Internal Medicine Commons^™

Dronedarone For Atrial Fibrillation Prophylaxis In Patients Undergoing Open Heart Surgical Interventions: A Case Series, Jay D. Patel, Mrhaf Alsamman, Dewansh Goel, Sai Gudduru, Rakesh Prashad

Journal of Community Hospital Internal Medicine Perspectives

Atrial fibrillation (a-fib) is one of the most frequently encountered and studied arrhythmias in medicine. The presence of A-fib in the post-operative period of coronary artery bypass graft (CABG) surgery is of particular concern for clinicians as this presents risks of post-operative stroke, hospital readmission, or anticoagulation dilemmas depending on the patient’s comorbidities. In this case study, we present 5 patients who were treated with dronedarone prior to undergoing open heart procedures. We subsequently followed each patients clinical course paying close attention for any evidence of post-operative a-fib.

Extranodal Rosai-Dorfman Disease- A Review Of Diagnostic Testing And Management., Imad Ud Deen, Abhinandan Chittal, Nabil Badro, Robert Jones, Christopher Haas

Journal of Community Hospital Internal Medicine Perspectives

Rosai-Dorfman disease (RDD) is a rare, benign histiocytic proliferative disorder primarily occurring in the lymph nodes. Extranodal disease can occur in skin and soft tissue, central nervous system, gastrointestinal tract, and breast. Here we present a case of a 55-year-old female with a history of hypertension, hyperlipidemia, and diabetes mellitus who presented with a fixed solid mass localized to the right medial thigh. Excision revealed S100 and CD 68 positive scattered lymphoid aggregates and emperipolesis, hallmark molecular and cytopathologic features of RDD. RDD is a nonmalignant, classically sporadic histiocytosis. Clinical outcome in terms of mortality seems to be favorable in …

Laboratory Findings In Covid-19 - Alterations Of Hematological, Immunological, Biochemical, Hormonal And Other Lab Panels: A Narrative Review, Yousef Rasmi, Lucas Paulo Jacinto Saavedra, Matei-Alexandru Cozma, Heba El-Nashar, Shaza Aly, Nouran Fahmy, Omayma Eldahshan, Mohamed El-Shazly, Elena Codruța Dobrică, Hamed Kord-Varkaneh, Camelia Cristina Diaconu, Mihnea Alexandru Găman

Journal of Mind and Medical Sciences

Up to the present date, according to the official reports of the World Health Organization (WHO), 205,338,159 patients have been confirmed with the coronavirus disease (COVID-19) and 4,333,094 have died as a consequence of this infectious disorder. The majority of COVID-19 patients will develop hematological, biochemical, immunological, hormonal and other complex alterations of their laboratory data which may be diagnosed using different biomarkers. In this paper, we review the alterations of the hematology, immunology, biochemistry, hormonal and other laboratory panels discovered in the subjects diagnosed with SARS-CoV-2 infection, based on the available data in the literature.

The Involvement Of Oxidative Stress In Non-Hodgkin’S Lymphomas; A Review Of The Literature, Ramona Ingrid Corbeanu, Amelia Maria Găman

Journal of Mind and Medical Sciences

Non-Hodgkin’s malignant lymphomas are a heterogeneous group of hematological malignancies, characterized by a variety of clinical, morphological, histopathological, immuno-histochemical, molecular and evolutionary features. They represent a form of cancer that develops from the lymphatic tissue, as a result of the malignant transformation of B (85%) or T (15%) lymphocytes. Lymphomagenesis is described as a multi-stage process involving the mutation and proliferation of cell clones. Oxidative stress is defined as an imbalance of cellular redox status caused by the production of reactive oxygen species (ROS) and/ or by decreasing antioxidant systems that allows their accumulation in the cell. Small quantities of …

Envisioning Future Urinary Tract Infection Diagnostics, Robin Patel, Christopher R Polage, Jennifer Dien Bard, Larissa May, Francesca M Lee, Valeria Fabre, Mary K Hayden, Sarah D B Doernberg, David A Haake, Barbara W Trautner, Larissa Grigoryan, Ephraim L Tsalik, Kimberly E Hanson

Faculty, Staff and Students Publications

Urinary tract infections (UTIs) are among the most common bacterial infections in the United States and are a major driver of antibiotic use, both appropriate and inappropriate, across healthcare settings. Novel UTI diagnostics are a strategy that might enable better UTI treatment. Members of the Antibacterial Resistance Leadership Group Laboratory Center and the Infectious Diseases Society of America Diagnostics Committee convened to envision ideal future UTI diagnostics, with a view towards improving delivery of healthcare, patient outcomes and experiences, and antibiotic use, addressing which types of UTI diagnostics are needed and how companies might approach development of novel UTI diagnostics.

