Medicine and Health Sciences Commons^™

Outcomes Of Telepractice Speech Therapy For An Adult Who Covertly Stutters: A Case Study, Megann Mcgill, Patrizha A. Schroth

PSU McNair Scholars Online Journal

Purpose: To report on telepractice-based holistic speech-language therapy services to reduce avoidance of stuttering and increase positive self-image as a communicator for an adult who covertly stutters as compared to baseline.

Method: A single case study design was employed with baseline, intervention, and maintenance phases completed via telepractice. The participant received bi-weekly speech-language therapy services, including both individual and group sessions. The Overall Assessment of the Speaker’s Experience of Stuttering-Adult (OASES-A) and Stuttering Severity Instrument-4th Edition (SSI-4) assessed the participant’s overt and covert stuttering behaviors at pre-treatment and post-treatment timeframes. Weekly data points of participant’s self-report of avoidance of stuttering …

We’Re All On This Spaceship Earth, Nancy Si

HCA Healthcare Journal of Medicine

The photo features the geodesic sphere at Epcot, Disney World in Orlando, FL. Inside the dome, there was an iconic ride called “Spaceship Earth”, which has since been shut down for refurbishment. This photo was taken November 2019, approximately 6 months before it was shut down. Much like how the ride emphasized the progress that human civilization has made in the last several hundred years and hopes to make in years to come, the current pandemic has shown us how far we have come in the medicine and other STEM fields. We hope only to do better and be better …

Still Learning: Covid Through The Eyes Of A Medical Student, Alexis Strahan

HCA Healthcare Journal of Medicine

As a first-year medical student when the COVID-19 pandemic found a foothold, I felt an overwhelming amount of emotions that accompanied the pandemic’s spread. Fear, although a reasonable choice, was not the first emotion that I experienced. In fact, it was a general feeling of paralysis. I had not six months prior taken an oath to commit my career and life to the service of the public’s health care needs, yet I could provide little more than the textbook knowledge of biochemistry or genetics from my first semester of learning. My hands felt unarmed and unskilled for the fight. What …

Effect Of An Electronic Order Set On Newborn Hepatitis B Immunization Rates, Daniel Pedersen, Angelina Rodriguez, Olu Oyesanmi, Heather Schramm, Michael King

HCA Healthcare Journal of Medicine

Objective

Hepatitis B is an infectious deoxyribonucleic acid virus which can cause significant morbidity and mortality. There is no current definitive treatment, however in the United States immunization is widely available. A paper published by the Advisory Committee on Immunization Practices/Centers for Disease Control (ACIP/CDC) in 2018 made updated recommendations regarding vaccination practices in the United States. The most notable change made was that all healthy newborns weighing ≥2000 g with a negative hepatitis B-status mother should receive hepatitis B immunization within 24 hours of birth. This quality improvement project studied the effect of the electronic medical record newborn admission …

Magic Medicine, Bruce St. Amour, William B. Dehart

HCA Healthcare Journal of Medicine

Background

A superstition is a belief or practice that is considered irrational, resulting from ignorance, fear of the unknown, trust in magic or chance or a false conception of causation. In medical settings superstitions often arise from attempts to assign causation to events that are either random, or in which all information is not available. In this manuscript, we present a descriptive review of the literature related to superstition in medicine and present the results of our own data; that one’s age is equal to the chance of being admitted from the emergency department.

