Medicine and Health Sciences Commons^™

Black Lung: Old Disease, New Lessons, Mohammed I. Ranavaya Ii, Mohammed Ranavaya, Natavoot Chongswatdi

Marshall Journal of Medicine

Previous to 2016, cases of progressive massive fibrosis secondary to mining exposure had dwindled and were considered nearly eradicated. However, over 40 new cases were recently discovered in Kentucky, indicating a resurgence of a previously rare disease. We herein report a case of a 44-year-old male underground coal miner from Appalachia with fifteen years coal mining dust exposure who presented with four years of productive cough, dyspnea upon exertion and wheezing for an occupational pneumoconiosis evaluation. Since 2016, he suffered a precipitous decline in lung function consistent with restrictive lung disease and concomitant progression from simple coal workers’ pneumoconiosis to …

Case Report On Leiomyosarcoma Of The Vulva: A Rare Pathology, Samantha A. Smith, Nadim Bou Zgheib, Andrea M. Vallejos, Jonathan D. Cuda

Marshall Journal of Medicine

Leiomyosarcoma (LMS) of the vulva is rare. However it is the most common histologic subtype of vulvar sarcoma, accounting for approximately 1% of all vulvar malignancies. ^[1-8] Whether genetics and epigenetics play a role in pathogenesis is unclear. ^[1] The tumor is slow-growing with non-specific symptoms, has high metastatic potential, and follows a bimodal age distribution. ^[1-8] Diagnosis and prognosis are based upon immunohistochemical expression and criteria from early literature. ^[1,3,5-7] The most common therapeutic approach involves radical vulvectomy with lymph node resection. The value of adjuvant chemotherapy and radiation remains unknown. ^[1,3,5-8] Our case describes a 46-year-old Caucasian G2P2 …

Eradication Of Stage Iv Gastric Cancer: Case Report, Ibrahim Mohammed, Cherishma Nagisetty, Arslan Iqbal, Michael Abdelmasseh, Doreen Griswold, Muhammad Omer Jamil, Juan R. Sanabria

Marshall Journal of Medicine

Background. Gastric cancer has a low overall survival rate worldwide, and surgery still remains the intent to cure option on early stages of disease. HER-2 positive cancers may have a survival advantage. We present a patient with stage IV gastric cancer HER-2 positive responsive to Herceptin, free of detectable disease two years after surgery.

Patient Presentation. 70 years old Caucasian male complained of left-sided chest pain. Upon evaluation, he was diagnosed with HER-2 positive adenocarcinoma of the stomach at the pylorus with two liver metastases. Near complete response was observed with Herceptin and Cis-platinum based chemotherapy followed by 80% distal …

All The Easy Jobs Are Filled": The Enduring Promise Of A Life In Medicine, Maurice A. Mufson

Marshall Journal of Medicine

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How Covid Has Illuminated The Pitfalls Of A Single-Payer System In The Us, Tamela J. White, Nicholas Wright

Marshall Journal of Medicine

Health care quality measures are impacted by resources invested into outcomes. COVID-19 has had a direct impact upon quality outcomes, the same illuminating just some of the problems with the concept of a single-payer health care system. The US government's inefficiencies in attempting to run the single-payer system known as IHS in context with its repeated failures in managing the COVID-19 crises along with the economic impact of the same, is but one call for strong leadership to dispel the myth that a single-payer system is a panacea for America.

When The Hospitalist Gets Hospitalized, Jay R. Lakhani

Marshall Journal of Medicine

Hospitalists have a unique opportunity to provide a compassionate environment for patients and families, who themselves are facing fear and uncertainty. Recently, I was able to experience hospitalization from the other side of the hospital bed. In this short article, I share a few lessons I am learning from my recent experiences with my father, my daughter, and my own experience.

