Medicine and Health Sciences Commons^™

On The Discontinuation Of Enteral Feeding In Head And Neck Cancer: A Case Report, Kyle Fisk, Ana Sanchez

HCA Healthcare Journal of Medicine

Introduction

The goal of palliative care is to preserve the quality of life or patient “comfort” in patients with serious diseases. Palliative care providers serve a wide range of patients: from those who seek curative treatment to those who are actively dying. Given this range, palliative care must mirror the dynamic goals of the patient at different stages of life and treatment. Throughout these stages, a goal of the palliative care provider would be to avoid hastening death; however, this often leads to clinical decisions that directly pit the patient’s comfort against the patient’s life span. This is most salient …

Lazarus Syndrome After Aortic Aneurysm Repair, Kevyn Niu, Jamie Lee Aldakkour, Charles Huyghues-Despointes, Yizhi Lin

HCA Healthcare Journal of Medicine

Introduction

Lazarus syndrome is defined as the spontaneous return of circulation after cessation of cardiopulmonary resuscitation (CPR). Though there have been multiple cases of Lazarus syndrome documented in the literature, it is a significantly underreported phenomenon with less than 100 cases reported in the literature since the first case in 1982.

Case Presentation

After elective aortic aneurysm repair, an 88-year-old with a do-not-resuscitate directive had cardiac arrest, briefly showing post-mortem respiration and pulse. Despite resuscitation efforts including pharmacological intervention and CPR, he passed away within an hour. This case highlights complexities in end-of-life care and warrants exploration of post-mortem physiological …

A Rare Case Of Candida Glabrata Cervical Spondylodiscitis, Angelina Hong, Lily Hyungjung Lim, Ali Tariq Alvi, Pallavi Aneja

HCA Healthcare Journal of Medicine

Introduction

Invasive candidiasis can lead to numerous life-threatening sequelae. Candida glabrata is the second-most common causative species of invasive candidiasis. This species possesses a high risk for persistent infection and candidemia. An uncommon complication of invasive candidiasis is spondylodiscitis and can rarely affect the cervical spine.

Case Presentation

The patient is a female in her late 50s with a complex medical history inclusive of chronic obstructive pulmonary disease, chronic pain, multiple abdominal surgeries, prolonged intensive care unit admission, and administration of total parenteral nutrition and broad-spectrum antibiotics who presented with complaints of worsening neck pain. She was last hospitalized 3 …

Impact Of Psychiatry Clerkship Rotation In Attitudes Towards Mental Illness And Psychiatry As A Career Among Medical Students, Jae Kim, Brian Blum, Shivani Kaushal, Sara Khan, Patrick Hardigan, Clara Alvarez Villaba

HCA Healthcare Journal of Medicine

Background

Stigma associated with mental illness (MI) permeates many professions, including healthcare. Recognizing and correcting bias is critical in delivering impartial and beneficial healthcare for all patients. Early educational interventions providing exposure to individuals with MI have shown to be effective at reducing MI stigma. The primary aim of our study was to assess the impact of a psychiatry clerkship on attitudes to MI. A secondary aim was to determine if the psychiatry clerkship influenced medical students’ perceptions of psychiatry as a career.

Methods

A cohort of third-year medical students in Florida was invited to complete an online survey before …

Significance Of Chronic Kidney Disease On Morbidity And Mortality In Hospitalized Patients With Covid-19, Varsha Suresh, Alexis Finer, Aarushi Varshney, Kay Thi Khine, Ishak Mansi, Abdo Asmar

HCA Healthcare Journal of Medicine

Background

Patients with comorbid illnesses are at risk for worse outcomes with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19). Our research examined patients with chronic kidney disease (CKD) to establish whether it remains an independent risk factor for mortality and morbidity in patients with COVID-19.

