Medicine and Health Sciences Commons^™

Effect Of An Electronic Order Set On Newborn Hepatitis B Immunization Rates, Daniel Pedersen, Angelina Rodriguez, Olu Oyesanmi, Heather Schramm, Michael King

HCA Healthcare Journal of Medicine

Objective

Hepatitis B is an infectious deoxyribonucleic acid virus which can cause significant morbidity and mortality. There is no current definitive treatment, however in the United States immunization is widely available. A paper published by the Advisory Committee on Immunization Practices/Centers for Disease Control (ACIP/CDC) in 2018 made updated recommendations regarding vaccination practices in the United States. The most notable change made was that all healthy newborns weighing ≥2000 g with a negative hepatitis B-status mother should receive hepatitis B immunization within 24 hours of birth. This quality improvement project studied the effect of the electronic medical record newborn admission …

Case Of Enterococcus Cecorum Human Bacteremia, United States, Alexander D. Lake, Ryan Fields, Francia Guerrero, Yousef Almuzaini, Koravangala Sundaresh, Joseph Staffetti

HCA Healthcare Journal of Medicine

Enterococcus cecorum rarely serves as a human pathogen, and only 6 cases of this microbe inoculating humans have been documented. We present an elderly female with a marked vascular history presenting with epigastric pain and diarrhea, followed by shaking chills. Laboratory findings revealed leukocytosis, with imaging showing diffuse colonic thickening. She had a bout of bloody diarrhea, raising the likelihood of ischemic colitis with her vascular history. To our surprise, both sets of blood cultures drawn on admission grew Enterococcus cecorum. This case is unique as it is the first documented case of E. cecorum human infection in the …

Goblet Cell Carcinoma Of The Appendix: A Case Report On Goblet Cell Carcinoid, Sheliza Kabani, Aubtin Saedi, Austin Lehr, Lina O'Brien

HCA Healthcare Journal of Medicine

Goblet cell carcinoid of the appendix is a rare neoplasm with histological features of both neuroendocrine and adenocarcinomas. The combination of its aggressive behavior, infrequent occurrence, and variable clinical presentation convolutes the management of this tumor. We report the case of a 75-year-old female presenting with acute appendicitis. A laparoscopic appendectomy was performed. The pathology report showed goblet cell carcinoid at the base of the appendix with involvement of the proximal surgical margins. At her postoperative visit, the patient’s pathology report and options for management were reviewed, and the patient agreed to proceed with a right hemicolectomy 8-10 weeks after …

A Rare Case Of C3 Glomerulonephritis Presenting As Pulmonary Renal Syndrome, Gerardo Mederos, Harsh Patel, Menalee Hapuarachchi, Machaiah Madhrira, Ranjit Nair, Dana Ciobanu

HCA Healthcare Journal of Medicine

C3 glomerulonephritis (C3GN) is a rare disease that falls under the umbrella of C3 glomerulopathy (C3G). Classic manifestations of C3G include acute renal failure, proteinuria, and hematuria. In some cases, extrarenal manifestations can include ocular drusen. Until recent reports, C3G manifesting with pulmonary symptoms has not been reported. In this report, we describe a patient that initially presented with hemoptysis and acute renal failure, eventually leading to a diagnosis of pulmonary renal syndrome. Renal biopsy showed C3GN. The patient’s symptoms improved with pulse dose steroids, plasmapheresis and mycophenolate mofetil. C3G presenting with pulmonary symptoms is rare. Further research is needed …

A Case Of Simpson-Golabi-Behmel Syndrome Presenting With Cutaneous Findings, Tessa Mullins, Abigail Russell, Chad Johnston

HCA Healthcare Journal of Medicine

Simpson-Golabi-Behmel syndrome is a rare, X-linked recessive syndrome associated with mutations in the genes encoding glypican 3 (GPC3). The majority of cases have been described in pediatric males, with those affected showing manifestations of overgrowth, congenital heart defects, and increased incidence of neoplasia. Due to the X-linked nature of this disorder, penetrance is not well understood in female cases. Very few cases of female presentations of Simpson-Golabi-Behmel syndrome have been described, and this case highlights that there may be an association between mutated GPC3 carrier status and other cancers. We present a case of GPC3 gene mutation suggestive …

