Internal Medicine Commons^™

Comparison Of Brain Nicotine Uptake From Electronic Cigarettes And Combustible Cigarettes, Yantao Zuo, Alexey G Mukhin, Hannah Berg, Janiece D Morgan, Akiva Mintz, Jed E Rose, Kiran Kumar Solingapuram Sai

Faculty, Staff and Student Publications

Brain accumulation rate and magnitude are critical for the acute reinforcing effects of nicotine. Despite electronic cigarettes’ (E-cigs) appeal as substitutes for traditional combustible cigarettes (C-cigs), brain nicotine accumulation (BNA) from E-cigs has not been compared with that from C-cigs using a within-subjects design. BNA was directly assessed with 16 adult dual users (10 females) of E-cigs (e-liquid pH 9.4) and C-cigs, using 11C-nicotine and positron emission tomography (PET). Participants went through two 15-min head scanning sessions during which they inhaled a single puff of E-cig vapor or C-cig smoke containing 11C-nicotine in a randomized order. A full-body scan was …

Role Of Sam68 In Sunitinib Induced Renal Cell Carcinoma Apoptosis, Zeshen Wu, Yulu Peng, Longbin Xiong, Jun Wang, Zhen Li, Kang Ning, Minhua Deng, Ning Wang, Wensu Wei, Zhiyong Li, Pei Dong, Chunping Yu, Fangjian Zhou, Zhiling Zhang

Faculty, Staff and Student Publications

Sunitinib is one of the first-line targeted drugs for metastatic renal cell carcinoma (RCC) with dual effects of antiangiogensis and proapoptosis. Sam68 (Src-associated in mitosis, 68 KDa), is found being involved in cell apoptosis. This article reveals that Sam68 impacts the sensitivity to sunitinib by mediating the apoptosis of RCC cells. Immunohistochemical staining indicated that the Sam68 expression levels in sunitinib sensitive tumor tissues were markedly higher than those in sunitinib resistant tumor tissues. Sunitinib induced RCC cell apoptosis in a concentration-dependent manner and inhibited the expression of total and phosphorylated Sam68 (p-Sam68). Downregulation of Sam68 expression inhibited RCC cell …

Selective Iga Deficiency In Spontaneously Hypertensive Rats With Gut Dysbiosis, Piu Saha, Blair Mell, Rachel M Golonka, Venugopal R Bovilla, Ahmed A Abokor, Xue Mei, Beng San Yeoh, Peter A Doris, Andrew T Gewirtz, Bina Joe, Matam Vijay-Kumar

Faculty, Staff and Student Publications

BACKGROUND: The spontaneously hypertensive rat (SHR) is extensively used to study hypertension. Gut microbiota dysbiosis is a notable feature in SHR for reasons unknown. Immunoglobulin A (IgA) is a major host factor required for gut microbiota homeostasis. We hypothesized that inadequate IgA contributes to gut microbiota dysbiosis in SHR.

METHODS: IgA was measured in feces, cecum, serum, liver, gut-associated lymphoid tissue, and milk from SHR and Wistar Kyoto rats. IgA regulatory factors like IgM, IgG, and

RESULTS: Compared with Wistar Kyoto rats, SHR displayed remarkably near-deficient IgA levels accompanied by compensatory increases in serum IgM and IgG and gut-liver

CONCLUSIONS: …

Effect Of Nintedanib On Progression Of Systemic Sclerosis-Associated Interstitial Lung Disease Over 100 Weeks: Data From A Randomized Controlled Trial, Shervin Assassi, Oliver Distler, Yannick Allanore, Takashi Ogura, John Varga, Serena Vettori, Bruno Crestani, Florian Voss, Margarida Alves, Susanne Stowasser, Toby M Maher

Faculty, Staff and Student Publications

Objective: In the SENSCIS trial, participants with systemic sclerosis-associated interstitial lung disease (SSc-ILD) were randomized to receive nintedanib or placebo until the last participant reached week 52 but for 100 weeks or less. Nintedanib reduced the rate of decline in forced vital capacity (FVC) (ml/year) over 52 weeks by 44% (41 ml [95% confidence interval (95% CI): 2.9-79.0]) versus placebo. We investigated the effect of nintedanib over the whole SENSCIS trial.

