Medical Specialties Commons^™

Adenosine At The Interphase Of Hypoxia And Inflammation In Lung Injury, Xiangyun Li, Nathanial K Berg, Tingting Mills, Kaiying Zhang, Holger K Eltzschig, Xiaoyi Yuan

Faculty, Staff and Student Publications

Hypoxia and inflammation often coincide in pathogenic conditions such as acute respiratory distress syndrome (ARDS) and chronic lung diseases, which are significant contributors to morbidity and mortality for the general population. For example, the recent global outbreak of Coronavirus disease 2019 (COVID-19) has placed viral infection-induced ARDS under the spotlight. Moreover, chronic lung disease ranks the third leading cause of death in the United States. Hypoxia signaling plays a diverse role in both acute and chronic lung inflammation, which could partially be explained by the divergent function of downstream target pathways such as adenosine signaling. Particularly, hypoxia signaling activates adenosine …

Anesthesiology Resident Performance On The Us Medical Licensing Examination Predicts Success On The American Board Of Anesthesiology Basic Staged Examination: An Observational Study, Travis H Markham, Johanna B De Haan, Sara Guzman-Reyes, John F Zaki, Semhar J Ghebremichael, Carlos Artime, Evan G Pivalizza

Faculty, Staff and Student Publications

BACKGROUND: Correlation has been found between the US Medical Licensing Examination (USMLE) Step 1 examination results and anesthesiology resident success on American Board of Anesthesiology (ABA) examinations. In 2014, the ABA instituted the BASIC examination at the end of the postgraduate year-2 year. We hypothesized a similar predictive value of USMLE scores on BASIC examination success.

METHODS: After the Committee for the Protection of Human Subjects at UTHealth Institutional Review Board approved and waived written consent, we retrospectively evaluated USMLE Step examination performance on first-time BASIC examination success in a single academic department from 2014-2018.

RESULTS: Over 5 years, 120 …

Stakeholder Alliances Are Essential To Reduce The Scourge Of Plastic Pollution, Patrick H Kee, Melanie R Moody, Shao-Ling Huang, Hyunggun Kim, Xing Yin, Tao Peng, Susan T Laing, Melvin E Klegerman, Mohammad H Rahbar, Deborah Vela, Curtis Genstler, Kevin J Haworth, Christy K Holland, David D Mcpherson

Faculty, Staff and Student Publications

Late in-stent restenosis remains a significant problem. Bare-metal stents were implanted into peripheral arteries in miniature swine, followed by direct intra-arterial infusion of nitric oxide-loaded echogenic liposomes (ELIPs) and anti-intercellular adhesion molecule-1 conjugated ELIPs loaded with pioglitazone exposed to an endovascular catheter with an ultrasonic core. Ultrasound-facilitated delivery of ELIP formulations into stented peripheral arteries attenuated neointimal growth. Local atheroma-targeted, ultrasound-triggered delivery of nitric oxide and pioglitazone, an anti-inflammatory peroxisome proliferator-activated receptor-γ agonist, into stented arteries has the potential to stabilize stent-induced neointimal growth and obviate the need for long-term antiplatelet therapy.

The Fms21 (Pila)-Fms20 Locus Encoding One Of Four Distinct Pili Of Enterococcus Faecium Is Harboured On A Large Transferable Plasmid Associated With Gut Colonization And Virulence, Louis Maximilian Buja, Dwayne A Wolf, Bihong Zhao, Bindu Akkanti, Michelle Mcdonald, Laura Lelenwa, Noah Reilly, Giulia Ottaviani, M Tarek Elghetany, Daniel Ocazionez Trujillo, Gabriel M Aisenberg, Mohammad Madjid, Biswajit Kar

Faculty, Staff and Student Publications

This paper collates the pathological findings from initial published autopsy reports on 23 patients with coronavirus disease 2019 (COVID-19) from 5 centers in the United States of America, including 3 cases from Houston, Texas. Findings confirm that COVID-19 is a systemic disease with major involvement of the lungs and heart. Acute COVID-19 pneumonia has features of a distinctive acute interstitial pneumonia with a diffuse alveolar damage component, coupled with microvascular involvement with intra- and extravascular fibrin deposition and intravascular trapping of neutrophils, and, frequently, with formation of microthombi in arterioles. Major pulmonary thromboemboli with pulmonary infarcts and/or hemorrhage occurred in …

Transcriptional Insights Into Pathogenesis Of Cutaneous Systemic Sclerosis Using Pathway Driven Meta-Analysis Assisted By Machine Learning Methods, Xiao Xu, Meera Ramanujam, Sudha Visvanathan, Shervin Assassi, Zheng Liu, Li Li

