Digital Commons Network^™

Optimizing Esophagogastric Junction Assessment And Antisecretory Medication Documentation During Egd: A Preintervention Quality Improvement Analysis, Vikram R. Ekambaram, Maneera Chopra, Wasseem Skef

Summer Research Program Abstracts

No abstract provided.

Regional Hemodynamic Characterization Of The Thoracic Aorta Using 4d Flow Mri: A Single-Center Pilot Study, John H. Major

Summer Research Program Abstracts

No abstract provided.

Ai-Segmented Upper Airway Imaging Biomarkers Across The Lifespan, David L. Holt, Vishwa S. Parekh

Summer Research Program Abstracts

No abstract provided.

Functional Characterization Of A Hepcidin Knockout Mouse Model For The Study Of Acute Pancreatitis, Andrew Schmidt, Amanda Bean, Jiajing Li, Danqing Ren, Suhair Al Salihi, Yanna Cao, Tien Ko

Summer Research Program Abstracts

No abstract provided.

Comparison Of Refractive Accuracy Of Iolmaster 700, Lenstar Ls 900, And Anterion For Iol Power Calculation, Travis Williams Md Ms, Mena Kozman Md, Siddhant Patil, Leon Toursarkissian, Ahmad Kheirkhah Md

Summer Research Program Abstracts

No abstract provided.

Procedural Pain In Extremely Preterm Infants During The First 28 Days Of Life, Emma Young, Manouchehr Hessabi Md, Amirali Tahanan Ms, Sepideh Saroukhani Md, Phd, Amanda Zander Msn, Rn, Christine Domonoske Pharmd, Matthew Martin-Souza Pharmd, Amir Khan Md, Allison Davidson Md, Jaclyn Ruggiero Md

Summer Research Program Abstracts

No abstract provided.

Endovascular Thrombectomy In Medium And Distal Vessel Occlusions: A Focused Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Shahram Majidi, Amol Mehta, Sami Al-Kasab, Kaustubh Limaye, Adam A. Dmytriw, Adam De Havenon, Farhan Siddiq, Robin Novakovic, Alexandra L. Czap, Ameer E. Hassan

School of Medicine Publications

Background: The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke from distal- and medium-vessel occlusion (DMVO) for endovascular thrombectomy (EVT). The intended audiences are prehospital care providers, physicians, and allied health professionals.

Methods: The Society of Vascular and Interventional Neurology Guidelines and Practice Standards committee formed a writing group to conduct a structured literature review on EVT for DMVO-related acute ischemic stroke and to draft practice recommendations in accordance with the Society of Vascular and Interventional Neurology Guidelines and Practice Algorithm. A structured literature search was conducted …

Hepatitis B In The Vaccine Era: Persistent Burden And Clinical Implications, Cherechi Nwabueze, Eunice Omeludike, Ridwan Ademola Lawal, Kedife Nwabueze

School of Medicine Publications

Hepatitis B virus (HBV) infection remains a leading global cause of advanced liver disease and imposes a substantial economic burden. Early prevention is critical, as perinatally acquired HBV carries a high risk of progression to cirrhosis or hepatocellular carcinoma (HCC). Hepatitis B vaccination has been proven effective in preventing cancer, yet coverage of the complete vaccine series remains suboptimal. This implementation gap perpetuates the clinical burden, manifesting decades later as hepatic decompensation and liver cancer. This narrative review synthesizes the current HBV landscape, highlighting how gaps in vaccination policy and delivery contribute to real-world gastrointestinal outcomes. By reframing HBV vaccination …

Determinants Of Early Mortality After Congenital Heart Surgery: A 7-Year Single-Center Experience In Saudi Arabia, Saud Abdulaziz Bahaidarah, Jowana Mahmoud Aljinaid, Amal Ahmad Alzahrani, Jana Mohammad Banjer, Lujain Abdulsalam Kofiyah, Nesmah Amin Noaman, Rahaf Adel Badkook, Raghad Abdulaziz Aljabri, Raghad Saeed Alghamdi, Renad Mohammed Alamoudi, Sarah Salem Bawazir, Gaser Abdelmohsen Abdelmohsen

Journal of the Saudi Heart Association

Objectives:

To determine predictors of early mortality among pediatric patients undergoing congenital heart surgery at a tertiary care center in Saudi Arabia.

