Internal Medicine Commons^™

Unraveling Daptomycin-Induced Lung Injury, Vishal Shah, Fady Awad, Jacob Keesee, Anna Cohen

South Atlantic Division GME Research Day 2025

No abstract provided.

Enhancing Patient Safety: The Role Of Interdisciplinary Teams In Reducing Blood Culture Contamination, Fady M. Awad, Austin Patrick-Eisenberg, Brian Watson, Mohamed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Viral Vengeance: A Case Of Hiv Induced Myocarditis, Jacob Keesee, Brenden Pearce, Mohammed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Left Atrial Appendage Morphology Related To Cva Risk In Patients With Atrial Fibrillation, Lincoln Smith, John-Michael Benson, Jacob Michael Keesee

South Atlantic Division GME Research Day 2025

No abstract provided.

Endocarditis Causing Complete Heart Block And Cardiogenic Shock, Ish Patel, Jacob M. Keesee, Brenden Pearce, Sarah Barnhardt, Mohamed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Home Dialysis For Latinx Individuals Living With Kidney Failure: A Qualitative Study Of Interdisciplinary Dialysis Clinicians, Katherine Rizzolo, Rebeca Gonzalez Jauregui, Jade Teakell, Michel Chonchol, Sushrut S Waikar, Lilia Cervantes

Faculty, Staff and Student Publications

Key Points:

1. Individual-level advocacy to overcome structural barriers to home dialysis is key in improving home dialysis access for Latinx individuals.

2. Acknowledging patient influences on dialysis modality choice is critical for Latinx individuals with kidney failure.

3. Early, repeated education from a trusted source is important for Latinx individuals with kidney failure.

Background: Latinx individuals experience two times the incidence of kidney failure compared with non-Latinx individuals and are less likely to use home dialysis therapies. In this qualitative study, interdisciplinary home dialysis clinicians were interviewed to understand the key factors and strategies used by clinicians to improve home dialysis uptake …

Predictors For Spontaneous Pleurodesis In Patients With Indwelling Pleural Catheters For Malignant Pleural Effusion: A Safety Net Hospital Experience, Saad Farooq, Sabiha Armin, Jordan E Killingsworth, Akriti Agrawal, Adishwar Rao, Rosa M Estrada-Y-Martin, Sujith V Cherian

Faculty, Staff and Student Publications

Background: Malignant pleural effusion (MPE) affects approximately 150,000 patients in the United States each year and usually signifies advanced-stage cancer. The optimal treatment remains a challenge but indwelling pleural catheters (IPC) offer several advantages and may help achieve spontaneous pleurodesis (SP) in some patients.

Objectives: We aim to investigate the predictors of SP among patients with MPE, particularly in a resource-limited community-based safety net hospital.

Design: This is a retrospective cohort study done at a community-based safety net hospital.

Methods: Adults diagnosed with or suspected of having MPE between January 2015 and December 2023 who underwent IPC placement were included. …

Measurement Of Oxygen Consumption Rate In Mouse Aortic Tissue, Zhen Zhou, Ripon Sarkar, Jose Emiliano Esparza Pinelo, Alexis Richard, Jay Dunn, Zhao Ren, Callie S Kwartler, Dianna M Milewicz

Faculty, Staff and Student Publications

Thoracic aortic aneurysm and dissection (TAD) is a life-threatening vascular disorder, and smooth muscle cell mitochondrial dysfunction leads to cell death, contributing to TAD. Accurate measurements of metabolic processes are essential for understanding cellular homeostasis in both healthy and diseased states. While assays for evaluating mitochondrial respiration have been well established for cultured cells and isolated mitochondria, no optimized application has been developed for aortic tissue. In this study, we generate an optimized protocol using the Agilent Seahorse XFe24 analyzer to measure mitochondrial respiration in mouse aortic tissue. This method allows for precise measurement of mitochondrial oxygen consumption in mouse …