Changing For The Better: Academic Scholars Find New Audience Through Video Abstracts, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

Prepare The Pharmacy For The Next Crisis: A Well-Drafted Business Continuity Plan Enables Continued Operations, Mitigates Potential Risks., Kenneth Maxik, Craig Kimble, Alberto Coustasse

Pharmacy Practice & Administration

The purpose of continuity planning is to ensure that dispensing operations continue, that pharmacy information systems’ data remain protected and accessible, and that telecommunications to support critical organization function during and after business interruption. Interruptions can occur for various reasons, such as earthquakes, fires, flooding, hurricanes, pandemics, power loss, tornadoes, and wildfires. Devising a crisis continuity plan can enable pharmacies to continue to provide patient care, ensure staff safety, and maintain financial viability after a disaster. The coronavirus disease 2019 (COVID-19) pandemic and the resulting business closures brought about by the shutdown have highlighted this need to plan for all …

Clinical And Basic Research Investigations Into The Long‐Term Effects Of Prenatal Opioid Exposure On Brain Development, Taylor Boggess, W. Chris Risher

Biomedical Sciences

Coincident with the opioid epidemic in the United States has been a dramatic increase in the number of children born with neonatal abstinence syndrome (NAS), a form of withdrawal resulting from opioid exposure during pregnancy. Many research efforts on NAS have focused on short‐term care, including acute symptom treatment and weaning of the infants off their drug dependency prior to authorizing their release. However, investigations into the long‐term effects of prenatal opioid exposure (POE) on brain development, from the cellular to the behavioral level, have not been as frequent. Given the importance of the perinatal period for human brain development, …

A Career Eulogy Reflective Exercise: A View Into Early Professional Identity Formation, William Crump, R. Steve Fricker, Allison Crump-Rogers

Marshall Journal of Medicine

Introduction

Beginning medical students have a very early idea of what their physician identity will be. Providing a brief structured opportunity to reflect on the end of their career can be an important first step in identity formation.

Methods

A reflective exercise was used in the summer prior to beginning medical school as each class of students at a regional rural medical school began a summer prematriculation program from 2015-2019. Students wrote what they wished to be said about them at the end of their career using a “Career Eulogy.” Identifiers were removed and narratives were coded into recurring text …

When Treating Sick Joints Harms Lungs, Ixekizumab Induced Pleural Effusion, Rami Batarseh, Kyle Smith, Mohammed Al-Ourani, Amro K. Al-Astal

Marshall Journal of Medicine

Immunological therapies have provided a multitude of new and effective treatment strategies for various disease states. While monoclonal antibody therapy benefits many patients, side effects are widely variable. here we present a case of pleural effusion complicating psoriatic arthritis treatment.

Secondary Scoliosis From A Retroperitoneal Ganglioneuroma In A 9-Year-Old Female: Case Report, Andrew J. Weaver, Keitaro Nakamoto, Daniel A. Beals

Marshall Journal of Medicine

Ganglioneuromas are rare benign tumors that tend to be asymptomatic until large enough to compress adjacent structures. These tumors are often found during childhood during evaluations for other pathologies. Retroperitoneal ganglioneuromas may be a secondary cause of scoliosis. Here, we present a case of a child who was found to have a retroperitoneal ganglioneuroma during an evaluation for scoliosis.

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The Opioid Epidemic In The United States: A Call For Practice Change In Pediatric Outpatient Surgeries, Emma Bacharach, Osama Al-Omar

Marshall Journal of Medicine

No abstract provided.

Complete Response To Stage Iv Colorectal Adenocarcinoma With Disease-Free Survival At 24 Months: Case Report And Overview Of The Literature, Madison N. Crank 6746693, Arslan Iqbal, Michael Abdelmasseh, Mohamed Alsharedi, Doreen Griswold, Alysia Browne, Juan R. Sanabria

Marshall Journal of Medicine

Over 150,000 new cases of colon cancer were diagnosed in the US in 2019. Stage and age at diagnosis are important prognostic factors for overall survival (OS). For the age group 70-79, the OS for females with poorly differentiated stage IV colon cancer at 1, 2 and 5 years after surgery is 39%, 15%, and 2%, respectively. We present a case of a 77-year-old female with significant cardiac history. She was diagnosed with stage IV colorectal cancer complicated with enteric fistula. Due to her initial performance status and comorbidities, she was not a candidate for surgery or systemic chemotherapy. Nonetheless, …