Faculty, Staff and Student Publications

Pathophysiology of systemic sclerosis (SSc, Scleroderma), an autoimmune rheumatic disease, comprises of mechanisms that drive vasculopathy, inflammation and fibrosis. Understanding of the disease and associated clinical heterogeneity has advanced considerably in the past decade, highlighting the necessity of more specific targeted therapy. While many of the recent trials in SSc failed to meet the primary end points that predominantly relied on changes in modified Rodnan skin scores (MRSS), sub-group analysis, especially those focused on the basal skin transcriptomic data have provided insights into patient subsets that respond to therapies. These findings suggest that deeper understanding of the molecular changes in …

Developing And Evaluating A Remote Quality Assurance System For Point-Of-Care Ultrasound For An Internal Medicine Residency Global Health Track, Steven Fox, Michelle Fleshner, Collin Flanagan, Thomas Robertson, Ayako Wendy Fujita, Divya Bhamidipati, Abdulrahman Sindi, Raghunandan Purushothaman, Thuy Bui

Faculty, Staff and Student Publications

Background: A quality assurance system is vital when using point-of-care ultrasound (POCUS) to ensure safe and effective ultrasound use. There are many barriers to implementing a quality assurance system including need for costly software, faculty time, and extra work to log images. Methods: With minimal funding or protected faculty time, we successfully developed an effective remote quality assurance system between residents rotating internationally and faculty in the US. Results: 270 total exams were logged using this system (41 per resident over a 7 week period). Over the course of the implementation period, a significant increase was seen in average image …

Recent Advances In The Treatment Of Clostridioides Difficile Infection: The Ever-Changing Guidelines, Shruti Khurana, Alyssa Kahl, Kevin Yu, Andrew W Dupont

Faculty, Staff and Student Publications

No abstract provided.

Proprotein Convertase Subtilisin/Kexin Type-9 (Pcsk-9) Inhibitors Induced Liver Injury - A Retrospective Analysis., Yousuf Zafar, Yasar Sattar, Waqas Ullah, Sohaib Roomi, Mamoon-Ur- Rashid, Muhammad Shayan Khan, Laura Schmidt

Abington Jefferson Health Papers

Background: Proprotein convertase subtilisin/Kexin type 9 (PCSK-9) inhibitors induced liver dysfunction in patients with or without previous liver injury, and this is not well discussed in the previous literature.

Methods: A total sample of 202 patients were retrospectively reviewed at the University of Missouri, Kansas City, from the year 2015 to 2018 based on predefined selection criteria. Inclusion criteria involved patients with dyslipidemia, with or without PCSK-9 inhibitors, liver function tests and lipid profile at baseline and at a mean of 6-month follow-up. The variables, including age, gender, and confounding factors like other medications (statin, oral antidiabetic, and antihypertensive) induced, …

Prevalence Of Chronic Hepatitis B In Oro Province, Papua New Guinea, Alice Unah Lee, Luke Mair, Bob Kevin, Lily Gandi, Olive Tarumuri, Caroline Lee, Sue Huntley, David Carl Hilmers

Faculty, Staff and Students Publications

Chronic hepatitis B (CHB) affects over 250 million people worldwide. In Papua New Guinea, the prevalence of CHB has been estimated to be over 8%, and it is a leading cause of death. To address this problem, an alliance was formed between the government of Oro Province, a large private employer and an Australian nongovernmental organization, which established a CHB test and treatment programme. Between 2014 and 2019, rapid hepatitis B surface antigen testing was performed on 4068 individuals in Oro Province. The crude prevalence rate was 12.98% and was significantly higher in males (15.26%) than females (10.94%) (P < 0.001). The rate was 4.72% among children aged 10 years and under, 12.81% among women of childbearing age (19–35 years) and 18.48% among health-care workers. These results indicate that the rates of vaccination at birth and later among women of childbearing age and health-care workers must be improved to prevent transmission of CHB.

