Medical Specialties Commons^™

Pemeriksaan Bilasan Lambung: Alternatif Diagnostik Tuberkulosis Pada Pasien Hiv Dewasa?, Evy Yunihastuti

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Association Of Clinical Features And Hematological Laboratoriesbetween Ph (+)/Bcr-Abl (+) Chronic Myeloid Leukemia And Other Type Of Ph/Bcr-Abl Chronic Myeloid Leukemia, Wulyo Rajabto, A. Harryanto, Hilman Tadjoedin, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Introduction. Patients with chronic phase Chronic Myeloid Leukemia (CML) at Hematology-Medical Oncology Clinic Department of Internal Medicine dr. Cipto Mangunkusumo National Hospital who haveperformed cytogenetic and RTPCR BCR-ABL examination showed: Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML. This study aims to identify the clinical features and hematological laboratories of chronic phase CML, the proportion of Ph (+)/BCR-ABL (+) CML, and association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/ BCR-ABL CML. Methods. This is a cross-sectional study. The samples were taken by consecutive method. We used Chi-square test and …

Validation Of C-Reactive Protein And Curb-65 In The Firsthospital Admission Community Acquired Pneumonia Patient Asa Predictor 30 Days Mortality, Borries Foresto Buharman, Ceva Wicaksono Pitoyo, Gurmeet Singh, Sukamto Koesnoe

Jurnal Penyakit Dalam Indonesia

Child Turcotte Pugh Score, diastolic dysfunction, liver cirrhosis, liver dysfunction

Left Ventricular Diastolic Dysfunction In Liver Cirrhotic Patients: Proportion, Correlation, And Relationship Of Diastolic Parameters With Stage Of Liver Dysfunction, Prionggo Mondrowinduro, Irsan Hasan, Idrus Alwi, Murdani Abdullah

Jurnal Penyakit Dalam Indonesia

Introduction. Cardiovascular complication of liver cirrhosis is relatively obscure. Pathophysiology of liver cirrhosis, involving portal hypertension made the possibility of cirrhosis complication manifested as left ventricular diastolic dysfunction. This study aims to determine proportion of left ventricular diastolic dysfunction among liver cirrhotic patients according to American Society of Echocardiography-European Association of Echocardiography (ASE-EAE) 2009 and conventional approach, to determine any correlation between left ventricular diastolic dysfunction severity stages with severity stages of liver dysfunction in cirrhotic patients represented by Child Turcotte Pugh (CTP ) score, also to asses relationship between severity stages of parameters of diastolic function according to ASE-EAE …

Management Of Antithrombotic In Endoscopic Procedures, Dwi Suseno, Ari Fahrial Syam

Jurnal Penyakit Dalam Indonesia

The use of antithrombotic medicine has increased along with the growing number of cardiovascular disease in the world. Endoscopy procedure often done to the patients who use antithrombotic medicine. Eventhough most of endoscopies are safe for those patients, there are some main things related to antithrombotic treatment management that have to be noted such as the kind of antithrombotic that being used, stratification of bleeding risk on the procedure, the risk of future thromboembolic, and the process of antithrombotic treatment re-initiation. So that, patient’s safety in undergoing endoscopy procedure is guaranteed.

Association Between Stigma, Arv Therapy And Complications Ofpsychiatric Disorders Iin Hiv / Aids Patients, Yamaji Adi Wicaksono, Alifiati Fitrikasari, Muchlis Achsan Udji Sofro, Hari Peni

Jurnal Penyakit Dalam Indonesia

Introduction. Stigma and discrimination among HIV/AIDS patients cause varrious problems such as physical, psychological, and social. Therefore, its management requires comprehensive intervention. Antiretroviral therapy improves the patient’s clinical course, but may lead to neuropsychiatric complications especially anxiety disorders, depression, and psychotic disorders. This study aimed to know the associationbetween stigma,ARV therapy and complications of psychiatric disorders of HIV patients. Methods. A cross-sectional study was conducted among HIV/AIDS patients undergoing antiretroviral therapy in VCT-CST RSUP dr. Kariadi and RSUD RAA Soewondo Pati. Subjects were recruited using consecutive sampling method. Asessment of disorders and stigma was conducted using Structured Clinical Interview for …