Macrophage Activation Syndrome As A Complication Of Systemic Lupus Erythematosus In An Adult Male, Rajesh Gopalarathinam, Vamsee Chirumamilla, Balachandran Vaidyanathan

Marshall Journal of Medicine

Macrophage activation syndrome (MAS) is a rare life-threatening complication that sometimes occurs in patients with systemic lupus erythematosus (SLE) and other connective tissue diseases. This syndrome is universally fatal without treatment, and therefore, prompt diagnosis and initiation of treatment is of vital importance.

Reflections On West Virginia's Early Covid-19 Experience, Stephen M. Petrany, Deb Koester, Robert Walker

Marshall Journal of Medicine

No abstract provided.

Navigating The Unknowns Of Covid-19, Larry Dial, Beth L. Hammers

Marshall Journal of Medicine

No abstract provided.

Leadership Challenges And Collaborative Opportunities Unveiled Through Covid-19, Gayle Brazeau

Marshall Journal of Medicine

No abstract provided.

Providing Dental Care In The Current Covid-19 Crisis, Raj Khanna

Marshall Journal of Medicine

Dental procedures typically generate aerosol. With the current covid19 crisis this is a serious problem for providers and patients. The commentary addresses some of the problems and possible solutions for providing dental care in the current covid-19 crisis.

The Eagle And The Phoenix, Clay Marsh

Marshall Journal of Medicine

No abstract provided.

The Covid-19 Crisis: How Rural Appalachia Is Handling The Pandemic?, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

Sustainability Of Rural Hospitals In The United States, Stephanie Cole, Kathleen Lanhan, Alberto Coustasse

Management Faculty Research

Introduction: Rural hospitals experienced both challenges and opportunities in providing healthcare to the community. As these facilities were one of the largest employers in the area, their impact was significant. The purpose of this study was to determine the sustainability of rural hospitals in the U.S. by examining variables that affect these institutions such as accessibility, availability of services, quality outcomes, and effective administrative practices.

Methodology: This qualitative study utilized a literature review and open-ended survey of an expert in Hospital Administration within or collaborating with rural areas. Five databases were used to collect 48 total sources. These sources were …

How Do Pharmacies Evaluate Cleanroom Automation Systems?, Kenneth Maxik, Craig Kimble, Alberto Coustasse, Chris Booth

Pharmacy Practice & Administration

Many pharmacies have implemented or considered implementing cleanroom automation or compounding systems. Intravenous (IV) admixture automation is one of the newest areas of technology that has been applied to pharmacy workflow. Manufacturers tout systems for reducing errors reaching patients. Clinical literature supports that cleanroom technology can aid in patient safety.

Pyrosequencing Analysis Of Irs1 Methylation Levels In Schizophrenia With Tardive Dyskinesia, Yanli Li, Kesheng Wang, Ping Zhang, Junchao Huang, Ying Liu, Zhiren Wang, Yongke Lu, Shuping Tan, Fude Yang, Yunlong Tan

Pharmacology, Physiology and Toxicology

Tardive dyskinesia (TD) is a serious side effect of certain antipsychotic medications that are used to treat schizophrenia (SCZ) and other mental illnesses. The methylation status of the insulin receptor substrate 1 (IRS1) gene is reportedly associated with SCZ; however, no study, to the best of the authors' knowledge, has focused on the quantitative DNA methylation levels of the IRS1 gene using pyrosequencing in SCZ with or without TD. The present study aimed to quantify DNA methylation levels of 4 CpG sites in the IRS1 gene using a Chinese sample including SCZ patients with TD and without TD (NTD) and …

Regulation Of Synaptic Development By Astrocyte Signaling Factors And Their Emerging Roles In Substance Abuse, Christopher D. Walker, W. Chris Risher, Mary-Louise Risher

