Medical Specialties Commons^™

Biological Treatment Usage In Patients With Hiv And Rheumatic Disease, 2003-2021: Long-Term Safety And Follow-Up, Benjamin Sornrung Naovarat, Gloria Salazar, Mariko Ishimori, Francis M Williams, John D Reveille

Faculty, Staff and Student Publications

OBJECTIVE: This study examined the safety and efficacy of biological agents, especially tumour necrosis factor (TNF) inhibitors, for HIV-positive rheumatology patients refractory to standard therapy.

METHODS: This study is a retrospective case series including patients derived from a community HIV clinic as well as from two academic centres. Initial visit data collected included: sociodemographic characteristics, CD4 counts, HIV viral load and medication use. Patients with persistent disease activity despite standard conservative therapy were begun on biological agents.The main outcomes were patient and physician global assessment of treatment response and medication side effects in patients with rheumatological disorders treated with biological …

Opposing Roles Of Hdac6 In Liver Regeneration And Hepatocarcinogenesis, Sophors Phorl, Azra Memon, Yuri Seo, Thi Oanh Hoang, Trung Nghia Tran, Le Minh Tri Nguyen, Chang Hoon Lee, Woon Kyu Lee, Joo-Yong Lee

Faculty, Staff and Student Publications

Histone deacetylase 6 (HDAC6), a deacetylase of p53, has emerged as a privileged inhibitory target for cancer therapy because of its deacetylating activity for p53 at K120 and K373/382. However, intricate roles of HDAC6 in hepatocellular carcinogenesis have been suggested by recent evidence, namely that HDAC6 ablation suppresses innate immunity, which plays critical roles in tumor immunosurveillance and antitumor immune responses. Therefore, it is valuable to determine whether HDAC6 ablation inhibits hepatocellular carcinogenesis using in vivo animal models. Here, we firstly showed that HDAC6 ablation increased K320 acetylation of p53, known as pro-survival acetylation, in all tested animal models but …

Skin Cancer Education Interventions For Primary Care Providers: A Scoping Review, Ashley E Brown, Maleka Najmi, Taylor Duke, Daniel A Grabell, Misha V Koshelev, Kelly C Nelson

Faculty, Staff and Student Publications

Primary care physicians (PCPs) are often the first line of defense against skin cancers. Despite this, many PCPs do not receive a comprehensive training in skin conditions. Educational interventions aimed at skin cancer screening instruction for PCPs offer an opportunity to detect skin cancer at earlier stages and subsequent improved morbidity and mortality. A scoping review was conducted to collect data about previously reported skin cancer screening interventions for PCPs. A structured literature search found 51 studies describing 37 unique educational interventions. Curriculum elements utilized by the interventions were divided into categories that would facilitate comparison including curriculum components, delivery …

Impact Of Gap Distance Between Fenestration And Aortic Wall On Target Artery Instability Following Fenestrated-Branched Endovascular Aortic Repair, Jesse Chait, Emanuel R Tenorio, Bernardo C Mendes, Guilherme B Barbosa Lima, Giulianna B Marcondes, Joshua Wong, Thanila A Macedo, Randall R De Martino, Gustavo S Oderich

Faculty, Staff and Student Publications

Objective: Target artery (TA) instability has been the most frequent indication for secondary intervention after fenestrated and branched endovascular aortic repair (FB-EVAR) of pararenal and thoracoabdominal aortic aneurysms (TAAAs). The aim of the present study was to evaluate the effect of the gap distance between the endograft reinforced fenestration and TA origin at the aortic wall (fenestration gap [FG]) on target-related outcomes after FB-EVAR.