Therapeutics Development For Pseudoxanthoma Elasticum And Related Ectopic Mineralization Disorders: Update 2020., Hongbin Luo, Qiaoli Li, Yi Cao, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

Pseudoxanthoma elasticum (PXE), the prototype of heritable ectopic mineralization disorders, manifests with deposition of calcium hydroxyapatite crystals in the skin, eyes and arterial blood vessels. This autosomal recessive disorder, due to mutations in ABCC6, is usually diagnosed around the second decade of life. In the spectrum of heritable ectopic mineralization disorders are also generalized arterial calcification of infancy (GACI), with extremely severe arterial calcification diagnosed by prenatal ultrasound or perinatally, and arterial calcification due to CD73 deficiency (ACDC) manifesting with arterial and juxta-articular mineralization in the elderly; the latter disorders are caused by mutations in ENPP1 and NT5E, respectively. The …

Low Serum Irisin As A Risk Factor Of Sarcopenia In Elderly, I Gust Putu Suka Aryana, I.B. Putrawan, Ni Ketut Rai Purnami, R.A. Tuty Kuswardhani, I Nyoman Astika, Ketut Suastika, I Putu Gede Adiatmika, I Made Jawi, I Nyoman Wande

Jurnal Penyakit Dalam Indonesia

Introduction. Sarcopenia is a condition characterized by a decrease in muscle mass accompanied by a decrease in strength and/or function. Sarcopenia is closely related to the aging process, but the mechanism of its occurrence is still not fully understood. Skeletal muscle is the largest organ in the human body, so the myokine produced through muscle contraction opens a new paradigm regarding the central role of muscles in regulating metabolism and other organ functions. One of the myokines that are currently found to affect physical activity is Irisin. This study aims to determine the role of low Irisin levels in serum …

Correlation Of The Quality Of Antibiotic Usage By Utilising Gyssens Flow And The Success Of Treatment In Negative Gram Mdr Sepsis In Tertiary Hospital, Soroy Lardo, Lie Khie Chen, Widayat Djoko Santoso, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Multi Drug Resistance (MDR) antibiotics have become a global health threat to the community. The use of appropriate antibiotics makes preventive and curative measures very important for the success of overcoming MDR and intervening the complexity of resistance, at least slowing the rate of occurrence of MDR. This study aimed to identify the difference in the quality of antibiotic use quality of use using gyssens flowchart and the success in sepsis patients’ treatment due to gram-negative MDR bacteria with non-MDR bacterial infections in tertiary hospitals. Methods. A retrospective cohort study was conducted using secondary data from patient with age …

The Selection Of Oral Antidiabetic Drugs In Type 2 Diabetes Mellitus Patients With High Risk For Cardiovascular Events, Derlin J. Leander, Dicky L. Tahapary

Jurnal Penyakit Dalam Indonesia

Type 2 diabetes mellitus (DMT2) patients are associated with an increased risk of cardiovascular events. Prior to the era of cardio-vascular trial outcome (CVOT) evidence on the efficacy of old oral diabetes (OAD) drugs such as metformin, sulfonylurea, thiazolidindion, glinid, and alpha glucosidase inhibitors in reducing the risk of cardiovascular events was very limited. Since 2008, all OADs must have CVOT data. DPP-4 inhibitors are neutral against the risk of cardiovascular events while SGLT-2 inhibitors are reported to significantly reduce the risk of cardiovascular events. This finding even helped to change the DMT2 management guidelines issued by American Diabetes Association …

Use Of A Cancer Registry To Evaluate Patient-Reported Outcomes Of Immune Checkpoint Inhibitors., Heather S L Jim, Sarah L Eisel, Aasha I Hoogland, Sandra Shaw, Jennifer C King, Adam P Dicker