Methods

We conducted a retrospective cohort study using an electronic patient database in 2020. An observational dataset from 149 hospitals comprising a United States-based health system (HCA Healthcare) was analyzed. Hospitalized patients (N=11 086), aged 18 and above, with a COVID-19 polymerase chain reaction positive result between January 1, 2020, and September 1, …

Engaging Chief Medical Officers To Improve Multidisciplinary Rounds, Gregory Mccormack, Pranav C. Mehta

HCA Healthcare Journal of Medicine

Background

Multidisciplinary rounds (MDRs), a model of care in which multiple members of the care team, representing different disciplines, come together to discuss the care of a patient in real-time. MDRs are a valuable tool for clinical teams to improve patient length of stay (LOS), reduce healthcare-associated infections, and increase care coordination. HCA Healthcare’s data science and performance improvement teams created a data visualization tool called Next-gen Analytics for Treatment and Efficiency (NATE) Tempo to support care teams in managing rounds and barriers.

Methods

A pilot implementation of MDRs using the NATE Tempo tool was initiated in 10 hospitals, accompanied …

Effects Of Attending To A 12-Week Structured Physical Activity Program On Fitness And Self-Perception Levels Of Obese Primary Schoolchildren, Yetkin Utku Kamuk, Spiridon Kamtsios

Baltic Journal of Health and Physical Activity

Introduction: Childhood obesity is a major health problem especially for schoolchildren both physically and mentally. The study was conducted to assess the effects of the structured physical activity (PA) program on the physical fitness (PF) and self-perception levels of obese schoolchildren. Materials and Methods: A total of 67 students aged 9-11 were recruited and the experimental group (n = 27) was attended to exercises once per week for 60 mins for 12 weeks. Self-perception Scale for Children and PF tests were applied as pre- and post-tests. Results: 12-week PA sessions improved obese schoolchildren’s self-perception levels in general self-worth, athletic …

Comparison Of The Effects Of The Three Methods Of Massage, Selected Yoga Exercises And Massage-Yoga Combination On The Depression In Elderly Women, Elham Piri, Behnam Ghasemi, Ali Shafizadeh

Baltic Journal of Health and Physical Activity

Introduction: The present study aims to compare the effects of massage, selected yoga exercises and massage-yoga combination methods on symptoms of depression. Materials and Methods: According to the research criteria, 60 available samples were selected and randomly divided into three experimental groups and single control one. The Beck Depression Inventory was completed by the examinees before the intervention, two months after its beginning and one month after ending. Each experimental group received one of the massage interventions, selected yoga exercises and massage-yoga combination for eight weeks, three sessions per week and for a period of 40 minutes per session. The …

Promoting Health Improvement Of Indonesian Migrant Workers And Their Children In Kuala Lumpur, Malaysia, Mitoriana Porusia, Listiana Masyita Dewi, Dewi Pertiwi Dyah Kusudaryati, Yuli Widyastuti, Lia Kicky Mahmudi, Wulan Prasesti, Fahwa Nyssa Insyiroh, Niken Diah Haryanti, Muhammad Fathan Nuralam, Nastiti Farasvita Putri, Miranda Azahra, Rafif Ryandra Izdhihar, Zulia Setiyaningrum, Siti Sabariah Buhari

ASEAN Journal of Community Engagement

This article discusses the health promotion program among Indonesian migrant workers and their children living in Kuala Lumpur, Malaysia, aiming for a better awareness of their health condition. In particular, this article describes and analyzes the community engagement program in Sekolah Indonesia Kuala Lumpur (SIKL) and Muhammadiyah Malaysia (PCIM) to provide health education and screening. Based on the preliminary study, Indonesian migrant workers and their families have limited access to healthcare facilities and programs. The program covers topics such as healthy reproduction and sexual vigilance for the youth, well-being and healthy lifestyles, as well as the importance

of basic health …

A Prioritized Patient-Centered Research Agenda To Reduce Disparities In Telehealth Uptake: Results From A National Consensus Conference, Kristin L. Rising, Mackenzie Kemp, Amy E. Leader, Anna Marie Chang, Andrew J. Monick, Amanda Guth, Tracy Esteves Camacho, Gregory Laynor, Brooke Worster

Department of Emergency Medicine Faculty Papers

Introduction: We hosted a national consensus conference with a diverse group of stakeholders to develop a patient-centered research agenda focused on reducing disparities in telehealth use.