Methods: The clinical data and imaging studies of 430 patients enrolled in a prospective, nonrandomized study to evaluate FB-EVAR using manufactured stent grafts were reviewed. Of the 430 patients, 340 (79%) had had more than one …

Prolonged Cardiac Nr4a2 Aactivation Causes Dilated Cardiomyopathy In Mice, Sadia Ashraf, Heinrich Taegtmeyer, Romain Harmancey

Faculty, Staff and Student Publications

Transcription factors play a fundamental role in cardiovascular adaptation to stress. Nuclear receptor subfamily 4 group A member 2 (NR4A2; NURR1) is an immediate-early gene and transcription factor with a versatile role throughout many organs. In the adult mammalian heart, and particularly in cardiac myocytes, NR4A2 is strongly up-regulated in response to beta-adrenergic stimulation. The physiologic implications of this increase remain unknown. In this study, we aimed to interrogate the consequences of cardiac NR4A2 up-regulation under normal conditions and in response to pressure overload. In mice, tamoxifen-dependent, cardiomyocyte-restricted overexpression of NR4A2 led to cardiomyocyte hypertrophy, left ventricular dilation, heart failure, …

Guidelines On Models Of Diabetic Heart Disease, Lisa C Heather, Anne D Hafstad, Ganesh V Halade, Romain Harmancey, Kimberley M Mellor, Paras K Mishra, Erin E Mulvihill, Miranda Nabben, Michinari Nakamura, Oliver J Rider, Matthieu Ruiz, Adam R Wende, John R Ussher

Faculty, Staff and Student Publications

Diabetes is a major risk factor for cardiovascular diseases, including diabetic cardiomyopathy, atherosclerosis, myocardial infarction, and heart failure. As cardiovascular disease represents the number one cause of death in people with diabetes, there has been a major emphasis on understanding the mechanisms by which diabetes promotes cardiovascular disease, and how antidiabetic therapies impact diabetic heart disease. With a wide array of models to study diabetes (both type 1 and type 2), the field has made major progress in answering these questions. However, each model has its own inherent limitations. Therefore, the purpose of this guidelines document is to provide the …

Computed Tomography Of The Chest To Screen For Interstitial Lung Disease In Patients With Systemic Sclerosis At Expert Scleroderma Centers In The United States, Elana J Bernstein, Shervin Assassi, Flavia V Castelino, Lorinda Chung, Chase Correia, Luke B Evnin, Tracy M Frech, Jessica K Gordon, Brian A Skaug, Faye N Hant, Laura K Hummers, Nora Sandorfi, Ami A Shah, Victoria K Shanmugam, Virginia D Steen, Dinesh Khanna

Faculty, Staff and Student Publications

OBJECTIVE: Although a high-resolution computed tomography (HRCT) scan of the chest is the gold standard test for the detection of interstitial lung disease (ILD), there is no consensus among rheumatologists regarding the use of HRCT to screen for ILD in their patients with systemic sclerosis (SSc). The aims of this study were to describe the HRCT ordering practices at SSc centers in the United States and to determine which patient characteristics are associated with HRCT performance.

METHODS: We performed a prospective cohort study of patients with SSc enrolled in the US-based Collaborative National Quality and Efficacy Registry (CONQUER). We performed …

Prolonged Cardiac Nr4a2 Activation Causes Dilated Cardiomyopathy In Mice, Sadia Ashraf, Heinrich Taegtmeyer, Romain Harmancey

Faculty, Staff and Student Publications

Transcription factors play a fundamental role in cardiovascular adaptation to stress. Nuclear receptor subfamily 4 group A member 2 (NR4A2; NURR1) is an immediate-early gene and transcription factor with a versatile role throughout many organs. In the adult mammalian heart, and particularly in cardiac myocytes, NR4A2 is strongly up-regulated in response to beta-adrenergic stimulation. The physiologic implications of this increase remain unknown. In this study, we aimed to interrogate the consequences of cardiac NR4A2 up-regulation under normal conditions and in response to pressure overload. In mice, tamoxifen-dependent, cardiomyocyte-restricted overexpression of NR4A2 led to cardiomyocyte hypertrophy, left ventricular dilation, heart failure, …

