Medicine and Health Sciences Commons^™

Post-Herpetic Paresis Of The Lower Extremity: An Unusual Complication Of Shingles, Leah Diane Stalnaker, Lynne J. Goebel, Md

Marshall Journal of Medicine

Herpes zoster, or shingles, is a disease process caused by re-activation of varicella zoster virus in the dorsal root ganglia. Most commonly, it presents with burning pain and a characteristic vesicular rash. However neurologic complications may occur, most often including neuralgia, and less commonly paresis. We present a case of post-herpetic paresis in an 86- year- old female.

Management Of Co-Existing Lung Cancer And Endobronchal Hamartomas, Mark H. Cooper, Md

Marshall Journal of Medicine

Abstract:

The coexistence of lung cancer with an endobronchial hamartoma is infrequent, and requires accurate oncologic evaluation of the endobronchial lesion prior to potential surgical treatment of the lung cancer. We describe a patient who presented with an undiagnosed endobronchial mass and and a biopsy-proven lung cancer which were successfully managed by a staged approach using initial bronchoscopic resection of the endobronchial lesion and subsequent lobectomy for squamous cell lung cancer.

Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, Md, Chadwick J. Knight, Md

Marshall Journal of Medicine

Abdominal trauma can be mysterious to some physicians. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, ultrasound and CT scans, patients can be quickly and efficiently evaluated.

Gradenigo Syndrome: A Rare Complication Of Otitis Media, Paul Brent Ferguson, Md

Marshall Journal of Medicine

Gradenigo syndrome is a very rare complication of otitis media that if left unrecognized and subsequently untreated will result in severe neurologic sequelae. Gradenigo Syndrome clinically represented by the triad of otitis media, ipsilateral, abducens nerve palsy and dysasthesia within the V1 and V2 divisions of the trigeminal nerve branches. We describe a 4 year-old patient who presented with headache, facial pain, diplopia and a recent history of upper respiratory tract symptomatology. Examination revealed an abducens palsy with subsequent magnetic resonance imaging demonstrating inflammation in the left petrous apex and along the tracts of the 6^th, 7^{th …}

Na/K-Atpase Amplification Of Oxidant Stress; A Universal But Unrecognized Clinical Target?, Zijian Xie, Phd, Joseph I. Shapiro, Md

Marshall Journal of Medicine

The Na/K-ATPase has a signaling function which appears to be separate from its ion pumping function. This signaling function refers to the transduction of conformational changes in the Na/K-ATPase alpha1 subunit into activating Src’s tyrosine kinase activity, triggering a cascade which generates reactive oxygen species (ROS), modulates other signaling pathways, and causes many physiological and pathophysiological effects. We have recently observed that ROS themselves as well as cardiotonic steroids can actually initiate the signal by directly inducing conformational changes in alpha1. It therefore appears that the Na/K-ATPase signal cascade can serve as a feed forward amplification for ROS with circulating …

Why Should Busy Clinicians Take Time To Participate In Clinical Research?, Todd H. Davies, Phd

Marshall Journal of Medicine

No abstract provided.

The Prescription Drug Epidemic In Appalachian Elderly, Suzanne Holroyd, Md

Marshall Journal of Medicine

No abstract provided.

Publishing To Progress Science: Shifting The Paradigm From Self To Selfless, Darshana T. Shah Phd

Marshall Journal of Medicine

“Publish or perish" is a phrase coined to describe the pressure in academia to rapidly and continually publish academic work to sustain or further one's career to the next level of academic promotion and to build an academic reputation^1. Prolific publishing increasingly affects funding as well as the reputation of individuals, their institutions, and journals themselves². While the drive behind this increase can be attributed to many factors, the impact can further both the author and the larger medical community. This leads to the juxtaposition of self and selflessness and suggests the question: How is this quantitative …

Vitamin D Deficiency: "At Risk" Patient Populations And Potential Drug Interactions, Dana Lycans Md, Elias Salloum Md, Matthew K. Wingate Md, Thomas Melvin Md, Grant S. Buchanan Md, Franklin D. Shuler Md, Phd

Marshall Journal of Medicine

Vitamin D is known to play an essential role in calcium homeostasis; however, excessive amounts can have harmful effects. Calcium and vitamin D levels are known to be influenced by drug interactions and pathology ranging from of cancer to cardiovascular disease. Vitamin D supplementation has become widespread, and it is important for clinicians to understand the way that certain conditions and medications interact with vitamin D and calcium homeostasis. The purpose of this review is to outline the benefits and adverse effects of vitamin D and how its levels are affected by certain pathologic and pharmacologic interactions.

Neurocognitive Dysfunction In Brain Tumor Patients Following Radiation Therapy: A Review Of Biological Hypotheses, Current Treatment Outcomes, And Novel Therapeutic Strategies, Raj Singh

Marshall Journal of Medicine

Given the difficulty of surgical resection of brain neoplasms located adjacent to vital structures of the brain as well as the challenges posed by the blood-brain-barrier for the efficacy of chemotherapeutic agents, whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) are often turned to for patients with brain metastases as well as primary brain neoplasms. Though radiation therapy may be successful in local control of these tumors, many patients experience treatment-related neurocognitive issues later in life. In this review, we examine cognitive dysfunction in brain tumor patients following radiation therapy, with an emphasis on the pediatric population. Articles were …

Generational Differences In Practice Site Selection Criteria Amongst Primary Care Physicians., Christopher Duffrin Phd, Mches, Molly Cashion Mph, Doyle M. Cummings Pharmd, Lauren Whetstone Phd, Jonathon Firnhaber Md, Gary Levine Md, Ricky Watson Md, Msph, Aaron Lambert Md

Marshall Journal of Medicine

ABSTRACT

Background and Objectives: Generational differences are often viewed as shaping the overall attitudes and actions of different age cohorts. It is essential to understand the motivations and generational differences in primary care physicians for efforts to recruit, retain, and educate the future physician workforce. Determining what factors most influence different generations of primary care physicians when choosing a practice site is essential to build our future primary care system. This study examined generational differences in the factors that attracted primary care physicians to their current practice.