Methods:

This retrospective cohort study included 955 pediatric patients who underwent congenital heart surgery at King Abdulaziz University Hospital, Jeddah, between January 2017 and December 2023. Demographic, clinical, operative, and postoperative variables were collected.

Results:

Overall mortality was 4.9%. Mortality was higher among neonates and infants and among patients with RACHS categories 4–6. Non-survivors had longer cardiopulmonary bypass times and more frequent delayed chest closure. Postoperative complications, including the need for extracorporeal membrane oxygenation (ECMO), depressed cardiac function, …

Facilitating Living Kidney Donation: Retrospective Evaluation Of Weight Loss Interventions To Support Kidney Donation, Julia Dumitrescu, Roslyn Mannon, Scott Westphal, Ashley Brabec, Regina Rau, Amy Olsen, Taylor Cidlik

Graduate Medical Education Research Journal

Background. Living kidney donor transplantation provides recipients with kidney failure with an excellent graft function and survival. Donation of a kidney entails a thorough medical and psychosocial evaluation. Obesity is an increasingly prevalent medical condition and a known risk factor for the development of chronic kidney disease post-donation. Accepting overweight and obese individuals as living kidney donors remains controversial. The purpose of this study was to review the impact of obesity on the determination of candidates for living kidney donation at a single transplant center.

Methods. We performed a retrospective chart review of living kidney donors evaluated over 5 …

Exercise-Induced Gene Expression Profiles In Adults With Obesity: A Systematic Review Of Molecular Adaptation, Brandon Galvan, Luis Alberto Flores, Flor Isela Torres-Rojo, Natanael Cervantes-Hernández, Cinthia Verónica Villegas-Balderrama, Liliana Aracely Enríquez-Del-Castillo

Baltic Journal of Health and Physical Activity

Background: Obesity is a multifactorial and chronic condition characterized by excess adiposity and systemic low-grade inflammation. Exercise exerts metabolic and anti-inflammatory effects partly mediated through gene expression modulation in skeletal muscle and adipose tissue. However, heterogeneous responses among obese individuals suggest that genetic and epigenetic mechanisms shape exercise adaptation. Objective: This systematic review aimed to identify the genes and molecular pathways modulated by physical exercise in adults with obesity, and to classify them according to their biological functions across different exercise modalities. Methods: Following PRISMA guidelines, randomized controlled trials were searched in PubMed, SpringerLink, Science Direct, Cochrane, LILACS, Web of …

The Effects Of Ballistic Resistance Training On Upper-Limb Power And Reaction Time In Youth Épée Fencers, Mahmoud Sallam, Mazin Hasan Alhasany, Hachin Chani, Ghofran Bashir, Bushra Al-Hammashi, Gaffar Saad, Hussein Hashos, Amr Hamza, Mariola Gepfert

Baltic Journal of Health and Physical Activity

Background: Explosive power and rapid reaction time are crucial in fencing. Ballistic resistance training (BRT) may improve these qualities but is rarely applied in fencing. Materials and methods: To assess the effects of an eight-week BRT program on upper-limb power and reaction time in youth Egyptian épée fencers, nineteen male fencers (aged 16.6 ± 1.5) were randomly divided into a BRT group (n = 10) and a control group (n = 9). The BRT group added three weekly 30-minute sessions of "Ballistic Six" exercises to regular fencing training. Tests before and after included: tennis ball throw (power), armed …

Predicting In-Hospital Mortality In Patients With Hypertensive Emergency: A Retrospective Cohort Study, Jay Satasiya, Bs, Devin Vasoya, Md, Darius Farzad, Md