Safety And Efficacy Of Colchicine In Covid-19 Patients: A Systematic Review And Meta-Analysis Of Randomized Control Trials, Farah Yasmin, Hala Najeeb, Abdul Moeed, Wardah Hassan, Mahima Khatri, Muhammad Sohaib Asghar, Ahmed Kunwer Naveed, Waqas Ullah, Salim Surani

Department of Medicine Faculty Papers

Background: Colchicine has been used an effective anti-inflammatory drug to treat gout diseases. Owing to its pharmacodynamic of inhibiting interleukins, it has been repurposed to target the cytokine storm post-SARS-CoV-2 invasion. The goal of this meta-analysis was to evaluate the safety profile of colchicine in COVID-19 patients using the gold-standard randomised-control trials.

Methods: Electronic databases (Pubmed, Google Scholar, and Cochrane) were systematically searched until June 2021 and RCTs were extracted. Outcomes of interest included all-cause mortality, COVID-19 severity, mechanical ventilation, C-reactive protein and D-dimer levels. Using a random-effects model, dichotomous outcomes were pooled using odds ratios (OR) through the generic …

Perceptions Of Weight Status And Energy Balance Behaviors Among Patients With Non-Alcoholic Fatty Liver Disease, Natalia I Heredia, Ruchi Gaba, Yan Liu, Shilpa Jain, Manasi Rungta, Manav Rungta, Hashem B El-Serag, Fasiha Kanwal, Aaron P Thrift, Maya Balakrishnan

Faculty, Staff and Students Publications

Weight loss through behavioral modification is central to treating non-alcoholic fatty liver disease (NAFLD). To achieve this, patients need to accurately self-perceive their health behaviors. We aimed to identify predictors of concordance between self-perception and objective measures of body weight, physical activity (PA) and dietary behaviors. We used data from the Harris County NAFLD Cohort, an ongoing prospective study in a regional safety-net healthcare system. Patients completed self-administered baseline questionnaires on demographics, diet, PA, and self-perceptions. We assessed concordance between actual and self-perceived body weight and energy-balance behaviors. Multivariable logistic regression identified predictors of concordance. Patients (n = 458; average …

The Nephrocheck Bedside System For Detecting Stage 3 Acute Kidney Injury After Open Thoracoabdominal Aortic Repair, Mark Hwang, Michael H Weisman

Faculty, Staff and Student Publications

No abstract provided.

Hiv-Associated Nephropathy Presenting As The First Manifestation Of Hiv-2 Infection, Kamil Sardarli, Rania Daboul, Sumesh Khanal, Sami Zarouk

Conference Presentation Abstracts

HIV-2 is distinguished from HIV-1 with low virulence, longer asymptomatic period, slower decline in CD4 count, low viral load, and low mortality from AIDS. While the kidney pathology associated with HIV-1 is well established, due to its low prevalence, kidney pathology in HIV-2 is not well documented. We report a case of HIV associated nephropathy (HIVAN) as the first presentation in a patient with HIV-2. A 65 year old man from Ghana presented within a few days of arrival to the United States with nausea, loss of appetite, shortness of breath, and bilateral lower extremity edema. He has a past …

Exposure To Per- And Polyfluoroalkyl Substances And Markers Of Liver Injury: A Systematic Review And Meta-Analysis, Elizabeth Costello, Sarah Rock, Nikos Stratakis, Sandrah P Eckel, Douglas I Walker, Damaskini Valvi, Dora Cserbik, Todd Jenkins, Stavra A Xanthakos, Rohit Kohli, Stephanie Sisley, Vasilis Vasiliou, Michele A La Merrill, Hugo Rosen, David V Conti, Rob Mcconnell, Leda Chatzi

Faculty, Staff and Students Publications

BACKGROUND: Experimental evidence indicates that exposure to certain pollutants is associated with liver damage. Per- and polyfluoroalkyl substances (PFAS) are persistent synthetic chemicals widely used in industry and consumer products and bioaccumulate in food webs and human tissues, such as the liver.

OBJECTIVE: The objective of this study was to conduct a systematic review of the literature and meta-analysis evaluating PFAS exposure and evidence of liver injury from rodent and epidemiological studies.