Comparison Of Mortality Between Intravenous Albumin And No Intravenous Albumin In Sepsis Patients With Hypoalbuminemia Conditions And Factors That Influence The Mortality Of Sepsis Patients, Mochammad Jalalul Marzuki, Supriono Supriono, Bogi Pratomo, Syifa Mustika

Jurnal Penyakit Dalam Indonesia

Introduction. Hypoalbuminemia is a strong predictor of mortality in nonoperative and operative patients. Albumin plays a role in maintaining oncotic pressure in critical conditions such as sepsis. The administration of exogenous Human Serum Albumin (HSA) in sepsis with hypoalbuminemia conditions is still controversial with varying outcomes.This study aimed to know the mortality ratio between intravenous albumin administration and no intravenous albumin administration in sepsis patients with hypoalbuminemia conditions and also to know the factors that influence the mortality of sepsis patients. Methods. An observational study with a prospective approach involving 75 research subjects aged >18 years with sepsis accompanied by …

Characteristics Of The Indonesian Pilgrims Mortality Due To Cardiovascular Disease, Ali Sakti, Idrus Alwi, Muhadi Muhadi, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Cardiovascular disease is one of the health problems in Indonesian pilgrims and has become the main cause of death for pilgrims in the past 3 years. Most of them are considered high risk for cardiovascular disease. Some of those risk factors are predicted to have strong association with the pilgrims mortality rate. This study is meant to seek for risk factor associated with the pilgrims mortality rate. Methods. Observational study method of the Indonesian pilgrims in 2017 was conducted to assess the characteristics of Indonesian pilgrims who follow the hajj in 2017 as well as the characteristics of pilgrims …

Immunohistochemistry Profile Of Breast Cancer Patients That Get Anthracyclin–Based Chemotherapy In Rsud Kota Bogor, Marthino Robinson, Tubagus Djumhana Atmakusumah, Cosphiadi Irawan, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Breast cancer is the most prominent cancer and causing death in women. Treatment of breast cancer requires immunohistochemistry (IHC) to determine prognostic and predictive and imaging tests to determine staging. However, currently in Indonesia only 17 hospital can conduct IHC test. RSUD Kota Bogor like other Type B Hospital have no IHC test facilities. To fullfil that test, its important to refer patient to referal hospital. Because of limitation there are patients who did not do IHC test and continued get anthracycline chemotherapy. The objective of this research is to find out immunohistochemistry profile of breast cancer patients who …

Association Of Comprehensive Geriatric Assessments Component And Sarcopenia In Elderly, Diar Meitha Wardhana, Novira Widajanti, Jusri Ichwani

Jurnal Penyakit Dalam Indonesia

Introduction. Sarcopenia is defined as a declined in skeletal muscle mass and strength along with its function may causes an increase in hospitalization, mortality, and health burden. Multi-factorial conditions of the aging process may cause sarcopenia. To assess those multi-factorial conditions in the elderly, a comprehensive geriatric assessment (CGA) method should be used, in which comprises of socio-demographic, medical, psychological, and functional domains. This research aims to analyze the components of CGA, including age, gender, nutritional status, mental status, and functional status as factors associated to sarcopenia in the elderly community in Surabaya. Methods. This community research was a cross …

Prediksi Respons Terapi Leukemia Granulositik Kronis: Skor Mana Yang Lebih Baik?, Nadia Ayu Mulansari

Jurnal Penyakit Dalam Indonesia

Leukemia granulositik kronik (LGK) merupakan suatu keganasan myeloproliferatif dengan karakteristik ditemukannya kromosom Philadelphia (Ph). Kromosom Ph ini disebabkan oleh translokasi resiprokal antara kromosom 9 dan 22 [t(9;22)] dan terbentuknya fusi gen BCR-ABL1. Fusi gen tersebut akan menghasilkan suatu protein yang menderegulasi aktivitas dari tirosin kinase (p210) yang berperan pada patogenesis LGK.

Role Of Cytokines In Stressful Condition As A Trigger For A Depression, Febyan Febyan, Sri Handawati Wijaya, Ayudhea Tannika, Johannes Hudyono

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Young Kidney-Transplant Recipient Woman With Recurrent Urinary Tract Infection And Graft Rejection: A Case Report, Nursamsu Nursamsu, M. Reza Febriliant

Jurnal Penyakit Dalam Indonesia

Urinary tract infection (UTI), especially recurrent UTI, is a common problem, occurring in >75% of kidney transplant recipients. Urinary tract infection (UTI) can reduce the quality of life, graft potential, and patient survival. Urosepsis with impairment of graft function is potential long-term sequelae of recurrent UTI in kidney transplantation recipients. We present a case of UTI that developed within a month after renal transplant. The patient got a urinary tract infection repeatedly. We suspect lack of hygiene as the cause of urinary tract infection, the patient was rarely cleaning-up, took a bath, changing clothes, and did not wash after urinating. …

