Internal Medicine Commons^™

Hubungan Skor Rale Gambaran Foto Toraks Dengan Kadar D-Dimer Pada Pasien Covid-19, Marsa Zaidan, Arifin Arifin, Sulistyani Kusumaningrum, Ratih Tri Kusuma Dewi

Jurnal Penyakit Dalam Indonesia

Introduction. COVID-19 pneumonia caused by SARS-CoV-2 leads to extensive pulmonary infiltrates. The Radiographic Assessment of Lung Edema (RALE) score is a quantitative radiological tool to evaluate the severity of lung lesions. Meanwhile, elevated D-dimer levels reflect coagulation and fibrinolysis activation. This study aimed to analyze the correlation between the initial RALE score on chest radiography and D-dimer levels upon hospital admission.

Methods. An analytical observational study with a cross-sectional design was conducted on hospitalized COVID-19 patients at Dr. Moewardi Hospital, Surakarta, from March to July 2021. A total of 98 patients were selected via simple random sampling based …

Trends And Demographic Disparities In Septicemia-Associated Cardiac Arrest Mortality In The United States, 1999–2023, Muhammad Owais, Maham Mehfooz, Hamza Nazir, Preeti Advani, Roha Riaz, Khanij Arya, Javeria Nawaz, Syed Hadi Raza Rizvi, Murtaza Aslam, Usman Nazeer, Jairo Melo, Bravein Amalakuhan

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Atrial Fibrillation In Athletes: Mechanisms, Management, And Future Directions, Ibrahim Alameh, Ghina Al Fout, Michael D. Ezekowitz, Mohammed Kamareddine

Department of Medicine Faculty Papers

BACKGROUND: High-volume endurance training may shift exercise from cardioprotective to arrhythmogenic, increasing the risk of atrial fibrillation (AF) in healthy athletes.

CASE SUMMARY: A 38-year-old marathon runner with a 15-year history of high-intensity endurance training presented with episodic palpitations and reduced athletic performance. Electrocardiogram showed paroxysmal AF; echocardiography revealed mild left atrial enlargement without structural heart disease. Symptoms worsened during the recovery phase after runs, suggesting vagally mediated AF. After unsuccessful flecainide therapy, he underwent pulmonary vein isolation. Twelve months later, he remained free of recurrent AF on Holter monitoring and successfully resumed endurance training following an 8-week recovery period. …

Improving Sepsis Order Set Utilization Through Targeted Resident Education: A Lean Six Sigma Green Belt Quality Improvement Project, Sarah Sheikh, Puneeth Shridhar, Bushra Bangash, Valerie Chukelu, Tonya Meirhofer, Arunima Jose, Zainab Shakir, Shane Jenks, Augusto Sepulveda, Trung Nguyen, Rajeev Raghavan

Gulf Coast Division GME Research Day 2026

No abstract provided.

A Rare Case Of Invasive Group A Streptococcus Bacteremia, Extensive Streptococcal Myositis, And Septic Knee Arthritis, Cristina Lee, Morgan Seaton, Christina Mie Minami, Bailey Weidner, Dmitriy Scherbak

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Refractory Status Epilepticus After Hair Transplant: A Case Of Lidocaine Toxicity In A Post-Craniotomy Patient, Sarai Arbus, Cheyenne Lockwood, Max Wei, Andrew Labelle

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

More Than A Scratch: Capnocytophaga Bacteremia Induced Severe Sepsis With Multi-Organ Failure With Occupational Dog Exposure, Cristina Lee, Alex Craig, Dmitriy Scherbak

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Early Detection And Interventions For Delirium, Angel Ryals, Aneesha Shaju, Veronica Phung, Ijeoma Arubaleze

Gulf Coast Division GME Research Day 2026

No abstract provided.

Dry Gangrene Following Av Fistula Ligation For Vascular Access-Induced Steal Syndrome: A Case Report, Marium Batool Abbas, Umema Ifran, Marelle Montanez

Gulf Coast Division GME Research Day 2026

No abstract provided.

When Life Gives You Lemons: A Novel Approach To Refractory Hiccups, Caitlyn Brown, Alexandra Perry, Morgan Wright

South Atlantic Division GME Research Days 2026

No abstract provided.