Haemodynamic Response Of Normal Aortic Valves To Stress Using Invasive, Non-Invasive, And Computational Techniques, Rob Eerdekens, Vijay Govindarajan, Nils P Johnson, Jesse P A Demandt, Mohamed El Farissi, Fabienne E Vervaat, Daniel T Johnson, Richard L Kirkeeide, Pim A L Tonino

Faculty, Staff and Student Publications

AIMS: The haemodynamic physiology of the aortic valve has attracted renewed attention after the introduction of transcatheter aortic valve implantation (TAVI). Understanding normal valve function, especially under stress conditions, permits identification of early pathology and quantification of the extent to which TAVI restores normalcy. We aimed to describe the haemodynamic behaviour of a normal aortic valve during stress via invasive, non-invasive, and computational techniques.

METHODS AND RESULTS: Our cohort included subjects already undergoing invasive coronary angiography for clinical indications. Haemodynamic measurements were made invasively and non-invasively along with dobutamine infusion. Additionally, patient-specific anatomy from computed tomographic imaging served as input …

Development, Delivery, And Evaluation Of The Texas Epidemic Public Health Institute Pilot Infection Control Lecture Series, Kayla E Ruch, Anabel Rodriguez, Janelle Rios, Luis Ostrosky-Zeichner, Eric L Brown

Faculty, Staff and Student Publications

Introduction: The Texas Epidemic Public Health Institute (TEPHI) aims to keep Texans healthy and the economy strong by preparing for the next infectious disease outbreak. TEPHI's Small Rural Healthcare Preparedness core developed, delivered, and evaluated a pilot infection prevention and control webinar series called Infection Control for rural-serving health professionals and organizations based on infection prevention and control field best practices.

Methods: Data from the first year of the Infection Control series was collected through attendee registration forms, attendance records, knowledge, and post-lecture evaluation surveys using Qualtrics. The data were analyzed using Qualtrics software. Lectures were free and open to …

Key Considerations For Combination Therapy In Alzheimer’S Clinical Trials: Perspectives From An Expert Advisory Board Convened By The Alzheimer’S Drug Discovery Foundation, Jeffrey Cummings, Michael Gold, Mark Mintun, Michael Irizarry, Andrew Von Eschenbach, Suzanne Hendrix, Donald Berry, Cristina Sampaio, Kaycee Sink, Jaren Landen, Miia Kivipelto, Michael Grundman, Steven E Arnold, Allan Green, Katherine Partrick, Laura Nisenbaum, Aaron Burstein, Howard Fillit

Faculty, Staff and Student Publications

There is growing consensus in the Alzheimer's community that combination therapy will be needed to maximize therapeutic benefits through the course of the disease. However, combination therapy raises complex questions and decisions for study sponsors, from preclinical research through clinical trial design to regulatory, statistical, and operational considerations. In January 2024, the Alzheimer's Drug Discovery Foundation convened an expert advisory board to discuss the key considerations in each of these areas. Experts agreed on the need to prioritize a combination therapy approach that encompasses a wide range of targets associated with aging and the underlying biology of Alzheimer's disease. Progress …

What Is The Robustness Of Randomized Controlled Trials Supporting Rhinosinusitis Guidelines?, Najm S Khan, Aatin K Dhanda, Masayoshi Takashima, Richard Liu, Yuki Yoshiyasu, Wenbo Wu, Whitney Jin, Edward D Mccoul, Murugappan Ramanathan, Omar G Ahmed

Faculty, Staff and Students Publications

Purpose: To determine the robustness of randomized controlled trials (RCTs) supporting the current rhinosinusitis guideline; International Consensus Statement on Allergy and Rhinology: rhinosinusitis (ICAR-RS).

Materials & methods: RCTs referenced by ICAR-RS with primary dichotomous outcomes were analyzed. The Fragility Index (FI) was calculated for trials with statistically significant findings. Trial characteristics, the FI, and FI minus number lost to follow-up (LTF) were assessed for associations.

