Medical Specialties Commons^™

Dimethyl Fumarate Suppresses Granulocyte Macrophage Colony-Stimulating Factor-Producing Th1 Cells In Cns Neuroinflammation., Farinaz Safavi, Rodolfo Thome, Zichen Li, Guang-Xian Zhang, Abdolmohamad Rostami

Department of Neurology Faculty Papers

Objective To study the immunomodulatory effect of dimethyl fumarate (DF) on granulocyte macrophage colony-stimulating factor (GM-CSF) production in CD4+ T cells in experimental autoimmune encephalomyelitis (EAE) and human peripheral blood mononuclear cells (PBMCs).

Methods We collected splenocytes and CD4+ T cells from C57BL/6 wild-type and interferon (IFN)-γ–deficient mice. For human PBMCs, venous blood was collected from healthy donors, and PBMCs were collected using the Percoll gradient method. Cells were cultured with anti-CD3/28 in the presence/absence of DF for 3 to 5 days. Cells were stained and analyzed by flow cytometry. Cytokines were measured by ELISA in cell supernatants. For in …

Atrx Deletion In Neurons Leads To Sexually Dimorphic Dysregulation Of Mir-137 And Spatial Learning And Memory Deficits., Renee J. Tamming, Vanessa Dumeaux, Yan Jiang, Sarfraz Shafiq, Luana Langlois, Jacob Ellegood, Lily R. Qiu, Jason P. Lerch, Nathalie G. Bérubé

Paediatrics Publications

ATRX gene mutations have been identified in syndromic and non-syndromic intellectual disabilities in humans. ATRX is known to maintain genomic stability in neuroprogenitor cells, but its function in differentiated neurons and memory processes remains largely unresolved. Here, we show that the deletion of neuronal Atrx in mice leads to distinct hippocampal structural defects, fewer presynaptic vesicles, and an enlarged postsynaptic area at CA1 apical dendrite-axon junctions. We identify male-specific impairments in long-term contextual memory and in synaptic gene expression, linked to altered miR-137 levels. We show that ATRX directly binds to the miR-137 locus and that the enrichment of the …

Efficacy Of Argon Plasma Coagulation Treatment In Radiation Colitis Patients And Its Confounding Factors, Aru Ariadno, Dadang Makmun, Andri S. Sulaiman, Sukamto Koesnoe

Jurnal Penyakit Dalam Indonesia

Introduction. Argon plasma coagulation (APC) is widely used in the treatment of radiation colitis among patients with gynecology, colorectal and urology malignancy. This study aimed to measure the result of APC conducted on radiation colitis patients and its counfounding factors. Methods. An analytic descriptive study with retrospective cohort design was conducted among radiation colitis patients received APC treatment in Cipto Mangunkusumo Hospital, Jakarta. Data were collected from medical record database between April 2012 until October 2019. Results. As much as 180 radiation colitis patients received APC treatment fulfilled inclusion criteria with characteristics female patients (89.4%) and age >50 years old …

Pengelolaan Predialisis Pasien Penyakit Ginjal Kronik, Ni Made Hustrini

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Factors Associated With Late Referral In End Stage Renal Disease Patients At Dr. Cipto Mangunkusumo Hospital, Aida Lydia, Grecia Rachmaningrum, Hamzah Shatri, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Relationship Between Total Session Of Hyperbaric Oxygen Therapy As Adjuvant Therapy With Diabetic Foot Ulcers Improvement In Dr. Mintohardjo Naval Hospital In The Year 2016−2018, Naufal Hilmi Andrisha, Pritha Maya Savitri, Nurfitri Bustamam

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic foot ulcers (DFU) are a common complication of diabetes mellitus (DM). High rates of amputation risk and mortality in DM patients with DFU as well as the use of conventional therapies that often fail to improve the DFU condition cause an adjuvant therapy such as hyperbaric oxygen therapy (HBOT) to be used. HBOT is known can facilitate wound bed closure and reduce the amputation rates in diabetic gangrene foot. This study aimed to determine the relationship between total sessions of HBOT as adjuvant therapy with an improvement of DFU patients. Method. A cross-sectional study was conducted among DFU …

The Correlation Between Transforming Growth Factor-Beta (Tgf- Β) Serum Level And Beck Depression Inventory (Bdi) Score In Colorectal Cancer Patients At Rsmh Palembang, Muhammad Ali Apriansyah, Mediarty Syahrir, Muhammad Rosyidi Kgs, Ahmad Faisyar