Methods: Attendees were purposively invited to participate in a 2-day virtual conference. The group developed a prioritized research agenda focused on reducing disparities in telehealth uptake, with discussion informed by findings from a scoping review. All work was conducted in partnership with a Steering Committee of national experts in telehealth and patient-centered care (n = 5) and a community-based Telehealth Advisory Board with experience with telehealth use and barriers (n = 8).

Results: Sixty …

Foreword From Editor - 14th Edition, Yandi Andri Yatmo

ASEAN Journal of Community Engagement

This edition of AJCE brings together discussions on the various roles and effectiveness of research and community engagement programs in strengthening local identity, developing skills, and enhancing quality of life towards a resilient society. Expanding such roles, this issue consists of four research articles, one review article, and three case-based articles. The authors of this edition emerge from the background of language, engineering, economy, policy, education, and health, providing different outlooks and methods in overseeing the processes of community-related programs.

Evaluating The Symptoms And Treatment-Related Knowledge Of Cancer Patients Receiving Chemotherapy In A Tertiary Care Hospital, Kiran Nawaz Ali

Theses & Dissertations

Background: Cancer has become the leading source of mortality and morbidity worldwide. Its prevalence is rising and high-risk behaviours are being adopted by the people in society. Knowledge about cancer and its management helps in adjusting the resource allocations and in terms of public health policy. Moreover, patient education about symptoms, treatment, and side effects is crucial and must be addressed.
Knowledge about cancer, its side effects, and the possible treatment outcomes is essential, as it helps in deciding about adherence to the treatment. It is observed that many oncology patients have information gaps related to cancer and chemotherapy. However, …

Assessing Medication Compliance And The Usage Of Complementary Therapies Effecting Hba1c Among Patients With Type 2 Diabetes Mellitus In A Tertiary Care Hospital In Karachi, Pakistan, Neelam Nasruddin

Theses & Dissertations

Background: Diabetes Mellitus is a chronic illness. It remains to be a major public health matter and a financial burden on the medical system worldwide. This condition can be managed and better treatment strategies and compliance can reduce the risk of complications. In 2022, there will be around 33,000,000 new cases of diabetes worldwide, with 26.7% of the adults in Pakistan being affected, predicts the (International Diabetes Federation, 2022). However, it is observed that most individuals turn to complementary and alternative methods (CAM)/Traditional medicine because of the rising cost of therapy, adverse effects of anti-diabetic medications, and accessibility concerns.
Purpose: …

Mental Health Effects Of The Covid-19 Pandemic On Aging Lesbian, Gay, Bisexual, Transgender, And Queer Populations., Iliza Minaya, Samuel Raine, Arkene Levy, Chasity B O'Malley

HPD Articles

INTRODUCTION: The COVID-19 pandemic affected numerous subpopulations of people in unique ways. This study evaluated the impact of the COVID-19 pandemic on the mental health status of Broward County's aging lesbian, gay, bisexual, transgender, and queer (LGBTQ) seniors and identified strengths, weaknesses, and opportunities for interventions to enhance positive mental health outcomes. The study was performed from April 2021 through July 2021.

METHODS: Online surveys measuring anxiety, depression, social support, and resilience were delivered by email to 47 residents of Wilton Manors, Florida. Study data were collected and collated using research electronic data capture tools with bivariate analysis using the …

Participant Engagement In A Community Health Worker-Delivered Intervention And Type 2 Diabetes Clinical Outcomes: A Quasiexperimental Study In Mexicanamericans, Belinda M. Reininger, Juliana Z. Lopez, Maria E. Zolezzi, Minjae Lee, Lisa A. Mitchell-Bennett, Tianlin Xu, Soo Kyung Park, Mayra V. Saldana, Lubeth Perez, Joseph B. Mccormick

Health & Biomedical Sciences Faculty Publications and Presentations

Objectives This study helps to fill the existing research gap related to participant engagement in behavioural interventions and diabetes management. We examined type 2 diabetes control over time among Mexican Americans by level of engagement in a chronic care management (CCM) program that included community health worker (CHW)-delivered multilevel interventions. The programme complemented clinical care and promoted behaviour changes to improve diabetes self-management.