Methods: The annual rate of decline in FVC (ml/year) over the whole trial was assessed descriptively using 1) on-treatment data plus off-treatment data from participants who prematurely discontinued treatment …

Ags And Nia Bench-To Bedside Conference Summary: Cancer And Cardiovascular Disease, Supriya Mohile, Caroline S Blaum, Peter M Abadir, William Dale, Daniel E Forman, Chunkit Fung, Holly M Holmes, Javid Moslehi, Karen M Mustian, Michael W Rich, Heather E Whitson

Faculty, Staff and Student Publications

This report summarizes the presentations, discussions, and recommendations of the most recent American Geriatrics Society and National Institute on Aging research conference, "Cancer and Cardiovascular Disease," on October 18-19, 2021. The purpose of this virtual meeting was to address the interface between cancer and heart disease, which are the two leading causes of death among older Americans. Age-related physiologic changes are implicated in the pathogenesis of both conditions. Emerging data suggest that cancer-related cardiovascular disease (CVD) involves disrupted cell signaling and cellular senescence. The risk factors for CVD are also risk factors for cancer and an increased likelihood of cancer …

Mesenchymal Stromal Cells For The Treatment Of Alzheimer’S Disease: Strategies And Limitations, Shobha Regmi, Daniel Dan Liu, Michelle Shen, Bhavesh D Kevadiya, Abantika Ganguly, Rosita Primavera, Shashank Chetty, Reza Yarani, Avnesh S Thakor

Faculty, Staff and Student Publications

Alzheimer's disease (AD) is a major cause of age-related dementia and is characterized by progressive brain damage that gradually destroys memory and the ability to learn, which ultimately leads to the decline of a patient's ability to perform daily activities. Although some of the pharmacological treatments of AD are available for symptomatic relief, they are not able to limit the progression of AD and have several side effects. Mesenchymal stem/stromal cells (MSCs) could be a potential therapeutic option for treating AD due to their immunomodulatory, anti-inflammatory, regenerative, antioxidant, anti-apoptotic, and neuroprotective effects. MSCs not only secret neuroprotective and anti-inflammatory factors …

False Positive Anti-Topoisomerase I (Scl-70) Antibody Results In Clinical Practice: A Case Series From A Scleroderma Referral Center, Brian H Lam, Shervin Assassi, Julio Charles, Rana Taherian, Marka A Lyons, Bochra Jandali, Maureen D Mayes, Brian Skaug

Faculty, Staff and Student Publications

PURPOSE: To determine if some patients who tested positive for anti-Scl-70 antibody in clinical practice, but did not have classifiable systemic sclerosis, were negative for anti-Scl-70 antibody by the more specific immunodiffusion method of testing.

METHODS: Patients evaluated by a rheumatologist at a Scleroderma referral center who had tested positive for anti-Scl-70 antibody prior to referral, but did not have classifiable SSc based on clinical criteria, were invited to undergo testing for anti-Scl-70 antibody by immunodiffusion. Patient demographics and clinical features were recorded at the time of their evaluation, and diagnostic testing results were reviewed using the medical records.

RESULTS: …

Cardio-Onco-Metabolism – Metabolic Vulnerabilities In Cancer And The Heart, Anja Karlstaedt, Heinrich Taegtmeyer

Faculty, Staff and Student Publications

Cancer and cardiovascular diseases (CVDs) are the leading cause of death worldwide. Metabolic remodeling is a hallmark of both cancer and the failing heart. Tumors reprogram metabolism to optimize nutrient utilization and meet increased demands for energy provision, biosynthetic pathways, and proliferation. Shared risk factors for cancer and CVDs suggest intersecting mechanisms for disease pathogenesis and progression. In this review, we aim to highlight the role of metabolic remodeling in cancer and its potential to impair cardiac function. Understanding these mechanisms will help us develop biomarkers, better therapies, and identify patients at risk of developing heart disease after surviving cancer.

