Medicine and Health Sciences Commons^™

A Case Of Xylazine-Induced Necrotic Skin Ulcerations In An Iv-Drug User In Florida, Mark Zaki, Cynthia Dillon, Anjali Patel, Barbara Gracious

HCA Healthcare Journal of Medicine

Introduction

As illicit drug manufacturers find new ways to market their products and increase their profit margins, multiple contaminants have found their way into the illicit drug supply. The newest addition, xylazine, also known as “tranq,” has spread through the city of Philadelphia and has recently been gaining ground across the United States, including in the state of Florida.

Case Presentation

This case describes a 37-year-old male with a significant past psychiatric history of severe polysubstance intravenous (IV) use, including fentanyl and methamphetamine. He was comorbid with other mental and physical conditions and presented to the emergency department with acute …

Successful Treatment Of An Atypical Presentation Of Disseminated Retroperitoneal Seminoma: A Case Report, Mahmoud Abd-El-Hafez, Kylie Johnson, Joe Cates, Alosh Madala

HCA Healthcare Journal of Medicine

Background

Testicular seminoma is the most common malignant tumor of the testis. It occurs at a rate of 5 per 100 000 men, primarily between the ages of 15 to 34. While seminomas typically occur in the testis, other primary sites include the mediastinum, the retroperitoneum, or other extra-gonadal sites. Due to the curable nature of the malignancy (5-year survival rate > 95%), detection at early stages of the disease is key. This case presentation explores the delayed diagnosis and treatments of an atypical presentation of disseminated seminoma.

Case Presentation

We present the unusual case of a 56-year-old male who had …

Hemophagocytic Lymphohistiocytosis Due To Ehrlichiosis: A Case Series, Ajay Iyer, Mattias D'Anna, Shruti Verma, Thomas Pritchard, Vladimir Begilman, Himal Bajracharya, Kaveh Naemi

HCA Healthcare Journal of Medicine

Background

Hemophagocytic lymphohistiocytosis (HLH) is an immunologic syndrome characterized by excessive inflammation and tissue injury due to uncontrolled activation of the phagocytic system. The underlying mechanism is a lack of downregulation of activated macrophages and lymphocytes by natural killer and T cells. Unfortunately, the diagnosis is often delayed or missed due to the rarity of the disease, decreased awareness, and clinical picture variability. Ehrlichiosis is becoming a more prevalent tick-borne illness in endemic regions and a relatively uncommon but increasingly considered cause of HLH.

Case Presentation

We describe the cases of 2 patients diagnosed with secondary HLH as per the …

Endovascular Repair Of A Superior Mesenteric Arteriovenous Fistula And Pseudoaneurysm After A Single Gunshot Wound To The Abdomen, Robert Ringersen Iii, Michael Shockley, Sanjiv Gray, Tracy Bilski, Julio Calderin, Philip Kondylis

HCA Healthcare Journal of Medicine

Background

Traumatic arteriovenous fistulas (AVFs) are rare entities, especially when referring to visceral arterioportal AVFs. Currently, there are no large epidemiological studies looking specifically at traumatic visceral AVFs. When traumatic AVFs have been discussed in the literature, it is in the form of case reports or case series and focused on peripheral AVFs. The following case is a presentation of a traumatic arterioportal AVF and its management with an endovascular approach.

Case Presentation

A 16-year-old adolescent boy presented tachycardic and hypotensive with a single gunshot wound in his left abdomen. Multiple operations were required. His intensive care unit course was …

Investigating The Effects Of Nosocomial Clostridioides Difficile Infection Among Acute Leukemia Patients: Insights From The 2020 National Inpatient Sample, Zubair Hassan Bodla, Mariam Hashmi, Fatima Niaz, Umer Farooq, Muhammad Jahanzeb Khalil, Farhan Khalid, Kipson Charles, Christopher L. Bray

HCA Healthcare Journal of Medicine

Background

Rising nosocomial Clostridioides difficile infections pose high risks, especially for immunocompromised leukemia patients, necessitating targeted research to enhance patient care and outcomes.

The objective of this study was to investigate the impact of nosocomial Clostridioides difficile infections (CDI) on patients hospitalized with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).