The Medicine Forum

Approximately 1.3 billion adults worldwide have hypertension.¹ Between 2006 and 2013, there was a two-fold increase in Emergency Department visits for hypertensive emergency.² The prevalence of hypertensive emergency ranges from 0.08% to 0.76% in patients presenting to the Emergency Department.^1,3-6 The estimated incidence of hospitalization with a hypertensive emergency is 111 per 100,000 patients.^1,7 Hypertensive emergency is also associated with significant morbidity and mortality, often leading to ischemic stroke, pulmonary edema, acute heart failure.^3-6 In-hospital mortality among patients with hypertensive emergency varies between 0.48% and 12.5%.^5,7 This retrospective cohort study aims to further clarify …

Assessment And Intervention For Health Behavior Change In Primary Care Across The Lifespan: A Guide For Residents In Primary Care Specialties, Stacy A. Ogbeide, Alexis Ramos, Bridget Murphy, Angel Ogbeide

HCA Healthcare Journal of Medicine

More than 45% of Americans have at least 1 chronic disease, with chronic disease also being a leading cause of death in the United States. In primary care settings, about 75% of visits are for management of multiple chronic diseases. Due to the increasing medical complexity of patients who present to primary care, these numbers make it more challenging for Primary Care Clinicians (PCCs) to manage these conditions alone and point to the need for innovative solutions to chronic disease care. One evidence-based innovation is team-based care to improve the treatment of these conditions. Clinicians such as clinical pharmacists, registered …

An Unusual Case Of Bilateral Upper And Lower Oral Cavity Cysts In A Newborn, Frances Rodriguez Lara, Jillian L. Chen, Jennifer N. Shehan, Jessica R. Levi

HCA Healthcare Journal of Medicine

Background

Oral mucosal lesions in newborns have a broad differential diagnosis, ranging from benign, transient conditions to potential early signs of systemic disease. Most of these lesions are resolved without intervention, but delayed recognition can lead to complications, such as airway obstruction. Early identification is crucial for appropriate management. This case report discusses an unusual presentation of multiple oral mucosal cysts in a newborn, emphasizing the challenges of diagnosis and management.

Case Presentation

A 1-day-old male was evaluated at Boston Medical Center for cystic oral lesions identified during newborn screening. The infant was born at 36 weeks and 2 days’ …

Navigating Complex Esophageal Perforations: A Case-Specific Approach To Successful Outcomes, Harsimran Kalsi, Anushree Rai, Kobina Essilfie-Quaye, Neeka Akhavan, Yaseen Perbtani, Tony S. Brar

HCA Healthcare Journal of Medicine

Esophageal perforation is a life-threatening condition requiring prompt diagnosis and effective management. While self-expanding metal stents (SEMS) are a first-line treatment, persistent leaks often necessitate adjunctive endoscopic interventions. A structured, multimodal approach is critical for optimizing outcomes and avoiding surgical intervention. A 44-year-old man developed an iatrogenic esophageal perforation following surgical leiomyoma enucleation. Initial treatment with overlapping fully covered self-expanding metal stents (FC-SEMS) failed to achieve closure, necessitating endoscopic suturing for defect reinforcement. Despite suturing, persistent leakage required placement of a larger-diameter FC-SEMS, secured with an endoscopic fixation system to prevent migration. Serial imaging confirmed successful defect closure, allowing the …

Using Mohs Micrographic Surgery To Treat A Large, Pedunculated Trichoblastoma On The Upper Cutaneous Lip, Richard G. Bindernagel Jr., Addie Walker, Richard Miller

HCA Healthcare Journal of Medicine

Trichoblastomas are uncommon adnexal tumors that usually occur on the face. We report a case of a 62-year-old White man with a large, asymptomatic, slow-growing lesion that had been on his right upper cutaneous lip for 15 years. A 2 cm pink, pedunculated nodule with telangiectasia was seen on examination. A shave biopsy was consistent with trichoblastoma: a circumscribed-appearing dermal tumor of basaloid cells arranged in cords and islands within a cellular stroma, focal epidermal connection, and papillary mesenchymal bodies. The patient elected for treatment with Mohs micrographic surgery (MMS) given the length of time that the tumor had been …