Sex Differences In Clinical Outcomes And Biological Profiles In Systemic Sclerosis-Associated Interstitial Lung Disease: A Post-Hoc Analysis Of Two Randomised Controlled Trials, Elizabeth R Volkmann, Donald P Tashkin, Richard Silver, Carol Feghali Bostwick, Shervin Assassi, Deanna Baker Frost, Mei Leng, Holly Wilhalme, Grace Hyun Kim, Jonathan Goldin, Michael D Roth

Faculty, Staff and Student Publications

BACKGROUND: Observational studies have shown that men with systemic sclerosis have an increased risk of interstitial lung disease (ILD) and mortality compared with women. However, previous studies have not controlled for treatment effect or evaluated the biological mechanism or mechanisms underlying this sex difference. We aimed to compare ILD progression and long-term morbidity and mortality outcomes in male and female participants of two randomised controlled trials for systemic sclerosis-associated ILD.

METHODS: For this post-hoc analysis, data from all participants in the Scleroderma Lung Study (SLS) I and SLS II were analysed. The primary objective was to explore the effect of …

The Impact Of Intraoperative Glucagon On The Diagnostic Accuracy Of Intraoperative Cholangiogram For The Diagnosis Of Choledocholithiasis: Experience From A Large Tertiary Care Center, Artem Boyev, Srinivas Sanjeevi, Martha M Estrada, Tien C Ko, Curtis J Wray

Faculty, Staff and Student Publications

INTRODUCTION: In response to the COVID-19 pandemic, hospitals reported decreased admissions for acute surgical diagnoses, but scant data was available to quantify the decrease and its consequences. The objective of this study was to examine the incidence of acute care surgery encounters before and during the COVID-19 pandemic.

MATERIALS AND METHODS: A retrospective cohort study was performed at a single, urban, United States safety-net hospital. Emergency room encounters, admissions, non-elective surgical procedures, patient acuity, and surgical complications were compared before and after the start of the COVID-19 pandemic. The primary outcome of the study was the incidence rate (IR) and …

The Association Of Baseline Plasma Sars-Cov-2 Nucleocapsid Antigen Level And Outcomes In Patients Hospitalized With Covid-19, Activ-3/Tico Study Group, Angela J Rogers, Deborah Wentworth, Andrew Phillips, Katy Shaw-Saliba, Robin L Dewar, Neil R Aggarwal, Abdel G Babiker, Weizhong Chang, Nila J Dharan, Victoria J Davey, Elizabeth S Higgs, Norman Gerry, Adit A Ginde, J W Awori Hayanga, Helene Highbarger, Jeroen L Highbarger, Mamta K Jain, Virginia Kan, Kami Kim, Perrine Lallemand, Bradley G Leshnower, Joseph K Lutaakome, Gail Matthews, Ahmad Mourad, Eleftherios Mylonakis, Ven Natarajan, Maria L Padilla, Lavannya M Pandit, Roger Paredes, Sarah Pett, Srikanth Ramachandruni, M Tauseef Rehman, Brad T Sherman, D Clark Files, Samuel M Brown, Michael A Matthay, B Taylor Thompson, James D Neaton, H Clifford Lane, Jens D Lundgren

Faculty, Staff and Students Publications

BACKGROUND: Levels of plasma SARS-CoV-2 nucleocapsid (N) antigen may be an important biomarker in patients with COVID-19 and enhance our understanding of the pathogenesis of COVID-19.

OBJECTIVE: To evaluate whether levels of plasma antigen can predict short-term clinical outcomes and identify clinical and viral factors associated with plasma antigen levels in hospitalized patients with SARS-CoV-2.