Methods

Our study was a retrospective analysis of adult patients hospitalized with a primary diagnosis of ALL or AML, using the Nationwide Inpatient Sample (NIS) database for 2020. Primary outcomes included the incidence of nosocomial CDI and all-cause inpatient mortality. Secondary outcomes included hospital length of stay, resource …

A Retrospective Data Analysis On Marine Animal Injuries At A Large, Multi-Site Medical System, Anthony Shadiack, J Burton Banks

HCA Healthcare Journal of Medicine

Background

With increasing numbers of human-animal interactions, there has been an increase in animal-related injuries. While canine bites are the most commonly reported animal injury, little data exists in regard to the other classes of animals, particularly marine life. The last comprehensive report on injuries related to noncanine bites and stings seen in emergency departments (EDs) across the US was between 2011 and 2015.

Methods

We performed a retrospective analysis from 2014-2019 on marine injuries from a large hospital network with over 180 hospitals, 100 freestanding EDs, and 170 urgent care centers to provide an update on the volume and …

Treatment Analysis Of Very Early And Early Onset Psychosis In The Youth Inpatient Setting, Acelyne Marie Summerson, Jordan Kalosieh, Sindhura Kompella, Clara Alvarez-Villaba, Yukthi Kodali

HCA Healthcare Journal of Medicine

Background

The United States Food and Drug Administration approved 6 atypical antipsychotics for pediatric treatment of schizophrenia. However, little has been published on the effectiveness of these medications in the acute treatment setting of adolescents with psychosis. Since the clinical uncertainty and poor prognosis proceeding the early onset of schizophrenia has a significant impact on a child’s development, there is a critical need for evidence-based data on this population. The aim of our study was to investigate the effect of various antipsychotics on young patients admitted to the inpatient ward presenting with acute psychosis.

Methods

A retrospective analysis was performed …

Assessment Of The European Hernia Society Classification Of Ventral Hernias And Clinical Outcomes, Oluwatunmininu A. Anwoju, Ashtyn Barrientes, Connor Hogan, Erik Askenasy, Jacob Greenberg, Keith Jerrod, Scott J. Roth, Zuhair Ali, Mike K. Liang

HCA Healthcare Journal of Medicine

Background

Ventral hernias are a common but heterogeneous disease. Communication among key stakeholders (eg, patients, clinicians, administrators, payers, and researchers) can be augmented by a widely utilized classification system. The European Hernia Society (EHS) developed an expert-opinion-based hernia classification system organized by hernia type (primary versus incisional) and size. We sought to assess what components of the EHS ventral hernia classification system were correlated to real-world clinical outcomes.

Methods

This was a multicenter cohort study. All hospitals contributing to the database were affiliated with 1 of 6 academic institutions. All adult patients who underwent ventral hernia repair over a 4-year …

Second Generation Antipsychotics And Cardiovascular Adverse Effects: Developing Evidence-Based Recommendations For Primary Care Medicine, Sana Borda, Ahn-Dao Lee, Paul F. Bell

HCA Healthcare Journal of Medicine

Background

Second-generation antipsychotic medications (SGAs) are often used by primary care physicians (PCPs) to treat multiple psychiatric diagnoses. SGAs have been connected to a number of adverse effects, including cardiovascular disease. Currently, there are no published evidence-based recommendations addressing SGAs and cardiotoxicity that are directed toward PCPs. This project aims to fill this gap.

Methods

Relevant search terms related to SGAs and cardiovascular disease were identified and then used to search databases (PubMed, PubMed Central, and AccessMedicine). Research studies obtained from the searches were narrowed to include systematic reviews and meta-analyses. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool was …

Sars-Cov-2 Vaccination Can Only Be Held Responsible For Thrombotic Thrombocytopenic Purpura After All Differentials Have Been Ruled Out, Josef Finsterer

HCA Healthcare Journal of Medicine

This letter to the editor addresses limitations to holding COVID vaccines responsible for the diagnosis of thrombotic thrombocytopenic purpura and discusses the potential differential diagnoses that must be considered.