METHODS: PubMed and Embase were searched for all studies from earliest available indexing year through 1 December 2021 using keywords corresponding to PFAS exposure and liver injury. For …

Intestinal Deletion Of 3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Promotes Expansion Of The Resident Stem Cell Compartment, Alexandria M Doerfler, Jun Han, Kelsey E Jarrett, Li Tang, Antrix Jain, Alexander Saltzman, Marco De Giorgi, Marcel Chuecos, Ayrea E Hurley, Ang Li, Pauline Morand, Claudia Ayala, David R Goodlett, Anna Malovannaya, James F Martin, Thomas Q De Aguiar Vallim, Noah Shroyer, William R Lagor

Faculty, Staff and Students Publications

BACKGROUND: The intestine occupies the critical interface between cholesterol absorption and excretion. Surprisingly little is known about the role of de novo cholesterol synthesis in this organ, and its relationship to whole body cholesterol homeostasis. Here, we investigate the physiological importance of this pathway through genetic deletion of the rate-limiting enzyme.

METHODS: Mice lacking 3-hydroxy-3-methylglutaryl-coenzyme A reductase (Hmgcr) in intestinal villus and crypt epithelial cells were generated using a Villin-Cre transgene. Plasma lipids, intestinal morphology, mevalonate pathway metabolites, and gene expression were analyzed.

RESULTS: Mice with intestine-specific loss of Hmgcr were markedly smaller at birth, but gain …

The Effect Of Scan And Patient Parameters On The Diagnostic Performance Of Ai For Detecting Coronary Stenosis On Coronary Ct Angiography, Rebecca Jonas, Emil Barkovich, Andrew D Choi, William F Griffin, Joanna Riess, Hugo Marques, Hyuk-Jae Chang, Jung Hyun Choi, Joon-Hyung Doh, Ae-Young Her, Bon-Kwon Koo, Chang-Wook Nam, Hyung-Bok Park, Sang-Hoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang Gao, Faisal Nabi, Ryo Nakazato, U Joseph Schoepf, Roel S Driessen, Michiel J Bom, Randall C Thompson, James J Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Généreux, Paul Knaapen, Guus A De Waard, Gianluca Pontone, Daniele Andreini, Marco Guglielmo, Mouaz H Al-Mallah, Robert S Jennings, Tami R Crabtree, James P Earls

Division of Internal Medicine Faculty Papers & Presentations

Objectives: To determine whether coronary computed tomography angiography (CCTA) scanning, scan preparation, contrast, and patient based parameters influence the diagnostic performance of an artificial intelligence (AI) based analysis software for identifying coronary lesions with ≥50% stenosis.

Background: CCTA is a noninvasive imaging modality that provides diagnostic and prognostic benefit to patients with coronary artery disease (CAD). The use of AI enabled quantitative CCTA (AI-QCT) analysis software enhances our diagnostic and prognostic ability, however, it is currently unclear whether software performance is influenced by CCTA scanning parameters.

Methods: CCTA and quantitative coronary CT (QCT) data from 303 stable patients (64 ± …

A Comprehensive Review On The Risk Of Metabolic Syndrome And Cardiovascular Disease After Liver Transplantation, Kashyap Chauhan, Adnan Khan, Salil Chowdhury, Heather Ross, Natali Salinas, Dina Halegoua-De Marzio

Division of Internal Medicine Faculty Papers & Presentations

Survival rates after liver transplantation have increased dramatically over the past 20 years. Cardiovascular disease is the most common extra-hepatic cause of mortality in the long-term post liver transplant. This is intimately linked with both the higher pre-existing rates of metabolic syndrome in these patients as well as increased propensity to develop de novo metabolic syndrome post-transplant. This unfavorable metabolic profile that contributes to cardiovascular disease is multifactorial and largely preventable. This review explores metabolic syndrome and cardiovascular disease and their contributory factors post liver transplantation to highlight areas for potential intervention and thus reduce the significant morbidity and mortality …

Comparison Of Hospital Mortality, Length Of Stay, Renal Recovery, And Needs For Hemodialysis In Acute Kidney Injury (Aki) Patients Due To Septic And Non-Septic, And Factors Affecting Patients’ Mortality, Mochammad Jalalul Marzuki, Nursamsu Nursamsu, Achmad Rifai

Jurnal Penyakit Dalam Indonesia

Introduction. Acute kidney injury (AKI) is a major complication in critically ill patients that affects mortality. Sepsis is a major predisposing factor for AKI and provides a poor prognosis and high mortality rate. Thisstudy aimed toidentifythe difference of hospital mortality, length of stay, renal recovery, and needs for hemodialysis between AKI patients due to sepsis and non-sepsis, as well as to determine the factors that influence the mortality of patients with AKI.Methods. An analytical observational study was conducted among patients with AKI according to the KDIGO criteria and aged ≥40 years old. Data were obtained from patients’ medical records in …

Characteristics Of Patients With Non-Malignant Pleural Effusion In Dr. Zainoel Abidin Hospital Banda Aceh In 2019, Teuku Romi Imansyah Putra, Price Maya, Maryatun Hasan, Agung Pranata, Safira Salsabila, Hesti Ariandani Sariningrum