Department of Radiation Oncology Faculty Papers

Immune checkpoint inhibitors (ICIs) are increasingly used for advanced lung cancer, butfew studies have reported on patient-reported outcomes (PROs) outside the context of a clinicaltrial. The goal of the current study was to assess PROs in participants of a lung cancer registry whohad been treated with an ICI. Patients participating in the GO2Foundation’s Lung Cancer Registrywho reported receiving atezolizumab, durvalumab, nivolumab, or pembrolizumab were invited toparticipate in a survey about their experiences during treatment. Quality of life was evaluated usingthe Functional Assessment of Cancer Therapy–General (FACT-G). Common symptomatic adverseevents were evaluated using an item bank generated for ICIs. Internationally, 226 …

The Impact Of “Code Stemi” Program Implementation On Door To Balloon Time And Major Adverse Cardiac Events Of Patients With St Elevation Myocardial Infarction, Prijander L B Funay, Ika Prasetya Wijaya, Eka Ginanjar, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Delay in the management of ST Elevation Myocardial Infarction (STEMI) patients is a cause of high mortality and the incidence of major adverse cardiac events (MACE). Efforts that can be made in health facilities with primary percutaneous coronary intervention (PCI) capability are achieving timely reperfusion of STEMI patients. Various strategies were carried out to achieve timely reperfusion including implementation the CODE STEMI program. This study aimed to determine the effect of the implementation of the CODE STEMI program on Door to Balloon Time (D2BT) and MACE of STEMI patients undergoing primary PCI. Methods. This was a retrospective cohort study …

Fluoroscopic Demonstration Of Thoracic Tumor Immobilization With High Frequency Percussive Ventilation, Ina M Sala, Beverly Maurer, Cristian Solano, Ronald Levitin, Thomas M Guerrero

Articles

Purpose: The purpose of this first-in-man study is to directly measure thoracic tumor immobilization by high frequency percussive ventilation (HFPV).

Methods: In an IRB approved protocol (IRB # 2017-046) we screened patients with conspicuous lung tumors that exhibited motion >10 mm to undergo kV fluoroscopy with HFPV. Two sets of consecutive AP (anterior posterior) fluoroscopy frames were acquired during multiple breathing cycles for free- and HFPV- breathing. All images were acquired using our kV source/panel of the therapeutic linear accelerator. Percussions were delivered via the intrapulmonary percussive ventilation device (IPV-2C) and phasitron (Percussionaire Corp., Sagle, Idaho). The baseline settings for …

Efficacy Of 3d-Pore Sanitary Napkin On Mild-To-Moderate Irritant Contact Dermatitis In The Female Genital Area, Srie Prihianti Gondokaryono, Hanny Nilasari, Inge Ade Krisanti, Tia Febrianti, Herliyani Purba, Haruko Toyoshima, Danang Agung Yunaidi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Women worldwide have their own strategies to cope with menstruation, and unhygienic menstrual practices often cause vaginal diseases. During menstruation, the skin is irritated by the remaining unabsorbed menstrual flow and sweat on sanitary pads. Irritation of vulvar skin by an external agent could cause contact dermatitis, which is an important contributor to vulvar diseases. Various sanitary napkins available today share similar materials. This study compared commonly used sanitary napkin among Indonesian women with 3D-pore sanitary napkin in terms of efficacy.

Methods: A randomized, controlled, single blind, crossover study of 72 participants who met the inclusion and …

Prevalence Of Nail Changes In Patients Infected With Hiv - A Cross Sectional Study, Seethalakshmi Ganga Vellaisamy, Priya Jeyaraman, Kannan Gopalan

Journal of General - Procedural Dermatology & Venereology Indonesia

Introduction: The spectrum of nail changes is wider and their frequency is higher among HIV patients. These changes magnify the range and multiplicity of AIDS manifestations. Their systematic examination is a non-invasive method of possible diagnostic value.

Objective: The present study was conducted to study the frequency and types of nail changes in HIV infected individuals and to correlate the severity of nail changes with CD4 count.

