Medical Specialties Commons^™

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, …

Analysis Of An Antibiotic Stewardship Program For Asymptomatic Bacteriuria In The Veterans Affairs Health Care System, Larissa Grigoryan, Aanand D Naik, Paola Lichtenberger, Christopher J Graber, Payal K Patel, Dimitri M Drekonja, Timothy P Gauthier, Bhavarth Shukla, Anne E Sales, Sarah L Krein, John N Van, Laura M Dillon, Sylvia J Hysong, Jennifer R Kramer, Annette Walder, David Ramsey, Barbara W Trautner

Faculty, Staff and Students Publications

IMPORTANCE: Antibiotic stewardship for asymptomatic bacteriuria (ASB) is an important quality improvement target. Understanding how to implement successful antibiotic stewardship interventions is limited.

OBJECTIVE: To evaluate the effectiveness of a quality improvement stewardship intervention on reducing unnecessary urine cultures and antibiotic use in patients with ASB.

DESIGN, SETTING, AND PARTICIPANTS: This interrupted time series quality improvement study was performed at the acute inpatient medical and long-term care units of 4 intervention sites and 4 comparison sites in the Veterans Affairs (VA) health care system from October 1, 2017, through April 30, 2020. Participants included the clinicians who order or collect …

White Coat Hypertension Persistence In Children And Adolescents: The Pediatric Nephrology Research Consortium Study, Yosuke Miyashita, Coral Hanevold, Anna Faino, Julia Scher, Marc Lande, Ikuyo Yamaguchi, Joel Hernandez, Alisa Acosta, Donald J Weaver, Jason Thomas, Mahmoud Kallash, Michael Ferguson, Ketan N Patel, Andrew M South, Megan Kelton, Joseph T Flynn

Faculty, Staff and Students Publications

OBJECTIVES: To determine whether youth with white coat hypertension on initial ambulatory blood pressure monitoring (ABPM) continue to demonstrate the same pattern on repeat ABPM.

STUDY DESIGN: Retrospective longitudinal cohort study of patients referred for high blood pressure (BP) and diagnosed with white coat hypertension by ABPM who had follow-up ABPM 0.5-4.6 years later at 11 centers in the Pediatric Nephrology Research Consortium. We classified ABPM phenotype using the American Heart Association guidelines. At baseline, we classified those with hypertensive BP in the clinic as "stable white coat hypertension," and those with normal BP as "intermittent white coat hypertension." We …

Changes In Measures Of Vestibular And Balance Function And Hippocampus Volume In Alzheimer's Disease And Mild Cognitive Impairment, Helen S Cohen, Christie M Lincoln, Valory N Pavlik, Haleh Sangi-Haghpeykar

Faculty, Staff and Students Publications

OBJECTIVE: To test the hypotheses that people with Alzheimer's disease and mild cognitive impairment have increased frequency of vestibular impairments and decreased hippocampal volume compared with healthy age-matched controls.

STUDY DESIGN: Retrospective, with some historical controls.

SETTING: Out-patient, tertiary care center.

SUBJECTS: People with mild to moderate dementia diagnosed with Alzheimer's disease and with mild cognitive impairment. Main Outcome Measures: A standard clinical battery of objective tests of the vestibular system, and screening for balance; available clinical diagnostic magnetic resonance imaging (MRIs) were reviewed and postprocessed to quantify the left and right hippocampal volumes utilizing both manual segmentation and computer …

Automatic Information Extraction From Childhood Cancer Pathology Reports, Hong Jun Yoon, Alina Peluso, Eric B. Durbin, Xiao Cheng Wu, Antoinette Stroup, Jennifer Doherty, Stephen Schwartz, Charles Wiggins, Linda Coyle, Lynne Penberthy

School of Medicine Faculty Publications

Objectives: The International Classification of Childhood Cancer (ICCC) facilitates the effective classification of a heterogeneous group of cancers in the important pediatric population. However, there has been no development of machine learning models for the ICCC classification. We developed deep learning-based information extraction models from cancer pathology reports based on the ICD-O-3 coding standard. In this article, we describe extending the models to perform ICCC classification. Materials and Methods: We developed 2 models, ICD-O-3 classification and ICCC recoding (Model 1) and direct ICCC classification (Model 2), and 4 scenarios subject to the training sample size. We evaluated these models with …

Association Of Obesity And Diabetes With The Incidence Of Breast Cancer In Louisiana, Fokhrul M. Hossain, Denise M. Danos, Qiufan Fu, Xinnan Wang, Richard A. Scribner, San T. Chu, Ronald L. Horswell, Eboni G. Price-Haywood, Bridgette M. Collins-Burow, Xiao Cheng Wu, Augusto C. Ochoa, Lucio Miele