Comparison Of Socal Score And Hasford Score Against The Response Of Imatinib Mesylate Therapy In Patients With Chronic Granulocytic Leukemia In Dr. Saiful Anwar Hospital Malang, Somarnam Somarnam, Budi Darmawan Machsoos, Djoko Heri Hermanto

Jurnal Penyakit Dalam Indonesia

Introduction. The Socal and Hasford scores developed before the era of tirosine kinase inhibitor (TKI) therapy to provide predictions and prognosis for the results of therapy for chronic myeloid leukemia patients (CML). Until now the superiority of Socal and Hasford scores is still debated in predicting the results of therapy in the era of TKI. Imatinib mesylat is a first line TKI in the treatment of CML. This study aims to determine the superior predictive score in predicting hematological and molecular response of patients treated with imatinib mesylate. Methods. A survey study was conducted with data taken retrospectively from medical …

The Role Of Paternal History Of Type 2 Diabetes Mellitus On Prediabetes Status Among The Offspring Of Type 2 Diabetes Mellitus Patients, Maulidia Ekaputri, Henrico Citrawijaya, Adrian Reynaldo Sudirman, Kevin Jonathan, Radityo Alu Murti, Ayu Putri Balqis, Dyah Purnamasari

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Sex Differences In 10-Year Ischemic Cardiovascular Disease Risk Prediction In Chinese Patients With Prediabetes And Type 2 Diabetes., Lihong Yang, Anne Fish, Yuanyuan Zhu, Xiaodan Yuan, Jianing Li, Xiaoyun Wang, Li Yuan, Zhumin Jia, Chao Liu, Yunchen Xu, Qingqing Lou

Nursing Faculty Works

No abstract provided.

Methods To Impair Hematologic Cancer Progenitor Cells And Compounds Related Thereto, Craig Jordan

Internal Medicine Faculty Patents

Primitive or progenitor hematologic cancer cells have been implicated in the early stages and development of leukemia and malignant lymphoproliferative disorders, including acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML) and chronic lymphoid leukemia (CLL). Interleukin-3 receptor alpha chain (IL-3Ra or CD123) is strongly expressed on progenitor hematologic cancer cells, but is virtually undetectable on normal bone marrow cells. The present invention provides methods of impairing progenitor hematologic cancer (e.g., leukemia and lymphomic) cells by selectively targeting cells expressing CD123. These methods are useful in the detection and treatment of leukemias and malignant lymphoproliferative disorders. Also provided are compounds useful …

Role Of Echocardiography In Diagnostic Evaluation Of Patients Admitted To Observation Unit., Muhammad Arslan Cheema, Hafez Mohammad Ammar Abdullah, Waqas Ullah, Yasar Sattar, Shujaul Haq, Khadija Cheema, Asrar Ahmad, Zain Ali, Asoka Balaratna

Abington Jefferson Health Papers

BACKGROUND: Syncope is a transient loss of consciousness due to transient decrease in cerebral perfusion. Syncope accounts for a 3-6% of all emergency department visits. Etiology of syncope can be neural, cardiogenic, or vascular. Previous studies have evaluated the types and management of syncope. Echocardiography is a commonly used test in the evaluation of causes of syncope. Whether the benefit compared to financial burden of this diagnostic study is in all subsets of syncope cases remains unclear.

AIM: To evaluate the impact of echocardiography in the diagnostic evaluation of syncope and to evaluate the subset of patients that would benefit …

The Use Of Probiotics To Prevent Ventilator-Associated Pneumonia In Adults, Michael Roper, Paige Douthett

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the efficacy and safety of preventing the acquisition of ventilator- associated pneumonia with the use of probiotic supplementation, as compared to a placebo, among hospitalized adult men and women receiving more than 24 hours of mechanical ventilation. Design: Systematic Literature Review. Methods: Systematic searches were conducted through PubMed and Scopus using the search terms “ventilator”, “probiotics”, and “prevention”. Records were excluded from the analysis if they were published before 2015, full text was not available, studies other than randomized control trial or cohort studies, and if the study population was less than 18 years old. Results: Of …

Preparing Healthcare Staff For Cardiac Arrest Codes In The Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes, Rowan Edwards, Rn

Master's Projects and Capstones

Preparing Healthcare Staff for Cardiac Arrest Codes in the Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes

The acuity of care provided in outpatient clinical settings across the United States continues to rise. It is estimated that more than 350,000 cardiac arrests occur outside of a hospital each year (AHA, 2019). For the purpose of this clinical nurse leader (CNL)-lead quality improvement project, the relevant focus is directed towards improving the knowledge, physical skills and perceptions of healthcare staff within an urgent care center (UCC) regarding the application of advanced rescue skills. It is important to note that the …