Design Quasiexperimental study.

Setting The study was implemented in the Rio Grande Valley region in the USA. Recruitment was conducted in clinics and community events. All other visits were provided in participant homes and community locations.

Participants …

Chronic Hepatitis B: A Summarized Anecdote Of Complexities In Natural History, Treatment, And Complications, Nicholas Noverati, Jay W. Jun, Vivan Yan, Dina Halegoua-De Marzio, Hie-Won Hann

Division of Gastroenterology and Hepatology Faculty Papers

Chronic hepatitis B is still a disease process that affects millions around the world. Serologies used to diagnose and follow the progression (or resolution) of the disease can be confusing for clinicians. Further, throughout years of treatment, there may be nuances in presentation that complicate management even further. In this short communication, we highlight six themes in response to treatment and outcomes, including complications. We have the unique perspective of following many patients over extended periods of time at our institution, which has brought these themes to life in order that they can be shared with other clinicians who may …

Quality Improvement In Healthcare: A Practical Guide For Providers (Part 2), Jeremy Ellis

Transformative Medicine

No abstract provided.

Respiratory Syncytial Virus Vaccines For Adults, Maley Zents, Emily Wagner, Mary Hoang, Christina Swiger

Transformative Medicine

Respiratory syncytial virus (RSV) is a virus that causes outbreaks of acute lower respiratory tract infections (LRTI) worldwide. The infections are associated with high rates of hospitalizations, which may lead to death, especially in older adults and young children. Due to the morbidity and mortality associated with RSV, pharmaceutical companies have dedicated research to create a vaccine since the 1960s. Despite setbacks after the failure of the first RSV vaccine, new developments in research have led to the approval of two new vaccines. Ensuring healthcare professionals and patients are well-informed about these vaccines is crucial for facilitating informed, collaborative clinical …

“What Should I Do About This New Left Bundle Branch Block?”, Muhammad Asad Hanif, Muhammad Mohsin Zafar, Aniruddha Singh

Transformative Medicine

No abstract provided.

Impact Of Adding Reduced And Weight-Based Insulin Dosing Options To The Emergency Department And Inpatient Hyperkalemia Order-Set, Elaina Lioudis Pharmd, Bs, Regine Ghoubrial-Waibel Pharmd, Micah Kidd Msn, Rn, Agcns-Bc, Cmsrn

Transformative Medicine

Purpose: To compare the effects of weight-based, reduced, and standard IV insulin doses on potassium reduction and hypoglycemia incidence in the treatment of acute hyperkalemia.

Methods: The hyperkalemia treatment order-set was updated to include reduced and weight-based insulin dose options. Patients ≥ 18 years old with acute hyperkalemia treated with insulin using the order-set were included. Patients with missing data or who started dialysis before follow-up potassium monitoring were excluded. The primary efficacy outcome was reduction in serum potassium. The primary safety outcome was incidence of hypoglycemia and severe hypoglycemia. Secondary outcomes included insulin dose administered, completion of …

Hoffmann Sign, Anthony A. Donato Jr, Chinedu Ezikanyi

Transformative Medicine

The Hoffmann sign or reflex is commonly taught as part of the physical examination to detect abstract upper motor neuron pathology. We present a case of a patient with congenital spinal stenosis and a fall who had a positive Hoffmann sign as the result of a central cord syndrome. The materials contain a video of this physical exam finding and briefly review its history, reliability and clinical utility.

