Internal Medicine Commons^™

Genetic Discovery And Risk Characterization In Type 2 Diabetes Across Diverse Populations, Linda M Polfus, Burcu F Darst, Heather Highland, Xin Sheng, Maggie C Y Ng, Jennifer E Below, Lauren Petty, Stephanie Bien, Xueling Sim, Wei Wang, Pierre Fontanillas, Yesha Patel, Michael Preuss, Claudia Schurmann, Zhaohui Du, Yingchang Lu, Suhn K Rhie, Joseph M Mercader, Teresa Tusie-Luna, Clicerio González-Villalpando, Lorena Orozco, Cassandra N Spracklen, Brian E Cade, Richard A Jensen, Meng Sun, Yoonjung Yoonie Joo, Ping An, Lisa R Yanek, Lawrence F Bielak, Salman Tajuddin, Aude Nicolas, Guanjie Chen, Laura Raffield, Xiuqing Guo, Wei-Min Chen, Girish N Nadkarni, Mariaelisa Graff, Ran Tao, James S Pankow, Martha Daviglus, Qibin Qi, Eric A Boerwinkle, Simin Liu, Lawrence S Phillips, Ulrike Peters, Chris Carlson, Lynne R Wikens, Loic Le Marchand, Kari E North, Steven Buyske, Charles Kooperberg, Ruth J F Loos, Daniel O Stram, Christopher A Haiman

Faculty, Staff and Student Publications

Genomic discovery and characterization of risk loci for type 2 diabetes (T2D) have been conducted primarily in individuals of European ancestry. We conducted a multiethnic genome-wide association study of T2D among 53,102 cases and 193,679 control subjects from African, Hispanic, Asian, Native Hawaiian, and European population groups in the Population Architecture Genomics and Epidemiology (PAGE) and Diabetes Genetics Replication and Meta-analysis (DIAGRAM) Consortia. In individuals of African ancestry, we discovered a risk variant in the

Immune Thrombocytopenia In Covid Pneumonia: A Case Report Of The Oldest Patient, Samiksha Pandey, Kamil Sardarli, Candace Franklin, Ashbina Pokharel, Sumesh Khanal, Bipin Ghimire, Feroze A. Momin

Conference Presentation Abstracts

Introduction: COVID infection has shown to cause thrombocytopenia with multiple different mechanisms including the destruction of platelets with immune system stimulation similar to ITP with little evidence for optimal management. Here, we present a COVID infected patient presented with idiopathic thrombocytopenia with a partial delayed response to the treatment. Case Presentation: A 92-year-old man with a past medical history of coronary artery disease status post remote coronary artery bypass graft, hypertension, diabetes mellitus presented with petechiae, epistaxis, and was found to be profoundly thrombocytopenic with a platelet count of 1x109/L. He also had an asymptomatic COVID 19 infection, a normal …

Association Between Obesity And Histological Tumor Budding In Patients With Nonmetastatic Colon Cancer, Tong Gan, Kurt B. Schaberg, Daheng He, Akila Mansour, Harit Kapoor, Chi Wang, B. Mark Evers, Therese J. Bocklage

Surgery Faculty Publications

Importance: Obesity is associated with increased risk of colorectal cancer (CRC) and a more aggressive disease course. Tumor budding (TB) is an important prognostic factor for CRC, but its association with obesity is unknown.

Objective: To evaluate the association of TB with obesity and other prognostic factors in colon cancer.

Design, Setting, and Participants: This cohort study involved a histological review of colon cancer specimens obtained during 7 years (January 2008 to December 2015) at the University of Kentucky Medical Center; data analysis was conducted from February 2020 to January 2021. Specimens came from 200 patients with stage I to …

Intestinal Dysbiosis Disguised As A Rectal Fistula Treated With Autologous Fecal Microbiota Transplantation, Nicolina Scibelli, Pratishtha Singh, Kathleen Raynor

South Atlantic Division GME Research Day 2021

No abstract provided.

Pvn Activity In Cardiac Sympathetic Afferent Reflex (Csar) Control And Cardiovascular Function, Shane H. Boomer

Honors Thesis

Regulation of blood pressure is essential in bodily health. Hypertension and hypotension can be associated with varying diseases that could potentiate further disease. From this, understanding the mechanisms that regulate blood pressure is important within medicine. In my study, I will be focusing on a cardiovascular reflex that is less well understood, the cardiac sympathetic afferent reflex (CSAR). In particular, this work will examine sex differences in this reflex in overall function and in the involvement of an area of the brain called the paraventricular nucleus (PVN). We will test the hypothesis that there will be a significant difference between …

Intimate Partner Violence Is A Barrier To Antiretroviral Therapy Adherence Among Hiv - Positive Women: Evidence From Government Facilities In Kenya, Bornice C. Biomndo, Alexander Bergmann, Nils Lahmann, Lukoye Atwoli

Internal Medicine, East Africa

Introduction: Intimate Partner Violence (IPV) is linked to low engagement with HIV management services and adverse clinical outcomes, including poor ART adherence. In sub-Saharan Africa, studies on pregnant/postpartum women and transactional sex workers have produced divergent evidence regarding IPV’s association with poor ART adherence. We investigate this association among a broad group of women.