Satisfaction Of Excellent Service Training Participants With The Kirkpatrick Model At Alia Hospital Depok, Nur Fadilah Dewi

Jurnal Vokasi Indonesia

The study aims to improve the quality of human resources and services at Alia Hospital Depok through evaluation of training programs. The approach used is the Donald Kirkpatrick model evaluation which is a common method used in evaluating the effectiveness of training. The main problem faced by Alia Hospital Depok is the lack of evaluation conducted on the training programs that have been held. Therefore, training evaluation needs to be considered to improve the quality of human resources and services provided. The research method used is a survey by distributing questionnaires to service excellent training participants to evaluate their reactions …

Hubungan Abnormalitas Ekokardiografi Terhadap Mortalitas Pasien Terkonfirmasi Covid-19 Derajat Berat Dan Kritis Di Rsupn Dr. Cipto Mangunkusumo, Fidiaji Hiltono Santoso, Idrus Alwi, Sally A. Nasution, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. The mortality rate of COVID-19 patients in Indonesia is high with manifestations of cardiac complications. Echocardiographic evaluation can help identify cardiac functional and structural disorders associated with patient mortality. Therefore, this study aims to determine the relationship between echocardiographic abnormalities and mortality in severe and critical COVID-19 patients.

Methods. A retrospective cohort study was conducted using medical record data of severe and critical COVID-19 patients at Dr. Cipto Mangunkusumo Hospital Jakarta during March 2020 to April 2021. Subjects were selected using total sampling. Descriptive analysis was performed, presenting descriptive tables, and bivariate analysis was conducted using the …

Saatnya Memberikan Vaksin Influenza Untuk Tenaga Kesehatan, Anshari Saifuddin Hasibuan

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Gastric Outlet Obstruction Sebagai Keluhan Awal Limfoma Gaster: Sebuah Laporan Kasus, Lie Khie Chen, Nurhidayat Mohammad, Bayu B. Rumondor, Virly Nanda Muzellina

Jurnal Penyakit Dalam Indonesia

Gastric lymphoma often presents with non-specific symptoms, contributing to delayed diagnosis. Gastric Outlet Obstruction (GOO) is a potential complication that may occur in patients with gastric lymphoma. A 62-year-old male patient presented with persistent weakness, nausea, and vomiting. His symptoms began with long-standing abdominal discomfort, which had not been further evaluated. Esophagogastroduodenoscopy (EGD) revealed GOO secondary to a mass, which, after pathological and immunohistochemical evaluation, was diagnosed as diffuse large B-cell lymphoma (DLBCL). The patient was subsequently given a nasojejunal feeding tube and treated with R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and oral prednisone). The non-specific nature of gastric lymphoma …

Pengaruh Durasi Pengobatan Dan Preferensi Pasien Kanker Stadium Akhir Terhadap Layanan Homecare Di Rumah Sakit Medistra Pada Tahun 2021-2023, Peter Brian Sutanto Putra Dr, Erfen Gustiawan Suwangto Dr, Tena Djuartina Dr, Iskandar Rahardjo Budianto Dr, C. Rinaldi A. Lesmana

Jurnal Penyakit Dalam Indonesia

Introduction. Cancer is still an enormous health problem in the world and rank second as the most common cause of mortality. End-stage cancer requires end-of-life or palliative care to improve the patient’s quality of life before death. Homecare services have become an option for providing palliative care to avoid long-term hospital stays. The study aimed to provide an overview of the treatment duration and other factors in end-stage cancer patients regarding the selection of homecare services at Medistra Hospital during the period of 2021-2023.

Methods. This study with a cross-sectional design analyzed medical records of end-stage cancer patients …

Efektivitas Vaksin Covid-19 Mrna Booster Kedua Pada Tenaga Kesehatan Di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Dan Faktor Yang Memengaruhinya, Siti Taqwa Fitria Lubis, Sukamto Koesnoe, Evy Yunihastuti, Hamzah Shatri, Teguh Harjono Karjadi, Kuntjoro Harimurti, Ceva Wicaksono Pitoyo, Em Yunir

Jurnal Penyakit Dalam Indonesia

Introduction. The emergence of the Omicron variant during the pandemic had an impact on the effectiveness of the COVID-19 vaccine. The spread of Omicron increased rapidly even in populations that had been vaccinated with booster doses, causing a high incidence of infection. This study aimed to determine the effectiveness and factors related to the effectiveness of the second mRNA booster vaccine as well as antibody levels after the second mRNA booster vaccine in healthcare workers at Cipto Mangunkusumo National General Hospital.