Microgreens Nutrition Outreach: A Novel Tool For Community-Wide Dietary Disease Prevention, Rayna Marshall, Jessica Nwabeke, Benjamin S. Haslund-Gourley, Cynthia Huang, Talmadge Gaither, Vibhuti Mishra, Sophia Kim, Hannah Xu, Faith Kean, Neiki Rokni, Annette Gadegbeku

Transformative Medicine

Purpose: To investigate how microgreens educational programming impacts the relationship between nutrition attitudes and healthy eating habits. Methods: A three-part workshop in Philadelphia, PA that consisted of a pre-survey, presentation, and microgreens kit assembly session was held. A post-survey was distributed electronically 1 week after the event. Results: 9 participants voluntarily attended the workshop and completed the pre-survey, and one-third of the participants submitted post-survey feedback. Participants were middle-aged, Black women from the Allegheny West neighborhood of Philadelphia, a predominantly (97.5%) Black neighborhood. The survey showed microgreens were well-received and suited for urban communities with little space and cold weather. …

Factors Influencing Ulcer Healing In Chronic Limb Threatening Ischemia Patients After Endovascular Angioplasty At Cipto Mangunkusumo General Hospital, Raden Suhartono, Ghany H. Wijaya, Akhmadu Muradi

The New Ropanasuri Journal of Surgery

Introduction. Chronic limb–threatening ischemia (CLTI) can cause rest pain in the lower extremities and the formation of ulcers or gangrene. Revascularization, which can be done using open surgery or endovascular procedures, is the first line of treatment in CLTI management. CLTI patients at CMGH usually came with advanced conditions and high re–amputation rates even after revascularization. This study aimed to determine factors associated with the outcome of endovascular angioplasty, especially ulcer healing.

Method. A cross–sectional study was conducted at CMGH, enrolling CLTI patients with Rutherford grades 5 and 6 who underwent angioplasty. Age, gender, history of smoking, hypertension, atrial fibrillation, …

Neutrophil-Lymphocyte-Ratio As Predictor Of Morbidity And Mortality In Adults With Gastrointestinal Obstruction, Agi S. Putranto, Bimo D. Pramesta

The New Ropanasuri Journal of Surgery

Introduction. Gastrointestinal (GI) obstruction is a condition that often requires surgery and can lead to severe complications. The neutrophil-to-lymphocyte ratio (NLR) has been used as an inflammation indicator in various medical conditions, but research on the relationship between NLR and GI obstruction is still limited. Therefore, this study aims to evaluate the role of NLR as a cost-effective and simple preoperative predictor of postoperative mortality and morbidity, mainly surgical site infection, in adult patients with GI obstruction.

Method. This cross-sectional study was conducted at Cipto Mangunkusumo General Hospital in Jakarta. The study sample consists of 150 adult patients with GI …

Preoperative Neutrophil–Lymphocyte Ratio And Serum Carcinoembryonic Antigen As Predictive Factors Of Colorectal Cancer Survival, Agi S. Putranto, Jackson Kamaruddin

The New Ropanasuri Journal of Surgery

Introduction. Colorectal cancer is the second leading cause of death worldwide, with a high mortality rate. This study investigates the predictive value of the neutrophil–lymphocyte ratio (NLR) and carcinoembryonic antigen (CEA) in predicting the survival rates of colorectal cancer patients in Indonesia.

Method. This retrospective cohort study enrolled the colorectal cancer stage I–IV patients treated at Cipto Mangunkusumo General Hospital (CMGH). The independent variables are NLR and CEA, while the dependent variable is the five–year survival of colorectal cancer. The log rank test proceeded to find a correlation between NLR and CEA with 5–year survival, and the Cox proportional hazard …

Epilepsy Networks And Their Surgical Relevance, Kevin Hines, Chengyuan Wu

Department of Neurosurgery Faculty Papers

Surgical epilepsy is a rapidly evolved field. As the understanding and concepts of epilepsy shift towards a network disorder, surgical outcomes may shed light on numerous components of these systems. This review documents the evolution of the understanding of epilepsy networks and examines the data generated by resective, ablative, neuromodulation, and invasive monitoring surgeries in epilepsy patients. As these network tools are better integrated into epilepsy practice, they may eventually inform surgical decisions and improve clinical outcomes.