Methods

In the descriptive review of …

Case Of Enterococcus Cecorum Human Bacteremia, United States, Alexander D. Lake, Ryan Fields, Francia Guerrero, Yousef Almuzaini, Koravangala Sundaresh, Joseph Staffetti

HCA Healthcare Journal of Medicine

Enterococcus cecorum rarely serves as a human pathogen, and only 6 cases of this microbe inoculating humans have been documented. We present an elderly female with a marked vascular history presenting with epigastric pain and diarrhea, followed by shaking chills. Laboratory findings revealed leukocytosis, with imaging showing diffuse colonic thickening. She had a bout of bloody diarrhea, raising the likelihood of ischemic colitis with her vascular history. To our surprise, both sets of blood cultures drawn on admission grew Enterococcus cecorum. This case is unique as it is the first documented case of E. cecorum human infection in the …

Goblet Cell Carcinoma Of The Appendix: A Case Report On Goblet Cell Carcinoid, Sheliza Kabani, Aubtin Saedi, Austin Lehr, Lina O'Brien

HCA Healthcare Journal of Medicine

Goblet cell carcinoid of the appendix is a rare neoplasm with histological features of both neuroendocrine and adenocarcinomas. The combination of its aggressive behavior, infrequent occurrence, and variable clinical presentation convolutes the management of this tumor. We report the case of a 75-year-old female presenting with acute appendicitis. A laparoscopic appendectomy was performed. The pathology report showed goblet cell carcinoid at the base of the appendix with involvement of the proximal surgical margins. At her postoperative visit, the patient’s pathology report and options for management were reviewed, and the patient agreed to proceed with a right hemicolectomy 8-10 weeks after …

A Rare Case Of C3 Glomerulonephritis Presenting As Pulmonary Renal Syndrome, Gerardo Mederos, Harsh Patel, Menalee Hapuarachchi, Machaiah Madhrira, Ranjit Nair, Dana Ciobanu

HCA Healthcare Journal of Medicine

C3 glomerulonephritis (C3GN) is a rare disease that falls under the umbrella of C3 glomerulopathy (C3G). Classic manifestations of C3G include acute renal failure, proteinuria, and hematuria. In some cases, extrarenal manifestations can include ocular drusen. Until recent reports, C3G manifesting with pulmonary symptoms has not been reported. In this report, we describe a patient that initially presented with hemoptysis and acute renal failure, eventually leading to a diagnosis of pulmonary renal syndrome. Renal biopsy showed C3GN. The patient’s symptoms improved with pulse dose steroids, plasmapheresis and mycophenolate mofetil. C3G presenting with pulmonary symptoms is rare. Further research is needed …

A Case Of Simpson-Golabi-Behmel Syndrome Presenting With Cutaneous Findings, Tessa Mullins, Abigail Russell, Chad Johnston

HCA Healthcare Journal of Medicine

Simpson-Golabi-Behmel syndrome is a rare, X-linked recessive syndrome associated with mutations in the genes encoding glypican 3 (GPC3). The majority of cases have been described in pediatric males, with those affected showing manifestations of overgrowth, congenital heart defects, and increased incidence of neoplasia. Due to the X-linked nature of this disorder, penetrance is not well understood in female cases. Very few cases of female presentations of Simpson-Golabi-Behmel syndrome have been described, and this case highlights that there may be an association between mutated GPC3 carrier status and other cancers. We present a case of GPC3 gene mutation suggestive …

Cutaneous Malignant Melanoma: A Synthesis On Updated Guidelines For The Primary Care Perspective, Seetha Venkateswaran, Nicholas D'Angelo

HCA Healthcare Journal of Medicine

Cutaneous malignant melanoma (CMM) is a condition wherein malignant cells form in the melanocytic cells. CMM is a potentially lethal form of skin cancer, commonly found in sun-exposed areas of the body. There are multiple risk factors for disease development, such as genetic mutation and UV radiation among others. Diagnosis and staging is important in determining disease morbidity and mortality. The United States Preventive Services Task Force (USPSTF) and the American Academy of Dermatology (AAD) have their respective guidelines and consensus on diagnosis, staging and treatment. It is imperative to delineate and educate primary care physicians on CMM, as they …

Covid-19: Race For Vaccine, L. Hayley Burgess, Jason J. Braithwaite, Emily Singleton, Aaron M. Young, Mandelin K. Cooper

HCA Healthcare Journal of Medicine

The world is in the midst of a pandemic from COVID-19, a disease caused by the virus SARS-CoV-2. Despite broad mitigation efforts, new cases continue with 74 million cases and 1.6 million deaths worldwide. Regardless of previous research efforts, there is no commercially available vaccine for any coronavirus. Novel vaccine development has historically taken at least 10 years from discovery to availability with only a 6% market entry probability.