DESIGN: Cross-sectional study of baseline plasma antigen level from 2540 participants enrolled in the TICO (Therapeutics for Inpatients With COVID-19) platform trial from August 2020 to November 2021, with additional data on day 5 outcome and time to discharge.

SETTING: 114 centers in 10 countries. …

Prevalence And Predictors Of Urine Culture Contamination In Primary Care: A Cross-Sectional Study, Michael A Hansen, Marissa Valentine-King, Roger Zoorob, Matthew Schlueter, Jennifer L Matas, Samuel E Willis, Lisa C K Danek, Kenneth L Muldrew, Mohammad Zare, Forrest Hudson, Robert L Atmar, Andrew Chou, Barbara W Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

BACKGROUND: Antimicrobial resistance is a global health threat. To slow resistance and preserve antibiotics, stewardship interventions are increasingly promoted and mandated. Urine cultures are the most common microbiological test in the outpatient setting. Contamination most likely occurs during urine collection from surrounding vaginal, perineal, and epidermal flora. Sample contamination can lead to incorrect diagnosis, unnecessary or inappropriate treatment, poor patient outcomes, and higher costs. Therefore, ensuring proper collection of urinary samples serves as a prime diagnostic stewardship target, one that international nursing societies increasingly endorse as an opportunity for nurse involvement.

OBJECTIVES: Determine the prevalence, predictors, and antibiotic prescribing associated …

First Steps: Primary Outcomes Of A Randomized, Stepped-Care Behavioral Clinical Trial For Parents Of Young Children With New-Onset Type 1 Diabetes, Marisa E Hilliard, Carrie Tully, Maureen Monaghan, Tom Hildebrandt, Christine H Wang, John R Barber, Lauren Clary, Katherine Gallagher, Wendy Levy, Fran Cogen, Celia Henderson, Lefkothea Karaviti, Randi Streisand

Faculty, Staff and Students Publications

OBJECTIVE: Despite the emotional challenges of parental adjustment to a child's type 1 diabetes diagnosis and the unique complexities of early childhood, there are few programs designed to meet the needs of parents of young children at new onset. This study evaluated First STEPS (Study of Type 1 in Early childhood and Parenting Support), a stepped-care behavioral intervention designed to support parents' psychosocial functioning and promote children's glycemic outcomes.

RESEARCH DESIGN AND METHODS: Using a two-site randomized clinical trial design, parents (n = 157) of children aged 1-6 years completed baseline data within 2 months of diabetes diagnosis and were …

Dampak Pandemi Covid-19 Terhadap Mahasiswa Kedokteran, Amanda P. Utari

Jurnal Penyakit Dalam Indonesia

No abstract provided.

The Assossiation Between Stress During The Covid-19 Pandemic And The Incidence Of Dyspepsia Syndrome In The First Year Medical Students, Wahida Rahmi, Yulistini Yulistini, Arina Widya Murni

Jurnal Penyakit Dalam Indonesia

Introduction. Dyspepsia syndrome is a collection of symptoms in the upper digestive tract associated with dysregulation of the hypothalamus-hypophysis axis that is triggered by stress. One of the problems faced in the world today is the COVID-19 pandemic which can be a new stressor, especially for students with many changes in the learning process. This study aimed to examine the relationship between stress during the COVID-19 pandemic and the incidence of dyspepsia syndrome.Methods. An analytic obsevasional with cross-sectional design was conducted in April-June 2021 at the Faculty of Medicine, Andalas University. The subjects of this study were the first batch …

Lactate/Albumin Ratio As A Predictor Of Mortality In Patients With Sepsis And Septic Shock: A Meta-Analysis Study, Fahri Ahmad Baihaqi, Dinda Olinda Delarosa, Rezki Ramadhan