School of Medicine Faculty Publications

Introduction: Breast cancer is a heterogeneous disease, consisting of multiple molecular subtypes. Obesity has been associated with an increased risk for postmenopausal breast cancer, but few studies have examined breast cancer subtypes separately. Obesity is often complicated by type 2 diabetes, but the possible association of diabetes with specific breast cancer subtypes remains poorly understood. Methods: In this retrospective case-control study, Louisiana Tumor Registry records of primary invasive breast cancer diagnosed in 2010–2015 were linked to electronic health records in the Louisiana Public Health Institute's Research Action for Health Network. Controls were selected from Research Action for Health Network and …

Hippo Signaling Pathway: A Comprehensive Gene Expression Profile Analysis In Breast Cancer, Hassan Yousefi, Mahsa Rostamian Delavar, Fatemeh Piroozian, Masoud Baghi, Khoa Nguyen, Thomas Cheng, Cecilia Vittori, David Worthylake, Suresh K. Alahari

School of Medicine Faculty Publications

Breast cancer (BC) is the most frequently diagnosed malignancy in women and a major public health concern. The Hippo pathway is an evolutionarily conserved signaling pathway that serves as a key regulator for a wide variety of biological processes. Hippo signaling has been shown to have both oncogenic and tumor-suppressive functions in various cancers. Core components of the Hippo pathway consist of various kinases and downstream effectors such as YAP/TAZ. In the current report, differential expression of Hippo pathway elements as well as the correlation of Hippo pathway mRNAs with various clinicopathologic characteristics, including molecular subtypes, receptor status, and methylation …

Physician Assistant Global Advancement Through The Use Of Medical Relief Organizations, Kara Crafts Pa-C, Sarah Mistrot Pa-C, Mary Henningsgaard Pa-C, Kaley Morris Pa-C, Tamarrah Oliver Pa-C, Kevin Tran Pa-C, Trevor Crafts Md

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Objectives: The physician assistant (PA) model has been adopted by many nations to alleviate health care disparities. The objective of the project is to understand how medical relief organizations are utilizing physician assistants and contributing to the advancement of the career globally.

Methods: A search was conducted to create a list of all U.S. based medical relief organizations. An 18-question online survey was sent to 493 organizations that met inclusion criteria.

Results: Total response rate of the survey was 56.2%. 75.6% of organizations reported using PAs on their medical relief projects, and PAs were used in clinic/hospital/and operative settings.

Conclusions: …

Emicizumab-Kxwh: A Critical Review, Kiera O'Leary

International Undergraduate Journal of Health Sciences

The first descriptions of haemophilia A were reported in the second century AD, with the first modern description by John Conrad Otto in 1803. Historically, the natural history of haemophilia A was associated with very high rates morbidity and mortality, often following trivial accidents. Although treatment options for haemophilia A have been revolutionised in recent decades, haemophilia A remains a hereditary disease of concern and factor replacement products remain the mainstay of treatment.

As such, patients with haemophilia can carry huge burdens, particularly when a complication such as a FVIII inhibitor is present. A recently approved novel therapeutic, Emicizumab-kxwh, has …

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 …

Delayed Diagnosis Of Klippel-Trénaunay Syndrome In A 23-Year-Old African American Male, Daniel A. Nguyen, Pranav Patel, Stephen E. Weis

HCA Healthcare Journal of Medicine

Klippel-Trénaunay syndrome is a rare genetic disorder that typically presents as a triad of symptoms consisting of venous malformations (varicosities), capillary malformations (port-wine stain), and limb overgrowth. We followed a 23-year-old African American male with a past medical history of peripheral vascular disease, who was visiting the dermatology clinic for a persistent skin lesion on his thigh. During physical examinations, we noted a subtle port-wine stain on his right leg, right leg hypertrophy, and peripheral vascular disease. Skin findings were difficult to observe on his darker skin tone, Fitzpatrick skin type VI, which may have led to the delayed diagnosis …

Free Silicone-Induced Granulomatosis And Hypercalcemia In A Transgender Female, Brian L. Pando, Benjamin Goldsmith, Adam Lane Webb, Komal Kinger, Brian Helmly

HCA Healthcare Journal of Medicine

Introduction

Vitamin D derangements are a rare but important cause of hypercalcemia. Granulomatous disease is a primary cause of vitamin D derangements and is frequently associated with sarcoidosis, tuberculosis, and in the present case, foreign body granulomatosis. Liquid or injectable silicone is used as a filler for cosmetic body contouring. Transgender patients may seek silicone injections as part of gender affirmation surgeries. Granuloma formation is a rare but well-described complication of injectable silicone.

Case Description

A 40-year-old, assigned male at birth (AMAB) transgender female patient, with a history of HIV and chronic kidney disease (CKD) stage 3b, was admitted to …

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

HCA Healthcare Journal of Medicine

Cutaneous abscesses are collections of pus resulting from skin and soft tissue bacterial infections. They clinically exhibit the four cardinal inflammatory signs of pain, warmth, swelling, and erythema. In patients with darkly pigmented skin, classically-associated erythema may be challenging to appreciate and can lead to missed or delayed diagnosis. We compare abscess presentations in different skin types. Recognition of varying presentations of cutaneous abscesses in diverse skin colors will help clinicians utilize additional clues to identify and diagnose this entity correctly.