Material and Method: This was a cross sectional study, conducted in Skin & STD Out-Patient department in a tertiary care hospital between March 2018 and April 2019. A total of …

Purpuric Lesion In A Patient With Leprosy: Was It A Lucio’S Phenomenon Or An Epiphenomenon?, Sri Linuwih Menaldi, Melani Marissa, Inadia Putri Chairista, Henry W. Lim, Rahadi Rihatmadja

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Lucio’s phenomenon (LP) is a severe necrotizing cutaneous reaction that occurs in patients with Lucio’s leprosy. The exact pathomechanism is not fully understood, but typically abundant acid-fast bacilli in the walls of blood vessels point to direct perturbation of blood supply to the epidermis. We report a case of LP where epidermal necrosis occurred in the absence of vascular invasion by mycobacteria, raising the question whether this was an epiphenomenon or a true LP.

Case Illustration: A 34-year-old male was referred for an episodic swelling of his hands and feet that persisted for two years. There were …

Reversal Reaction With Nodules Clinical Manifestations That Initially Diagnosed As Erythema Nodosum Leprosum In Borderline Lepromatous Leprosy, Laila Tsaqilah, Pati Aji Achdiat, Hendra Gunawan

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: The reversal leprosy reaction generally manifest as larger, swollen, red and shiny the pre-existing skin lesions which are accompanied with pain. This reaction can be manifest as infiltration and nodules which resembles the features of erythema nodosum leprosum (ENL) leprosy reaction.

Case Illustration: We present a case of 26-year-old woman with erythematous nodules on almost all the body since two weeks ago. She had pre-existing erythema plaque on the right elbow became more erythematous and arouse with partially felt pain, fever, and malaise. Nodule lesions in BL leprosy with reaction need to be distinguished between ENL and …

Lucio’S Phenomenon: A Report On Six Patients In A Tertiary Referral Hospital In Indonesia, Melani Marissa, Rahadi Rihatmadja, Denny Surya, Henry W. Lim, Sri Linuwih Menaldi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Lucio's phenomenon (LP) is a rare variant of leprosy reaction, with the clinical manifestation of “necrotizing erythema.” LP was observed in patients with lepromatous leprosy who have not received or completed the treatment, and it is especially evident in patients with diffuse lepromatous leprosy (DLL), known as Lucio-Latapi’s leprosy. LP occurs due to M. leprae invading the blood vessels, causing endothelial damage that leads to thrombosis, ischemia, infarction, and tissue necrosis. The clinical features of the disease are erythematous lesions that can be accompanied by vesicles or bullae, with ulcers forming scar tissues. Histopathological examination can help establish …

Cutaneous Candidiasis Mimicking Inverse Psoriasis Lesion In A Type 2 Diabetes Mellitus Patient, Steven Philip Surya, Kardiana Purnama Dewi, Regina Regina

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Type 2 diabetes mellitus (T2DM) condition could affect the skin. The disease is among the greatest risk factors of skin infection such as cutaneous candidiasis and is also associated with autoimmune skin diseases such as psoriasis, which lesion morphologies and predilection areas are quite similar. These similarities are a source of confusion to clinicians.

Case illustration: We present a 60-year-old female patient with uncontrolled T2DM and multiple erythematous plaques in the form of shiny lesions at the intertriginous area that developed 1 week prior to her hyperglycemic state. The lesions had recurred at the same site for …

Fever-Induced Brugada Syndrome In An Acute Gastroenteritis Patient: A Case Report, Rio Yansen Cikutra, Irwin Irwin

Jurnal Penyakit Dalam Indonesia

Brugada syndrome (BS) is a disease caused by autosomal dominant sodium channel mutation in the heart. The prevalence of BS worldwide is estimated to be 1-5/10,000 population and the highest prevalence is in Southeast Asia which is >5/10,000 population. Brugada syndrome is a dangerous condition because it predisposes to malignant arrhythmias (ventricular tachycardia/VT and ventricular fibrillation/VS) and sudden cardiac death (SCD). Fever is a trigger for malignant arrhythmias, syncope, or SCD in BS. This article discusses about a case of 64-year-od man patient with complaint of syncope, preceded by chest pain and palpitation. The patient also had a fever and …