Jurnal Penyakit Dalam Indonesia

Introduction. The lactate/albumin ratio is an inflammatory biomarker that has been widely used and suggested as a predictor of mortality in patients with sepsis and septic shock. However, the results are inconsistent. This meta-analysis aimed to evaluate the prognostic value of lactate/albumin ratio as a predictor of mortality in patients with sepsis and septic shock.Methods. The study protocol was registered with PROSPERO (CRD42021286242). A literature search was performed using PubMed, Ovid EMBASE, Ovid MEDLINE, SCOPUS, and Web of Sciences to find all studies evaluating the association between lactate/albumin ratio and mortality in patients with sepsis and septic shock. Meta-analysis was …

Effectivity Of Acupuncture Therapy In Reduction Of Pain Intensity In Cancer Pain, Hanna Lianti Affadhia, Rahmat Cahyanur, Sri Wahdini, Andhika Rachman

Jurnal Penyakit Dalam Indonesia

Pain is one of the most common complaints and interferes with the quality of life of cancer patients. Several studies recommend multimodal interventions that combine pharmacological and non-pharmacological therapies. Acupuncture therapy is one of the non-pharmacological treatment options that could be considered. This evidence-based case report aimed to examine the effectiveness of acupuncture therapy in reducing pain intensity in patients with cancer pain. Literature searching was performed on three databases (PubMed, Scopus, and Embase). The keywords used are cancer pain, malignant pain, acupuncture, acupuncture therapy, pain intensity, pain assessment, pain scale. The critical review was carried out using guidelines from …

Risk Factors Analysis For Gastroesophageal Reflux Disease In Covid-19 Pandemic Era On Resident Physicians Faculty Of Medicine Brawijaya University, Pandu Tridana Sakti, Syifa Mustika

Jurnal Penyakit Dalam Indonesia

Introduction. Resident physicians have a high risk of GERD due to excessive fatigue especially during a COVID-19 pandemic. However, research on resident physicians risk factors for the incidence of GERD in the COVID-19 pandemic era has never been conducted. This study aimed to analyze the risk factors for GERD in the era of the COVID-19 pandemic on resident physicians.

Methods. This study used an analytic observational design with a cross sectional approach. Subjects were resident physicians in clinical and pre-clinical stage at the Faculty of Medicine Brawijaya University which were selected using random sampling method. Questionnaires were given …

Kasabach-Merritt Syndrome In Liver Hemangioma: A Case Report, Michelle Frastica, Rudi Putranto, Chyntia Olivia Maurine Jasirwan, Kresna Adhiatma

Jurnal Penyakit Dalam Indonesia

Hemangioma is the most common congenital benign liver tumor. It affects mostly female, with the incidence of 0.4- 20%. Giant liver hemangioma induce the Kasabach Merritt syndome, a life threathening coagulation disorder which occur due to consumptive coagulopathy: trombocyte sequestration and agregation inside the hemangioma. The mortality rate is around 60%, with the most common cause is multiorgan complication which may end up with sepsis. The core management is hemangioma decompression by surgical measure. However, this often considered as a very risky procedure leading to massive bleeding. In most cases, conservative treatment is the preferred option. It is important to …

Prevalence Of Geriatric Syndromes In Elderly Undergoing Chemotherapy, Aulia Rizka, Helda Helda, Findy Prasetyawaty, Arcita Hanjani

Jurnal Penyakit Dalam Indonesia

Introduction. Geriatric syndromes is associated with poor survival, poor quality of life and increased chemotoxicity risk in elderly receiving chemotherapy. Geriatric syndromes is currently not routinely evaluated in pre-chemotherapy clinical setting. This study aimed to identify the prevalence of some geriatric syndromes in elderly patients undergoing chemotherapy.Methods. This study is part of primary study investigating geriatric syndromes in elderly with cancer. A descriptive cross sectional study during March 2020 – March 2021 was conducted to elderly patients before chemotherapy administration in Cipto Mangunkusumo Hospital, a national referral hospital in Jakarta. Patients were recruited consecutively. Patients underwent Comprehensive Geriatric Assesment (CGA), …