Pantoprazole Continuous Infusion Versus Intermittent Bolus For Gastrointestinal Bleed Prior To Esophagogastroduodenoscopy (Egd), Vy Dang Pharmd, Mickayla Clark Pharmd, Bcps, Kartika Shetty Md, James Hwang, Pinak Shah, Scott J. Anderson

Gastroenterology

Purpose: Practice guidelines recommend patients with non-variceal upper gastrointestinal (GI) bleeds who have a high risk of active bleeding, nonbleeding visible vessels, and adherent clots should be given proton pump inhibitors (PPIs) intravenous (IV) bolus followed by continuous infusion after esophagogastroduodenoscopy (EGD). The use of PPIs before EGD has shown to reduce the requirement for EGD, however, there are no studies evaluating the difference in outcomes of continuous infusion PPI versus intermittent IV bolus PPI prior to EGD. The objective of this study is to evaluate clinical outcomes of continuous infusion PPI versus intermittent IV bolus PPI prior to EGD. …

Immune-Mediated Colitis From Dual Checkpoint Inhibitors., Nishanth Thalambedu, Yasir Khan, Qian Zhang, Shristi Khanal, Ammar Ashfaq

Abington Jefferson Health Papers

Melanoma is a deadly disease with immunotherapy treatment options that emerged in the last few years and have changed the disease outcome. However, it is associated with immune-related toxic effects despite improving survival. We present the case of a 53-year-old woman who had two weeks of diarrhea after she was treated with dual immunotherapy agents for her advanced melanoma. The final workup revealed pancolitis, possibly due to immunotherapy adverse effects. Initial conservative treatment, unfortunately, did not lead to a clinical improvement until a steroid was introduced. We are reporting this case to alert our fellow physicians about the immune-mediated toxicities …

Does Depressed Persons With Non-Cardiovascular Morbidity Have A Higher Risk Of Cvd? A Population-Based Cohort Study In Sweden, Aysha Almas, Jette Moller, Romaina Iqbal, Andreas Lundin, Yvonne Forsel

Section of Internal Medicine

Background: Depression often co-exists with non-cardiovascular morbid conditions. Whether this comorbidity increases the risk of cardiovascular disease has so far not been studied. Thus, the aim of this study was to determine if non-cardiovascular morbidity modifies the effect of depression on future risk of CVD.
Methods: Data was derived from the PART study (acronym in Swedish for: Psykisk hälsa, Arbete och RelaTioner: Mental Health, Work and Relationships), a longitudinal cohort study on mental health, work and relations, including 10,443 adults (aged 20-64 years). Depression was assessed using the Major Depression Inventory (MDI) and self-reported data on non-cardiovascular morbidity was assessed …

Concomitant Presentation With Cardioembolic Ischemic Stroke And Non St Elevation Myocardial Infarction In A Patient With New Onset Atrial Fibrillation, Amogh M. Joshi Do, Emilee E. Kurtz Do, Kourtney Erickson Do, Margaret R. Kluck Do, Benjamin Sanchez Md

Department of Medicine

Introduction: Although Atrial Fibrillation (AF) is a common cause of ischemic stroke, it rarely causes acute coronary syndromes (ACS). Cardioembolic events from AF cause considerable morbidity and mortality. Concomitant ischemic stroke and ACS remains an exceedingly rare event. We describe the case of a patient presenting with cardioembolic ischemic stroke and acute coronary syndrome.

Case Presentation: An 83 year old male with a prior history of heart failure with preserved ejection fraction, permanent pacemaker for complete heart block, and chronic kidney disease on hemodialysis presented with acute left sided facial and extremity weakness, gait ataxia and profound dysarthria. Physical examination …

Creutzfeldt Jakob Disease: Progressive Neurological Decline, Christine Fayad Md, Scott J. Anderson, H. Alex Akhondi Md

Internal Medicine

No abstract provided.

Practice-Based Education Program To Increase Vaccination Rate In Patients On Immunotherapeutic Agents, Andrea M. Soliman Do, Soorya N. Aggarwal Do, Kyle Kreitman Do, Kourtney Erickson Do, Abdul Aleem Md, Marie S. O'Brien Do

Department of Medicine

No abstract provided.

A “Sweet” Look Into A Rare Disease: Presentation And Management Of Acute Febrile Neutrophilic Dermatosis, Christian L. Menezes Do, Joseph Moran Do, Kaitlyn Musco Md, Andres Zirlinger Md

Department of Medicine

No abstract provided.