Profile Of Patients Neutropenia Fever Unrelated To Chemotherapy In Dr. Cipto Mangunkusumo General Hospital, Gantira Danasasmita, Lie Khie Chen, Robert Sinto, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. The condition of neutropenia increases the risk of infection. The causes of neutropenia are widely discussed as side effects of chemotherapy, but patients with neutropenia who are not due to side effects of chemotherapy are increasing in number. This study aims to provide an overview of the characteristics of neutropenic fever population unrelated to chemotherapy. Method. The study was conducted retrospectively on the medical records of neutropenic fever patients who were not chemotherapy-related in the National Hospital Dr. Cipto Mangunkusumo in January 2018-November 2019. Variables studied included demographic, clinical characteristics, classification of multinational association of supportive care in cancer …

Validity And Reliability Test Of European Organization For Research And Treatment Of Cancer Quality Of Life Questionnairebreast 23 In Breast Cancer Patient On Treatment, Mizanul Adli, Hamzah Shatri, Noorwati Sutandyo, Suhendro Suwarto

Jurnal Penyakit Dalam Indonesia

Introduction. Improved survival of breast cancer patients are not necessarily followed by improvement of quality of life. According to the European Organization for Research and Treatment of Cancer (EORTC), cancer patients’ quality of life are very important to be evaluated. In Indonesia, breast cancer patients cannot be assessed their quality of life accurately because there is no valid and reliable questionnaire. This study aims to prove that the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast 23 (EORTC QLQ-BR23) is a valid and reliable measuring instrument to be used in Indonesia. Methods. This study was a …

Peran Penting Pengendalian Resistensi Antibiotik Pada Pandemi Covid-19, Robert Sinto

Jurnal Penyakit Dalam Indonesia

No abstract provided.

The Management Of Seborrheic Dermatitis 2020, Sandra Widaty, Kusmarinah Bramono, Muhammad Yulianto Listiawan, Ariyati Yosi, Eliza Miranda, Githa Rahmayunita, Herwinda Brahmanti, Henry W. Lim

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Seborrheic dermatitis (SD) is a chronic relapsing dermatitis manifesting in the seborrheic area, affecting infants or adults. In Indonesia, the prevalence of SD is 0.99–5.8% of all dermatology cases from 2013 to 2015. SD has been known to be a prominent manifestation among HIV patients, but there is an increasing trend in the general population. Therefore, in 2017, the Indonesian Society for Dermatology and Venereology proposed a consensus for the management of SD in Indonesia based on the discussion from 12 dermatological centers. Concurrent with the development of new drugs, this study aims to evaluate and develop a …

Correlation Between Clinical And Histopathological Findings Of Five Puzzling Cases Of Cutaneous Tuberculosis, Eliza Miranda, Sandra Widaty, Sondang Pandjaitan Sirait, Luddwi Achmad Rizky, Sri Linuwih Menaldi, Henry W. Lim

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Cutaneous tuberculosis refers to the clinical manifestation of extrapulmonary tuberculosis affecting the skin. Determining the type of cutaneous tuberculosis from a patient afflicted with is challenging because clinical and histopathological similarities exist between types. Moreover, confirming a diagnosis of cutaneous tuberculosis is difficult because of its similarity with other diseases. For instance, typical and atypical cutaneous tuberculosis may have similar manifestations, but each disease is managed by completely different approaches. Microbiological examination with polymerase chain reaction and bacterial culture are the gold standard methods used to confirm a diagnosis of cutaneous tuberculosis. However, results often demonstrate negative findings. …

Level Of Disability And Limitation Of Shoulder Motion In Post Mastectomy At Hasan Sadikin Hospital Bandung In 2019, Nadya Rachmawati, Tertianto Prabowo, Fathurrachman Fathurrachman