With the global impact, there is an urgency to expedite a vaccine to protect the population. The U.S. government launched Operation Warp Speed with the goal to produce and deliver 300 …

Importance Of Awareness Of Adverse Drug Reaction Reporting During The Covid-19 Pandemic, Heather Ellis, Hale Z. Toklu

HCA Healthcare Journal of Medicine

Health care professionals hold the responsibility of reporting any adverse drug reactions in order to learn about new therapy and how best to safely care for our patients. The information derived from case publications and FDA MedWatch reports are essential to accumulate information and increase awareness for the possible risks of new drugs.

The Relationship Between Narrative Informativeness And Psychosocial Outcomes In Chronic Stroke-Induced Aphasia, Eileen Armes, Jessica Richardson, Rick Arenas, Lori Nelson

Speech and Hearing Sciences ETDs

Currently there is a gap in the literature in understanding the relationship between the newly categorized primary outcome measure of discourse and secondary outcomes related to psychosocial impact, such as participation, psychological impact, social well-being, or mood. In a large sample of persons with stroke-induced aphasia (N=115), this study analyzed discourse samples using main concept analysis to determine how discourse performance correlates with the secondary outcome measures ALA, CCRSA, GDS, and CIQ. As a secondary research question, the differences in these relationships dependent on severity was also explored. Results showed statistically significant positive correlations between main concepts (MCs) and ALA …

Gender In The Time Of Covid-19: Evaluating National Leadership And Covid-19 Fatalities, Leah C. Windsor, Gina Yannitell Reinhardt, Alistair J. Windsor, Robert Ostergard, Susan Allen, Courtney Burns, Jarod Giger, Reed Wood

Social Work Faculty Publications

In this paper we explore whether countries led by women have fared better during the COVID-19 pandemic than those led by men. Media and public health officials have lauded the perceived gender-related influence on policies and strategies for reducing the deleterious effects of the pandemic. We examine this proposition by analyzing COVID-19-related deaths globally across countries led by men and women. While we find some limited support for lower reported fatality rates in countries led by women, they are not statistically significant. Country cultural values offer more substantive explanation for COVID-19 outcomes. We offer several potential explanations for the pervasive …

Effect Of Kinesio Taping On Knee Symptoms In Patients With Hemophilia: A Prospective Study, Yen-Liang Ke, Cih-En Huang, Sheng-Lung Hsu, Chih-Cheng Chen, Yi-Hsuan Lai, Chih-Ying Wu, Chien-Min Chen

Rehabilitation Practice and Science

Background: Kinesio Taping is effective for treating knee symptoms in various diseases. However, the outcome of using this method in hemophilia patients with knee symptoms has not been previously studied. Objective: To evaluate the therapeutic effects of Kinesio Taping on the knee symptoms in patients with hemophilia who had knee symptoms in the previous year. Methods: Kinesio Tape was applied on the anterior thigh and knee in all subjects. To measure the outcome, we collected the visual analogue scale (VAS) score of the knee during walking, knee-flexion and knee-extension muscle strength, active knee-flexion and knee-extension range of motion, Hemophilia Joint …

The Effects Of The Rewalk^(Tm) Robotic System On Walking Capability In Paraplegic Spinal Cord Injury Patients In Taiwan, Alice Cw Tang, Shao An Lee, Albert Ck Chen, Ching Yu Wang, Wan Yu Chou, Show Chun Chen, Chih Lin Wu, Simon Fuk Tan Tang