Methods: We sampled 408 HIV-positive women receiving free ART from different types of HIV clinics at government health facilities, assessing for IPV exposure by a current partner, ART adherence rate, and other factors that affect ART adherence (e.g. education, disclosure). ART adherence rates were measured using …

Efficacy, Pharmacokinetics, And Safety Over 48 Weeks With Ibalizumab-Based Therapy In Treatment-Experienced Adults Infected With Hiv-1: A Phase 2a Study, Joseph C Gathe, Robin L Hardwicke, Fernando Garcia, Steven Weinheimer, Stanley T Lewis, Robert Brandon Cash

Faculty, Staff and Student Publications

Ibalizumab, a humanized monoclonal antibody targeting CD4, blocks HIV-1 entry into cells and is the first Food and Drug Adminstration-approved long-acting agent for HIV-1 treatment. In this phase 2a study, 82 HIV-infected adults failing antiretroviral therapy were assigned an individually optimized background regimen (OBR) and randomized 1:1:1 to arm A (15 mg/kg ibalizumab q2wk), arm B (10 mg/kg weekly for 9 weeks, then q2wk), or placebo. Subjects with an inadequate response at week 16 were permitted to cross over to a new OBR plus 15 mg/kg ibalizumab q2wk. At week 16, viral load (VL) reduction was significantly greater than placebo …

Hypoxia-Inducible Factor–1Α–Dependent Induction Of Mir122 Enhances Hepatic Ischemia Tolerance, Cynthia Ju, Meng Wang, Eunyoung Tak, Boyun Kim, Christoph Emontzpohl, Yang Yang, Xiaoyi Yuan, Huban Kutay, Yafen Liang, David R Hall, Wasim A Dar, J Steve Bynon, Peter Carmeliet, Kalpana Ghoshal, Holger K Eltzschig

Faculty, Staff and Student Publications

Hepatic ischemia and reperfusion (IR) injury contributes to the morbidity and mortality associated with liver transplantation. microRNAs (miRNAs) constitute a family of noncoding RNAs that regulate gene expression at the posttranslational level through the repression of specific target genes. Here, we hypothesized that miRNAs could be targeted to enhance hepatic ischemia tolerance. A miRNA screen in a murine model of hepatic IR injury pointed us toward the liver-specific miRNA miR122. Subsequent studies in mice with hepatocyte-specific deletion of miR122 (miR122loxP/loxP Alb-Cre+ mice) during hepatic ischemia and reperfusion revealed exacerbated liver injury. Transcriptional studies implicated hypoxia-inducible factor-1α (HIF1α) in the induction …

Hypoxia-Inducible Factor-Dependent Induction Of Myeloid-Derived Netrin-1 Attenuates Natural Killer Cell Infiltration During Endotoxin-Induced Lung Injury, Nathaniel K Berg, Jiwen Li, Boyun Kim, Tingting Mills, Guangsheng Pei, Zhongming Zhao, Xiangyun Li, Xu Zhang, Wei Ruan, Holger K Eltzschig, Xiaoyi Yuan

Faculty, Staff and Student Publications

Sepsis and sepsis-associated lung inflammation significantly contribute to the morbidity and mortality of critical illness. Here, we examined the hypothesis that neuronal guidance proteins could orchestrate inflammatory events during endotoxin-induced lung injury. Through a targeted array, we identified netrin-1 as the top upregulated neuronal guidance protein in macrophages treated with lipopolysaccharide (LPS). Furthermore, we found that netrin-1 is highly enriched in infiltrating myeloid cells, particularly in macrophages during LPS-induced lung injury. Transcriptional studies implicate hypoxia-inducible factor HIF-1α in the transcriptional induction of netrin-1 during LPS treatment. Subsequently, the deletion of netrin-1 in the myeloid compartment (Ntn1