The Rapid Case Of Anoxic Brain Injury Secondary To Hyperammonemia, Jacqueline Bekhit, Ngoc Vu, Jiaming Xue, Gabriella David, Qasim Sajawal

North Texas GME Research Forum 2026

Background: Acute hyperammonemia presents as a toxic state with the clinical presentation as altered consciousness, seizures, and coma. Hyperammonemia disrupts astrocytes osmotic balance via glutamine accumulation, triggering brain edema, inflammation, and apoptosis whom mechanism is closely parallel to hypoxic ischemic injury. This overlap necessitates differentiating metabolic causes from hypoxic etiologies, as timely ammonia clearance therapies can prevent catastrophic outcomes. This case underscores the need for close clinical vigilance and early recognition of severe hyperammonemia

Case Presentation: A 65-year-old woman with metabolic dysfunction-associated steatotic liver disease related cirrhosis complicated by recurrent ascites requiring bimonthly paracentesis presented with abdominal distension and pain. …

Termination Of A Fatal Malignant Arrhythmia By Treating Respiratory Alkalosis At The Ventilator: A Case Report, Thea Danielle Amadasun, Muhammed Salman Ullah, Vladimir Begilman

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

The Unlikely Case Of Sporadic Immune Thrombotic Thrombocytopenic Purpura With Refractory And Seizure-Like Activity Features: Case Report, Brandon Gremmer, Alain Folefack

North Texas GME Research Forum 2026

Introduction/Background: Thrombotic Thrombocytopenic Purpura (TTP) is a multisystem disease that can lead to multiorgan failure by disseminated mechanical destruction, microangiopathic hemolytic anemia, and thrombocytopenia. Most TTP cases are classified as acquired or hereditary; however, sporadic immune TTP with a refractory episode during the same hospital admission is not well documented in the literature. Furthermore, seizure-like activity during plasma exchange is not a common adverse effect.

Case Presentation: A 35-year-old African American female with no documented medical, surgical, or social history, changes to medications, or lifestyle changes presented with full body fatigue, fever, loss of balance, and confusion. On arrival, labs …

Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

Lemierre’S Syndrome With Copper Iud, Hemorrhagic Cyst, Septic And Hemorrhagic Shock, Kyle Distler, Alexander Sasso, Elizabeth Ryder, Suzanne Martinez, Nilmarie Guzman

South Atlantic Division GME Research Days 2026

No abstract provided.

Not Your Average Taco: Persistent Hypoxemia Beyond Volume Overload, Caroline Byrd, Mohamed Faris

South Atlantic Division GME Research Days 2026

No abstract provided.

Intracranial Mycotic Aneurysm With Subarachnoid Hemorrhage: A Rare Neurologic Presentation Of Streptococcus Constellatus Bacteremia, Matthew R. Corn, Grace Fawcett, Cooper Alden Josephs, Matthew Mcginty, Ellie Stark, Thomas Horton

South Atlantic Division GME Research Days 2026

No abstract provided.

Polisitemia Sekunder Pada Pasien Laki-Laki Muda Dengan Sindrom Nefrotik, Ariani Intan Wardhani, Pringgodigdo Nugroho, Ikhwan Rinaldi, Meilania Sarasawati, Monik Ediana Miranda, Agnes Stephanie Harahap

Jurnal Penyakit Dalam Indonesia

Polycythemia is a condition characterized by an abnormal increase in the total red blood cell mass and is classified into primary and secondary polycythemia. Secondary polycythemia occurs as a physiological response to tissue hypoxia or increased erythropoietin production, without intrinsic abnormalities in erythroid progenitor cells. This condition is rare, particularly when associated with nephrotic syndrome. This report aims to describe a case of secondary polycythemia associated with focal segmental glomerulosclerosis (FSGS). A 20-year-old man presented with generalized edema for five months prior to admission, accompanied by foamy urine. Physical examination revealed peripheral edema and minimal ascites. Laboratory investigations demonstrated massive …

Delayed Diagnosis Of Systemic Lupus Erythematosus Presenting As Autoimmune Hemolytic Anemia: A Case For Heightened Clinical Suspicion, Diana Acosta Pozo, Luis Álvarez Pérez

Research Colloquium

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem involvement, including hematologic manifestations. Autoimmune Hemolytic Anemia (AIHA), though an established feature, is relatively uncommon and may occur early or in isolation. When AIHA presents without overt systemic symptoms, the underlying autoimmune etiology may be overlooked, resulting in delays in diagnosis and treatment. Prompt recognition is essential to prevent unnecessary interventions and prolonged morbidity.