Rehabilitation Practice and Science

Background: The ReWalk^(TM) system is an exoskeleton robotic device developed for ambulation assistance in patients with paraplegic spinal cord injury (SCI). The purpose of this study is to evaluate the safety and walking capability of the ReWalk^(TM) system for patients with paraplegic spinal cord injury in Taiwan. Methods: Eight patients with SCI and paraplegia were recruited for the study in a period from April 2015 to April 2016. The level of injuries ranged from T4 to T11. Assessments included the continuous walking time, the continuous walking distance, 6-minute walking test and 10-meter walking test after training for forty hours. Results: …

Evaluation Of Clinical Morbidities And Their Influence On Quality Of Life In Patients With Oral Cavity Cancer After Radiotherapy, Hao-Wei Tang, Tung-Hao Chang, Kuan-Lin Chen, Kuo-Yang Tsai, Su-Fen Liao, Wei-Te Wang

Rehabilitation Practice and Science

Background: Oral cavity cancer is the most common cancer in middle-aged men in Taiwan. Radiation fibrosis syndrome and lymphedema are the leading side effects in patients with oral cavity cancer, and can deteriorate their quality of life (QOL). The aim of this study was to prospectively evaluate common morbidities and their influences on QOL in patients with oral cavity cancer. Methods: 27 patients with oral cavity cancer who received surgery and radiotherapy (RT) were recruited. Clinical evaluations of each patient included the VAS pain scale, the lymphedema scale, facial distance measurement for lymphedema, maximal interincisal distance (MID), range of motion …

A Pilot Study Of Group-Based Computer-Assisted Cognitive Rehabilitation For Patients With Cognitive Impairment, Wan-Ling Hsu, Tzu-Wei Liao, Yi-Chun Lu, Hsin-Man Chien, I-Shiang Tzeng

Rehabilitation Practice and Science

Objective: This study attempted to investigate effects of group-based computer-assisted cognitive rehabilitation for patients with cognitive impairment. Methods: A total of 11 patients with cognitive impairment were included in the study. Cognitive impairment and activities of daily living were assessed using Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Cognitive Abilities. Screening Instrument (CASI C-2.0), Digit Span subtest (DS), Trail Making Test part A (TMT-A), Color Trail Making Test (CTT), Functional Independence Measure (FIM), and Instrumental Activities of Daily Living scale (IADLs) at the beginning of the study, soon after receiving the intervention. Treatment was scheduled for 2 hours …

Closed Mallet Finger Injury Conservative Treatment - The Experience In Plastic And Reconstructive Surgery Department Of Chang Gung Memorial Hospital At Linkou, Shwu-Huei Lien, Yu-Te Lin

Rehabilitation Practice and Science

Objective: Mallet finger injury is a common injury in hand therapy. Orthoses are used as the standard method to conservatively treat simple tendon mallet finger injuries worldwide. Different types of orthoses have advantages and disadvantages. We explored the clinical outcomes of treating mallet fingers by using a series of casereports from the plastic department of Linkou Chang Gung Memorial Hospital, and we analyzed how these outcomes differed across patient characteristics, injured fingers, and clinical problems. We also compared our findings with findings from previous research. Methods: Medical records were reviewarticleed to collect the treatment results of adult patients who were …

Using A Towel For Resistance Training In Non-Exercising Elderly Women: A Cluster Controlled Trial, Yu-Hsuan Tseng, Hsiu-Hui Chen, Wen-Chi Wu, Fang-Ping Chen, Jung-Fu Chen, Jen-Wen Hung

Rehabilitation Practice and Science

Background: Aging results in deterioration of physical performance, including muscle strength, gait, and balance. Resistance training has been shown to be effective in enhancing physical function in elderlypeople. For people, who do not have regular exercise before, an easily available tool might increase their motivation to do exercise training. A towel is available for any person and it could be used in low intensity resistance training. The purpose of this study was to evaluate the effects of resistance training with a towel in community-dwelling elderly women who did not have regular exercise before. Methods: This was a cluster controlled study. …

Implemented Evidence-Based Treatment Of Parent-Esdm Enhances The Social-Communication Ability Of The Toddler, Parenting Functions And Flexibility Of Personal Phenotype: A Casereport, Sheng-Fen Fan, Sung-Hui Tseng

