Internal Medicine Commons^™

Power Washing Pulmonary Alveolar Proteinosis, Tiana R Endicott-Yazdani, Gary S Schwartz, Haiying Zhang, Randall L Rosenblatt, Puneet S Garcha

Faculty, Staff and Students Publications

Pulmonary alveolar proteinosis is an uncommon cause of insidious onset shortness of breath and hypoxemia. It is caused by an accumulation of surfactant within the alveoli. Left untreated, it can be fatal. Standard-of-care treatment is whole-lung lavage; however, in severe cases, the associated hypoxemia can be profound and single-lung ventilation would not be tolerated, potentially preventing a lifesaving treatment. Single cases using veno-venous extracorporeal membrane oxygenation to perform whole-lung lavage have been reported. Here we describe three patients with severe pulmonary alveolar proteinosis who were successfully treated with whole-lung lavage using veno-venous extracorporeal membrane oxygenation for oxygenation support.

Assessment Of The Impact Of Tardive Dyskinesia In Clinical Practice: Consensus Panel Recommendations, Richard Jackson, Matthew N Brams, Leslie Citrome, Amber R Hoberg, Stuart H Isaacson, John M Kane, Rajeev Kumar

Faculty, Staff and Students Publications

PURPOSE: Tardive dyskinesia (TD) is a hyperkinetic movement disorder in which patients experience abnormal involuntary movements that can have profound negative impacts on physical, cognitive, and psychosocial functioning. Use of measures to assess the functional impact of TD in routine clinical practice is lacking. To address this gap, an advisory panel of experts in psychiatry and movement disorder neurology was convened to develop consensus recommendations on assessment of the impact of TD on patients' functioning that can be used in clinical practice.

METHODS: An advisory panel provided recommendations using an iterative process, beginning with a narrative literature review regarding current …

Level Of Disability And Limitation Of Shoulder Motion In Post Mastectomy At Hasan Sadikin Hospital Bandung In 2019, Nadya Rachmawati, Tertianto Prabowo, Fathurrachman Fathurrachman

Jurnal Penyakit Dalam Indonesia

Introduction. Post-mastectomy complications in breast cancer patients can be a long-term disabilities such as limitation of shoulder function that only appears after several months to years after surgery and may remain for the rest of the patient’s life. This study aims to describe the level of disability and limitation of the shoulder joint’s range of motion in breast cancer patients following mastectomy at Hasan Sadikin Hospital, Bandung 2019. Methods. This research was conducted by using descriptive method with cross-sectional study design. Sampling technique using consecutive sampling method during one-month study period. Samples were post-mastectomy breast cancer patients who came to …

Profile Of Patients Neutropenia Fever Unrelated To Chemotherapy In Dr. Cipto Mangunkusumo General Hospital, Gantira Danasasmita, Lie Khie Chen, Robert Sinto, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. The condition of neutropenia increases the risk of infection. The causes of neutropenia are widely discussed as side effects of chemotherapy, but patients with neutropenia who are not due to side effects of chemotherapy are increasing in number. This study aims to provide an overview of the characteristics of neutropenic fever population unrelated to chemotherapy. Method. The study was conducted retrospectively on the medical records of neutropenic fever patients who were not chemotherapy-related in the National Hospital Dr. Cipto Mangunkusumo in January 2018-November 2019. Variables studied included demographic, clinical characteristics, classification of multinational association of supportive care in cancer …

Correlation Of The Quality Of Antibiotic Usage By Utilising Gyssens Flow And The Success Of Treatment In Negative Gram Mdr Sepsis In Tertiary Hospital, Soroy Lardo, Lie Khie Chen, Widayat Djoko Santoso, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Multi Drug Resistance (MDR) antibiotics have become a global health threat to the community. The use of appropriate antibiotics makes preventive and curative measures very important for the success of overcoming MDR and intervening the complexity of resistance, at least slowing the rate of occurrence of MDR. This study aimed to identify the difference in the quality of antibiotic use quality of use using gyssens flowchart and the success in sepsis patients’ treatment due to gram-negative MDR bacteria with non-MDR bacterial infections in tertiary hospitals. Methods. A retrospective cohort study was conducted using secondary data from patient with age …

