Internal Medicine Commons^™

Comparison Of Absolute Neutrophil Count Between Hospital And Community Acquired Methicillin-Resistant Staphylococcus Aureus Infection, Kurniyanto Kurniyanto, Widayat Djoko Santoso, Leonard Nainggolan, Juferdy Kurniawan

Jurnal Penyakit Dalam Indonesia

Introduction. The virulence factors from community acquired-methicillin resistant Staphylococcus aureus (CA-MRSA) mainly due to toxins like Panton Valentin Leukocidin (PVL) and Phenol Soluble Modulin (PSM). Both of toxins cause decrease of value through neutrophil lysis. This study aimed to identify different value of absolute neutrophil count between hospital and community acquired MRSA. Methods. A cross sectional was conducted which included subjects who were infected by MRSA and hospitalized during 2012-2017. Classification of MRSA were divided due to its sensitivity and resistance to non-beta lactam antibiotics. Isolate that resistance to ≤ 2 antibiotics were classified as CA-MRSA. The others with resistance …

Relationship Between Neutrophil Lymphocyte Ratio And Lower Extremity Peripheral Artery Disease In Patients With Type 2 Diabetes Mellitus, Krishna Adi Wibisana, Imam Subekti, Dono Antono, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. Lower extremity peripheral artery disease (PAD) is one of diabetic macrovascular complication which has high rate of morbidity and mortality. Chronic inflammation has been known to have a role in the pathogenesis of PAD in diabetic patient. Recently, neutrophil lymphocyte ratio (NLR) has been used as a marker of chronic inflammation. This study aimed to determine the relationship between neutrophil lymphocyte ratio and lower extremity peripheral artery disease in type 2 diabetic patient in Cipto Mangunkusumo hospital. Methods. A cross sectional study was conducted on 249 patients with type 2 diabetes mellitus who underwent ankle brachial index (ABI) examination …

Cause Of The Low Positivity Of Blood Culture In Septic Patients, Krishna Yana, Bachti Alisjahbana, Yovita Hartantri

Jurnal Penyakit Dalam Indonesia

Introduction. Sepsis due to bacterial infection is one of the main causes of high disease morbidity and mortality. Management of sepsis, the detection of bacteriemia by examination of blood cultures has an important role, but until now the positivity of blood culture results at Hasan Sadikin Hospital (RSHS) is still low (13.45%). The purpose of this study was to determine profile the causes of low positivity of blood culture results in sepsis patients in RSHS. Methods. A cross sectional study was conducted on sepsis patient treated in Emergency Un it (ER) and inpatient of Hasan Sadikin hospital Internal Medicine from …

Herpes Zooster Induced Diabetic Ketoacidosis, Christopher Surya Suwita, Michael Johan, Dicky L. Tahapary, Budiman Darmowidjojo

Jurnal Penyakit Dalam Indonesia

Diabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes which is common in daily practice. DKA is the result of severe insulin deficiency and often presents as the first symptom of an undiagnosed diabetes even though it may also appear in individuals with diabetes. Some conditions that can trigger DKA include infections, myocardial infarction, stroke, pancreatitis, trauma, or poor treatment compliance. Skin tissue infections such as herpes zoster are rare inciting factor in DKA. This article will discuss a case of DKA that is triggered by herpes zoster.

Sarcoidosis Presenting As Acute Respiratory Distress Syndrome., Bilal Lashari, Ahmad Raza, Vincent Chan, William Ward

Abington Jefferson Health Papers

Sarcoidosis is a multisystem granulomatous disease of unknown origin. It typically involves the lungs and mediastinal lymph nodes in a chronic fashion. However, acute syndrome has been reported possibly in response to systemic release of proinflammatory cytokines. Acute pulmonary manifestations, especially acute respiratory failure or acute respiratory distress syndrome, remain extremely uncommon in individuals without a prior diagnosis. We present the case of a 41-year-old African American female, who presented with ARDS. An extensive workup into the cause of her illness remained negative, and she subsequently succumbed to her illness. A diagnosis of sarcoidosis was made upon autopsy, after exclusion …

It's Getting Hot In Here: A Rare Case Of Heat Stroke In A Young Male., Oriana Ramirez, Yury Malyshev, Sonu Sahni

