Internal Medicine Commons^™

Rhabdomyolysis: An Unusual Presenting Symptom Of Hypothyroidism, Kourtney Erickson Do, Grace Berlin Do, Marie S. O’Brien Do

Department of Medicine

No abstract provided.

Comparison Of The Sofa And Qsofa Scores In Predicting In-Hospital Mortality Among Adult Critical Care Patients With Suspected Infection., Mohammed Said

Master of Medicine in Internal Medicine

Background: Sepsis is global health priority and the commonest cause of death in critical care. SEPSIS 3 criteria introduced in 2016 is the latest tool in diagnosing sepsis, uses qSOFA and SOFA scores in place of the SIRS based definition for better prediction of mortality in patients with suspected infections. Their performance in predicting mortality in critical care units outside high- income countries remains largely unknown. Objective: We compared the SOFA and qSOFA scores in predicting the hospital mortality of adult critical care patients admitted with suspected infection at the Aga Khan University Hospital Nairobi, Kenya. Methods: We did a …

Clinical Spectrum And Factors Impacting Outcome Of Candida Auris: A Single Center Study From Pakistan, Muneeba Ahsan Sayeed, Joveria Farooqi, Kauser Jabeen, Safia Awan, S Mahmood

Section of Internal Medicine

Background: An outbreak of Candida auris began globally in 2014 including Pakistan and since then it has emerged as a nosocomial multi-drug resistant pathogen. The aim of this study was to assess the clinical spectrum and outcome of patients, from a single center in Pakistan, in whom C. auris was isolated.

Methods: A retrospective study was conducted on 92 patients; ≥16 years with at least one culture positive for C. auris, at the Aga Khan University Hospital Karachi, Pakistan from Sept 2014-Mar 2017.Demographics, clinical history, management and outcome were studied. A logistic regression model was used to identify the risk …

An Integrative Approach To Mindfulness-Based Symptom Management For Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Lisa Barer

Mindfulness Studies Theses

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic health condition; its etiology is poorly understood, and treatment options are limited to management of symptoms. Current recommended treatment options are controversial, and evidence of effectiveness is limited. This paper proposes a novel model for symptom management of ME/CFS using mindfulness-based interventions, cognitive behavioural therapy (CBT), and relaxation techniques. A comprehensive review of available evidence is used to support this approach. The idea is that, working synergistically, these three approaches, grounded by mindfulness-based principles, can address many of the symptoms of the illness and help patients better cope and manage their day-to-day …

Doxycycline Didn’T Cure The Fever! An Interesting Case Of Large Granular Lymphocytic (Lgl) Leukemia With Secondary Hemophagocytic Lymphohistiocytosis (Hlh)., Dayan Ojeda Damas, Ayesha Hamid, Kevin Wu, Michael Lapelusa, Nabeel Sarhill, Henry Kwang

School of Medicine Publications

HLH: A rare association with LGL Leukemia Dayan Ojeda-Damas MD, Ayesha Hamid MD, Kevin Wu MD, Michael Lapelusa MS-3, Nabeel Sarhill MD, Henry Kwang MD University of Texas Rio Grande Valley. Internal Medicine Residency at Valley Baptist Medical Center. Harlingen, TX Introduction Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal syndrome characterized by excessive immune activation. It is diagnosed in patients of all ages and is classified as either primary from gene mutations or secondary from various triggers. We present an interesting case of HLH in a patient with large granular lymphocytic leukemia (LGL). Presentation A 53-year-old female with a questionable …

A Case Of An Anomalous Right Coronary Artery Arising From The Left Coronary Cusp, Muhammad Shabbir Rawala, Ahmer A. Longi, Arfeen A. Khan, Syed Inam Rizvi, Syed B. Rizvi

Section of Internal Medicine

An anomalous origin of the right coronary artery is usually asymptomatic. It is mostly found incidentally on an invasive diagnostic angiogram. It does lead to an increased risk of sudden cardiac death, especially in younger patients. We present a case of a 41-year-old who had presented to the hospital with complaints of chest pain. The patient was evaluated by cardiology who performed an angiography that identified an anomalous origin of the right coronary artery arising from the left coronary cusp but no evidence of coronary artery disease. Once identified, these anomalous vessels should be corrected surgically, as these conditions increase …

Discontinuation Of Proton Pump Inhibitor Use Reduces The Number Of Endoscopic Procedures Required For Resolution Of Walled-Off Pancreatic Necrosis., Patrick C. Powers, Ali Siddiqui, Reem Z. Sharaiha, Grace Yang, Enad Dawod, Aleksey A. Novikov, Amy Javia, Cynthia Edirisuriya, Arish Noor, Tayebah Mumtaz, Usama Iqbal, David .E Loren, Thomas E. Kowalski, Natalie Cosgrove, Yordano Alicea, Amy Tyberg, Iman Andalib, Michel Kahaleh, Douglas G. Adler

Division of Gastroenterology and Hepatology Faculty Papers

Background and Objectives: Endoscopic drainage/debridement of symptomatic walled off necrosis (WON) using lumen-apposing metal stents (LAMS) is both safe and effective. While endoscopic management of WON is the standard approach to treatment, the ideal concomitant medical therapy remains unclear. The purpose of this study was to further elucidate the effect of proton pump inhibitor (PPIs) therapy on the technical and clinical success of endoscopic treatment of WON.