Methods: A survey instrument was mailed to all active members of the North …

Keeping Rural Medical Students Connected To Their Roots: A “Home For The Holidays” Immersion Experience, William J. Crump Md, R. Steve Fricker Mpa

Marshall Journal of Medicine

Keeping Rural Medical Students Connected to their Roots: A “Home for the Holidays” Immersion Experience

Abstract

Introduction

Preclinical medical students with an initial affinity for rural practice often experience urban disruption during training. Longer summer rural immersion experiences have been shown to be somewhat effective in keeping rural students connected to their rural roots. Some students cannot adapt their schedules to these longer experiences. In response, a brief practice experience near home during the winter break of the academic year was established.

Methods

Nineteen detailed rural practice assessments were completed by preclinical medical students during school years 2009-2014 and essays …

Why Does Obesity Lead To Hypertension? Further Lessons From The Intersalt Study., Preeya T. Shah, Anna P. Shapiro, Zeid Khitan Md, Prasanna Santhanam Md, Joseph I. Shapiro Md

Marshall Journal of Medicine

Objectives

To analyze correlations between major determinants of blood pressure (BP), in efforts to generate and compare predictive models that explain for variance in systolic, diastolic, and mean BP amongst participants of the Intersalt study.

Methods

Data from the Intersalt study, consisting of nearly 10,000 subjects from 32 different countries, were reviewed and analyzed. Published mean values of 24 hour urinary electrolyte excretion (Na+, K+), 24 hour urine creatinine excretion, body mass index (BMI, kg/m^2), and blood pressure data were extracted and imported into Matlab™ for stepwise linear regression analysis.

Results

As shown earlier, strong correlations between urinary sodium excretion …

Case Report: Recurrent Staphylococcal Scalded Skin Syndrome In Healthy Term Neonate Despite Full Course Of Antibiotic Therapy, Indira Bhavsar, Rebecca Hayes, Amy Vaughan

Marshall Journal of Medicine

Background

Staphylococcal scalded skin syndrome (SSSS) describes a blistering skin infection caused by the exfoliative toxin in the bacterium Staphylococcus aureus. It more commonly affects the infant population and is characterized by large blistering bullae that rupture upon application of pressure.

Case description

We describe a case of recurrent SSSS in a healthy term neonate who initially presented with a perioral rash on day of life (DOL) 11 that quickly became vesicular with new lesions on the sternum and extremities. The patient’s rash began to resolve upon administration of culture-specific IV antibiotics. She was appropriately treated with a 14-day …

Endoscopic Ultrasound Guided Drainage Of Peri-Rectal Collections: A Salvage Approach, Yana Cavanagh, Kevin Hosein, Nihar Shah, Edward Milman, Sohail N. Shaikh

Marshall Journal of Medicine

Abdominal and pelvic abscesses can occur as a consequence of surgery and are associated with significant morbidity and mortality. It is well accepted that the primary treatment is antibiotic therapy and minimally invasive drainage. Surgical measures are typically reserved for patients with luminal perforations or those who do not respond to conservative measures. Previously available modalities of drainage involved percutaneous and computed tomography guided access. Recently, endoscopic ultrasound guided aspiration has emerged as a safe alternative for management of intra-abdominal abscesses.

Since its first application for peripancreatic drainage, endoscopic ultrasound techniques and technologies have significantly evolved. Endoscopic ultrasound interventions can …

Denosumab Use In A Patient With Bisphosphonate-Resistant Humoral Hypercalcemia Of Malignancy, Maali M. Milhem Md, Adeel Mahmood Md, John Leidy Md-Phd

Marshall Journal of Medicine

ABSTRACT

Objective: To describe the use of denosumab as an option for treating bisphosphonate-resistant humoral hypercalcemia of malignancy.

Methods: We present the clinical history and laboratory findings of a patient with a review of related literature.

Results: A 62 year-old male with stage IV laryngeal squamous cell carcinoma and lung metastases had multiple hospital admissions for asymptomatic hypercalcemia. The patient had no known bone metastases. His laboratory data showed a high calcium level, a low level of intact PTH and a high level of PTHrP, which confirmed the diagnosis of humoral hypercalcemia of malignancy. There was atypically an elevated level …

The Crisis Of Opiates In Appalachia, James B. Becker Md

Marshall Journal of Medicine

No abstract provided.

Marshall Journal Of Medicine: Communicating A Scholarship Of Engagement, Darshana Shah Ph.D

Marshall Journal of Medicine

Often, at the root of scholarly work, between the scientific and geographic communities we serve, exists the driver of conversation: the faculty. Grounded by first-hand knowledge of the areas in which they live, yet focused by an unyielding passion for academic and professional achievement, faculty provide a perspective that is at once familiar yet innovative. We must use our professional capabilities as well as our partnerships to create socially responsible, unified dialogue that is purposefully disseminated to educate and serve the needs of our rural society.

In order to survive and thrive in academic medicine, our work and our passion …