Association Of Rare Apoe Missense Variants V236e And R251g With Risk Of Alzheimer Disease, Yann Le Guen, Michael E Belloy, Benjamin Grenier-Boley, Itziar De Rojas, Atahualpa Castillo-Morales, Iris Jansen, Aude Nicolas, Céline Bellenguez, Carolina Dalmasso, Fahri Küçükali, Sarah J Eger, Katrine Laura Rasmussen, Jesper Qvist Thomassen, Jean-François Deleuze, Zihuai He, Valerio Napolioni, Philippe Amouyel, Frank Jessen, Patrick G Kehoe, Cornelia Van Duijn, Magda Tsolaki, Pascual Sánchez-Juan, Kristel Sleegers, Martin Ingelsson, Giacomina Rossi, Mikko Hiltunen, Rebecca Sims, Wiesje M Van Der Flier, Alfredo Ramirez, Ole A Andreassen, Ruth Frikke-Schmidt, Julie Williams, Agustín Ruiz, Jean-Charles Lambert, Michael D Greicius, Members Of The Eadb, Gr@Ace, Degesco, Demgene, Gerad, And Eadi Groups, Beatrice Arosio, Luisa Benussi, Anne Boland, Barbara Borroni, Paolo Caffarra, Delphine Daian, Antonio Daniele, Stéphanie Debette, Carole Dufouil, Emrah Düzel, Daniela Galimberti, Vilmantas Giedraitis, Timo Grimmer, Caroline Graff, Edna Grünblatt, Olivier Hanon, Lucrezia Hausner, Stefanie Heilmann-Heimbach, Henne Holstege, Jakub Hort, Deckert Jürgen, Teemu Kuulasmaa, Aad Van Der Lugt, Carlo Masullo, Patrizia Mecocci, Shima Mehrabian, Alexandre De Mendonça, Susanne Moebus, Benedetta Nacmias, Gael Nicolas, Robert Olaso, Goran Papenberg, Lucilla Parnetti, Florence Pasquier, Oliver Peters, Yolande A L Pijnenburg, Julius Popp, Innocenzo Rainero, Inez Ramakers, Steffi Riedel-Heller, Nikolaos Scarmeas, Philip Scheltens, Norbert Scherbaum, Anja Schneider, Davide Seripa, Hilkka Soininen, Vincenzo Solfrizzi, Gianfranco Spalletta, Alessio Squassina, John Van Swieten, Thomas J Tegos, Lucio Tremolizzo, Frans Verhey, Martin Vyhnalek, Jens Wiltfang, Mercè Boada, Pablo García-González, Raquel Puerta, Luis M Real, Victoria Álvarez, María J Bullido, Jordi Clarimon, José María García-Alberca, Pablo Mir, Fermin Moreno, Pau Pastor, Gerard Piñol-Ripoll, Laura Molina-Porcel, Jordi Pérez-Tur, Eloy Rodríguez-Rodríguez, Jose Luís Royo, Raquel Sánchez-Valle, Martin Dichgans, Dan Rujescu

Faculty, Staff and Students Publications

IMPORTANCE: The APOE ε2 and APOE ε4 alleles are the strongest protective and risk-increasing, respectively, genetic variants for late-onset Alzheimer disease (AD). However, the mechanisms linking APOE to AD-particularly the apoE protein's role in AD pathogenesis and how this is affected by APOE variants-remain poorly understood. Identifying missense variants in addition to APOE ε2 and APOE ε4 could provide critical new insights, but given the low frequency of additional missense variants, AD genetic cohorts have previously been too small to interrogate this question robustly.

OBJECTIVE: To determine whether rare missense variants on APOE are associated with AD risk.

DESIGN, SETTING, …

Innovation And Missed Opportunities In Internal Medicine Undergraduate Education During Covid-19: Results From A National Survey, Irene Alexandraki, Katherine J Walsh, Temple Ratcliffe, Chavon Onumah, Karen Szauter, Camilla Curren, Nora Osman, Cindy J Lai, Deborah Dewaay, Nicholas S Duca, Amy Weinstein, Nadia Ismail, Jackcy Jacob, Michael Kisielewski, Amber T Pincavage

Faculty, Staff and Students Publications

BACKGROUND: COVID-19 disrupted undergraduate clinical education when medical schools removed students from clinical rotations following AAMC recommendations. Clerkship directors (CDs) had to adapt rapidly and modify clerkship curricula. However, the scope and effects of these modifications are unknown.