Methods. This study used a cohort design. Total sampling of 271 healthcare workers were obtained from previous …

Efek Terapeutik Analog Somatostatin Dalam Menghambat Perkembangan Autosomal Dominant Polycystic Kidney Disease, Irvin Rembrant Holleritz Sitompul, Grasella Angelika Putri, Purwita Wijaya Laksmi

Jurnal Penyakit Dalam Indonesia

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a hereditary disorder characterized by formation and progressive growth of cysts in the kidneys and other organs such as liver, spleen, and pancreas. Recent advances have led to possibilities to target the main cause of cyst growth, cAMP. Somatostatin targets cAMP and inhibits its production directly and indirectly in kidney and liver, which might potentially prevent renal and liver cyst progression in ADPKD. This report aims to evaluate the effectiveness of somatostatin analogue therapy in slowing disease progression in ADPKD patients, according to the latest evidence. A literature search was conducted on five …

Long Covid Dan Sistem Kardiovaskular, Muhadi Muhadi, Ivan Mardhi Laksmana

Jurnal Penyakit Dalam Indonesia

Even after nasopharyngeal Polymerase Chain Reaction (PCR) swab investigation revealed no COVID-19 infection, some individuals continue to have long COVID symptoms. According to a research published in 2022, 4.5 – 36.6% of patients had symptoms following a COVID-19 infection more than three months. Long COVID symptoms may impact multiple organ systems, including the cardiovascular system. Chest pain, palpitations, arrhythmia, postural orthostatic tachycardia syndrome, and other symptoms are possible appeared in long COVID. D-Dimer, echocardiography, CT scan, cMRI and other supportive test showed meaningful results. Pharmacological treatment can be given based on the concurrent diagnosis found in patients with long COVID. …

The Use Of Primal Reflex Release Technique To Address Pain And Stress: An Exploratory Case Series, Nathan R. Reep, Sydney N. Leverett, Rebecca M. Heywood, Zachary Johnson, Alan Nasypany, James May, Scott W. Cheatham

Clinical Practice in Athletic Training

The majority of the world population is experiencing more stress after the COVID-19 pandemic. Working in an outpatient healthcare setting it can be expected that patients will present with stress in combination with other perceptions of pain related to injury. Stress alone may be the cause of pain perception especially in patients who present with no specific mechanism of injury. There is a need for a quick full-body approach to assessment and treatment while considering the stress response to injury. Therefore, the purpose of this study was to determine the immediate effects of Primal Reflex Release Technique (PRRT) Primals on …

Single-Step Synthesis Of Activated Carbon From Arabica Spent Coffee Ground Using K2co3 As Activator Agent, Ghina Ivana Mieldan, Yuliusman Yuliusman

Journal of Materials Exploration and Findings

Activated carbon is a nanomaterial that is often used as an effective adsorbent. Activated carbon raw materials can use biomass, such as coffee grounds, which can be found along with the growth of public interest in coffee drinks. Chemical activators are used for activation to increase biomass carbon's adsorption capacity. Using K₂CO₃ activator to increase the specific surface area of activated carbon is more harmless than KOH. The use of spent coffee grounds as carbon source and food additive K₂CO₃ as an activator can make food-grade activated carbon that can be used for food. …

Effect Of Alkyd And Polyester Resin Compositions On Corrosion Resistance, Blistering, And Adhesion In Utilization Of Oily Sludge As Anti-Rust Coating Material, Gerets Land Kakalang, Yohanes David Kristianto, Johny Wahyuadi Mudaryoto