Performance Of Xpert Mtb/Rif By Using Gastric Lavage Samplein The Diagnosis Of Pulmonary Tuberculosis In Hiv Patients Withsuspected Pulmonary Tuberculosis, Manuel Lamberto Willem Mboeik, Ceva Wicaksono Pitoyo, Teguh Harjono Karjadi, Anis Karuniawati, Esthika Dewiasty

Jurnal Penyakit Dalam Indonesia

Introduction. Xpert MTB/RIF test on gastric lavage sample may improve pulmonary tuberculosis (TB) case finding, but its performance as a diagnostic test for pulmonary TB in HIV-infected adults patients has not been studied widely, including in Indonesia. This study aims to determine the performance of the Xpert MTB/RIF test in diagnosing pulmonary tuberculosis 30 | Jurnal Penyakit Dalam Indonesia | Vol. 5, No. 1 | Maret 2018 Manuel Lamberto Willem Mboeik, Ceva Wicaksono Pitoyo, Teguh Harjono Karjadi, Anis Karuniawati, Esthika Dewiasty among HIV-infected adult patients with suspected pulmonary tuberculosis by using gastric lavage sample. Method. A cross-sectional study was conducted …

Rino-Orbital-Cerebral Mucormicosys In A Patient Type 1diabetic: A Case Report, Hamka Gunawan Marpaung, Gery Dala Prima Baso, Aulia Rizka, Erni Juwita Nelwan, Retno S. Wardani, Retno Wahyuningsih

Jurnal Penyakit Dalam Indonesia

Mucormycosis is an opportunistic andfrequently fulminating fungal infection causedby members of the family Mucoraceae, orderMucorales and class Zygomycetes which highly invasive and high mortality. Mucormycosis occurs in diabetic patients with poor blood glucose control. We reported a case of rhinocerebral mucormycosis in 20-year-old female patient with type 1 diabetes. The patient was treated for diabetic ketoacidosis and swollen symptoms in the left eye and out secretions from the left nose containing blackish spots. The probable diagnosis of rhinocerebral mucormycosis is made based on the results of direct examination and culture of nasal and palate tissue biopcywhich result suitable for Mucor …

Apolipoprotein-Defined Lipoprotein Subclasses, Serum Apolipoproteins, And Carotid Intima-Media Thickness In T1d, Arpita Basu, Alicia J. Jenkins, Julie A. Stoner, Ying Zhang, Richrd L. Klein

Kinesiology and Nutrition Sciences Faculty Research

Circulating apolipoprotein-defined lipoprotein subclasses (ADLS) and apolipoproteins predict vascular events in the general and type 2 diabetes populations, but data in T1D are limited. We examined associations of ADLS, serum apolipoproteins, and conventional lipids with carotid intima-media thickness (IMT) measured contemporaneously and 6 years later in 417 T1D participants [men: n = 269, age 42 +/- 6 y (mean +/- SD); women: n = 148, age 39 +/- 8 y] in the Epidemiology of Diabetes Interventions and Complications study, the follow-up of the Diabetes Control and Complications Trial (DCCT). Date were analyzed by multiple linear regression stratified by sex, and …

Large, Long Range Tensile Forces Drive Convergence During, David R. Shook, Eric Kasprowicz, Md, Lance A. Davidson, Raymond Keller

Division of Internal Medicine Faculty Papers & Presentations

Indirect evidence suggests that blastopore closure during gastrulation of anamniotes, including amphibians such as Xenopus laevis, depends on circumblastoporal convergence forces generated by the marginal zone (MZ), but direct evidence is lacking. We show that explanted MZs generate tensile convergence forces up to 1.5 mN during gastrulation and over 4 mN thereafter. These forces are generated by convergent thickening (CT) until the midgastrula and increasingly by convergent extension (CE) thereafter. Explants from ventralized embryos, which lack tissues expressing CE but close their blastopores, produce up to 2 mN of tensile force, showing that CT alone generates forces sufficient to close …