Case Presentation: A 39-year-old woman residing in Texas presented to the Rheumatology office with persistent synovitis and severe transfusion-dependent anemia, requiring red blood cell transfusions every 48 hours for over three months. She …

A Puzzling Case Of Visual Disturbances Leads To A Fatal Neurodegenerative Diagnosis, Courtney J. Austin, Aaron Carrillo, Jennifer Rojas Huen, Victoria Parada

Research Colloquium

Background: Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative disease in which early diagnosis is complicated by the presence of early non-specific and atypical presentations. Sporadic CJD (sCJD), the most common type of CJD, is caused by the spread of a disease-forming prion known as PrPSc. PrPSc multiplies and binds to the normal form of prion, or PrP, converting it to an abnormal, structurally altered disease form that spreads throughout the brain. sCJD can initially present with six different phenotypes: cognitive, affective, classic, visual (Heidenhain variant), atactic (Oppenheimer-Brownell variant), and indeterminate. The classic presentation of CJD includes rapidly progressive dementia with …

Retrieval Of An Embolized Left Atrial Appendage Occluder From The Aortic Arch Using A Transcatheter Retrieval Device, Juan Siordia, Hussam Al Hennawi, Muhammad Sabri, Daniel Ice, Ronald Ross, Sheena Rastogi, Chunguang Chen, Richard Kovach, Muhammad Raza

Abington Jefferson Health Papers

BACKGROUND: Device embolization is a recognized complication of left atrial appendage occlusion (LAAO) procedures, with outcomes depending on the location of the embolized device and patient management.

CASE SUMMARY: A 70-year-old male with atrial fibrillation underwent LAAO due to high bleeding risk. Postoperative surveillance revealed an Amplatzer Amulet device embolized in the transverse arch of the aorta. The patient remained asymptomatic, and transcatheter retrieval was planned. A percutaneous approach was used with the ONOCOR system and snare devices with successful retrieval. The patient recovered without complications and remained stable at follow-up.

DISCUSSION: Device embolization often presents challenges, with clinical outcomes …

The Acute Care Mobility Assessment Is A Promising Tool For Evaluating Day-To-Day Mobility In Clinical Settings: Linguistic And Convergent-Validity In Danish Geriatric Patients, Britt Stævnsbo Pedersen, Lea Kromann Johansen, Thomas Kallemose, Thomas Bandholm, Cynthia J. Brown, Mette Merete Pedersen

School of Medicine Faculty Publications

Objective: Low in-hospital mobility is highly prevalent and can cause hospital-associated-disability. In both research and clinical care, valid and reliable outcome measures of in-hospital mobility are necessary. The Acute Care Mobility Assessment (ACMA) provides a single measure of hospital out-of-bed mobility and may be a promising tool. The purpose of this study was to perform a cross-cultural validation to facilitate international uptake. Methods: We performed a linguistic validation (translation, cognitive interviewing, cultural adaptation) of the ACMA in Denmark and investigated the convergent-validity of the Danish version (ACMA-DK) in older hospitalized (+65) Danish adults by evaluating the correlation between the ACMA-DK …

Slow-Growing Lung Mass In A Patient With Multiple Endocrine Neoplasia Type I: Consider Carcinoid Tumor, Ramin Talebi, Charalambos C. Solomides, Nathaniel R. Evans Iii, Gregory C. Kane

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

A 23-year-old man with multiple endocrine neoplasia type 1 (MEN 1) with pancreatic tail masses and Cushing syndrome (status after transsphenoidal adenomectomy) presented with a slow-growing, asymptomatic right lower lung lobe mass confirmed to be an atypical carcinoid tumor by pathologic staging following successful basilar segmentectomy with mediastinal lymphadenectomy. Pulmonary carcinoid tumor (PCT) is a rare neoplasm in patients with MEN 1, but there is limited data on trends in atypical versus typical carcinoid tumors in these patients. This case emphasizes the need to characterize these trends given the implications for metastatic potential and 5-year survival, which can help guide …