Touro College of Osteopathic Medicine (New York) Publications and Research

Heat stroke is a severe acute illness characterized by a core temperature greater than 40°C (104°F) and central nervous system manifestations, such as delirium, convulsions, or coma, resulting from exposure to environmental heat or strenuous physical activity. Early recognition and treatment including aggressive cooling and management of life-threatening systemic complications, such as cardiac arrest, rhabdomyolysis and acute renal failure, are essential to reduce morbidity and mortality. Herein we describe a case of heat stroke in a 23-year-old male who suffered cardiac arrest in which prompt initiation of cooling measures prevented permanent neurological sequelae, provided swift neurological recovery and resolution of …

Agep Overlap Induced By Hydroxychloroquine: A Case Report And Literature Review., Christopher Mercogliano, Muhammad Khan, Catherine Lin, Elan Mohanty, Ryan Zimmerman

Reading Hospital Internal Medicine Residency

Acute Generalized Exanthematous Pustulosis (AGEP) is a rare drug reaction manifesting as pustular lesions with surrounding erythema following exposure. The disease is often self-limited and treatment is supportive. It may present in an atypical variant with vesicles that desquamate into erosions, which classifies the disease as an AGEP/SJS Overlap. This overlap syndrome can carry a substantial mortality rate and necessitate elevation in the level of care. Hydroxychloroquine has been implicated in cases of AGEP, and we present a case of AGEP/SJS overlap attributed to this common medication. Given the prevalence of drug eruptions, it is critical for the physicians to …

Clostridium Sporogenes Bacteremia In An Immunocompetent Patient, Waiel Abusnina, Mena Shehata, Emhemmid S. Karem, Zeynep C. Koc, Elie Khalil

Internal Medicine

Of the 200 Clostridium spp. known to exist, approximately 30 have been associated with human disease. Commonly found in soil, marine sediment and mammalian intestinal tracts, these gram-positive bacilli are known to cause infections ranging from cellulitis to septicemia. Isolates that are identified by clinical microbiology laboratories include Clostridium perfrigens species in 20–40% of cases. However, when Clostridium sporogenes is identified, is rarely considered to be pathogenic. We present a case of Clostridium sporogenes bacteremia secondary to lower limb cellulitis and osteomyelitis in an immunocompetent patient.

Screening, Brief Intervention, And Referral To Treatment For Alcohol Misuse In Primary Care, Sai-Han Ackerman Yu

Doctor of Nursing Practice

An annual average of 88,000 deaths in the United States from 2006 to 2010 has been attributed to alcohol misuse, defined as risky or heavy alcohol consumption. Heavy or risky alcohol use for all adults aged 65 and older and for women aged 18 and older is defined as consuming more than 7 drinks per week and/or 3 drinks per day. For men aged 18 to 65 years of age, heavy or risky alcohol use is defined as consuming more than 14 drinks a week and/or 4 drinks a day. Chronic alcohol misuse increases the incidence of heart problems, cognitive …

Clinician Perspectives On Factors Affecting Shared Decision Making About Lung Cancer Screening, Mohammad Abubaker-Sharif, Melissa Dicarlo, Mph, Ms, Ronald E. Myers, Phd, Dsw

Phase 1

Background/Objective. In 2015, the Centers for Medicare and Medicaid Services (CMS) announced coverage for annual lung cancer screening (LCS) with low dose computed tomography (LDCT) for individuals who are 55 to 77 years of age, have > 30 pack years of smoking history, and undergo shared decision making (SDM) prior to screening. Most referrals for LCS are initiated in primary care. Currently, little is known about how primary care physicians view SDM and barriers in practice to SDM about LCS. This study aimed to gather information to help fill these knowledge gaps.