Spontaneous Regression Of A Primary Squamous Cell Lung Cancer Following Biopsy: A Case Report, Nathan Esplin, Khadija Fergiani, Timothy B. Legare, John W. Stelzer, Hammad Bhatti, Sayed Karar

Internal Medicine, East Africa

Background: Spontaneous regression has been defined as occurring when the malignant tumor mass partially or completely disappears without any treatment or as a result of a therapy considered inadequate to influence systemic neoplastic disease. Recently, studies have implicated immunological responses as likely being involved. We report a case of a patient with squamous cell carcinoma of the lung who experienced spontaneous regression following biopsy without other intervention.

Case Presentation: A 57-year-old white man was referred to our pulmonary clinic after an incidental finding of a nodule in the lower lobe of his left lung. Thoracic computed tomography revealed a 2.0 …

Small Cell Carcinoma Of Prostate: A Case Report Of A Patient With Concomitant Transitional Cell Cancer Of The Bladder, Waiel Abusnina, Eric Y. Auyoung, Mohammed Megri, Toni H. Pacioles

Internal Medicine

Small cell carcinomas (SCCs) are aggressive neoplasms commonly associated with a pulmonary origin. However, albeit rare, extrapulmonary SCC can occur in a variety of sites with an incidence in North America approximated to be 0.1% to 0.4%. Among these sites, approximately 10% of extrapulmonary SCC cases occur in the prostate and are associated with a poor mortality with a median survival of 10 months. Because of the rarity of the prostatic SCC, there is no formal treatment protocol. In this case report, we present a patient who was diagnosed with SCC in the prostate as primary origin. Adjuvant concurrent chemoradiotherapy …

Outcome Of Patients With Small Vessel Vasculitis After Renal Transplantation: National Database Analysis, Amr El-Husseini, Sherif Saleh, Omer Hamad, Xiaonan Mei, Ana L. Castellanos, Daniel L. Davenport, Roberto Gedaly, B. Peter Sawaya

Internal Medicine Faculty Publications

Background. Small vessel vasculitis commonly affects the kidney and can progress to end-stage renal disease. The goal of this study is to compare outcomes of patients who received a renal transplant as a result of small vessel vasculitis (group A) with those who received kidney transplants because of other causes (group B). Methods. This is a retrospective analysis of United Network for Organ Sharing registry data for adult primary kidney transplants from January 2000 to December 2014. Group A patients (N = 2196) were compared with a group B (N = 6588); groups were case matched for age, race, sex, …

Delayed Sternal Closure Does Not Reduce Complications Associated With Coagulopathy And Right Ventricular Failure After Left Ventricular Assist Device Implantation, Roh Yanagida, Navin Rajagopalan, Daniel L. Davenport, Thomas A. Tribble, Mark A. Bradley, Charles W. Hoopes

Internal Medicine Faculty Publications

Delayed sternal closure (DSC) is occasionally adopted after implantation of left ventricular assist device (LVAD). Recent studies suggest that DSC be used for high risk group of patients with coagulopathy, hemodynamic instability or right ventricular failure. However, whether DSC is efficacious for bleeding complication or right ventricular failure is not known. This study is single center analysis of 52 patients, who underwent LVAD implantation. Of those 52 patients, 40 consecutive patients underwent DSC routinely. The sternum was left open with vacuum assist device after implantation of LVAD. Perioperative outcome of the patients who underwent routine DSC were compared with 12 …

Cough, Hemoptysis And Hair Expectoration: An Intrapulmonary Teratoma, Shanila Ahmed, Habib Kibzai, Talha Shahzad, Saulat Fatimi, Madiha Bilal L Qureshi