Jurnal Penyakit Dalam Indonesia

Introduction. Pleural effusion occurs when there is a pathological process causing fluid to accumulate in the pleural cavity. Pleural effusion is still the main cause of respiratory distress and can also be caused by many diseases either from pleural, lungs, or even extrapulmonary problems. The morbidity and mortality of this condition are directly associated with the underlying causes. The aim of this study is to investigate the profile of the patients, etiology, location, fluid characteristics, comorbidities, and also the bacteria pattern of non-malignant pleural effusion. Methods. This is a retrospective descriptive study thatused patient’s medical records from January to December …

Kidney Disease And Its Impact On Covid-19 Patients At Sanglah Hospital Denpasar, Bali, Indonesia In 2021, Putu Satyakumara Upadhana, I Gede Gita Sastrawan Sastrawan, I Gusti Agung Ayu Chintya Cahyarini, Anbiya Khairul Umam, Amanda Trisliana Dwi Putri, I Gede Raka Adhyatma, I Ketut Agus Somia

Jurnal Penyakit Dalam Indonesia

Introduction. Besides having an impact on the respiratory system, COVID-19 also has an impact on other organ such as the kidneys. The systemic inflammatory response thought to be associated with bad prognosis of COVID-19 patients with kidney disease. This study aimed to determine the impact of kidney disease on COVID-19 patients. Methods. This study is an observational analytic study with a cross-sectional approach. The data used is secondary data from the records of confirmed COVID-19 patients who were treated at Sanglah Hospital from 1 May 2021 to 31 August 2021 using total sampling technique.Results. There were 248 patients included in …

Abnormal Liver Function In Predicting Covid-19 Patients’ Prognosis, Sakinah Rahma Sari, Juferdy Kurniawan

Jurnal Penyakit Dalam Indonesia

Despite of the high prevalence of liver enzyme elevation in COVID-19 patients, its effect on predicting COVID-19 patients’ prognosis was still debatable. This evidence-based case report aims to evaluate the effect of abnormal liver function in the prognosis of COVID-19 patients. Literature searching was performed on August 16-17 2021 using 3 databases: PubMed, Scopus, and Proquest. The articles selected by title/abstract screening, duplication elimination, and applying eligibility criteria were then appraised using Centre of Evidence Based Medicine (CEBM), University of Oxford. Some of the studies reported there were no significant difference in the prognosis of COVID-19 patient with and without …

Mutation And Variant Of Coronavirus Disease 2019 (Covid-19): Review Of Current Literatures, Adityo Susilo, Chyntia Olivia Maurine Jasirwan, Syahidatul Wafa, Suzy Maria, Wulyo Rajabto, Akhmadu Muradi, Ihza Fachriza, Myranda Zahrah Putri, Stacy Gabriella

Jurnal Penyakit Dalam Indonesia

Since March 2020, the Coronavirus Disease 2019 (COVID-19) pandemic has engulfed the world, including Indonesia, for nearly two years. SARS-CoV-2 has undergone several mutations during its evolution as a pathogen, resulting in various variants of global concern. Variants of this virus are suspected to impede the outbreak resolution and possibly causing the outbreak to spiral out of control. There is still considerable debate and research underway regarding the new SARS-CoV-2 variants. Rapid transmission mechanisms and widespread vaccination coverage have accelerated the virus’s mutation rate and resulted in numerous new variants. To date, this has resulted in the discovery of a …

The Prevalence Of Irritable Bowel Syndrome Using Rome Iv Criteria In Medical Student And The Related Factors, Ardhi Rahman Ahani, Ari Fahrial Syam, Rudi Putranto, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. Medicine is a long study time. Medical student will take five years study to accomplish the education. Because the lot of task and some taken test, some medical student will face irritable bowel syndrome in their study periods. This study aims to identify the prevalence of IBS in medical student and related factors.Methods. A cross-sectional study of 350 medical student Universitas Indonesia from first grade until fifth grade was done during November-December 2016. This study used stratified randomized sampling. The Rome IV criteria was used for diagnosing IBS. Interview with questionnaire guided was applied to all subjects. A bivariate …

Covid-19 Dari Perspektif Penyakit Ginjal : Dalam Rangka Memperingati Hari Ginjal Sedunia (World Kidney Day 2022), Anandhara Indriani Khumaedi

Jurnal Penyakit Dalam Indonesia

Secara global, hingga saat ini pandemi Coronavirus disease-19 (COVID-19) telah menjangkit lebih dari 450 juta orang di dunia dan menyumbang kematian sebanyak 6 juta jiwa.