Impact Of Pre-Existing Psychiatric Conditions On Trauma Outcomes: A National Analysis, Kelly Mckenney, Marie Ugo, Sindhura Kompella, Clara Alvarez, Ilko Luque

HCA Healthcare Journal of Medicine

Background

Understanding the impact of psychiatric pre-existing conditions (PsyPECs) on trauma outcomes is crucial, as trauma is the leading cause of mortality for Americans aged 1-45. Although previous regional studies have shown higher mortality rates and longer hospital length of stay (H-LOS) for injured patients with PsyPECs, this has not been studied at the national level. The purpose of this study is to identify the PsyPECs associated with mechanism of injury and other outcomes in adult patients admitted for trauma in the United States’ trauma centers.

Methods

Data were extracted from the National Trauma Data Bank (NTDB). There were 5301 …

Time For A New Whole-Person Care Pathway For Chest Pain Admissions, Dana Kajan, Sabbir Mirza, Alexander M. Ruiz, Anthony Degennaro, Mohamad S. Saad

HCA Healthcare Journal of Medicine

Background

Emergency department (ED) visits for chest pain are common and costly, and ED workup often shows no clear cardiac etiology in low-risk patients. Emerging evidence suggests that social determinants of health (SDOH) such as loneliness, social isolation, and food insecurity contribute to cardiovascular outcomes and chest pain presentations.

Methods

We interviewed 114 patients (>18 years) presenting with chest pain and a thrombolysis in myocardial infarction (TIMI) score less than 4 at our community teaching hospital ED. Structured questionnaires assessed the SDOH triad of loneliness, social isolation, and food insecurity. Dependent variables included systolic blood pressure (SBP) at admission, …

Does Staff Education Increase Sequential Compression Device Utilization: A Retrospective Study, Devin Q. John, Vincent Lee, Akshay V. Daji, Hans Lapica, Connor Donley, Matthew J. Mccrosson, Nino Coutelle, Carlos Fernandez, Diego Lima

HCA Healthcare Journal of Medicine

Background

Venous thromboembolism (VTE) is a significant perioperative safety concern among orthopedic patients, with an incidence of 0.4%-1.0% and a substantial risk of chronic complications. Sequential compression devices (SCDs) are recommended for VTE prophylaxis, yet compliance remains suboptimal due to staff misconceptions. This study evaluates the impact of a resident-led educational intervention on SCD utilization among nursing staff in orthopedic postoperative care.

Methods

This retrospective study was conducted at 2 hospitals (HCA Florida JFK Hospital and HCA Florida Palms West Hospital). Nursing staff participated in a single educational session addressing SCD benefits, application techniques, and operational protocols. Data on SCD …

Trends In Emergency Department Utilization After Metabolic And Bariatric Surgery In The United States, Andrew Sanders, Isabella Moncada, Sabrina Avanzato, Michelle Fakler, Michael Dombek, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

In this article, we sought to understand the factors associated with emergency department (ED) utilization by patients after metabolic and bariatric surgery (MBS). The hopes were that modifiable risk factors could be identified to reduce ED visits after MBS.