Validity And Reliability Test Of European Organization For Research And Treatment Of Cancer Quality Of Life Questionnairebreast 23 In Breast Cancer Patient On Treatment, Mizanul Adli, Hamzah Shatri, Noorwati Sutandyo, Suhendro Suwarto

Jurnal Penyakit Dalam Indonesia

Introduction. Improved survival of breast cancer patients are not necessarily followed by improvement of quality of life. According to the European Organization for Research and Treatment of Cancer (EORTC), cancer patients’ quality of life are very important to be evaluated. In Indonesia, breast cancer patients cannot be assessed their quality of life accurately because there is no valid and reliable questionnaire. This study aims to prove that the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast 23 (EORTC QLQ-BR23) is a valid and reliable measuring instrument to be used in Indonesia. Methods. This study was a …

Fever-Induced Brugada Syndrome In An Acute Gastroenteritis Patient: A Case Report, Rio Yansen Cikutra, Irwin Irwin

Jurnal Penyakit Dalam Indonesia

Brugada syndrome (BS) is a disease caused by autosomal dominant sodium channel mutation in the heart. The prevalence of BS worldwide is estimated to be 1-5/10,000 population and the highest prevalence is in Southeast Asia which is >5/10,000 population. Brugada syndrome is a dangerous condition because it predisposes to malignant arrhythmias (ventricular tachycardia/VT and ventricular fibrillation/VS) and sudden cardiac death (SCD). Fever is a trigger for malignant arrhythmias, syncope, or SCD in BS. This article discusses about a case of 64-year-od man patient with complaint of syncope, preceded by chest pain and palpitation. The patient also had a fever and …

Peran Penting Pengendalian Resistensi Antibiotik Pada Pandemi Covid-19, Robert Sinto

Jurnal Penyakit Dalam Indonesia

No abstract provided.

The Selection Of Oral Antidiabetic Drugs In Type 2 Diabetes Mellitus Patients With High Risk For Cardiovascular Events, Derlin J. Leander, Dicky L. Tahapary

Jurnal Penyakit Dalam Indonesia

Type 2 diabetes mellitus (DMT2) patients are associated with an increased risk of cardiovascular events. Prior to the era of cardio-vascular trial outcome (CVOT) evidence on the efficacy of old oral diabetes (OAD) drugs such as metformin, sulfonylurea, thiazolidindion, glinid, and alpha glucosidase inhibitors in reducing the risk of cardiovascular events was very limited. Since 2008, all OADs must have CVOT data. DPP-4 inhibitors are neutral against the risk of cardiovascular events while SGLT-2 inhibitors are reported to significantly reduce the risk of cardiovascular events. This finding even helped to change the DMT2 management guidelines issued by American Diabetes Association …

The Impact Of “Code Stemi” Program Implementation On Door To Balloon Time And Major Adverse Cardiac Events Of Patients With St Elevation Myocardial Infarction, Prijander L B Funay, Ika Prasetya Wijaya, Eka Ginanjar, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Delay in the management of ST Elevation Myocardial Infarction (STEMI) patients is a cause of high mortality and the incidence of major adverse cardiac events (MACE). Efforts that can be made in health facilities with primary percutaneous coronary intervention (PCI) capability are achieving timely reperfusion of STEMI patients. Various strategies were carried out to achieve timely reperfusion including implementation the CODE STEMI program. This study aimed to determine the effect of the implementation of the CODE STEMI program on Door to Balloon Time (D2BT) and MACE of STEMI patients undergoing primary PCI. Methods. This was a retrospective cohort study …

Low Serum Irisin As A Risk Factor Of Sarcopenia In Elderly, I Gust Putu Suka Aryana, I.B. Putrawan, Ni Ketut Rai Purnami, R.A. Tuty Kuswardhani, I Nyoman Astika, Ketut Suastika, I Putu Gede Adiatmika, I Made Jawi, I Nyoman Wande