Results: A total of 317 RCTs were identified, with 38 trials possessing a primary dichotomous outcome. Thirty-one percent evaluated surgical interventions and 24 % were industry-sponsored. The mean sample size was 116 with 9 patients, …

Developing An Annual Review Of The Literature, Weinstein R Amy, Szauter Karen, Duca Nicholas, Jacob Jackcy, Ismail Nadia, Pincavage Amber, Walsh Katherine, Alexandraki Irene

Faculty, Staff and Students Publications

Many national meetings and speaker series feature an "Annual Review of the Literature" (ARL) session in which an individual or team presents a sampling of articles, selected and prepared because they represent important current topics or new ideas in the discipline of interest. Despite this, there is little in the medical literature describing how to thoughtfully and systematically develop these sessions. We identify best practices that we have developed and used in the United States Clerkship Directors of Internal Medicine (CDIM) over many years. These include identification of a theme, team assembly, timeline development, search strategy and rubric development and …

Veillonella Discitis: A Rare Presentation And Review Of Literature, Akankcha Alok, Vidya Sagar Kollu, Gautam Kalyatanda

HCA Healthcare Journal of Medicine

Background

Veillonella is an anaerobic gram-negative coccus found as a commensal organism in the oral, respiratory, gastrointestinal, and genitourinary tract of humans. Rarely, it can cause serious infections by the production of lipopolysaccharide, an endotoxin. Although most Veillonella infections occur in immunocompromised individuals, we herein describe cases of Veillonella discitis, a rare presentation of Veillonella, in immunocompetent patients.

Case Presentation

The first presented case was encountered in a patient admitted at our facility. All patient data were obtained from the hospital's electronic medical record system. Thereafter, a literature search and subsequent review was done on PubMed with the MEDLINE …

Hemophagocytic Lymphohistiocytosis Due To Ehrlichiosis: A Case Series, Ajay Iyer, Mattias D'Anna, Shruti Verma, Thomas Pritchard, Vladimir Begilman, Himal Bajracharya, Kaveh Naemi

HCA Healthcare Journal of Medicine

Background

Hemophagocytic lymphohistiocytosis (HLH) is an immunologic syndrome characterized by excessive inflammation and tissue injury due to uncontrolled activation of the phagocytic system. The underlying mechanism is a lack of downregulation of activated macrophages and lymphocytes by natural killer and T cells. Unfortunately, the diagnosis is often delayed or missed due to the rarity of the disease, decreased awareness, and clinical picture variability. Ehrlichiosis is becoming a more prevalent tick-borne illness in endemic regions and a relatively uncommon but increasingly considered cause of HLH.

Case Presentation

We describe the cases of 2 patients diagnosed with secondary HLH as per the …

Second Generation Antipsychotics And Cardiovascular Adverse Effects: Developing Evidence-Based Recommendations For Primary Care Medicine, Sana Borda, Ahn-Dao Lee, Paul F. Bell

HCA Healthcare Journal of Medicine

Background

Second-generation antipsychotic medications (SGAs) are often used by primary care physicians (PCPs) to treat multiple psychiatric diagnoses. SGAs have been connected to a number of adverse effects, including cardiovascular disease. Currently, there are no published evidence-based recommendations addressing SGAs and cardiotoxicity that are directed toward PCPs. This project aims to fill this gap.

Methods

Relevant search terms related to SGAs and cardiovascular disease were identified and then used to search databases (PubMed, PubMed Central, and AccessMedicine). Research studies obtained from the searches were narrowed to include systematic reviews and meta-analyses. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool was …

Hubungan Abnormalitas Ekokardiografi Terhadap Mortalitas Pasien Terkonfirmasi Covid-19 Derajat Berat Dan Kritis Di Rsupn Dr. Cipto Mangunkusumo, Fidiaji Hiltono Santoso, Idrus Alwi, Sally A. Nasution, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. The mortality rate of COVID-19 patients in Indonesia is high with manifestations of cardiac complications. Echocardiographic evaluation can help identify cardiac functional and structural disorders associated with patient mortality. Therefore, this study aims to determine the relationship between echocardiographic abnormalities and mortality in severe and critical COVID-19 patients.