Section of Haematology/Oncology

Teratomas can be found in different organs of the body and may involve gonads, saccrococcygeal region, mediastinum and other sites. Intrathoracic teratomas always occur in mediastinum and less often arise within the lung. As teratomas mostly involve sex organs (gonads), they rarely occur as extra-gonadal tumors accounting for only 3% of all the cases and very small percentage of such tumors occur in mediastinum.We reported an interesting case of middle aged male who presented to us with symptoms of cough, hemoptysis and trichoptysis (hair expectoration).We found that patient had intrapulmonary teratoma that was initially being treated as case of pulmonary …

Closed-Eye Visualizations In The Setting Of Hyponatremia., Travis Peck, Christopher Mercogliano, Eugene York

Reading Hospital Internal Medicine Residency

Purpose: To report a case of closed-eye visualizations and to clarify the different types of hallucinations and their etiologies.

Methods: Retrospective case report of a patient with closed-eye visualizations secondary to hyponatremia. Clinical findings, physical exam, laboratory assessment, treatment, and disease course from the patient's hospitalization were used in creating this report. Follow-up data after discharge were also obtained.

Results: Closed-eye visualizations were diagnosed as secondary to hyponatremia, as they did not occur with the eyes open, and potential alternate causes were excluded. Serum sodium nadir was 119 mEq/L. Symptoms resolved with correction of hyponatremia via fluid resuscitation and electrolyte …

Primary Thyroid Maltoma- A Rare Diagnosis Of An Unassuming Thyroid Nodule., Pragya Shrestha, Kimberly Aderhold, Sharon Swierczynski, Catherine Lin, Ronald Herb

Reading Hospital Internal Medicine Residency

Primary thyroid lymphoma, although a rare malignancy, can arise in common chronic inflammatory conditions such as Hashimoto's thyroiditis. Incidental finding of a thyroid nodule with chronic thyroid inflammation warrants further investigation. Early detection of malignancy can play a vital role in improved outcomes. We report a case of a 60-year-old male who presented to the clinic for a routine visit. An enlarged, firm, non-tender thyroid gland was appreciated on exam with high thyroid stimulating hormone (TSH) level. Fine needle aspiration of the mass revealed nonspecific atypical lymphocytes. The pathology and immunohistochemical stains were consistent with histologic impression of extra nodal …

Prevalence Of Irritable Bowel Syndrome, Psychological Ill-Health And Health-Seeking Behavior In A Population Of Nigerian Medical Students, Abiodun Christopher Jemilohun, Olukayode Abayomi, Philip Adebayo

Internal Medicine, East Africa

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with considerable morbidity and profound negative impact on quality of life. It has been observed that patients with psychological disturbances relate more frequently with the symptoms of IBS, and they have more debilitating illness than control populations. We examined the prevalence of IBS among a population of Nigerian medical students and its association with two common psychological conditions (anxiety and depression).

Methods: In a descriptive cross-sectional study, we enrolled 321 consenting medical students aged 20 to 50 years. A 34-item self-reporting questionnaire consisting of sociodemographic data, the Rome III …

Hepatitis B Virus Infection In Tanzania: Current Status And Challenges, Semvua B. Kilonzo, Daniel W. Gunda, Bonaventura C.T. Mpondo, Fatma Bakshi, Hyasinta Jaka

Internal Medicine, East Africa

Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatment, and prevention.

Chasing The Dragon, Daniel Young Cho, Hani Nazha, Kalin Fisher

Marshall Journal of Medicine

Abstract: Although rare, toxic leukoencephalopathy (TLE) associated with heroin inhalation have been reported. ‘Chasing the dragon’ may lead to progressive spongiform degeneration of the brain and presents with a large range of neuropsychological sequelae. A thorough social history and clinical suspicion are paramount in recognizing the diagnosis. This case is an example of TLE in a middle-aged white male with a history of polysubstance abuse. He presented with a three week history of progressive neuropsychological symptoms, including abulia, bradyphrenia, hyperreflexia, and visual hallucinations. He was initially suspected to have progressive multifocal leukoencephalopathy, however, JCV PCR was negative. MRI showed diffuse …