Methods: Two hundred and seventy-two patients in 8 centers with WON managed by endoscopic drainage using LAMS were evaluated. Patients were followed for at least 6 months following treatment. The patients were divided …

Relapsing Hcv Associated Glomerulonephritis Despite Sustained Virologic Response (Svr) To Direct-Acting Antivirals (Daa), Joseph Scurozo Do, Wael Hanna Md, Grace Chong Do, Frederick S. Fleszler Md

Department of Medicine

No abstract provided.

Massive Hemoptysis In The Setting Of Acute Mitral Regurgitation, Joseph Moran Do, George Prousi Md, Ross Biggs Do, Nirupama Kakumanu Md, Fccp

Department of Medicine

No abstract provided.

Mycosis Fungoides: A Master Of Disguise, Amogh M. Joshi Do, Emilee E. Kurtz Do, Yehia Y. Mishriki Md

Department of Medicine

No abstract provided.

Rare Sarcomatoid Carcinoma Of The Liver In A Patient With No History Of Hepatocellular Carcinoma: A Case Report, Kevat B. Patel, Rita H. Hawarny, Elizabeth Saunders, Marc Hettlinger, Niru Nahar

Marshall Journal of Medicine

Sarcomatoid carcinoma is a rare malignant tumor of unknown pathogenesis characterized by poorly differentiated carcinoma tissue containing sarcoma-like differentiation of either spindle or giant cell and rarely occurs in the gastrointestinal tract and hepatobiliary-pancreatic system.¹ Primary hepatic sarcomatoid carcinoma accounts for only 0.2 % of primary malignant liver tumors, and 1.8% of all surgically resected hepatocellular carcinomas.² The majority of hepatic sarcomatoid carcinoma cases appear to occur simultaneously with hepatocellular or cholangiocellular carcinoma.³ The preferred treatment for hepatic sarcomatoid carcinoma is surgical resection and the overall prognosis is poor.⁴ This case depicts a 62-year-old female whom …

Cardio Metabolic Risk Factors For Atrial Fibrillation In Type 2 Diabetes Mellitus: Focus On Hypertension, Metabolic Syndrome And Obesity, Mihnea-Alexandru Gaman, Elena-Codruta Dobrica, Emilia G. Pascu, Matei-Alexandru Cozma, Mirela-Elena Epingeac, Amelia M. Gaman, Anca M. Pantea Stoian, Ovidiu G. Bratu, Camelia C. Diaconu

Journal of Mind and Medical Sciences

Objective. Atrial fibrillation (AF) in type 2 diabetes mellitus (T2DM) has been little explored so far. However, there are several cardio metabolic risk factors for AF in T2DM patients, such as arterial hypertension, obesity or the metabolic syndrome. Our objective was to evaluate cardio metabolic risk factors for AF in T2DM patients. Methods. We studied the medical records of T2DM patients hospitalized in the Internal Medicine department of an emergency referral hospital in Bucharest, Romania. The study was observational, retrospective and carried out between January-June 2018. Results. The study group included 221 T2DM patients (with a mean age of 68.65 …

Immune And Inflammatory Pathways In Non-Alcoholic Steatohepatitis (Nash). An Update, Sorina Cezara Coste, Ionela Popovici, Andreea Maria Stefan, Iulia Breaban, Adela Sitar Taut, Simina Tarmure Sarlea, Angela Cozma, Dorel Sampelean, Olga Hilda Orasan, Vasile Negrean, Lucia Maria Procopciuc

Journal of Mind and Medical Sciences

Non-alcoholic steatohepatitis (NASH), also known as fatty liver disease (FLD), is a major public health problem. It is considered to be the hepatic manifestation of the metabolic syndrome. Chronic inflammation of the liver is an essential key in the progression from simple hepatic steatosis to steatohepatitis, the evolutionary stage of fatty liver disease. Moreover, the innate immune system plays a crucial role in the progression of hepatic inflammation. For this reason, it is of utmost importance to elucidate the connections between immune mechanisms, Toll-like receptor cytokine signalling, in order to find new effective treatments. Further studies are necessary to test …