Efficacy Of Neuromuscular Ultrasound In Diagnosing And Treating A Mammogram-Induced Brachial Plexus Injury-A Case Report, Jaime Dougherty, Tyler Pigott, Altamash E Raja

Rowan-Virtua School of Osteopathic Medicine Departmental Research

A 40-year-old woman presented with chronic left anterior shoulder, upper arm, and axillary pain following a routine mammogram 3 years prior. Despite multiple interventions, her pain persisted significantly affecting her quality of life. Ultrasound examination revealed fascicular edema in the medial brachial cutaneous nerve (MBCN), intercostobrachial cutaneous nerve (ICBN), and a positive sono-Tinel. Ultrasound-guided hydrodissection of these nerves provided complete axillary pain relief and significant improvement in anterior arm pain, sustained for 6 months. This case highlights the diagnostic challenges of cutaneous nerve entrapment syndromes, often overlooked and misdiagnosed, especially without a clear inciting injury. Ultrasound proves superior to electrodiagnostic …

Early Celiac Plexus Block In Metastatic Pancreatic Cancer, Brian Fardman, Christina Sheedy, Joshua Raymond

Rowan-Virtua Research Day

Both Early and Delayed Celiac Plexus Blocks (CPBs) have been used in pancreatic cancer. Early CPB is completed when criteria for CPB is initially met, whereas Delayed CPB is implemented only after recalcitrant pain persists. We describe the benefit of early CPB in pancreatic cancer management.

Outcomes Of Left Atrial Appendage Occlusion In Patients With Obstructive Sleep Apnea: A Comprehensive National Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

We sought to explore a sample of the inpatient population with OSA with AF who underwent LAAO.

Case Report: A Case Of Tracheal Perforation, Cyrus Davati, Eric Maddock

Rowan-Virtua Research Day

Here we present the case of a 93-year-old female with a past medical history of arthritis and dementia who came to the hospital for a change in mental status and decreased responsiveness at home. The patient was intubated at home by EMS secondary to continued respiratory distress. The patient had a history of a productive cough over the past three days. The patient arrived at the emergency department with continued respiratory failure. During the ED evaluation, the patient was noted to have tracheal rupture. The patient was admitted to the ICU for severe sepsis and continued on broad spectrum IV …

Clinical Outcomes For Patients With Ventilator-Associated Pneumonia In Octogenarians, Nonagenarians, And Centenarians: A Population-Based Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

We sought to examine the national inpatient sample data-base to describe in-hospital outcomes among patients over seventy who acquire ventilator-associated pneumonia after being on the ventilator for over 48 hours.

Case Report: When Confusion Signals A Crisis: Rethinking The Diagnosis Of Meningitis In Geriatric Sepsis, Asma Zahid

Rowan-Virtua Research Day

We report the case of an 88-year-old female who presented with altered mental status, initially suspected to have urosepsis but ultimately diagnosed with streptococcal meningitis. The patient had a history of lethargy and anorexia over the past few days and was found to have sepsis. Despite initial focus on urosepsis, blood cultures revealed Streptococcus, and cerebrospinal fluid analysis confirmed bacterial meningitis. This case highlights the potential for meningitis to be overlooked in elderly patients with suspected sepsis, underscoring the importance of broad diagnostic considerations and early intervention. This case highlights the importance of considering meningitis in elderly patients presenting with …

Meta-Analysis On Sex Differences In Mortality And Neurodevelopment In Congenital Heart Defects, Alyssa K Crain, Zhia N Lim, Chloe J Sarfatis, Magela Arias, Travis Holder, Alvaro G Moreira, Antonio F Corno, Tina O Findley

Faculty, Staff and Student Publications

Given the increasing survival rates among congenital heart disease (CHD) patients and the growing emphasis on their quality of life, there is a need to comprehensively assess the impact of surgical interventions on neurodevelopmental outcomes. With increasing awareness in sex-related disparities in CHD, there is a need to explore potential differences in surgical mortality and neurodevelopmental outcomes between male and female patients. In this systematic review, we adhered to PRISMA guidelines and PROSPERO registration (#CRD42021225610). Articles published from 2015 to 2021 were searched using MeSH descriptors in three major databases (MEDLINE Ovid, Elsevier Embase, and Cochrane Library). Study selection criteria …