Jurnal Penyakit Dalam Indonesia

Introduction. Depression not only increase the mortality rate, but also can interfere the quality of life of colorectal cancer patients during treatment. Low levels of systemic inflammation may contribute to the development of depression. The inflammatory process can be seen by measuring serum transforming growth factor-β (TGF-β) levels and depressive symptoms using the beck depression inventory (BDI) score. This study aimed to determine the correlation between TGF-β serum levels with depression in colorectal cancer patients. Methods. Analytical observational research with cross sectional design was conducted among colorectal cancer patients who underwent chemotherapy with a BDI score ≥10 (depression) in the …

Prediction Model Of 30-Day Mortality In Elderly Patients Admitted To Geriatric Acute Ward Using Comprehensive Geriatric Assessment Domain, Noto Dwimartutie, Slti Setiati, Edy Rizal Wahyudi, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Advanced Directives In Palliative Care, Hamzah Shatri, Edward Faisal, Rudi Putranto, Budi Sampurna

Jurnal Penyakit Dalam Indonesia

Initially palliative care is emphasized at the end of life, but the right thing is to begin identifying palliative care needs when the disease is diagnosed. Palliative care is the treatment needed to improve the quality of life of patients and their families that suffering from life threatening and progressive disease such as cancer, non-cancer diseases, and HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome). Palliative care decision must be in place from the beginning of treatment, so the patient’s preferences are met. The goals of this care are to reduce physical, social, psychological, and spiritual suffers. Further treatment plan is based …

Anti-Dfs70 As Nonsystemic Autoimmune (Primary Billiar Cholangitis) Concomitant Disease Marker In Systemic Lupus Erythematosus, Yasjudan Rastrama Putra, Deshinta Putri Mulya, Fahmi Indrarti

Jurnal Penyakit Dalam Indonesia

Anti-dense fine speckled 70 (DFS70) is known as a non-systemic autoimmune marker. It is only found in 1% of systemic autoimmune patients and 2–22% in healthy population. To the best of our knowledge, no anti-DFS70 positive has been reported in systemic lupus erythematosus (SLE) patients with primary billiary cholangitis (PBC) comorbidities. We reported a 40-year-old woman that was diagnosed with SLE 1-month before, came to the hospital due to seven days of fatigue, loss of appetite, icteric, arthralgia, hair loss, and unexplained fever. Total bilirubin was 9.46 mg/dl, direct bilirubin 7.73 mg/dl, gamma-glutamyl transferase (GGT) 503 U/L, alkaline phosphatase (ALP) …

The Proportion Of Acute Transfusion Reaction At Outpatient Blood Transfusion Unit In Tertiary Hospital In Indonesia, Ahmad Fariz Malvi Zamzam Zein, Lugyanti Sukrisman

Jurnal Penyakit Dalam Indonesia

Introduction. Acute transfusion reaction (ATR) is an important issue related to patient safety. The prevalence of ATR at tertiary hospital in Indonesia is 0.5%. This study was aimed to determine the proportion of ATR in outpatient blood transfusion unit at tertiary hospital. Method. This retrospective study implemented data from medical records of adult patients who underwent blood transfusion in outpatient blood transfusion unit, Cipto Mangunkusumo Hospital between August – October 2014. The blood components included packed red cells (PRC), thrombocyte concentrate (TC), fresh frozen plasma (FFP), and cryoprecipitate. We recorded the administration of premedication and ATR-related symptoms/signs. The ATR report …

Crack Cocaine Induced Upper Airway Injury., N D Vandjelovic, A K Larson, E M Sugihara, N A Stern

Articles, Abstracts, and Reports

The paper describes the presentation and management of patients presenting with crack cocaine induced upper airway injury. The study involved a retrospective clinical series of six patients with crack cocaine induced upper airway injury. Demographics, symptoms, physical exam, flexible laryngoscopy findings, treatment and intervention were recorded. All patients with crack cocaine induced thermal injury presented with mouth or throat pain plus at least one other laryngeal symptom, such as globus sensation, dysphagia or throat tightness. On physical exam, the supraglottis was the most common subsite of endolaryngeal injury. The only statistically significant finding was the number of subsites on initial …

Working With People With Disabilities: An Interactive Video/Lecture Session For First- And Second-Year Medical Students., Sandra L Hearn, Pamela J Hearn

Articles, Abstracts, and Reports

Introduction: Negative physician attitudes toward people with disabilities create barriers to health care for these individuals. Barriers can include withholding of standard medical and preventive care, provision of inferior treatment, and patient mistrust of the health care system. Thus, preparing medical students to care for people with disabilities is especially important. Educating health care providers early in their careers can shape their interactions while their approach to patients is still deliberate.