High Intensity Interval Training - As Good As In Athletes As In Subjects With Metabolic Syndrome?, Iulia O. Pfingstgraf, Victoria M. Ruta, Vasile Negrean, Mircea I. Handru, Olga H. Orășan, Teodora G. Alexescu

Journal of Mind and Medical Sciences

HIIT training (high intensity interval training) is one of the most effective means of improving both cardio-respiratory and metabolic functions as well as physical performance of athletes. It includes a series of intensive physical exercises (e.g. running until reaching 90% of the maximum possible pulse), with intermittent rest periods. Active intervals can range between 45 and 240 seconds and alternate with easy exercise periods or even rest periods. This type of training is based on a different principle than regular exercises, where the effort is constantly dosed with an average intensity over a longer period of time. Initially, these exercised …

The Relationship Between Gut Microbiota And Spontaneous Bacterial Peritonitis In Patients With Liver Cirrhosis - A Literature Review, Roxana-Emanuela Popoiag, Anca Mihaela Pantea Stoian, Adrian P. Suceveanu, Andra I. Suceveanu, Laura Mazilu, Irinel R. Parepa, Laura M. Serban, Mihai Paunica, Catalina Motofei, Carmen Fierbinteanu Braticevici

Journal of Mind and Medical Sciences

Gut microbiota is an essential component in the pathogenesis of liver cirrhosis and its complications. There is a direct relationship between the gut and the liver called the gutliver axis through which bacteria can reach the liver through the portal venous blood. However, it remains unclear how bacteria leave the intestine and reach the fluid collection in the abdomen. A series of mechanisms have been postulated to be involved in the pathogenesis of spontaneous bacterial peritonitis (SBP) and other complications of liver cirrhosis, including bacterial translocation, bacterial overgrowth, altered intestinal permeability and dysfunctional immunity. The hepatic function may also be …

Using The Ebus Scope In The Esophagus, Yousef Shweihat, Shantanu Singh

Internal Medicine

This chapter aims at introducing the interested Pulmonologist/Interventional Pulmonologist to the esophageal ultrasound. In this chapter, we give short descriptions of some technical aspects of the endobronchial ultrasound (EBUS) scope and explain in detail why we believe the EBUS scope is well suited to be an esophageal scope in the hands of the trained pulmonologist. The chapter then explains indications and benefits of this procedure that we consider central to the practice of chest physicians. We also describe in steps how to reach each lymph node station using the EBUS scope as a EUS scope (EUS-B) from our own experience. …

Eus-B For The Interventional Pulmonologist Using The Ebus Scope In The Esophagus, Yousef Shweihat, Shantanu Singh

Internal Medicine

This chapter aims at introducing the interested Pulmonologist/Interventional Pulmonologist to the esophageal ultrasound. In this chapter, we give short descriptions of some technical aspects of the endobronchial ultrasound (EBUS) scope and explain in detail why we believe the EBUS scope is well suited to be an esophageal scope in the hands of the trained pulmonologist. The chapter then explains indications and benefits of this procedure that we consider central to the practice of chest physicians. We also describe in steps how to reach each lymph node station using the EBUS scope as a EUS scope (EUS-B) from our own experience. …

P62-Mediated Selective Autophagy Endows Virus-Transformed Cells With Insusceptibility To Dna Damage Under Oxidative Stress, Ling Wang, Mary E. A. Howell, Aryianna Sparks Wallace, Caroline Hawkins, Camri A. Nicksic, Carissa Kohne, Kenton H. Hall, Jonathan P. Moorman, Zhi Q. Yao, Shunbin Ning

ETSU Faculty Works

DNA damage response (DDR) and selective autophagy both can be activated by reactive oxygen/nitrogen species (ROS/RNS), and both are of paramount importance in cancer development. The selective autophagy receptor and ubiquitin (Ub) sensor p62 plays a key role in their crosstalk. ROS production has been well documented in latent infection of oncogenic viruses including Epstein-Barr Virus (EBV). However, p62-mediated selective autophagy and its interplay with DDR have not been investigated in these settings. In this study, we provide evidence that considerable levels of p62-mediated selective autophagy are spontaneously induced, and correlate with ROS-Keap1-NRF2 pathway activity, in virus-transformed cells. Inhibition of …

An Incidental Diagnosis Of Aids-Related Disseminated Kaposi’S Sarcoma, Kathryn Kass Md, Amy Slenker Md

Department of Medicine

No abstract provided.

An Uncommon Complication Of A Common Medication: Diffuse Alveolar Hemorrhage Secondary To Supratherapeutic Inr, Nathan Brewster Do, Christopher Lenivy Do, Kareem Godil Md, Andres Zirlinger Md

Department of Medicine

No abstract provided.