Rehabilitation Practice and Science

Clinically, individuals with the autism spectrum disorder display difficulties with social communication and restricted, repetitive behaviors. The parent-implemented version of the Early Start Denver Model (P-ESDM) has proven to be an effective intervention. However, there is yet to be research on whether it is suitable for Taiwanese culture. This study aimed to increase the application of P-ESDM techniques to daily life through a case therapy report and observed whether parents can reduce their parenting stress through learning and change the way they interact with their autistic child so as to provide him or her with more learning opportunities in communication. …

The Roles Of Videofluoroscopic Swallowing Study (Vfss) And Fiberoptic Endoscopic Evaluation Of Swallowing (Fees) In The Assessment Of Dysphagia, Yi-Hsiang Chiu, Wen-Hsuan Tseng, Tyng-Guey Wang

Rehabilitation Practice and Science

Dysphagia is a prevailing complication of various central nervous diseases and oral pharyngeal cancer. Once dysphagia occurred, it may affect a patient's physical and psychological condition and thus their quality of daily activities. Therefore, early detection and the application of appropriate treatments for patients with dysphagia is essential. Videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) are two common instrument modalities used to evaluate swallowing function. VFSS has been acknowledged as the gold standard for the diagnosis of dysphagia by most scholars. Nevertheless, there is debate that FEES is superior to VFSS as it provides additional information …

A Systematic Reviewarticle On Discharge Destinations For Patients With Stroke, Lin-Fu Lee, Wen-Chih Lin, Willy Chou

Rehabilitation Practice and Science

Introduction: Complex and diverse factors affect the placement of patients with stroke after they are discharged from hospitals. In this study, a systematic reviewarticle of relevant literature was performed to compile related research data and explore the importance of individuals factors and the overall predictive power of multiple variables. Methods: Electronic resources from PubMed and the Cochrane Library were used along with keywords such as ＂stroke＂ and ＂discharge destination＂ to search for relevant articles published between 2005 and 2018. Only original research articles written in English were selected. Results: A total of 19 articles were selected to compile 10 factors, …

Effects Of An Anterior Ankle-Foot Orthosis On Static Standing Balance Control In Patients With Chronic Stroke Wearing The Orthosis For A Long Time, Min-Yuan Yu, Yu-Hsuan Tseng, Po-Chih Chen, Jen-Wen Hung

Rehabilitation Practice and Science

Aims: To investigate the effects of anterior ankle-foot orthosis (A-AFO) on static standing postural control in patients with chronic stroke wearing the A-AFO for a long time. Methods: We recruited patients with chronic stroke wearing an A-AFO for at least 5 months. Static standing balance control was evaluated using the Tetrax Balance System in eight positions: (1) eyes open on a solid surface [NO];(2) eyes closed on a solid surface [NC];(3) eyes open on a foam surface [PO];(4) eyes closed on a foam surface [PC];and head turned at 30° to (5) right [HR], (6) left [HL], (7) up [HB], and …

Rehabilitation Is Associated With Lower Mortality In Patients With Dengue Fever In Intensive Care Units: A Retrospective Study, Hsin-Han Cheng, Chin-Ming Chen, Willy Chou

Rehabilitation Practice and Science

Objective: The study aimed to examine the effect of rehabilitation on mortality in patients with dengue in intensive care units (ICUs). Design: This was a retrospective cohort study. In this study, 142 patients with dengue from ICUs were enrolled from August to December, 2015. They were divided into two groups: patients with or without rehabilitation. The relationship between rehabilitative therapy and the risk of dengue-related mortality was assessed using a multivariate Cox regression model after adjustment for related variables. Results: Of the 142 patients, 70 (49.3%) were men, and the mean age was 69.97 ± 15.93 years. The average length …

Inter-Rater Reliability Of The Barthel Index Scoring Between Nurses And Doctors, Ying-Chao Lin, Yu-Tzu Dai, Tyng-Guey Wang