Methods: We developed an interactive introductory session for first- and second-year medical students on how to approach individuals with observable disability in clinical settings. In the session, we explored-through …

The Absence Of Prophylactic Antibiotics Administration And The Surgical Site Infections Rate In Mohs Micrographic Surgery, Riva Ambardina Pradita, Larisa Paramitha Wibawa

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: The use of prophylactic antibiotics in dermatologic surgery, particularly in Mohs micrographic surgery (MMS), remains a gray area. Despite the low rate of surgical site infection (SSI), SSI can result in some significant morbidities. Thus, numerous dermatologists keep administering prophylactic antibiotics in MMS.

Method: A search was conducted to identify clinically significant topics followed by literature review through the main available medical literature database. The three selected studies that met the inclusion and exclusion criteria were then critically assessed for their validity, importance, and applicability using the guidance from Centre for Evidence-Based Medicine for Critical Appraisal …

Case Series Of Primary Psychiatric Skin Disorders With Multi-Disciplinary Approach, Lusiana Lusiana, Rizky Lendi Prayogo, Shannaz Nadia Yusharyahya, Irma Bernadette S. Sitohang, Kusmarinah Bramono

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: The incidence of psychodermatologic diseases, a group of skin abnormalities associated with psychosomatic factor, are increasing recently. About 20-40% patients with skin symptoms have concurrent psychiatric problems which are often difficult to diagnose and treat. The new classification of primary psychiatric skin disorders are delusional disorders, obsessive-compulsive and related disorders, and factitious disorders. This classification could be used for effective treatment in each patient which involves multi-disciplinary approach, including dermatology, psychiatry and other discipline if necessary.

Case Illustration: The first case was a 39-year-old unmarried female, with anemia and dermatitis artefacta occurred as wound due to …

Narrowband Ultraviolet B Phototherapy Combined With Topical Treatment For Vitiligo In 2 Geriatric Patients, Rinadewi Astriningrum, Lili Legiawati, Vivianne Chandrakesuma, Department Of Dermatology And Venereology, Faculty Of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo National Central General Hospital Jakarta, Indonesia Shannaz Nadia Yusharyahya

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Narrowband ultraviolet B (NB-UVB) become the mainstay of widespread vitiligo therapy due to its great efficacy and safety compared with other modalities. The use of NB-UVB for vitiligo has been widely studied in adult patients, while studies on geriatric patients specifically are still very limited. This report aims to show the immediate response after the initial treatment, side effects of therapy, and other problems that were encountered during therapy in two geriatric patients with vitiligo who have been followed up for more than 12 months.

Case Illustration: We reported two geriatric patients with vitiligo treated with NB-UVB …

Association Of Zinc Intake & Serum Zinc Levels With Acne Severity, Chintia Otami, Novita Chandra, Irma Bernadette S. Sitohang

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Recent studies have suggested the relationship between diet and acne, and zinc plays a role through its anti-inflammatory mechanism. This study aimed to determine the association between zinc intake and serum zinc levels with acne severity.

Methods: A comparative cross-sectional study was conducted to assess the difference in zinc intake and serum zinc levels with acne severity based on Indonesian Acne Expert Meeting (IAEM) criteria. Sixty patients with acne in Dr. Cipto Mangunkusumo General Hospital were selected. The effect of zinc intake on acne severity was analyzed via unpaired T test, whereas the effect of serum zinc …

Validity And Reliability Of Melasma Quality Of Life Scale Questionnaire In Bahasa Indonesia For Female Patients, Rubby Aditya, Aida S. D. Hoemardani, Irma Bernadette, Levina Chandra, Rajesh Balkrisnan

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: At present, there is no questionnaire in Bahasa Indonesia to assess the quality of life of female patients with melasma. The aim of this study is to adapt the existing English questionnaire, MELASQOL, into Bahasa Indonesia, and to assess its validity and reliability.

Methods: This is a cross-sectional study consisting of two stages. The initial stage is cross-cultural and language adaptation. The final stage is the validity and reliability test. The original MELASQOL questionnaire is in English and is adapted into Bahasa Indonesia according to the cross-cultural and language adaptation guidelines. The subjects were recruited from two …

The Association Between Blotting Paper Application And Severity Of Acne Vulgaris Among Medical Students, Ivana Beatrice Alberta, Melyawati Hermawan, Soegianto Ali

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Acne vulgaris is an inflammatory condition of the pilosebaceous glands caused by various factors including excessive excretion of sebaceous glands. Excess sebum can be reduced using oil blotting paper (OBP), a thin paper with microspores that absorb the oil on the face. This study was conducted to determine the association between OBP application and sebum excretion according to the Oily Skin Self- Assessment Scale (OSSAS) questionnaire and acne severity according to the Global Acne Grading System (GAGS) questionnaire.

