Internal Medicine Commons^™

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 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 …

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.

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 …

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 …

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 …

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 …

Prediction Model Of 30-Days Postoperative Pneumonia In Elderly Patient Undergoing Abdominal Surgery, Noto Dwimartutie, Harini Oktadiana, Gurmeet Singh, Wifanto Saditya Jeo, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Introduction. Physiologic changes in respiratory tract in elderly increase incidence of post-operative pneumonia. Post-operative pneumonia in non-thoracic surgery was found higher in abdominal surgery. This study aimed to develop a prediction model of 30-day post-operative pneumonia in elderly patients undergoing abdominal surgery.

Methods. A retrospective cohort study was conducted using elderly patient’s medical records who underwent abdominal surgery in Cipto Mangunkusumo General Hospital. Multivariate analysis using logistic regression was used to determine Odds Ratio (OR). Model’s calibration performance was determined by Hosmer-Lameshow test and its discrimination performance was determined by calculating area under the curve (AUC).

Results. Of …

Pain Management In Advanced Hepatocellular Carcinoma:A Case Study, Fita Fitrianti, Hamzah Shatri, Edward Faisal, Rud Putranto, Ratih Arianita Agung, Leonard Nainggolan, Kemal Fariz Kalista, Cophiadi Irawan

Jurnal Penyakit Dalam Indonesia

Hepatocelullar carcinoma (HCC), the most common primary liver malignancy is the fifth most common cancer and the third most frequent cause of cancer related death globally. Pain comprises one the most common symptoms of HCC and may have severely negative effects on patient’s quality life. Furthermore, patients with HCC often presented with a cirrochis,so to control pain in this patient poses a clinical challenge. This case report discuss about a young 26-years-old male patient who presented with a four-month history of right upper quadrant abdominal pain and weight loss. HbsAg positive and serum alpha-fetoprotein level was high. Computed tomography (CT) …

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 …

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.

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 …

Intelligent Malingering In The Setting Of Porphyria Variegata: A Rare Occurrence On Both Fronts, Gersham J. Rainone, Oleg E. Reznik, Mahrukh Majeed, Alina Popa

Transformative Medicine

Malingering can be a difficult diagnosis to discern, especially in patients with well-crafted stories presenting with signs and symptoms that align directly with the literature. This can further become a challenge when a patient is malingering in the setting of a rare disease, where many complaints can be subjective in nature and not entirely testable by physical exam alone. Malingering is responsible for billions of dollars of healthcare waste every single year, and this report can serve as a guide of history elements, signs and symptoms to look out for with patients malingering in the setting of the porphyrias. It …

Efficacy And Safety Of Direct Oral Anticoagulants With And Without Aspirin: A Systematic Review And Meta-Analysis, Talal Almas, Adeena Musheer, Arooba Ejaz, Fahd Niaz Shaikh, Anousheh Awais Paracha, Fizza Raza, Maryam Sarwar Khan, Fahad Masood, Faiza Siddiqui, Muhammad Hasnain Mankani

Medical College Documents

Background: Various anticoagulant therapies are prescribed to patients under physicians' discretion and recently Direct Oral Anticoagulants(DOAC) have been under trials to evaluate their safety and efficacy. In addition to this, the regimen of DOACs and Aspirin is of keen interest as researchers continue to find an optimal regimen to treat blood clots in patients. This study is a systematic review and meta-analysis of randomized controlled trials and observational studies that asses the safety and efficacy of DOAC with and without Aspirin.
Methods: We queried MEDLINE and Cochrane CENTRAL from their inception to April 2021, for published and randomized controlled …

Predicting Health-Related Social Needs In Medicaid And Medicare Populations Using Machine Learning, Jennifer Holcomb, Luis C Oliveira, Linda Highfield, Kevin O Hwang, Luca Giancardo, Elmer Victor Bernstam

Faculty, Staff and Student Publications

Providers currently rely on universal screening to identify health-related social needs (HRSNs). Predicting HRSNs using EHR and community-level data could be more efficient and less resource intensive. Using machine learning models, we evaluated the predictive performance of HRSN status from EHR and community-level social determinants of health (SDOH) data for Medicare and Medicaid beneficiaries participating in the Accountable Health Communities Model. We hypothesized that Medicaid insurance coverage would predict HRSN status. All models significantly outperformed the baseline Medicaid hypothesis. AUCs ranged from 0.59 to 0.68. The top performance (AUC = 0.68 CI 0.66-0.70) was achieved by the "any HRSNs" outcome, …