pitoyo, Aldy Heriwardito, Sukamto Koesnoe

Jurnal Penyakit Dalam Indonesia

Introduction. There are several prediction model score instruments that can help to assess pulmonary preoperative evaluation and it is believed that ARISCAT model score is very simple to do and have good performance, but not widely used. This score has not been yet validated in Indonesia. This study aimed to assess the performance of discrimination and calibration of ARISCAT score in predicting postoperative pulmonary complication who underwent surgery in a tertiary referral hospital in Indonesia. Methods. A retrospective cohort study was conducted to assess the external validation of ARISCAT scores in the Indonesian population. This study involved patients underwent surgery …

The Effect Of Green Tea Extract Supplementation On Plasmamalondialdehyde (Mda) In Human With Sub-Maximal Physicalactivity, Double-Blind And Placebo-Controlled Trials, Putu Moda Arsana, Laksmi Sasiarini, Bayu Eka Nugraha

Jurnal Penyakit Dalam Indonesia

Introduction. Green Tea extract has been proven in vitro to have the ability as an antioxidant. Submaximal physical activity causes an increase in free radicals. The increase of MDA can detect the increase of free radicals. This study aimed to determine the effects of green tea extract supplementation against free radicals in submaximal physical activity by measuring plasma MDA. Methods. This double-blind controlled trial study was performed in 20 students of faculty of sports science with submaximal physical activity in the form of 1,500 meters running in 12 minutes using a treadmill. Subjects were divided into two groups: green tea …

Immunotherapy For Food Allergy: Myth Or Reality?, Gatot Soegiarto

Jurnal Penyakit Dalam Indonesia

Allergic reaction to food can have serious consequences. The only treatment option is strict allergen avoidance, but accidental ingestions happen frequently and can lead to severe and potentially life-threatening allergic reactions. Food allergy is one of the most common causes of anaphylactic reactions. Therefore self-injectable epinephrine should always be at hand in case of accidental exposure. Many food allergies may resolve over time, but most patients with persistent food allergies live with fear of anaphylactic reactions. Within the last several years, the usefulness of immunotherapy for food allergies has been investigated. Several food immunotherapies are being developed; which include oral, …

Profilaksis Pasca Pajanan Terhadap Hepatitis B, Hepatitisc, Dan Human Immunodeficiency Virus Pada Petugaskesehatan, Alvina Widhani

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Using The Qsat To Generate Multi-Source Feedback On An In-Situ Pediatric Simulation Case, Michael C. Nguyen Md, Nicole Elliott Do, Michael R. Jong Md, Msc, Suzanne S. Puentes Bsn, Ccrn, Rn, Diane Begany Md, Matthew D. Cook Do, Louis Morolla Do, Zachary Matuzsan Do, Jennifer E. Macfarlan Mph, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Pediatric Erythromelalgia Treated With Epidural Ropivacaine Infusion, Caroline E. Lee, Kelly Paulk, Kristen Garvie, Elizabeth Grieshaber, Jeffrey Carter, Brian Ball

School of Medicine Faculty Publications

No abstract provided.

Whole Egg Consumption Impairs Insulin Sensitivity In Rat Model Of Obesity And Type 2 Diabetes, Cassondra J. Saande, Megan A. Steffes, Joseph L. Webb, Rudy J. Valentine, Matthew J. Rowling, Kevin Schalinske

Rudy Valentine

Background: The literature regarding the relation between egg consumption and type 2 diabetes (T2D) is inconsistent and there is limited evidence pertaining to the impact of egg consumption on measures of insulin sensitivity. Objective: The objective of this study was to investigate the effect of dietary whole egg on metabolic biomarkers of insulin resistance in T2D rats. Downloaded from https://academic.oup.com/cdn/advance-article-abstract/doi/10.1093/cdn/nzz015/5374517 by Iowa State University user on 28 March 2019 Methods: Male Zucker diabetic fatty rats (n=12; 6 wk of age) and their lean controls (n=12; 6 wk of age) were randomly assigned to a casein- or whole egg-based diet. At …

Eeg Findings In Infants With Neonatal Abstinence Syndrome Presenting With Clinical Seizures, Murali Reddy Palla, Gulam Q. Khan, Zahra M. Haghighat, Henrietta S. Bada

Pediatrics Faculty Publications

Neonatal abstinence syndrome (NAS) refers to a constellation of signs occurring in newborn infants who were exposed to opioids or opiates in utero. These manifestations include poor feeding, gastrointestinal disorders, abnormal sleep patterns, and neurological signs such as jitteriness, tremors, and seizures (1, 2). Myoclonus, jitteriness, and tremors often may be interpreted as seizures and therefore treated as epileptic seizures.

Objective: To determine whether seizure like activity observed in infants with NAS correlate with electroencephalogram (EEG) findings.

Design/ Method: We reviewed the standard EEG or video electroencephalogram (VEEG) of infants with NAS who were admitted because of seizure-like clinical …

Current Patient Perspectives Of Vulvovaginal Candidiasis: Incidence, Symptoms, Management And Post-Treatment Outcomes., Junko Yano, Jack D. Sobel, Paul Nyirjesy, Ryan Sobel, Valerie L. Williams, Qingzhao Yu, Mairi C. Noverr, Paul L. Fidel

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Vulvovaginal candidiasis (VVC) is a common infection affecting women worldwide. Reports of patterns/risk factors/trends for episodic/recurrent VVC (RVVC) are largely outdated. The purpose of this study was to obtain current patient perspectives of several aspects of VVC/RVVC.

METHODS: Business cards containing on-line survey information were distributed to healthy volunteers and patients seeking standard, elective, or referral gynecologic care in university-affiliated Obstetrics/Gynecology clinics. The internet-based questionnaire was completed by 284 non-pregnant women (78% Caucasian, 14% African American, 8% Asian).

RESULTS: The majority of the participants (78%) indicated a history of VVC with 34% defined as having RVVC. The most common …