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.

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

HCA Healthcare Journal of Medicine

Recent studies estimate that more than 8 million Americans have psoriasis. The prevalence of psoriasis in African Americans is 1.5% compared to 3.6% of Caucasians. Psoriasis is likely to be underdiagnosed among African Americans and other individuals with darker pigmented skin due to variations in clinical presentation in addition to disease distribution and severity. We present images of psoriasis vulgaris in a variety of Fitzpatrick skin types. Differences in the biology of skin pigmentation may explain the clinical masking of erythema in darker-skinned individuals. Recognition of this important difference will help clinicians utilize additional clues to identify and diagnose this …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: An Introduction, Christian J. Scheufele, Delfin Weis, Stephen E. Weis

HCA Healthcare Journal of Medicine

Dermatological disease has historically been dependent on photography as a primary modality for education. Previously, photographs used for medical education were representative of the regional patient populations at that time; however, they have not proportionally reflected the rapidly changing demographics in the United States. Education on the diagnosis of cutaneous disease has, therefore, primarily relied on photographs of lighter skin tones. There is a need for a better representation of darker skin tones in dermatologic medical education. This article introduces a clinical series that highlights dermatological diseases in various skin pigmentations, which are commonly seen in the primary care office. …

Pilot Mental Health Offender Program Improves Participant Outcomes And Lowers Costs In A Large Urban County, Colleen Bell, Mohsin Raza, David Kilcrease, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Introduction

Mass incarceration, particularly of the mentally ill, continues to pervade our criminal justice system. Jails in many areas have become the largest mental health facilities, especially in large urban communities, despite increasing societal recognition that those with mental illness are not best served behind bars. Misdemeanors are an often-overlooked contributor to mass incarceration, and may be preventable for those with chronic severe mental illness.

Methods

This Northeast Florida pilot program, the Mental Health Offenders Program (MHOP), is based on the successful Miami Eleventh Circuit Court Criminal Mental Health Project. MHOP provided pretrial release from custody, through diversion with a …

Care Alert Program In Chronic Recurrent Ed Utilizing Patients, Kaitlyn Phelps, Jonathan Bryan, Jonathan Leggett, Erica Gibbons, Brian Griggs

HCA Healthcare Journal of Medicine

The Care Alert program is designed to help navigate encounters with patient populations that are high utilizers of emergency department (ED) resources. These populations often have chronic medical conditions, have a poor understanding of their conditions, are unfamiliar with the EDs’ role in the management of these conditions, and commonly lack outpatient resources. The Care Alert program intends to address the needs of this challenging patient population by designing individualized care plans that are approved through a multidisciplinary committee. Data from this study showed a 37% decrease in ED visits and a 47% decrease in hospitalizations during the initial 8 …

Examining Racial, Ethnic, And Gender Disparities In The Treatment Of Pain And Injury Emergencies, Laurel A. Wimbish, Janelle R. Simpson, Lauren R. Gilbert, Andria Blackwood, Emily A. Grant

HCA Healthcare Journal of Medicine

Background

Racial, ethnic, and gender disparities in effective pain management have been well-documented across healthcare settings. However, discrepancies in the treatment of patients in prehospital pain management settings have not been well researched. The objective of this study was to determine whether Wyoming emergency medical service (EMS) providers’ use of opioids to treat prehospital pain or injury varies by patient race/ethnicity or gender.

Methods

This cross-sectional study of EMS records examined 27 448 patient care reports (PCRs) generated during emergency medical responses to pain/injury emergencies in the state of Wyoming between January 2016 and March 2019. We included PCRs in …

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.

A Qualitative Inquiry On Smokers’ Perceptions Of Smoking Cessation During Covid-19, Sajid Iqbal, Rubina Barolia, Kiran Iftikhar, Pammla Petrucka, Jeniefer Anastasi, Faris Farooq Saeed Khan, Naheed Feroz Ali

School of Nursing & Midwifery

Background: This qualitative exploratory study explores smokers’ perspectives regarding smoking cessation processes amid the COVID-19 pandemic.
Methods: Purposive sampling was employed to conduct semi-structured interviews with cigarette smokers visiting cardiac and pulmonary clinics at a tertiary care hospital in Karachi, Pakistan. Thematic analysis was performed to identify themes from the participants’ responses.
Results: Three themes emerged from the thematic analysis. These were smoking cessation facilitators, smoking cessation barriers, and COVID-19 impacts on smoking cessation. Awareness and education, threat of acquiring health problems, religious beliefs and family or support system behave as smoking cessation facilitators. While, role modeling, associating smoking to …

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 …