Rehabilitation Practice and Science

The Barthel Index is not only used to assess the status of activities of daily living and the planning of rehabilitation program but also to hire foreign health aids as a qualification standard for patients in Taiwan. However, studies on the inter-rater reliability of the Barthel Index are lacking between nurses and doctors, who are common specialties in evaluating the Barthel Index in Taiwan. The present study evaluates the inter-rater reliability of the Barthel Index and related influential factors of assessment. This study was conducted in a rehabilitation ward of a medical center in the northern part of Taiwan from …

Increased Risk Of Arrhythmia In Patients With Cervical Spinal Cord Injury: A Nationwide Population-Based Matched Cohort Study, Chia-Hsuan Lin, Yan-Yuh Lee, Chun-En Kuo, Po-Cheng Chen

Rehabilitation Practice and Science

Objective: To investigate the risk of cardiac arrhythmias among adults with spinal cord injury (SCI). Methods: This is a retrospective population-based matched cohort study. Data were derived from the National Health Insurance Research Database. This study identified all patients diagnosed with SCI from January 1, 2000 to December 31, 2013. Patients with SCI were categorized into the cervical SCI (C-SCI) and other SCI (O-SCI) groups according to the level of injury. The cumulative incidence of cardiac arrhythmias was compared between patients with C-SCI, those with O-SCI, and those without SCI. Cox proportional hazards regression model was used to assess the …

Secondary Syringomyelia After Subarachnoid Hemorrhage: A Casereport, Shih-Shin Huang, Yen-Liang Ke, Wei-Chi Hsieh, Hung-Chih Hsu, Chien-Min Chen

Rehabilitation Practice and Science

Background: Cerebral artery aneurysm rupture is one of the common causes of subarachnoid hemorrhage. Patients with subarachnoid hemorrhage may have some degree of neurological defects and impairment on activity of daily living. Syringomyelia refer to the cavity formation in spinal cord. Possible etiologies may include congenital and acquired types. Patients with syringomyelia may suffer from limb pain and paresthesia. According to previous studies, secondary syringomyelia due to subarachnoid hemorrhage was not common. Hence, a case with syringomyelia secondary to subarachnoid hemorrhage was presented by introducing the clinical signs and image findings. Moreover, current literatures about syringomyelia secondary to subarachnoid hemorrhage …

Role Of High Intensity Laser Therapy On A Child With Atlantoaxial Rotatory Fixation-Casereport, Li-Yun Teng, Ko-Long Lin, Sheng-Hui Tuan, Shu-Fen Sun, Min-Hui Li, I-Hsiu Liou

Rehabilitation Practice and Science

After wearing a hairpin for the entire evening during her sleep, 8-year-old girl experienced acute onset of torticollis and neck pain after walking up the next morning. She was brought to our outpatient department. Her head was tilted to the left, with tenderness over the left neck region. Imaging studies revealed atlantoaxial rotatory fixation. She initially received a combination of soft neck collar and medications with muscle relaxants as well as anti-inflammatory agents. However, these treatments had limited effects. Then, she received high-intensity laser therapy on the left posterior deep neck muscles, which greatly improved the range of motion of …

Kienböck's Disease In A Patient With Hemiparetic Stroke: A Casereport, Pao-Sheng Wu, Yen-Ting Cho

Rehabilitation Practice and Science

Kienböck's disease of the wrist is a multifactorial, progressive osteonecrosis of the lunate bone. Patients with this disease often complain of dorsal wrist pain and other wrist dysfunctions. Image studies are usually required for definite diagnosis; however, careful history taking and physical examination are also necessary. Treatment varies according to the stage of the disease; although surgery is needed in most of the cases, rehabilitation after the surgery seems helpful as well. Kienböck's disease is rarely seen in our daily practice, and even though we do recognize the disease, diagnosing it correctly in patients with comorbidities such as stroke is …