Internal Medicine Commons^™

So Much Soma, Satvir Dhillon Md, Gregory Shimizu Md

Internal Medicine

No abstract provided.

Primary Hyperparathyroidism Can Generate Recurrent Pancreatitis And Secondary Diabetes Mellitus – A Case Report, Nicoleta Mîndrescu, Georgeta Văcaru, Emil Ștefănescu, Loreta Guja, Rucsandra Elena Dănciulescu Miulescu

Journal of Mind and Medical Sciences

Introduction. Acute or recurrent pancreatitis may be a complication of primary hyperparathyroidism and patients with previous episodes of pancreatitis may develop secondary diabetes mellitus. Case report. We describe the clinical case of a 52-year old Caucasian man diagnosed with chronic recurrent pancreatitis in 2007. The first episode of acute pancreatitis occurred in 2002, followed by another 4 episodes in 2004 and 2007. In 2004, papilosfincterectomy was implemented with a stent mount that was removed one month later. In 2005, the patient underwent a surgical intervention for the diagnosis of chronic lithiasis, and cholecystectomy was performed. Additional investigations on the etiology …

Therapeutic Alternatives With Cpap In Obstructive Sleep Apnea, Corina E. Budin, Lorena Ciumarnean, Anca Maierean, Ruxandra Rajnovean, Bianca D. Gergely, Milena Man, Maria Aluas, Angela Cozma, Roxana I. Bordea

Journal of Mind and Medical Sciences

Obstructive Sleep Apnea (OSA), characterized by airflow cessation (apnea) or reduction (hypopnea) due to repeated pharyngeal obstructions during sleep, causes frequent disruption of sleep and hypoxic events. The condition is linked to many adverse health related consequences, such as neurocognitive and cardiovascular disorders, and metabolic syndrome. OSA is a chronic condition requiring long-term treatment, so treatment using continuous positive airway pressure (CPAP) has become the gold standard in cases of moderate or severe OSA. However, its effectiveness is influenced by patients’ adherence. Surgery for OSA or treatment with oral appliances can be successful in selected patients, but for the majority, …

Impact Of Ivig Vs. Scig On Igg Trough Level And Infection Incidence In Primary Immunodeficiency Diseases: A Systematic Review And Meta-Analysis Of Clinical Studies., Pragya Shrestha, Paras Karmacharya, Zhen Wang, Anthony Donato, Avni Y Joshi

Reading Hospital Internal Medicine Residency

Background: Monthly intravenous immunoglobulin (IVIG) and weekly subcutaneous immunoglobulin (SCIG) have been regarded as therapeutically equivalent treatments for primary immunodeficiency diseases (PIDD). Immunoglobulin G (IgG) trough level is used as a monitoring measure for infection prevention.

Objective: A systematic review and meta-analysis were performed to elucidate the relationship between IgG dosing, trough IgG levels with overall infection incidence in patients with PIDD receiving IVIG and SCIG therapy.

Methods: Medline, EMBASE, Cochrane, Central, and Scopus were searched for studies published from Jan 2010-June 2018, fulfilling the inclusion criteria. DerSimonian and Laird random-effects method were used to pool the difference of IgG …

Nocardia Beijingensis: A Rare And Unusual Cause Of Intracranial Abscess, Lakshpaul Chauhan Md, Nirali Vassa Md, Elizabeth Henderson Md, Ateeq Mubarik Md, Danish M. Siddiq Md, Abdulmagid Eddib Md

Infectious Disease

Background : Nocardia species are thin, aerobic, filamentous, gram-positive bacilli that are ubiquitous in soil worldwide. Nocardia infections are divided into three main categories: pulmonary nocardiosis, disseminated nocardiosis, and cutaneous nocardiosis.

Methods : We present a case of cerebral nocardiosis in an immunocompetent patient caused by Nocardia beijingensis (NB).

Results : A 60-year-old Caucasian lady from Florida with type 2 diabetes mellitus, hypertension, hyperlipidemia, presented to the emergency room with complaints of altered mentation. Per husband, she was having episodes of emesis and diarrhea three days prior to admission that resolved however, her mentation significantly deteriorated to where she was …

Global Burden Of Atherosclerotic Cardiovascular Disease In People With Hepatitis C Virus Infection: A Systematic Review, Meta-Analysis, And Modelling Study, Kuan Ken Lee, Dominik Stelzle, Rong Bing, Mohamed Anwar, Fiona Strachan, Sophia Bashir, David E. Newby, Jasmit Shah, Michael Chung, Gerald S. Bloomfield

Internal Medicine, East Africa

Background: More than 70 million people worldwide are estimated to have hepatitis C virus (HCV) infection. Emerging evidence indicates an association between HCV and atherosclerotic cardiovascular disease. We aimed to determine the association between HCV and cardiovascular disease, and estimate the national, regional, and global burden of cardiovascular disease attributable to HCV.