Methods: This experimental study was conducted in 2017 among 60 students aged 17–22 years at the Faculty of Medicine, …

The Applicability Of Sonic Hedgehog In Mixed Type Basal Cell Carcinoma, Zahra Ayu Lukita Sari, Yulia Farida Yahya, Theresia Lumban Toruan

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Basal cell carcinoma (BCC) is the most common skin malignancy found in nonmelanoma skin cancer. There are multiple factors contribute to risks for BCC but the underlying mechanism is genetic alteration. The Sonic hedgehog (SHH) pathway is implicated in the etiology of the most common BCC. We reported BCC nodular type in the tip of nasal region with increase SHH.

Case Illustration: 50 years old man, presented with hyperpigmented tumor on the nasal tip which easily bleed since 6 months ago. Dermatological examination: the tip of nasal region: a solitaire irregular immobile hyperpigmented tumor, with the size …

Nail Involvement In Langerhans Cell Histiocytosis: Diagnostic And Prognostic Clues, Sondang P. Sirait, Rahadi Rihatmadja, Rizky Lendl Prayogo, Riesye Arisanty, Gisca Melviana, Kuniaki Ohara

Journal of General - Procedural Dermatology and Venereology Indonesia

Introduction: Despite its rarity, nail involvement in Langerhans cell histiocytosis (LCH) may show various clinical presentations. This study aims to show the roles of nail involvement in LCH patients as the diagnostic and prognostic clues.
Case illustrations: We presented four cases of multisystem LCH in children which were already confirmed by skin biopsy with various nail abnormalities. We were able to perform nail biopsy in two patients and confirmed the nail involvement. Histopathological examination showed the infiltration of Langerhans cells characterized by indented/reniform nuclei and CD1a expressions. All patients had high-risk organ involvements.

Discussion: Langerhans cells may infiltrate …

Spontaneous Regression Of Divided Nevus Of The Eyelid Evaluated By Dermoscopy : Is It Hypopigmentation After Regression Or Vitiligo, Danang Tri Wahyudi, Izzah Aulia, Aida S. D. Hoemardani, Agassi Suseno Sutarjo

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Divided nevus, also known as “kissing nevus,” is a rare form of congenital melanocytic nevus that occurs on opposing margins of upper and lower eyelids. A paucity of literature on this rare anomaly exists, with most being case reports and series. Moreover, regression of this lesion was rarely reported.

Case Illustration: We present a rare case of congenital divided nevus of the eyelid that regressed after eight years, confirmed with dermoscopy. A six-year-old boy presented to the Dharmais National Cancer Hospital with two pigmented macules on the upper and lower right eyelid since birth. A year ago, …

The Promotion Of Physical Activity For The Prevention Of Alzheimer's Disease In Adults With Down Syndrome: Rationale And Design For A 12 Month Randomized Trial., Lauren T. Ptomey, Amanda N. Szabo-Reed, Laura E. Martin, Matthew S. Mayo, Richard A. Washburn, Anna M. Gorczyca, Rebecca J. Lepping, Phill Lee, Daniel Forsha, Joseph R. Sherman, Jessica C. Danon, Joseph E. Donnelly

Manuscripts, Articles, Book Chapters and Other Papers

Nearly all individuals with Down Syndrome (DS) display pathology associated with Alzheimer's disease (AD) beginning as early as age 30. Previous research in typically developed adults suggests that increased moderate-to-vigorous physical activity (MVPA) may improve cognitive function and protect against age-related structural and functional changes in the brain; however, the potential impact of increased MVPA on the development of AD in adults with DS has not been evaluated. Despite the potential positive impact of MVPA on cognition and AD risk, participation in MVPA among young adults with DS is low. The limited research evaluating strategies for increasing MVPA in adults …

Host Immune Response To Enterovirus And Parechovirus Systemic Infections In Children., Anjana Sasidharan, Wail M. Hassan, Christopher J. Harrison, Ferdaus Hassan, Rangaraj Selvarangan

Manuscripts, Articles, Book Chapters and Other Papers

Background: Enterovirus (EV) and parechovirus type A3 (PeV-A3) cause infections ranging from asymptomatic to life-threatening. Host immune responses in children, particularly innate responses to PeV-A3, remain largely unknown. The aim of this study was to determine aspects of the cytokine/chemokine responses to EV and PeV-A3 in cerebrospinal fluid (CSF) and plasma obtained from children with systemic/central nervous system infection.