OBJECTIVE: To examine the effects of the initial phase of COVID-19 on the internal medicine (IM) undergraduate clinical education.

DESIGN: A nationally representative web survey.

PARTICIPANTS: IM CDs from 137 LCME-accredited US medical schools in 2020.

MAIN MEASURES: Items (80) assessed clerkship structure and curriculum, assessment in clerkships, post-clerkship IM clinical experiences, and CD roles and support. The framework of Understanding Crisis …

Translating Electronic Health Record-Based Patient Safety Algorithms From Research To Clinical Practice At Multiple Sites, Andrew J Zimolzak, Hardeep Singh, Daniel R Murphy, Li Wei, Sahar A Memon, Divvy K Upadhyay, Saritha Korukonda, Lisa Zubkoff, Dean F Sittig

Faculty, Staff and Students Publications

INTRODUCTION: Researchers are increasingly developing algorithms that impact patient care, but algorithms must also be implemented in practice to improve quality and safety.

OBJECTIVE: We worked with clinical operations personnel at two US health systems to implement algorithms to proactively identify patients without timely follow-up of abnormal test results that warrant diagnostic evaluation for colorectal or lung cancer. We summarise the steps involved and lessons learned.

METHODS: Twelve sites were involved across two health systems. Implementation involved extensive software documentation, frequent communication with sites and local validation of results. Additionally, we used automated edits of existing code to adapt it …

Doctors And Disability: Improving Inclusion In Medical Education, Mary Alice Keller

HCA Healthcare Journal of Medicine

Disability is extremely common in the United States with 26% of adults identifying as having some type of disability. Oftentimes, people with disabilities need to access health care services frequently in order to receive adequate care and support. However, despite this need, medical students receive limited, if any, education about people with disabilities and how to appropriately provide medical care and interact with them. This lack of education exacerbates health care disparities experienced by people with disabilities. This article highlights these disparities as well as the history of disability and health care. Current advancements in medical education regarding people with …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Inverse Psoriasis, Daniel A. Nguyen, Henry Lim, Christopher M. Wong, Christian J. Scheufele, Ashleigh E. Hermann, Jean Elizze M. Charles, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Inverse psoriasis is a clinical variant of psoriasis involving flexural or intertriginous areas of the body. Inverse psoriasis may be present in 3 to 36% of psoriasis patients. Lesions are clinically characterized as smooth, well-demarcated, erythematous plaques (raised, >1 cm) without the typical silvery scales of classic psoriasis. Differential diagnosis includes tinea infection, candidiasis, seborrheic dermatitis, or bacterial streptococcal infection. The clinical images in this review focus on identifying inverse psoriasis along the full spectrum of skin tones.

Is There A Bias Toward Unvaccinated Covid-19 Patients?, Abbas B. Jama, Anwar Khedr, Hisham Mushtaq, Nitesh K. Jain, Thoyaja Koritala, Syed Anjum Khan

HCA Healthcare Journal of Medicine

With more than 22% of the United States still not vaccinated for COVID-19, we are trying to shed some light on whether there is any bias when treating unvaccinated COVID-19 patients. We highlight several reports where some individuals or organizations displayed possible bias, whether implicit or explicit. We examine the legal and ethical implications of these biases and offer a general overview of how to tackle them.

Revaksinasi Covid-19 Pada Kelompok Lansia Dengan Frailty, Ika Fitriana

Jurnal Penyakit Dalam Indonesia

No abstract provided.