Jurnal Penyakit Dalam Indonesia

Introduction. Post-mastectomy complications in breast cancer patients can be a long-term disabilities such as limitation of shoulder function that only appears after several months to years after surgery and may remain for the rest of the patient’s life. This study aims to describe the level of disability and limitation of the shoulder joint’s range of motion in breast cancer patients following mastectomy at Hasan Sadikin Hospital, Bandung 2019. Methods. This research was conducted by using descriptive method with cross-sectional study design. Sampling technique using consecutive sampling method during one-month study period. Samples were post-mastectomy breast cancer patients who came to …

Unusual Cardiac Presentation Of Covid-19 With Significant Sinus Pauses, Tarique S. Chachar, Salman K. Slais, Abdulrahman Almadani, Adel K. Hamad

Journal of the Saudi Heart Association

There is growing evidence of cardiac complications due to corona virus disease 2019 (COVID 19). Our case is a case of a young patient with COVID-19 and symptomatic sinus pauses.

A Multiloculated Left Ventricular Thrombus, Dinkar Bhasin, Gaurav K. Arora, Anunay Gupta, Hermohander S. Isser, Sandeep Bansal

Journal of the Saudi Heart Association

No abstract provided.

Dach1 Mutation Frequency In Endometrial Cancer Is Associated With High Tumor Mutation Burden, Mckayla J. Riggs, Nan Lin, Chi Wang, Dava W. Piecoro, Rachel W. Miller, Oliver A. Hampton, Mahadev Rao, Frederick R. Ueland, Jill M. Kolesar

Obstetrics and Gynecology Faculty Publications

OBJECTIVE: DACH1 is a transcriptional repressor and tumor suppressor gene frequently mutated in melanoma, bladder, and prostate cancer. Loss of DACH1 expression is associated with poor prognostic features and reduced overall survival in uterine cancer. In this study, we utilized the Oncology Research Information Exchange Network (ORIEN) Avatar database to determine the frequency of DACH1 mutations in patients with endometrial cancer in our Kentucky population.

METHODS: We obtained clinical and genomic data for 65 patients with endometrial cancer from the Markey Cancer Center (MCC). We examined the clinical attributes of the cancers by DACH1 status by comparing whole-exome sequencing (WES), …

Identifying Personalized Metabolic Signatures In Breast Cancer., Priyanka Baloni, Wikum Dinalankara, John C Earls, Theo A Knijnenburg, Donald Geman, Luigi Marchionni, Nathan D Price

Articles, Abstracts, and Reports

Cancer cells are adept at reprogramming energy metabolism, and the precise manifestation of this metabolic reprogramming exhibits heterogeneity across individuals (and from cell to cell). In this study, we analyzed the metabolic differences between interpersonal heterogeneous cancer phenotypes. We used divergence analysis on gene expression data of 1156 breast normal and tumor samples from The Cancer Genome Atlas (TCGA) and integrated this information with a genome-scale reconstruction of human metabolism to generate personalized, context-specific metabolic networks. Using this approach, we classified the samples into four distinct groups based on their metabolic profiles. Enrichment analysis of the subsystems indicated that amino …

Genetic Variants In Immune Related Genes As Predictors Of Responsiveness To Bcg Immunotherapy In Metastatic Melanoma Patients., Romela Irene Ramos, Misa A Shaw, Leland J Foshag, Stacey L Stern, Negin Rahimzadeh, David Elashoff, Dave Hoon

Articles, Abstracts, and Reports

Adjuvant immunotherapy in melanoma patients improves clinical outcomes. However, success is unpredictable due to inherited heterogeneity of immune responses. Inherent immune genes associated with single nucleotide polymorphisms (SNPs) may influence anti-tumor immune responses. We assessed the predictive ability of 26 immune-gene SNPs genomic panels for a clinical response to adjuvant BCG (Bacillus Calmette-Guérin) immunotherapy, using melanoma patient cohorts derived from three phase III multicenter clinical trials: AJCC (American Joint Committee on Cancer) stage IV patients given adjuvant BCG (pilot cohort; n = 92), AJCC stage III patients given adjuvant BCG (verification cohort; n = 269), and …