Jurnal Penyakit Dalam Indonesia

Introduction. Sarcopenia is a condition characterized by a decrease in muscle mass accompanied by a decrease in strength and/or function. Sarcopenia is closely related to the aging process, but the mechanism of its occurrence is still not fully understood. Skeletal muscle is the largest organ in the human body, so the myokine produced through muscle contraction opens a new paradigm regarding the central role of muscles in regulating metabolism and other organ functions. One of the myokines that are currently found to affect physical activity is Irisin. This study aims to determine the role of low Irisin levels in serum …

Medical Marijuana And Opioids (Memo) Study: Protocol Of A Longitudinal Cohort Study To Examine If Medical Cannabis Reduces Opioid Use Among Adults With Chronic Pain, Chinazo O. Cunningham, Joanna L. Starrels, Chenshu Zhang, Marcus A. Bachhuber, Nancy L. Sohler, Frances R. Levin, Haruka Minami, Deepika E. Slawek, Julia H. Arnsten

School of Medicine Faculty Publications

Introduction In the USA, opioid analgesic use and overdoses have increased dramatically. One rapidly expanding strategy to manage chronic pain in the context of this epidemic is medical cannabis. Cannabis has analgesic effects, but it also has potential adverse effects. Further, its impact on opioid analgesic use is not well studied. Managing pain in people living with HIV is particularly challenging, given the high prevalence of opioid analgesic and cannabis use. This study's overarching goal is to understand how medical cannabis use affects opioid analgesic use, with attention to Δ9-tetrahydrocannabinol and cannabidiol content, HIV outcomes and adverse events. Methods and …

Predictors Of Mortality In Hospitalized Patients With Influenza: A Five-Year Experience From A Tertiary Care Centre In Pakistan, Iffat Khanum, Amber Sabeen Ahmed, Safia Awan, Sabiha Banu, Bushra Jamil

Department of Medicine

Influenza outbreaks are associated with significant morbidity. Our aim was to determine the factors associated with increased mortality in hospitalized patients admitted with diagnosis of influenza, at a tertiary care center in Pakistan. This study included all adult patients with an influenza infection, confirmed by realtime reverse-transcriptase polymerase-chain-reaction (RT-PCR) at Aga Khan University Hospital Pakistan. In our study, 112 patients with laboratory-confirmed influenza virus infection were admittedat our hospital from the 1st of January 2013 to the 31st of December 2018. Eighty-nine patients (79.46%) were managed in ward or special care units and 23 patients (20.5%) received treatment in intensive …

Loss-Of-Function Genomic Variants Highlight Potential Therapeutic Targets For Cardiovascular Disease, Jonas B. Nielsen, Oren Rom, Ida Surakka, Sarah E. Graham, Wei Zhou, Tanmoy Roychowdhury, Lars G. Fritsche, Sarah A. Gagliano Taliun, Carlo Sidore, Yuhao Liu, Maiken E. Gabrielsen, Anne Heidi Skogholt, Brooke Wolford, William Overton, Ying Zhao, Jin Chen, He Zhang, Whitney E. Hornsby, Akua Acheampong, Austen Grooms, Amanda Schaefer, Gregory J. M. Zajac, Luis Villacorta, Jifeng Zhang, Ben Brumpton, Mari Løset, Vivek Rai, Pia R. Lundegaard, Morten S. Olesen, Kent D. Taylor, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Pharmaceutical drugs targeting dyslipidemia and cardiovascular disease (CVD) may increase the risk of fatty liver disease and other metabolic disorders. To identify potential novel CVD drug targets without these adverse effects, we perform genome-wide analyses of participants in the HUNT Study in Norway (n = 69,479) to search for protein-altering variants with beneficial impact on quantitative blood traits related to cardiovascular disease, but without detrimental impact on liver function. We identify 76 (11 previously unreported) presumed causal protein-altering variants associated with one or more CVD- or liver-related blood traits. Nine of the variants are predicted to result in loss-of-function of …

The Cardiac Neural Crest Cells In Heart Development And Congenital Heart Defects, Eileen M Burd, Ahmed Babiker, Jessica K Fairley, Divya Bhamidipati, Laila E Woc-Colburn, Blaine A Mathison

Faculty, Staff and Student Publications

No abstract provided.