The Correlation Between Mir-146a And Platelet To Lymphocyte Ratio To Liver Fibrotic On Hepatitis B, Brillian Van Fito S.R, R. Satriyo Budi S, Triyanta Yuli Pramana

Jurnal Penyakit Dalam Indonesia

Introduction. Liver fibrosis is a pathological condition as a recovery tissue respond, characterized by excessive extracellular matrix deposit. MicroRNA (miRNA or miR) has a pivotal role on progression of hepatic cirrhosis. Platelet to lymphocyte ratio (PLR) could be as a good predictor of liver fibrosis. This study aimed to find the correlation between miR-146a and PLR with liver fibrosis in Hepatitis B.Method. The cross sectional study conducted in Gastroenterohepatology Clinic of Internal Medicine Department RSUD Dr. Moewardi Surakarta in Januari – Juli 2020, involving 26 Hepatitis B naïve patients. Complete blood count, serum creatinine, liver enzyme, HBsAg, miR-146a, elastography measurement …

Clinical Profile Of Covid-19 Older Patients Hospitalized In Immanuel Teaching Hospital Bandung, Vera Vera, Yossie Guventri Eka Suprana

Jurnal Penyakit Dalam Indonesia

Introduction. It was reported that 11.2% out of the 78,572 confirmed cases of COVID-19 in Indonesia was foundinolder people with a high mortality rate. There is no available data regarding functional and frailty status of these COVID-19 older patients. This study aimed to describe clinical profile of older COVID-19 patients in terms of geriatric aspect, in order to design better hospital policy for older patients in the COVID-19 isolation ward.Methods. This was a retrospective cohort study of confirmed COVID-19 patients aged >60 years which were admitted to Immanuel Teaching Hospital Bandung during the period of October 2020 - January 2021. …

Proportion Of Depression Symptoms And Its Relationship With Arv Therapy: A Study At The Vct Clinic, Dr. Kariadi General Hospital, Muchlis Achsan Udji Sofro, Tommy Raharja, Titis Haidati, Linda Kartika Sari, Innawati Jusup

Jurnal Penyakit Dalam Indonesia

Introduction. Indonesia has the second largest HIV burden in Asia. The prevalence of depression in HIV/AIDS is 2-10 times higher than the general population, influenced by biological, environmental, psychological, and demographic factors. Data on the proportion of depression symptoms in HIV/AIDS patients and their relationship to biological factors are still limited, which needed for better treatment of HIV/AIDS. This study aimed to determine the prevalence of depression and its relationship to the biologic factors of ARV therapy (ART) in HIV/AIDS patients.Methods. Cross-sectional study was conducted among 142 HIV/AIDS patients undergoing ARV treatment at RSUP. Dr. Kariadi in January – March …

The Association Between Type 2 Diabetes Mellitus And The Outcome Of Covid-19 Patients At Sanglah Hospital In 2020-2022, Putu Sayakumara Upadhana, I Gede Gita Sastrawan, I Gita Dewi Rahmautami, Merry Merry, Ni Putu Kostarika Melia Daradila, Derian Adiguna Sutanto, Ida Ayu Santhi Pertiwi Manuaba, Putu Ardy Hartadi, Komang Vika Nariswari Ratna Kinasih, Putu Sudarmika

Jurnal Penyakit Dalam Indonesia

Introduction.People with type 2 diabetes mellitus (T2DM) are at a higher risk of mortality from COVID-19. This study aimed to identify the relationship between T2DM and the outcome of COVID-19 patients in Sanglah Hospital Denpasar, Bali. Methods. An observational analytic study with a cross-sectional approach was conducted among COVID-19 patients. We used secondary data from the records of confirmed COVID-19 patients who were treated at Sanglah Hospital on 1 August 2020 – 28 February 2022. Sample were selected with total sampling technique. Results. There were 1,056 patients involved in this study. Most of the patients were male (n=571; 54.1%), with …

Atherogenic Index Of Plasma Is Correlated With Prolonged Length Of Stay In Covid-19 Patients With Type 2 Diabetes Mellitus In Rsup Sanglah Denpasar, I Gede Gita Sastrawan, Putu Satyakumara Upadhana, Putu Novi Handayani, Tika Rizki Nur Laela, Kadek Aprilia Sukma Dewi, I Nyoman Bayu Andika Wiguna, Cindy Gracia Trisna, Komang Anjani Putri, Komang Adya Data Agrasidi, Putu Sudarmika