Biomedical Sciences

Astrocytes have critical functions throughout the central nervous system (CNS) and have emerged as regulators of synaptic development and function. With their highly complex morphologies, they are able to interact with thousands of synapses via peripheral astrocytic processes (PAPs), ensheathing neuronal axons and dendrites to form the tripartite synapse. In this way, astrocytes engage in crosstalk with neurons to mediate a variety of CNS processes including the regulation of extracellular matrix protein signaling, formation and maintenance of the blood-brain barrier (BBB), axon growth and guidance, homeostasis of the synaptic microenvironment, synaptogenesis, and the promotion of synaptic diversity. In this review, …

The Role Of An Auditory Cue In Generating Anticipatory Postural Adjustments In Response To An External Perturbation, Huaqing Liang, Tippawan Kaewmanee, Alexander S. Aruin

Physical Therapy Faculty Research

Anticipatory postural adjustments (APAs) are usually generated to minimize the potential postural disturbance induced by predictable external perturbations. Visual information about a perturbation is important for the generation of APAs, but whether people can rely on auditory information to generate APAs is unknown. The aim of this study was to investigate the role of an auditory cue in generating APAs when visual information is not available. Fifteen young adults participated in the study. They received external perturbations a) with visual information but no auditory information available, b) without neither visual nor auditory information, c) with both visual and auditory information …

Knee Joint Kinematics Of The Pendulum Test In Children With And Without Down Syndrome, Diego M. Ferreira, Huaqing Liang, Jianhan Wua

Physical Therapy Faculty Research

Background: The Wartenberg pendulum test is a common clinical test that is used to measure stiffness about the knee in persons with and without disabilities such as cerebral palsy and Down syndrome (DS). Adults and adolescents with DS show fewer number of swing cycles and a lower relaxation index than healthy controls. However, it is not clear if children with DS show a similar trend compared to typically developing (TD) children.

Research question: Was the knee joint kinematics different between children with and without DS during the pendulum test?

Methods: Thirteen children with DS and 13 TD children participated in …

An Intervention To Improve The Evaluation Of Clerkship Students, Landon Thompson, Marc Hettlinger, Lynne J. Goebel

Marshall Journal of Medicine

Background: Effective feedback is an important part of formative evaluation of clerkship students, improving student performance by increasing awareness to weaknesses and strengths.

Aim: The aim of this study was to obtain more helpful feedback.

Setting: Internal Medicine third year clerkship rotation at Joan C Edwards School of Medicine, Huntington, WV.

Participants: The Internal Medicine department has fifty-nine general and subspecialty faculty physicians.

Program Description: We changed the structure of the existing feedback form by requesting written comments at the beginning and asking for specific strengths and areas for improvement, educated faculty, and gave them a milestones card. Three reviewers …

Modern Ventilator Management In Surgical/Trauma Patients, Errington C. Thompson

Marshall Journal of Medicine

Physicians have a lot to consider when they place a patient on the ventilator. This article reviews the literature and provides the physician with a clear guide to managing the ventilator in the ICU. This manuscript is meant to be a practical guide to managing the ventilator at the patient's bedside.

Rectal Neuroendocrine Tumor In A Patient With Chek2 Mutation, Shefali Khanna, Deena Dahshan, Erin Fankhanel, Doreen Griswold, Lynne J. Goebel

Marshall Journal of Medicine

We provide new information about CHEK2 mutation in association with a rectal neuroendocrine tumor (NET). A 67-year-old Caucasian woman diagnosed with estrogen receptor positive ductal carcinoma in situ breast cancer underwent genetic testing, revealing a CHEK2 mutation that prompted her to have a colonoscopy. This revealed a polyp with immunohistochemical staining positive for markers classically associated with NETs. Six-month follow up surveillance colonoscopy after initial polyp removal found no evidence of recurrence. While the CHEK2 mutation is known to be associated with adenocarcinomas, there is only one other reported case of its association with NETs.