Methods: For this systematic review and meta-analysis, we searched MEDLINE, Embase, Ovid Global Health, and Web of Science databases from inception to May 9, 2018, without language restrictions, for longitudinal studies that evaluated the risk ratio (RR) of cardiovascular disease in people with HCV compared with those without …

Which Student Characteristics Are Most Important In Determining Clinical Honors In Clerkships? A Teaching Ward Attending Perspective., Lauren Nicholas Herrera, Ryan Khodadadi, Erinn Schmit, James Willig, Andrew Hoellein, Christopher Knudson, Karen Law, Nina Mingioni, Katherine Walsh, Carlos Estrada, Winter Williams

Division of Internal Medicine Faculty Papers & Presentations

PURPOSE: To explore faculty perspectives on which characteristics of high-performing clerkship students are most important when determining an honors or top grade designation for clinical performance.

METHOD: In 2016-2017, the authors surveyed faculty (teaching ward attendings) for internal medicine clerkships and 1 pediatrics clerkship in inpatient settings at 5 U.S. academic medical centers. Survey items were framed around competencies, 24 student characteristics, and attitudes toward evaluation. Factor analysis examined constructs defining high-performing students.

RESULTS: Of 516 faculty invited, 319 (62%) responded. The top 5 characteristics as rated by respondents were taking ownership, clinical reasoning, curiosity, dependability, and high ethical standards …

Multiple Sclerosis Outcomes After Cancer Immunotherapy, Catherine R. Garcia, Rani Jayswal, Val R. Adams, Lowell B. Anthony, John L. Villano

Markey Cancer Center Faculty Publications

INTRODUCTION: Neurological immune-related adverse events are a rare but potentially deadly complication after immune checkpoint inhibitor (ICI) treatment. As multiple sclerosis (MS) is an immune-mediated disease, it is unknown how ICI treatment may affect outcomes.

METHODS: We analyzed the United States Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database for pembrolizumab, atezolizumab, nivolumab, ipilimumab, avelumab, and durvalumab 2 years prior their FDA approval until December 31, 2017, to include all cases with confirmed diagnosis/relapse of MS. We also included cases reported in the literature and a patient from our institution.

RESULTS: We identified 14 cases of MS …

A Study To Assess The Relationship Between Attention Deficit Hyperactivity Disorder And Obstructive Sleep Apnea In Adults, Sean Hesselbacher, Akshar A. Aiyer, Salim R. Surani, Alishah A. Suleman, Joseph Varon

Internal Medicine, East Africa

The association between obstructive sleep apnea (OSA) and attention deficit hyperactivity disorder (ADHD) is well-established in children. However, there is a paucity of literature regarding this association in adults. The aim of this study was to determine if ADHD is more common in adult patients with OSA. All patients referred to a sleep center for sleep evaluation were administered the Adult ADHD Self-Report Scale and diagnostic polysomnogram. The ADHD screen is considered positive if 4 of 6 questions in part A of the screening questionnaire were answered abnormally. The study population consisted of 194 participants, predominantly male (62%), Caucasian (54%), …

Oral Delivery Of Xenon For Cardiovascular Protection, Xing Yin, Melanie R Moody, Valeria Hebert, Melvin E Klegerman, Yong-Jian Geng, Tammy R Dugas, David D Mcpherson, Hyunggun Kim, Shao-Ling Huang

Faculty, Staff and Student Publications

Cardiac hypertrophy often causes impairment of cardiac function. Xenon (Xe), a naturally occurring noble gas, is known to provide neurological and myocardial protection without side effects. The conventional method of Xe delivery by inhalation is not feasible on a chronic basis. We have developed an orally deliverable, effective Xe formulation for long-term administration. We employed 2-hydroxypropyl)-β-cyclodextrin (HPCD), which was dissolved in water to increase the Xe concentration in solution. The beneficial effects of long-term oral administration of Xe-enriched solutions on cardiovascular function were evaluated in vivo. HPCD increased Xe solubility from 0.22 mM to 0.67 mM (3.8-fold). Aged ApoE knockout …

69-Year-Old Male After Gastric Bypass With Choledocholithiasis Treated With Edge Procedure Complicated By Lams Dislocation, Michal Kloska Md, Phd, Reema M. Vaze Md, Ricky Buckshaw Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Endoscopic Ultrasound-Guided Drainage Of Pancreatic Fluid Collections Using Axios™ Electrocautery Enhanced Delivery System: A Retrospective Experience At A Large Quaternary Care Center, Michal Kloska Md, Phd, Valery Hrad Md, Soorya N. Aggarwal Do, Shashin Shah Md, Zachary Zator Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Umbilical Hernia Rupture Complicated By Enterocutaneous Fistula In 63-Years-Old Female With Decompensated Nash Cirrhosis, Michal Kloska Md, Phd, Matthew J. Sullivan Do, Adam Peyton Do, Waqas Adeel

Department of Medicine

No abstract provided.