Jurnal Penyakit Dalam Indonesia

Introduction. Atherogenic index of plasma (AIP) is a logarithmic calculation of the ratio of triglycerides to HDL cholesterol as a marker of lipid profile abnormalities. In COVID-19 patients with comorbid type 2 diabetes mellitus (T2DM), higher AIP tend to worsen the patient conditions. This study aims to assess the correlation between AIP and length of stay (LOS) in COVID-19 patients with T2DM.Methods. An analytical observational study with a cross-sectional approach was conducted among COVID-19 patients with comorbid T2DM. Data were collected from online medical records of confirmed COVID-19 patients with comorbid T2DM who were treated at Sanglah Hospital Denpasar during …

Effectivity Of Opioid Rotation Compared To Opioid Combination For Cancer Pain: An Evidence Case Report, Edward Faisal, Shafira Puspadina, Rudi Puranto, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Pain is the main symptom in cancer patients that needs to be addressed immediately because it can reduce the quality of life. Concern or the ineffectiveness of using one type of opioid makes it necessary for clinicians to understand how to rotate opioids. Therefore, this evidence-based case report was conducted to identify the effectiveness of opioid rotation and combined opioids for the cancer pain management through a literature search on three databases. Literature searching was performed by using Pubmed, Cochrane library, and EBSCO according to clinical inquiries. Of the 24 studies obtained, only one study met the criteria and was …

Sars-Cov-2 Infection Complicated By Acute Pericarditis Concurrent With Malaria Infection, Kevin Hocin, Yudha Kusuma, Atit Puspitasari Dewi

Jurnal Penyakit Dalam Indonesia

Coronavirus disease 19 (COVID-19) can present as various symptoms, which range from asymptomatic to severe symptoms. We report a case of COVID-19 female patient with malaria co-infection who developed pericarditis complication. In this pandemic era, it is mandatory to rule out COVID-19. Coinfection with malaria will result in higher cytokine levels which lead to atypical complication, such as pericarditis. Prompt identification of atypical COVID-19 complications is essential as it can lower the mortality rate and reduce the duration of hospitalization.

Update In Laboratory Diagnosis Of Urinary Tract Infection, Weny Rinawati, Diana Aulia

Jurnal Penyakit Dalam Indonesia

Urinary tract infection (UTI) is an infection caused by the entry of pathogens into the urinary tract. Symptoms of a UTI are not always obvious, and some are asymptomatic or atypical. Urinary tract infections must be distinguished from other diseases that have a similar clinical appearance. Many UTIs resolve spontaneously, but often cause significant morbidity and mortality. With the unpredictable nature of the disease, laboratory tests are required for accurate diagnosis and identification of the cause of infection. Thus, it is necessary to understand the interpretation and limitations of urinalysis and urine culture results. To assist in the diagnosis of …

Feasible Stenting Of A Large Septal Perforator Providing A Sizeable Coronary Collaterals, Hussam Al Hennawi, Mohammad F. Mathbout,, Abdulrahman Taftafa, Christopher D. Nielsen

Division of Internal Medicine Faculty Papers & Presentations

While coronary artery disease involving the septal perforator branches presents similar to diseases of major coronary arteries, management can present a challenge. Owing to their relatively small size, performing interventional procedures is often impractical in terms of selecting appropriate devices. Although larger septal perforator branches have been managed percutaneously, similar to major vessels, long-term sequelae and clinical effectiveness have been indeterminate. We present our experience in managing a patient with a stenosed septal perforator branch and challenging comorbidities.