Journal of Materials Exploration and Findings

Oil sludge is a waste derived from upstream and downstream activities of the oil and gas industry which is estimated at 10,000 tonnes generated from all PERTAMINA downstream activities spread across various fields, processing units and depots throughout Indonesia. Oil sludge has the same characteristics as asphalt, where asphalt in previous studies can be used as an anti-rust coating, so that the handling of oily sludge can be topped up by reusing and having its own added value. The purpose of this research is to utilise waste oily sludge as an alternative anti-rust coating material and compare alkyd resin and …

Prevalence Of Lipohypertrophy And Lipoatrophy In Individuals With Type 2 Diabetes And Determination Of Associated Risk Factors, Huriye Kırmızıgül, Seher Gönen Şentürk

Makara Journal of Health Research

Background: This study aimed to determine the prevalence of lipohypertrophy and lipoatrophy and their associated risk factors in individuals with type 2 diabetes taking insulin.

Methods: This descriptive and cross-sectional study used the STROBE checklist. In January 2022 to April 2022, 271 individuals with type 2 diabetes were studied. The presence of lipoatrophy and lipohypertrophy was evaluated with inspection and palpation, and the sociodemographic and clinical characteristics of the patients were obtained using a questionnaire. Data were collected in face-to-face interviews.

Results: Lipoatrophy and lipohypertrophy prevalence was 4.8% and 19.2%, respectively. Lipoatrophy was more common in patients …

Histodynamics Of Natural Killer Cells From A Healthy Donor Exposed To Exosomes From The Blood Of Hepatocellular Carcinoma Patients, Indria Asrinda, Radiana Dhewayani Antarianto, Ahmad Aulia Jusuf, Ardhi Rahman Ahani, Chyntia Olivia Maurine Jasirwan, Ni Ken Ritchie, Robby Nur Aditya, Cosphiadi Irawan

Makara Journal of Health Research

Background: Hepatocellular carcinoma (HCC) is the leading form of liver cancer and the second leading cause of cancer-related deaths globally. Exosomes in the HCC microenvironment can induce significant changes in natural killer (NK) cells during endocytosis. The present study aimed to distinguish exosomes in the blood of HCC patients, analyze changes in NK cell phenotype, and evaluate peroxidase and toluidine blue staining as alternative methods for observing the changes.

Methods: NK cells were collected from healthy donors, and exosomes were extracted from the blood of HCC patients. The exosomes were characterized in accordance with MISEV 2018 guidelines, and …

Prevalence Of Abortifacient Disorders In Small Ruminants: A Comprehensive Review, Abdul Saboor, Qudratullah Kalwar, Muhammad Mohsen Rahimoon, Hubdar Ali Kolachi, Sajad Ali Laghari, Asmatullah Kaka, Rafique Ahmed, Fayaz Hussain, Taj Muhammad, Atthar Uddin

Journal of Bioresource Management

Abortifacient disorders in small ruminants present a serious problem for livestock farmers, leading to financial losses and lower production rates. This review examines both infectious and non-infectious factors that cause abortions in goats (Capra hircus) and sheep (Ovis aries), which are crucial animals in rural farming practices. Infectious causes, such as bacteria (Brucella melitensis, Chlamydia abortus, Coxiella burnetii), viruses (bluetongue, border disease), and parasites (Toxoplasma gondii), are major factors in reproductive health problems, resulting in considerable livestock losses. Additionally, non-infectious factors like poor nutrition, toxins, and genetic issues also contribute to these …

A Growing Concern: Long Commutes And Mental Fatigue Among Workers, Dayana Hazwani Mohd Suadi Nata, Putri Anis Syahira Mohamad Jamil, Mira Nursabrina Muhammad Rawee

Makara Journal of Health Research

Background: Commuting stress is a growing concern for workers with long daily journeys between home and work. This study explores the effects of commuting on workers’ mental and physical health, focusing on stress, mental fatigue, and productivity at work.

Methods: The research conducted in Selangor, Malaysia, involved 212 commuters who completed a survey that included sociodemographic and commuting information, the Depression Anxiety and Stress Score (DASS-21), and a mental fatigue questionnaire.