Amondys 45 (Casimersen), A Novel Antisense Phosphorodiamidate Morpholino Oligomer: Clinical Considerations For Treatment In Duchenne Muscular Dystrophy, Megan E. Vasterling, Rebecca J. Maitski, Brice A. Davis, Julie E. Barnes, Rucha A. Kelkar, Rachel J. Klapper, Hirni Patel, Shahab Ahmadzadeh, Sahar Shekoohi, Alan D. Kaye, Giustino Varrassi

School of Medicine Faculty Publications

AMONDYS 45 (casimersen) is an antisense oligonucleotide therapy used to treat Duchenne muscular dystrophy (DMD), a rare genetic disorder characterized by a mutation in the DMD gene. Symptoms include progressive muscle weakness, respiratory and cardiac complications, and premature death. Casimersen targets a specific mutation in the DMD gene that results in the absence of dystrophin protein, a key structural component of muscle fibers. While there is currently no cure for DMD, exon-skipping therapy works by restoring the reading frame of the mutated gene, allowing the production of a partially functional dystrophin protein. Clinical trials of casimersen have shown promising results …

Patient-Reported Sexual Function, Bladder Function And Quality Of Life For Patients With Low Rectal Cancers With Or Without A Permanent Ostomy, Michael K Rooney, Melisa Pasli, George J Chang, Prajnan Das, Eugene J Koay, Albert C Koong, Ethan B Ludmir, Bruce D Minsky, Sonal S Noticewala, Oliver Peacock, Grace L Smith, Emma B Holliday

Faculty, Staff and Student Publications

BACKGROUND: Despite the increasing utilization of sphincter and/or organ-preservation treatment strategies, many patients with low-lying rectal cancers require abdominoperineal resection (APR), leading to permanent ostomy. Here, we aimed to characterize overall, sexual-, and bladder-related patient-reported quality of life (QOL) for individuals with low rectal cancers. We additionally aimed to explore potential differences in patient-reported outcomes between patients with and without a permanent ostomy.

METHODS: We distributed a comprehensive survey consisting of various patient-reported outcome measures, including the FACT-G7 survey, ICIQ MLUTS/FLUTS, IIEF-5/FSFI, and a specific questionnaire for ostomy patients. Descriptive statistics and univariate comparisons were used to compared demographics, treatments, …

Glp1 Receptor Agonists-Effects Beyond Obesity And Diabetes, Sydney S Wilbon, Mikhail G Kolonin

Faculty, Staff and Student Publications

Glucagon-like peptide-1 receptor agonists (GLP1RA) have been transformative for patients and clinicians in treating type-2 diabetes and obesity. Drugs of this class, the bioavailability of which is continuously improving, enable weight loss and control blood glucose with minimal unwanted side effects. Since adopting GLP1RA for treating metabolic diseases, animal and clinical studies have revealed their beneficial effects on several other pathologies, including cardiovascular diseases, neurodegeneration, kidney disease, and cancer. A notable commonality between these diseases is their association with older age. Clinical trials and preclinical data suggest that GLP1RA may improve outcomes in these aging-related diseases. Some of the benefits …

Open Sympathectomy Effectiveness On Buerger's Disease’S Pain: An Evidence–Based Case Report, Rangga S. Prawiro, Alexander J. Utama

The New Ropanasuri Journal of Surgery

Introduction. Thromboangiitis obliterans, often referred to as Buerger's disease, is a vascular disease that causes chronic inflammatory conditions, edema, and vascular obstruction due to blood clots. In Cipto Mangunkusumo General Hospital (CMGH), sympathectomy is a rarely done procedure. This evidence–based case report aimed to prove the effectiveness of sympathectomy for Buerger's Disease to reduce pain.

Method. We reported a case of 44–year–old male with progressive pain and a history of darkened fingers of left limbs six months before admission. The patient underwent a lumbar sympathectomy, and there was no recurrence of symptoms after one year of follow–up. A systematic literature …