A Phase Ii Study Of Autologous Mesenchymal Stromal Cells And C-Kit Positive Cardiac Cells, Alone Or In Combination, In Patients With Ischaemic Heart Failure: The Cctrn Concert-Hf Trial, Roberto Bolli, Raul D Mitrani, Joshua M Hare, Carl J Pepine, Emerson C Perin, James T Willerson, Jay H Traverse, Timothy D Henry, Phillip C Yang, Michael P Murphy, Keith L March, Ivonne H Schulman, Sohail Ikram, David P Lee, Connor O'Brien, Joao A Lima, Mohammad R Ostovaneh, Bharath Ambale-Venkatesh, Gregory Lewis, Aisha Khan, Ketty Bacallao, Krystalenia Valasaki, Bangon Longsomboon, Adrian P Gee, Sara Richman, Doris A Taylor, Dejian Lai, Shelly L Sayre, Judy Bettencourt, Rachel W Vojvodic, Michelle L Cohen, Lara Simpson, David Aguilar, Catalin Loghin, Lem Moyé, Ray F Ebert, Barry R Davis, Robert D Simari

Faculty, Staff and Student Publications

AIMS: CONCERT-HF is an NHLBI-sponsored, double-blind, placebo-controlled, Phase II trial designed to determine whether treatment with autologous bone marrow-derived mesenchymal stromal cells (MSCs) and c-kit positive cardiac cells (CPCs), given alone or in combination, is feasible, safe, and beneficial in patients with heart failure (HF) caused by ischaemic cardiomyopathy.

METHODS AND RESULTS: Patients were randomized (1:1:1:1) to transendocardial injection of MSCs combined with CPCs, MSCs alone, CPCs alone, or placebo, and followed for 12 months. Seven centres enrolled 125 participants with left ventricular ejection fraction of 28.6 ± 6.1% and scar size 19.4 ± 5.8%, in New York Heart Association …

Characterization Of Age-Associated Gut Microbial Dysbiosis And Plasma Metabolite Alterations In People Living With Hiv (Plwh)., R. Sighal, Smita Ghare, Vaughn Bryant, Sabina Gautam, Chanakya Charan Tirumala, Andrea Reyes-Vega, Craig J. Mcclain, Ronald Cohen, Varand Govind, R L. Cook, Shirish Barve

Faculty and Staff Scholarship

Background: HIV-1 infection and aging are independently associated with gut microbial dysbiosis and neurocognitive impairment. However, the interactive effects of HIV-infection and aging on the development of specific pathogenic features of gut microbial dysbiosis and consequent metabolic abnormalities associated with neurocognitive dysfunction remain largely undetermined and were examined in the present study

Correlation Of Ramadan Fasting With Hba1c And Lipid Profilelevel Changes In The Risk Stratification Of Complications Indiabetes Mellitus Patients, Rinadhi Reza Bramantya, Putu Moda Arsana, Laksmi Sasiarini

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic patients will still do Ramadan fasting, which could affect the levels of HbA1C and lipid change after Ramadan. This study aimed to identify the correlation between fasting of Ramadan risk stratification with HbA1C and lipid levels diabetic patients who run the fast of Ramadan. Methods. This was a survey research using pre - post test. Study was conducted among diabetes patients who meet the criteria: carry out routine controls before and after Ramadan fasting at dr. Saiful Anwar Malang Hospital, filling in the required data, and underwent examination laboratory. Patients were grouped into moderate, high, and very high-risk …

Correlation Between Parathyroid Hormone Serum Levels Andabdominal Aortic Calcification In Chronic Hemodialysis Patientsat Dr. Mohammad Hoesin Center General Hospital Palembang, M Yusuf Arief Akbar, Zulkhair Ali, Taufik Indrajaya, Novadian Suhaimi, Sna Ratnasari Devi, Erial Bahar

Jurnal Penyakit Dalam Indonesia

Introduction. Cardiovascular disease is the most common cause of death in patients with chronic kidney disease (CKD). This is evidenced by the finding of vascular calcification in CKD patients. The process of vascular calcification that occurs is often associated with secondary hyperparathyroid conditions that are complications of CKD patients. The aim of this study was to asses the relationship between serum PTH levels and the abdominal aorta calcification (AAC) in CKD patients undergoing hemodialysis (HD) Methods. This observational analytic study with cross-sectional correlation test was conducted in the internal medicine ward of dr. Mohammad Hoesin Palembang from July to December …

Comparative Evaluation Of Alpha-Fetoprotein Serum Inhepatocellular Carcinoma Patients With Non-Viral Etiology, Gita Aprilicia, Krisnawati Bantas, Syahrizal Syarif, Kemal Fariz Kalista

Jurnal Penyakit Dalam Indonesia

Introduction. Non-viral etiology of hepatocellular carcinoma (HCC) now needs attention. Hepatocellular carcinoma which was caused by hepatitis B and hepatitis C could be controlled in the national program, while HCC from non-B non-C etiology has become a further concern with the with the increased of metabolic syndrome. Serum alpha-fetoprotein is a tumor marker commonly used for screening for HCC in patients with liver cirrhosis (LC). However, in HCC patients with nonviral etiology, AFP serum tends to be normal. This study aimed to evaluate the performance of AFP serum based in HCC and LC patient with non-viral etiology and to evaluate …