Methods. I worked with senior leadership in …

Clinical Outcomes Of Successful Revascularization Of Chronic Total Coronary Occlusions With Bioresorbable Vascular Scaffolds: A Systematic Review., Roman Marchenko, Salik Nazir, Shelina Malla, Anthony Donato

Reading Hospital Internal Medicine Residency

Revascularization of chronic total occlusions (CTO) with percutaneous coronary intervention is associated with favorable long-term clinical and echocardiographic outcomes. Whether bioresorbable vascular scaffolds (BVS) would be advantageous in the treatment of CTO is unknown as patients with these lesions were generally excluded from large BVS randomized trials. We performed a systematic review, which sought to summarize known data on mid- to long-term clinical outcomes for BVS in CTO. We searched MEDLINE, EMBASE, clinicaltrials.gov, and the Cochrane Library through April 2018 to look for studies on implantation of BVS in CTO. Outcomes of interest included myocardial infarction, cardiac death, all-cause mortality, …

Myeloablative Vs Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation For Chronic Myeloid Leukemia, Saurabh Chhabra, Kwang Woo Ahn, Zhen-Huan Hu, Sandeep Jain, Amer Assal, Jan Cerny, Edward A. Copelan, Andrew Daly, Zachariah Defilipp, Shahinaz M Gadalla, Robert Peter Gale, Siddhartha Ganguly, Betty K. Hamilton, Gerhard C. Hildebrandt, Jack W. Hsu, Yoshihiro Inamoto, Abraham S. Kanate, H. Jean Khoury, Hillard M. Lazarus, Mark R. Litzow, Sunita Nathan, Richard F. Olsson, Attaphol Pawarode, Olle Ringden, Jacob M. Rowe, Ayman Saad, Bipin N. Savani, Harry C. Schouten, Sachiko Seo, Nirav N. Shah

Markey Cancer Center Faculty Publications

Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative treatment of chronic myeloid leukemia (CML). Optimal conditioning intensity for allo-HCT for CML in the era of tyrosine kinase inhibitors (TKIs) is unknown. Using the Center for International Blood and Marrow Transplant Research database, we sought to determine whether reduced-intensity/nonmyeloablative conditioning (RIC) allo-HCT and myeloablative conditioning (MAC) result in similar outcomes in CML patients. We evaluated 1395 CML allo-HCT recipients between the ages of 18 and 60 years. The disease status at transplant was divided into the following categories: chronic phase 1, chronic phase 2 or greater, and accelerated phase. Patients …

Anaplastic Pleomorphic Xanthoastrocytoma Presenting With Musical Hallucination., Oreoluwa Oladiran, Ifeanyi Nwosu, Steve Obanor, Chinyere Ogbonna-Nwosu, Brian Le

Reading Hospital Internal Medicine Residency

Musical hallucinations are a relatively rare form of auditory hallucination characterized by hearing of music in the absence of any external stimuli. This phenomenon has been linked to both psychiatric and structural lesions. We present the case of a previously healthy young male whose presentation with musical hallucinations led to the diagnosis of a rare tumour, anaplastic pleomorphic xanthoastrocytoma.

When Minimal Becomes Multiple: An Adult With Multiple Flares Of Minimal Change Disease, Kyle Kreitman Do, Nathan Brewster Do, Kaitlyn Musco Md

Department of Medicine

No abstract provided.

Sapho: A Challenging Diagnosis In A Young Woman With Recurrent Osteomyelitis, Kourtney Erickson Do, Grace Berlin Do, Yehia Y. Mishriki Md

Department of Medicine

No abstract provided.

An Atypical Presentation Of Mycobacterium Abscessus Soft Tissue Infection Leading To A Protracted Disease Course, Joseph Moran Do, Joseph Scurozo Do, Brian Friel Do

Department of Medicine

No abstract provided.

Chemo-Coronaries: A Rare Form Of Coronary Vasospasm Following 5-Fu Infusion, George Prousi Md, Joseph Moran Do, Ross Biggs Do, John Mannisi Md

Department of Medicine

No abstract provided.

Between A Rock And A Hard Place: Thrombotic Thrombocytopenic Purpura Induced St-Elevation Myocardial Infarction, Sagar Vadhar Do, Damon Mcenroe Md, Shivtaj Mann Do

Department of Medicine

No abstract provided.

An Atypical Adverse Drug Event: Bactrim Induced Autoimmune Hemolytic Anemia, Joseph Scurozo Do, George Prousi Md, Grace Chong Do, Brian J. Costello Do

Department of Medicine

No abstract provided.

Immune Related Adverse Events: Isolated Acth Deficiency With Nivolumab/ Ipilimumab Combination Therapy, Joseph Scurozo Do, Angela Magdaleno Do, Sharmila C. Koshy Md

Department of Medicine

No abstract provided.