Methods

We analyzed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database (MBSAQIP) which is comprised of data from all nationally accredited bariatric centers in the United States. For our study, we included a population of 681 743 patients having undergone the 2 most common MBS procedures: sleeve gastrectomy (SG) and gastric bypass (GBP). Using logistic …

Are Combat Athletes Different Sleepers? A Pittsburgh Sleep Quality Index-Based Comparative Survey Across Athletic Populations, Zofia Tkocz, Małgorzata Hołda Dr, Michał Spieszny, Adam Zając, Robert Trybulski, Aleksandra Filip-Stachnik

Baltic Journal of Health and Physical Activity

Background: Sleep plays an important role in athletic performance, recovery, and cognitive function. The aim of this study was to compare sleep quality and selected sleep-related  variables in combat sports athletes and athletes from other sport disciplines . Materials and Methods: Ninety-eight competitive athletes participated in the study, including 52 combat sports athletes and 46 athletes  representing other sport disciplines. Sleep quality was assessed using the modified Pittsburgh Sleep Quality Index (PSQI) with a weekly recall period, global PSQI score and additional  variables, such as sleep duration, sleep latency, and habitual sleep-wake times, were analyzed using general linear models adjusted …

Hubungan Kadar Malondialdehida (Mda) Serum Dan Fraksi Ejeksi Ventrikel Kiri Pada Pasien Hemodialisis Reguler, Teguh Setiadi Amir, Taufik Indrajaya, Zulkhair Ali

Jurnal Penyakit Dalam Indonesia

Introduction. Malondialdehyde (MDA) is a marker of oxidative stress that is elevated in chronic kidney disease (CKD) patients undergoing regular hemodialysis. Oxidative stress can affect cardiac function especially left ventricular function. This study aimed to evaluate the relationship between serum MDA levels with left ventricular function in regular hemodialysis patients at Dr. Mohammad Hoesin Genaral Hospital, Palembang.

Methods. This study was an analytic observational study with a cross-sectional design conducted on regular hemodialysis patients in the Hemodialysis Installation of Dr. Mohammad Hoesin Genaral Hospital, Palembang. The MDA levels were examined from the serum of post-hemodialysis patients using ELISA …

Takikardia Ventrikel Berulang Pasca Coronary Artery Bypass Grafting (Cabg): Laporan Kasus Berbasis Bukti, Ika Prasetya Wijaya, Simon Salim, Audina Dhiya Nabila

Jurnal Penyakit Dalam Indonesia

Coronary artery bypass grafting (CABG) remains the treatment of choice for patients with complex multivessel coronary artery disease but carries a risk of serious perioperative complications, including ventricular arrhythmias such as ventricular tachycardia (VT). Although VT following CABG is rare, it is potentially life-threatening and often results from multiple interrelated factors. This report presents a case of recurrent ventricular tachycardia after CABG and to highlight the underlying mechanisms, risk factors, and evidence-based management strategies aimed at preventing adverse outcomes.We report a 54-year-old woman with diabetes, hypertension, prior myocardial infarction, and severe left ventricular dysfunction who underwent urgent CABG for three-vessel …

Variabel Dan Model Prediktor Perdarahan Varises Esofagus Berulang Pada Pasien Sirosis Hati Di Rsupn Dr. Cipto Mangunkusumo, Ifani Media Sari, Juferdy Kurniawan, Kemal Fariz Kalista, Aulia Rizka, Eka Ginanjar, Sally Aman Nasution, Leonard Nainggolan Md. Internal Medicine, Tropic-Infection Spesialist, Sukamto Koesnoe

Jurnal Penyakit Dalam Indonesia

Introduction. Liver cirrhosis is a chronic condition associated with severe complications, including esophageal variceal bleeding, which carries high morbidity and mortality rates. Approximately 60% of patients with cirrhosis experience recurrent bleeding within one year, with a mortality rate of 20–60% within six weeks after the initial bleeding episode. Therefore, identifying predictors of recurrent bleeding is essential for improving preventive strategies. This study aimed to identify predictors of recurrent esophageal variceal bleeding in patients with liver cirrhosis and to develop a predictive model.