Infection Of A Ventricular Septal Defect Patch With Acremonium Species, Nosheen Nasir, Kauser Jabeen, Joveria Farooqi, Binish Arif Sultan, Afia Zafar, Aamir Hameed Khan, Muneer Amanullah, Farheen Ali

Section of Internal Medicine

A ventricular septal defect (VSD) patch infection with Acremonium species isolated from vegetation and blood culture is described. Antifungal treatment was discontinued after 3 months and patient developed relapse. Surgery with prolonged oral voriconazole was instituted with recovery. We emphasize importance of surgery and prolonged therapy to treat such infections.

Mammographic Breast Density And Breast Cancer Molecular Subtypes: The Kenyan-African Aspect, Asim Jamal, Maeve Mullooly, Shahin Sayed, Rose Ndumia, Innocent Abayo, James Orwa, Ronald Wasike, Zahir Moloo, Gretchen L. Gierach

Internal Medicine, East Africa

Introduction: Data examiningmammographic breast density (MBD) among patients in Sub-Saharan Africa are sparse.We evaluated how MBD relates to breast cancer characteristics in Kenyan women undergoing diagnostic mammography.

Methods: This crosssectional study included women with pathologically confirmed breast cancers (𝑛 = 123). Pretreatment mammograms of the unaffectedbreast were assessed to estimate absolute dense area (cm2), nondense area (cm2), and percent density (PD). Relationships between density measurements and clinical characteristics were evaluated using analysis of covariance.

Results: Median PD and dense area were 24.9% and 85.3 cm2. Higher PD and dense area were observed in younger women (𝑃 < 0.01). Higher dense and nondense areas were observed in obese women (𝑃-trend < 0.01). Estrogen receptor (ER) positive patients (73%) had higher PD and dense area than ER-negative patients (𝑃 ≤ 0.02). Triple negative breast cancer (TNBC) patients (17%) had lower PD and dense area (𝑃 ≤ 0.01) compared with non-TNBCs. No associations were observed between MBD and tumor size and grade.

Conclusions: Our findings show …

Beta-Catenin Cleavage Enhances Transcriptional Activation, Tatiana Goretsky, Emily M. Bradford, Qing Ye, Olivia F. Lamping, Tomas Vanagunas, Mary Pat Moyer, Patrick C. Keller, Preetika Sinh, Josep M. Llovet, Tianyan Gao, Qing-Bai She, Linheng Li, Terrence A. Barrett

Internal Medicine Faculty Publications

Nuclear activation of Wnt/β-catenin signaling is required for cell proliferation in inflammation and cancer. Studies from our group indicate that β-catenin activation in colitis and colorectal cancer (CRC) correlates with increased nuclear levels of β-catenin phosphorylated at serine 552 (pβ-Cat⁵⁵²). Biochemical analysis of nuclear extracts from cancer biopsies revealed the existence of low molecular weight (LMW) pβ-Cat⁵⁵², increased to the exclusion of full size (FS) forms of β-catenin. LMW β-catenin lacks both termini, leaving residues in the armadillo repeat intact. Further experiments showed that TCF4 predominantly binds LMW pβ-Cat⁵⁵² in the nucleus of inflamed and …

Refractory Abdominal Pain In A Patient With Chronic Lymphocytic Leukemia: Be Wary Of Acquired Angioedema Due To C1 Esterase Inhibitor Deficiency., Abdullateef Abdulkareem, Ryan S D'Souza, Joshua Mundorff, Pragya Shrestha, Oluwaseun Shogbesan, Anthony Donato