The Overestimation Of Concentric Hypertrophy In Patients With Hfpef As Determined By 2d-Echocardiography, Mohammad F. Mathbout, Hussam Al Hennawi, Anwar Khedr, Gaurang N. Vaidya, Marcus Stoddard

Division of Internal Medicine Faculty Papers & Presentations

Background: Heart failure with preserved ejection fraction continues to pose multiple challenges in terms of accurate diagnosis, treatment, and associated morbidity. Accurate left ventricular (LV) mass calculation yields essential prognostic information relating to structural heart disease. Two-dimensional (2D) echocardiography-based calculations are solely limited to LV geometric assumptions of symmetry, whereas three-dimensional (3D) echocardiography could overcome these limitations. This study aims to compare the performance of 2D and 3D LV mass calculations. Methods: A prospective review of echocardiography findings at the University of Louisville, Kentucky, was conducted and assessed. Normal ejection fraction (EF) was defined as >=52% in males and >=54% …

Role Of Lipid-Lowering Therapy In Peripheral Artery Disease, Agastya Deepak Belur, Aangi J. Shah, Salim S. Virani, Mounica Vorla, Dinesh K. Kalra

Office of the Provost

Atherosclerosis is a multifactorial, lipoprotein-driven condition that leads to plaque formation within the arterial tree, leading to subsequent arterial stenosis and thrombosis that accounts for a large burden of cardiovascular morbidity and mortality globally. Atherosclerosis of the lower extremities is called peripheral artery disease and is a major cause of loss in mobility, amputation, and critical limb ischemia. Peripheral artery disease is a common condition with a gamut of clinical manifestations that affects an estimated 10 million people in the United States of America and 200 million people worldwide. The role of apolipoprotein B-containing lipoproteins, such as LDL and remnant …

Thyrotoxic Periodic Paralysis: A Case Report And Discussion Of Clinical And Imaging Features, Kristian Quevada, Kishan Patel, Pauline Germaine

Cooper Rowan Medical Journal

Thyrotoxic Periodic Paralysis (TPP) is a rare manifestation of thyrotoxicosis, resulting in periodic episodes of acute onset muscle weakness in the setting of hypokalemia. The thyrotoxic form of Hypokalemic Periodic Paralysis (HPP) is less studied than the more well-known familial form due to fewer reported cases and smaller prevalence. This case study presents a 30-year-old African American male with multiple episodes of acute lower extremity muscle weakness, tachycardia, and a history of heat intolerance. Abnormal findings on thyroid ultrasound coupled with increased thyroid related immunoglobulins led to a diagnosis of TPP related to exacerbation of newly-found Graves’ disease. The case …

Treating Cytokine Storm In Patients With Covid-19, Ahmed Abdelhaleem, Deekshitha Turaka, Shameera Shaik Masthan, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Smartphone Apps For Diabetes Medication Adherence: Systematic Review, Sheikh Mohammed Shariful Islam, Vinaytosh Mishra, Muhammad U Siddiqui, Jeban Chandir Moses, Sasan Adibi, Lemai Nguyen, Nilmini Wickramasinghe

Division of Internal Medicine Faculty Papers & Presentations

Background: Diabetes is one of the leading noncommunicable chronic diseases globally. In people with diabetes, blood glucose levels need to be monitored regularly and managed adequately through healthy lifestyles and medications. However, various factors contribute to poor medication adherence. Smartphone apps can improve medication adherence in people with diabetes, but it is not clear which app features are most beneficial.

Objective: This study aims to systematically review and evaluate high-quality apps for diabetes medication adherence, which are freely available to the public in Android and Apple app stores and present the technical features of the apps.

Methods: We systematically searched …

Anxiety Symptoms And Suicidal Thoughts And Behaviors Among Patients With Mood Disorders, Marsal Sanches, Linh K Nguyen, Tong Han Chung, Paul Nestadt, Holly C Wilcox, William H Coryell, Jair C Soares, Sudhakar Selvaraj

Faculty, Staff and Student Publications

Background: Though the association between anxiety disorders and suicidal behavior is well-described, the impact of anxiety symptoms on suicidal thoughts and behaviors (STB) across different mood disorders is still unclear.

Methods: We performed a registry-based retrospective study utilizing outcome measure data collected by the National Network of Depression Centers (NNDC), a nationwide nonprofit consortium of 26 leading clinical and academic member centers in the United States. The sample consisted of 2607 outpatients with mood disorders (major depressive disorder or bipolar disorders). Demographic and clinical variables were compared based on the presence or absence of STB and severity of anxiety symptoms …