Egfr Mutation As A Predictive Factor To Treatment Response Oftki (Tyrosine Kinase Inhibitor) In Non-Small Cell Lung Cancerstage 4: A Case Report, Wulyo Rajabto, Yohana Kusuma Angkasa

Jurnal Penyakit Dalam Indonesia

Non-small cell lung cancer (NSCLC) typically presents in patients at an advanced stage, with a poor prognosis. The development of epidermal growth factor receptor (EGFR) – tyrosine kinase inhibitors (TKIs) and the systematic identification of EGFR mutations heralded the advent of targeted therapy in lung cancer, transforming the landscape of its treatment and prognosis. This is a case of 37 years-old female patient presented with metastatic bone disease secondary to pulmonary adenocarcinoma EGFR mutation positive which demonstrated a remarkable result to TKI.

The Pattern Of Microorganism On Adult Acute Leukemia Patientsduring Bacterial Surveillance And Febrile Neutropenia At Ciptomangunkusumo Hospital, Lugyanti Sukrisman

Jurnal Penyakit Dalam Indonesia

Introduction. The standard intensive chemotherapy in acute leukemia patients will cause severe neutropenia and infection (febrile neutropenia) with high fatality rate. The availability of accurate data on causative pathogens is essential to the appropriate selection of empirical therapy and usually obtained from bacterial surveillance. This study was intended to evaluate bacterial pathogens found on surveillance and during febrile neutropenia in acute leukemia patients undergoing chemotherapy at Cipto Mangunkusumo Hospital and to provide information for antimicrobial policy in the hospital. Methods. A retrospective study from data of bacterial surveillance of acute leukemia patients undergoing chemotherapy during 2008-2010 in isolation room for …

Correlation Of Haemoglobin Platelet Ratio (Hpr) And Leukocyteplatelet Ratio (Lpr) With Syntax-2 Score In Stemi Patients, Muhammad Ikhsan, Sally Aman Nasution, Andhika Rachman, Muhadi Muhadi

Jurnal Penyakit Dalam Indonesia

Introduction. Various studies have concluded the association between various markers of inflammation with the clinical outcome in STEMI patients. However, most of these markers are quite expensive and not available in healthcare facilities. Hence, we aim to study the correlation between haemoglobin platelet ratio (HPR) and leucocyte platelet ratio (RPL) and the clinical outcomes of STEMI patients. Methods. This is a cross-sectional study performed in adult patients with STEMI who were hospitalized in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital between January 2016 and October 2020. The data was analyzed by testing the correlation between HPR and LPR with SYNTAX-2 …

Management Of Diabetic Ketoacidosis In Patient With Heartfailure, Dicky Febrianto, Est Hindariati

Jurnal Penyakit Dalam Indonesia

Diabetic ketoacidosis (DKA) is diabetes mellitus emergency which is defined by the biochemical triad of hyperglycemia, ketonemia, and acidemia. Diabetic ketoacidosis continues to have high rates of morbidity and mortality despite advances in the treatment of diabetes. Crucial aspects of DKA management involve adequate replacement of fluids and electrolytes, particularly potassium, and the continuous administration of insulin. Hydration status in patients with DKA and heart failure can be assessed by physical examination, such as consciousness, vital signs, capillary refill time, skin turgor, jugular venous pressure, and signs of pulmonary edema. Invasive and non-invasive methods can also assess fluid adequacy in …

Puasa Ramadan Dan Diabetes Melitus: Risiko, Manfaat Dan Peluang Penelitian, Dicky L Tahapary, Syahidatul Wafa, Dante S. Harbuwono

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Retraction: Correlation Of Serum Uric Acid Levels With The Severity Of Coronary Artery Stenosis In Patients With Acute Coronarysyndrome: Meta-Analysis Study, Diding Heri Prasetyo, Sally Aman Nasution, Idrus Alwi, Murdani Abdullah

Jurnal Penyakit Dalam Indonesia

Introduction. The relationship between serum uric acid (SUA) level and ischemic heart disease abides controversial and still has not been established as a cardiovascular risk factor. The cooperative interaction between those two factors is not fully understood. Prior epidemiological evidences of the causal relationship is still argumentative. There were various studies using the same methods yet the outcome were different. This study aims to conduct a meta-analysis to synthesize the results of recent studies in order to obtain data quantitatively and also accurately. Methods. This study protocol was registered with PROSPERO (CRD42020210948), and conducted according to PRISMA guidelines, tracing studies …