Methods. A retrospective cohort study was conducted using medical record data of severe and critical COVID-19 patients at Dr. Cipto Mangunkusumo Hospital Jakarta during March 2020 to April 2021. Subjects were selected using total sampling. Descriptive analysis was performed, presenting descriptive tables, and bivariate analysis was conducted using the …

Implications Of Myocardial Strain In Primary Mitral Regurgitation-A Cardiovascular Magnetic Resonance Study, Simone Romano, Danai Kitkungvan, Duc T Nguyen, Carlos El-Tallawi, Edward A Graviss, Afshin Farzaneh-Far, Dipan J Shah

Faculty, Staff and Student Publications

Aims: Chronic primary mitral regurgitation (MR) results in progressive left ventricular (LV) remodelling. Abnormal myocardial deformation (strain) can be present despite preserved ejection fraction (EF). Cardiovascular magnetic resonance (CMR) feature-tracking techniques allow assessment of global longitudinal strain (GLS) from routine cine images. The aim of this study is to evaluate the prognostic value of CMR feature tracking-derived GLS in patients with primary MR.

Methods and results: Consecutive patients undergoing CMR for chronic MR from January 2012 to June 2018 were enrolled. Patients with LVEF < 50% were excluded. The composite primary outcome aiming to detect decompensation related to MR comprised (i) referral for mitral surgery owing to symptoms or LV systolic dysfunction or (ii) cardiovascular death. The secondary outcome was all-cause death. A total of 422 patients were followed for a median of 2.7 years, and the primary endpoint was met in 93 patients (34 patients reported symptoms at baseline). At multivariable analysis, GLS≥ -16.6% was associated with primary outcome [hazard ratio (HR) 1.90, P = 0.01]. In moderate MR cohort, patients with GLS≥ -16.6% had worse event-free survival, whereas there was no significant difference in mild or severe MR groups. GLS≥ -16.0% remained associated with all-cause death after adjusting for other covariates including the MR severity (HR 2.24, P = 0.02).

Conclusion: In patients with primary MR with preserved systolic function, GLS was associated with our composite …

Pengetahuan Dan Persepsi Keluarga Penderita Penyakit Ginjal Tahap Akhir (Pgta) Terhadap Transplantasi Ginjal Di Rs Hasan Sadikin Bandung, Rizqa Adinda Syakira, Helni Mariani, Rizky Andhika

Jurnal Penyakit Dalam Indonesia

Introduction. Kidney transplantation is the best kidney replacement therapy for End Stage Renal Disease (ESRD) patients. The gap between the number of donors and recipients remains a problem contributing to the low rate of kidney transplantation in Indonesia. The families of ESRD patients are the most recommended donor candidates. Knowledge and perception have a crucial role in the decision to donate organs, making it important to know the knowledge and perception of ESRD patients’ families towards kidney transplantation. This study aimed to describe the knowledge and perception of families of ESRD patients undergoing dialysis at Dr. Hasan Sadikin General …

Pengaruh Durasi Pengobatan Dan Preferensi Pasien Kanker Stadium Akhir Terhadap Layanan Homecare Di Rumah Sakit Medistra Pada Tahun 2021-2023, Peter Brian Sutanto Putra Dr, Erfen Gustiawan Suwangto Dr, Tena Djuartina Dr, Iskandar Rahardjo Budianto Dr, C. Rinaldi A. Lesmana

Jurnal Penyakit Dalam Indonesia

Introduction. Cancer is still an enormous health problem in the world and rank second as the most common cause of mortality. End-stage cancer requires end-of-life or palliative care to improve the patient’s quality of life before death. Homecare services have become an option for providing palliative care to avoid long-term hospital stays. The study aimed to provide an overview of the treatment duration and other factors in end-stage cancer patients regarding the selection of homecare services at Medistra Hospital during the period of 2021-2023.

Methods. This study with a cross-sectional design analyzed medical records of end-stage cancer patients …