Reading Hospital Internal Medicine Residency

Acquired angioedema due to C1 inhibitor deficiency (C1INH-AAE) is a rare and potentially fatal syndrome of bradykinin-mediated angioedema characterized by episodes of angioedema without urticaria. It typically manifests with nonpitting edema of the skin and edema in the gastrointestinal (GI) tract mucosa or upper airway. Edema of the upper airway and tongue may lead to life-threatening asphyxiation. C1INH-AAE is typically under-diagnosed because of its rarity and its propensity to mimic more common abdominal conditions and allergic reactions. In this article, we present the case of a 62-year-old male with a history of recently diagnosed chronic lymphocytic leukemia (CLL) who presented …

Agranulocytosis Associated With Topiramate: A Case Report And Review Of Published Cases., Saroj Lohani, Niranjan Tachamo, Salik Nazir, Anthony Donato

Reading Hospital Internal Medicine Residency

A 41-year-old female presented to the hospital with sore throat and shortness of breath. She was hypoxic with an oxygen saturation of 87% in room air. Physical examination revealed swollen uvula with exudates. She had been started on topiramate for treatment of migraine few months ago. The dose of topiramate was increased to 100 mg twice daily 2 weeks ago. Complete blood count revealed an absolute neutrophil count (ANC) of 8 c/mm

Deciphering A Case Of Pulmonary Hypertension In A Young Female: Partial Anomalous Pulmonary Venous Drainage The Culprit, Hiten R. Patel, Suchit Bhutani, Fayez Shamoon, Hartaj Virk

Abington Jefferson Health Papers

Partial anomalous pulmonary venous drainage (PAPVD) is a rare congenital cardiac defect and is associated with sinus venosus atrial septal defect. While most cases are asymptomatic, a patient can present with pulmonary hypertension (PHTN) and it can be difficult to diagnose. Here, we discuss the case of a young female with PHTN who was found to have two right-sided PAPVD. Through this case, authors try to emphasize the importance of meticulous and thorough investigation when evaluating PHTN, which allows for correct diagnosis and a timely intervention before PHTN becomes irreversible.

The Impact Of Schizophrenia On Copd Readmission Rate Among Hospitalized South Carolinians, Emilienne Y. Watonsi

DNP Research Projects

Due to elevated readmission costs, the Affordable Care Act established the Hospital Readmission Reduction Program in 2012 to curb the 30-day readmission rates. COPD and schizophrenia are two very expensive diseases, COPD national medical costs is projected to be $49.0 billion in 2020; the cost of schizophrenia was 155.7 billion in 2013. The main objective of this study was to determine if schizophrenia is a significant predictor of 30-day readmission following hospitalization for acute exacerbation of COPD after adjusting for age, gender, anxiety, smoking status, T2DM, chronic ischemic heart disease, and GERD. Methods: A retrospective cohort design was used to …

Racial/Ethnic Disparities Among Asian Americans In Inpatient Acute Myocardial Infarction Mortality In The United States, E. J. Kim, N. R. Kressin, M. K. Paasche-Orlow, L. Lopez, J. E. Rosens, M. Lin, A. D. Hanchate

Journal Articles

No abstract provided.

Understanding The Digital Gap Among Us Adults With Disability: Cross-Sectional Analysis Of The Health Information National Trends Survey 2013, E. J. Kim, Y. Yuan, J. Liebschutz, H. Cabral, L. Kazis

Journal Articles

©Eun Ji Kim, Yiyang Yuan, Jane Liebschutz, Howard Cabral, Lewis Kazis. Background: Disabilities affect more than 1 in 5 US adults, and those with disabilities face multiple barriers in accessing health care. A digital gap, defined as the disparity caused by differences in the ability to use advanced technologies, is assumed to be prevalent among individuals with disabilities. Objective: This study examined the associations between disability and use of information technology (IT) in obtaining health information and between trust factors and IT use. We hypothesized that compared to US adults without disabilities, those with disabilities are less likely to refer …

Fertility Information Needs And Concerns Post-Treatment Contribute To Lowered Quality Of Life Among Young Adult Female Cancer Survivors, C. Benedict, B. Thom, D. N. Friedman, E. Pottenger, N. Raghunathan, J. F. Kelvin

Journal Articles

No abstract provided.