A Rare Case Of Biliary Pancreatitis Caused By Ampullary Somatostatinoma In A 46-Year-Old Female, Michal Kloska Md, Phd, Reema M. Vaze Md, Ricky Buckshaw Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Abdominal Tb, More To Abdominal Masses And Symptoms Than Meets The Eye, Johnathon Dallarosa Md, Breanna S. Goldner Do

Department of Medicine

No abstract provided.

Management Of Large Aspergilloma With Massive Hemoptysis Complicated By Adhesions From A Previous Partial Lobectomy, Johnathon Dallarosa Md, Nathan Brewster Do, Brian J. Holahan Do, Kareem Godil Md, Jaimin Patel Do, Jessica Boehmler Md

Department of Medicine

No abstract provided.

Bile Reflux Gastritis Patient Profile In Dr. Saiful Anwar Malang Hospital, Fadhila Nurisa, Supriono Supriono

Jurnal Penyakit Dalam Indonesia

Introduction. Bile reflux gastritis is bile reflux to gaster with fullness sensation, uncomfort, nausea, and vomiting. Bile reflux gastritis usually happens after surgery, as partial gastrectomy, truncal vagotomy, pyloroplasty, cholecystectomy, or sphinchteroplasty. This study aimed to determine the description of endoscopic of patients with bile reflux gastritis and the location of abnormalities found in endoscopy patient at Saiful Anwar Hospital Malang. Methods. Data were taken from the medical record of endoscopy patient in Saiful Anwar Hospital Malang from 2012 January the 1st until 2016 December the 31st that fulfill bile reflux gastritis inclusion criteria. Abnormality location divided near and far …

Neutrophil Lymphocyte Ratio As A Predictor Of The First Onset Acute Neutropenia After R-Chop Chemotherapy In Diffuse Large B-Cell Lymphoma Patients, Griskalia Christine, Lugyanti Sukrisman, Noorwati Sutandyo, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Background. Diffuse Large B-cell Lymphoma (DLBCL) is the most common lymphoma in Indonesia. R-CHOP chemotherapy has a moderate risk for neutropenia / febrile neutropenia. Lymphocytes can describe host immunity, while neutrophils and monocytes can describe the inflammatory response. No study has assessed differential count of leukocytes as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients. This study aimed to determine the relationship between differential count of leukocytes before chemotherapy as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients. Methods. A retrospective cohort study was conducted among 18–60 years …

The Additive Effect Of Rosmarinic Acid For The Reduction Of Glomerular Nf-Kb Expression In Diabetes Rat That Was Given Telmisartan, Mochamad Fachrureza, Nur Samsu, Achmad Rudijanto

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic nephropathy is one of the common complications of diabetes, which one of its causes is the increase of free radicals through the activation of NF-kβ and Angiotensin II. Rosmarinic acid has the activity as the anti-oxidant and anti-inflammatory, and the telmisartan is the partial PPAR-γ agonist that has the anti-fibrotic effect. This study aimed to identify the effect of rosmarinic acid and telmisartan in the reduction of subunit p65 NF-kB expression on the glomerular diabetes rat. Methods. An experimental study with a post-test only controlled group was conducted in a group of rats (Rattus norvegicus). Rats were randomly …

Factors Affecting Rapid Decline In Glomerular Filtration Rate In Hiv/Aids Patients Using Tenofovir Disoproxil Fumarate, Prima Yuriandro, Evy Yunihastuti, Maruhum Bonar H Marbun, Pringgodidgo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. Tenofovir disoproxil fumarate (TDF) treatment in HIV/AIDS patient has particular effect to the kidney, which is rapid decline in glomerular filtration rate (GFR) (> 5 cc/min/1.72 m2 one year after using the drug). The incidence rate for rapid decline in GFR and factors affecting it are still contradictive and not assessed completely. This study was done to identify cumulative incidence and factors affecting TDF related nephrotoxicity. Methods. A retrospective cohort study was conducted in HIV/AIDS outpatient clinic Cipto Mangunkusumo Hospital Jakarta. We included patients who start taking TDF as their medication from January 2010 until January 2015 with consecutive …