Antibodies Against Lysophosphatidic Acid Protect Against Blast-Induced Ocular Injuries, Peethambaran Arun, Franco Rossetti, James C. Demar, Ying Wang, Andrew B. Batuure, Donna M. Wilder, Irene D. Gist, Andrew J. Morris, Roger A. Sabbadini, Joseph B. Long

Internal Medicine Faculty Publications

Exposure to blast overpressure waves is implicated as the major cause of ocular injuries and resultant visual dysfunction in veterans involved in recent combat operations. No effective therapeutic strategies have been developed so far for blast-induced ocular dysfunction. Lysophosphatidic acid (LPA) is a bioactive phospholipid generated by activated platelets, astrocytes, choroidal plexus cells, and microglia and is reported to play major roles in stimulating inflammatory processes. The levels of LPA in the cerebrospinal fluid have been reported to increase acutely in patients with traumatic brain injury (TBI) as well as in a controlled cortical impact (CCI) TBI model in mice. …

Web-Based Interactive Mapping From Data Dictionaries To Ontologies, With An Application To Cancer Registry, Shiqiang Tao, Ningzhou Zeng, Isaac Hands, Joseph Hurt-Mueller, Eric B. Durbin, Licong Cui, Guoqiang Zhang

Internal Medicine Faculty Publications

BACKGROUND: The Kentucky Cancer Registry (KCR) is a central cancer registry for the state of Kentucky that receives data about incident cancer cases from all healthcare facilities in the state within 6 months of diagnosis. Similar to all other U.S. and Canadian cancer registries, KCR uses a data dictionary provided by the North American Association of Central Cancer Registries (NAACCR) for standardized data entry. The NAACCR data dictionary is not an ontological system. Mapping between the NAACCR data dictionary and the National Cancer Institute (NCI) Thesaurus (NCIt) will facilitate the enrichment, dissemination and utilization of cancer registry data. We introduce …

Perinatal Substance Use Screenings In Marin County: A Brief Overview Of Screening Protocols And Identifying Gaps In Care, Breanna Wiliams

Master's Projects and Capstones

Introduction

Perinatal substance use continues to be a major public health issue in women’s health. The purpose of this study was to determine the frequency of substance use screenings in care and assess how well the existing services in Marin County are serving the needs of pregnant and parenting women and identifying the gaps and/or weaknesses in current practice.

Methods

Data for this study was collected via semi-structured interviews with five professionals that worked at the local community clinic, hospital and a non-profit agency. Some questions were slightly modified to be configured toward the participant’s specific profession.

Results

Results from …

Pregabalin-Induced Myopathy In A Double Lung Transplant Recipient, Vishwajit Hegde, Nidhi Shekar, Filip G. Garrett, Maher A. Baz, Michael I. Anstead

Internal Medicine Faculty Publications

Pregabalin is a gamma-aminobutyric acid (GABA) derivative that was commercially approved by the Food and Drug Administration (FDA) in 2004. It is commonly used in the treatment of diabetic neuropathy, peripheral neuropathy, and spinal cord injury. We present the case of a 36-year-old Caucasian male double lung transplant recipient who presented with an 18-month history of fatigue and muscle weakness. He had elevated creatinine kinase level and his muscle biopsy showed evidence of drug-induced myopathy that improved after the cessation of pregabalin. We present a case of drug-induced myopathy as a rare complication of pregabalin therapy in a double lung …

Clinical Prediction Of Coronavirus Disease-2019: How Accurate Can One Be?, Gabriel Aisenberg, Kevin O Hwang

Faculty, Staff and Student Publications

Background Some models based on clinical information have been reported to predict which patients have Coronavirus Disease-2019 (COVID-19) pneumonia but have failed so far to yield reliable results. We aimed to determine if physicians were able to accurately predict which patients, as described in clinical vignettes, had, or did not have this infection using their clinical acumen and epidemiological data. Methods Of 1177 patients under investigation for COVID-19 admitted, we selected 20 and presented them in a vignette form. We surveyed physicians from different levels of training (