Methods: A total of 74 salvaged CSF samples (27 with EV, 23 with PeV-A3, and 24 with neither EV nor PeV-A3) and 35 paired blood samples (10 with EV, 14 with PeV-A3, and 11 with neither) were studied. Concentrations of cytokines …

Oral Anticoagulants For Nonvalvular Atrial Fibrillation In Frail Elderly Patients: Insights From The Aristophanes Study, G. Y. H. Lip, A. V. Keshishian, A. L. Kang, A. D. Dhamane, X. Luo, X. Li, N. Balachander, L. Rosenblatt, J. Mardekian, X. Pan, M. Di Fusco, A. B. Garcia Reeves, Huseyin Yuce, S. Deitelzweig

Publications and Research

Background

Patient frailty amongst patients with nonvalvular atrial fibrillation (NVAF) is associated with adverse health outcomes and increased risk of mortality. Additional evidence is needed to evaluate effective and safe NVAF treatment in this patient population.

Objectives

This subgroup analysis of the ARISTOPHANES study compared the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) amongst frail NVAF patients prescribed nonvitamin K antagonist oral anticoagulants (NOACs) or warfarin.

Methods

This comparative retrospective observational study of frail, older NVAF patients who initiated apixaban, dabigatran, rivaroxaban or warfarin from 01JAN2013‐30SEP2015 was conducted using Medicare and 3 US commercial claims databases. To compare …

Social Services Cases, Maria Hervada-Page, Mms

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Understand common Social Work referrals and possible solutions
• Understand the roles of the members of our team
• Understand the basics of insurance
• Basic community resources

Benefits Of Palliative Care In The Intensive Care Unit, Stephen Swenson, Stephen M. Swenson

Nursing Masters Papers

Abstract

The use of palliative care is often overlooked until the terminal phase of serious illness when life-prolonging interventions are deemed futile and death is considered imminent.

Alongside the well regarded Clinical Practice Guidelines for Quality Palliative Care (National Coalition for Hospice and Palliative Care, 2018), numerous critical care societies including the American Association of Critical-Care Nurses (Medina & Puntillo, 2006), American College of Critical Care Medicine (Davidson et al., 2008), American College of Chest Physicians (Selecky et al., 2005), American College of Surgeons (2017), and the American Thoracic Society (Lanken et al., 2007) have each published individual policies highlighting …

Active Deep Learning Method To Automate Unbiased Stereology Cell Counting, Saeed Alahmari

USF Tampa Graduate Theses and Dissertations

Cell quantification in histopathology images plays a significant role in understanding and diagnosing diseases such as cancer and Alzheimers. The gold-standard for quantifying cells in tissue sections is the unbiased stereology approach. Unfortunately, in unbiased stereology current practices rely on a well-trained human to manually count hundreds of cells in microscopy images. However, this human-based manual approach is time-consuming, labor-intensive, subject to human errors, recognition bias, fatigue, variable training, poor reproducibility, and inter-observer error. Thus, the lack of high-throughput technology for automating unbiased stereology analyses remains a major obstacle to further progress in a wide range of neuroscience and cancer …

Trends In Cancer Prevalence In Punjab, Pakistan: A Systematic Study From 2010 To 2016, Sana Hafeez, Asmat Mahmood, Rizwan Ullah Khan, Naila Malkani

Journal of Bioresource Management

Cancer is the second leading cause of death globally. However, in Pakistan, in the absence of a national cancer registry, it is difficult to predict the current status of cancer incidence. Therefore, a need was felt to design a study that can give a depiction of the prevalence of common cancer types and their relevance to the local population in the absence of a proper cancer registry system. In view of this, data was collected from 2010 to 2016 for breast, prostate, head and neck, cervical and colorectal cancer from the cancer hospitals and centres located all over Punjab, Pakistan. …

Timely Diagnosis And Staging Of Non-Alcoholic Fatty Liver Disease Using Transient Elastography And Clinical Parameters., Christine Shieh, Dina L. Halegoua-De Marzio, Matthew L. Hung, Jonathan M. Fenkel, Steven K. Herrine

Division of Gastroenterology and Hepatology Faculty Papers

Background and Aim: There is no standardized guideline to screen, image, or refer patients with non-alcoholic fatty liver disease (NAFLD) to a specialist. In this study, we used transient elastography (TE) to examine the fibrosis stages at which patients are first diagnosed with NAFLD. Subsequently, we analyzed metabolic markers to establish cut-offs beyond which noninvasive imaging should be considered to confirm NAFLD/non-alcoholic steatohepatitis fibrosis in patients.

Methods: Charts spanning July 2015-April 2018 for 116 NAFLD patients who had TE performed were reviewed. Univariate and multivariate analysis of metabolic markers was conducted.

Results: At the first hepatology visit, TE showed 73% …