Results: The findings revealed that a significant proportion of workers experienced stress from their commuting routines: approximately 74.5% reported that commuting had a detrimental effect on …

Association Between Knowledge, Attitude, And Practice On Dietary Fiber Intake And Body Mass Index Among Undergraduate Students In Universiti Kebangsaan Malaysia, Arimi Fitri Mat Ludin, Munirah Ismail, Mohd Sham Othman, Divya Vanoh, Chai Huoy Tyng, Irdina Ibrahim, Jasmine Lavang Surang, Muhammad Adam Jayiddin, Noor Afiifah Ibrahim, Nur Arina Shazrina Abdullah, Nur Athirah Harun, Nur Fatihah Rashidi, Lew Leong Chen

Makara Journal of Health Research

Background: A fiber-rich diet lowers the risk of various diseases by increasing fecal bulk, shortening intestinal transit time, and stimulating intestinal flora. This study examines the association between knowledge, attitude, and practice (KAP) regarding dietary fiber intake and body mass index (BMI) among Dentistry and Software Engineering undergraduates.

Methods: This cross-sectional study included 95 Dentistry and 92 Software Engineering students at the Universiti Kebangsaan Malaysia. The KAP questionnaire was analyzed for its reliability using Cronbach’s alpha and distributed through email.

Results: Most respondents had normal weight. The Software Engineering students had a higher percentage of overweight and …

Threat Of Hypercholesterolemia In Urban Adults And Its Associates: Evidence From A Community-Based Study, Ambika Rani Yadav, Priya Keshari

Makara Journal of Health Research

Background: Hypercholesterolemia is an abnormality of lipids. It is a crucial modifiable risk factor for cardiovascular diseases. There is a paucity of community-based studies on hypercholesterolemia in the adult population in India. Given this context, the study aims to assess the prevalence and spectrum of hypercholesterolemia, along with its associated factors, among adult residents of urban areas in Prayagraj district, Uttar Pradesh, India.

Methods: This community-based cross-sectional study was done on 536 urban adult subjects (30 to 59 years) of Prayagraj, India, selected by multistage sampling procedure. The predesigned and pretested interview schedule was used to obtain socio-demographic …

Investigation Of The Relationship Between Nursing Students’ Ethical Sensitivities And Care Behaviors, Pınar Yel, Neriman Zengin, Aysenur Çetin Üçeriz

Makara Journal of Health Research

Background: Care encompassing ethical and legal aspects is essential for nursing and involves actions that aim to improve individual well-being. In this study, we assessed the relationship between nursing students’ ethical sensitivity and care behaviors.

Methods: This descriptive study included 191 students enrolled at a foundation university who consented to participate. Relevant data were gathered by using the Descriptive Information Form, Ethical Sensitivity Scale Adapted for Nursing Students, and Caring Behaviors Scale-24. Surveys were conducted face-to-face with the attending students and via Google Forms for the non-attending students.

Results: The mean total score of the ethical sensitivity …

The Impact Of Immigrants On The Number And Type Of Births, Neset Gumusburun, Ergun Mendes

Makara Journal of Health Research

Background: Although cesarean section is a life-saving procedure in certain situations, it may result in complications for maternal and infant health when conducted, especially for nonmedical purposes. The civil war in Syria has significantly modified the demographic and ethnic structure of Turkey, which has affected the number and type of births occurring here. In this study, we aimed to determine the effect of the increasing Syrian refugee patient population on primary cesarean section rates in Kilis/Turkey.

Methods: In this retrospective cohort study, pregnant women who gave birth at the State Hospital in the Kilis province in Turkiye between …

The Association Between Sleep Quality, Depression, Anxiety, And Job-Related Stress Among Nurses In Saudi Arabia, Romeo Jr Patague Mostoles

Makara Journal of Health Research

Background: This study examined the mediating role of sleep quality in the relationship between depression, anxiety, and job-related stress among nurses in Saudi Arabia.

Methods: Sociodemographic information, Pittsburgh Sleep Quality Index, depression, anxiety, and work-related stress were evaluated in 851 nurses. Structural equation modeling was used to investigate the mediation effect of sleep quality on mental health and job stress in nurses.

Results: High rates of anxiety (65.9% severe, 34.1% moderate), depression (37.2% moderate to severe), and poor sleep (51.4%) were found. Sex, marital status, education, nationality, and smoking status significantly influenced mental health outcomes. For example, …