Methods. This retrospective study included 220 patients with liver cirrhosis and a history of esophageal variceal …

Kontinuitas Terapi Lupus: Kesenjangan Antara Evidence-Based Medicine Dan Real-World Practice, Abirianty P. Araminta

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Hubungan Penggantian Imunosupresan Tidak Terencana Dengan Aktivitas Penyakit Lupus Eritematosus Sistemik: Studi Kohort Retrospektif Di Rsupn Dr. Cipto Mangunkusumo, Jakarta, Rosvitha Amanda, Sukamto Koesnoe, Alvina Widhani, Ikhwan Rinaldi, Adityo Susilo, Juferdy Kurniawan, Rudi Putranto, Birry Karim

Jurnal Penyakit Dalam Indonesia

Introduction. Systemic lupus erythematosus (SLE) is a complex chronic autoimmune disease with diverse clinical manifestations. Treatment stabilization is crucial for optimal disease control, but the consistency of immunosuppressive therapy may be affected by non-ideal conditions, including drug unavailability or adverse effects. This study aimed to assess the association between unplanned immunosuppressant switching and increased disease activity in SLE patients.

Methods. A retrospective cohort study of SLE patients meeting the inclusion criteria, whose disease activity was evaluated using the MEX-SLEDAI score during immunosuppressant substitution. Participants were grouped into an exposed group undergoing unplanned immunosuppressant switching due to drug unavailability …

Efektivitas Penambahan Suplementasi Vitamin C Terhadap Penurunan Malondialdehid Dan Perbaikan Derajat Aktivitas Penyakit Lupus Eritematosus Sistemik: Uji Klinis Acak Tersamar Ganda, Yuniza Yuniza, Nova Kurniati, Theodorus Theodorus, Eddy M. Salim, Kristian S. Hartanto

Jurnal Penyakit Dalam Indonesia

Introduction. Vitamin C is an antioxidant that exerts its effects at multiple cellular levels. However, evidence regarding its effects in systemic lupus erythematosus (SLE) remain inconclusive. This study aimed to evaluate the potential of vitamin as an adjunctive antioxidant therapy in patients with SLE by assessing its effects on serum malondialdehyde (MDA) levels and disease activity using the Mexical Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI) score.

Methods. This pilot double-blind, randomized controlled trial was conducted at Dr. Mohammad Hoesin General Hospital, Palembang. Participants were patients with mild-to-moderate SLE diagnosed according to the 2019 European Alliance of Association …

Profil Biomarker Apolipoprotein B Dan Lipid Terhadap Skor Syntax Pada Pasien Sindrom Koroner Kronik, Muhammad Novran Chalik, Erwin Sukandi, Taufik Indrajaya, Ferry Usnizar, Syamsu Indra, Imran Saleh, Rukiah Chodilawati, Irfannuddin Irfannuddin

Jurnal Penyakit Dalam Indonesia

Introduction. Apolipoproteins are structural components of plasma lipoproteins that are involved in lipoprotein metabolism and lipid transport, reflecting the number of circulating atherogenic particles. The degree of coronary artery stenosis can be assessed by calculating the Synergy between PCI with TAXUS/paclitaxel-eluting stent and Cardiac Surgery (SYNTAX) score, which is an angiographic scoring system used to evaluate the complexity of coronary artery lesions. This study aimed to investigate the profile of apolipoprotein B and lipids, as well as their correlation with the SYNTAX score in patients with chronic coronary syndrome.

Methods. An observational analytic study with a cross-sectional design …

Gagal Jantung Kanan Pada Hipertiroid Tidak Terkontrol: Laporan Kasus, Kevin Lazuardy, Leonard Nainggolan, Nadim Marchian Tedyanto

Jurnal Penyakit Dalam Indonesia

Right heart failure is a clinical syndrome that is influenced by various factors. The incidence of heart failure reaches 5/1,000 population, while the prevalence of heart failure reaches 1-2% of the adult population. Management of the main etiology of heart failure is the main therapy. In some cases, hyperthyroidism is an indirect cause of heart failure, especially in right heart failure. Hyperthyroidism can cause reversible pulmonary hypertension which causes right heart failure, although the underlying mechanism is uncertain at the moment. This study reports a 46-year-old woman who was diagnosed with right heart failure and also had hyperthyroidism. In this …