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How To Assess Ventricular Function By Fetal Echocardiography: Expert Guidance From The Fetal Heart Society., S R Patel, Nitin Madan, L Eckersley, Z Roytman, M Perez, L Gindes, L K Hornberger Jul 2026

How To Assess Ventricular Function By Fetal Echocardiography: Expert Guidance From The Fetal Heart Society., S R Patel, Nitin Madan, L Eckersley, Z Roytman, M Perez, L Gindes, L K Hornberger

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.


Current Practices And Variations Among Pediatric Severe Asthma Programs In The United States-The North American Severe Pediatric Asthma Consortium., Kristina Gaietto, Nadia Krupp, Avani V. Shah, Erhan Ararat, Samantha H. Averill, Sachin Baxi, Matejka Cernelc-Kohan, Jeffrey M. Chambliss, Heather De Keyser, Monica Federico, Bob Geng, Akilah A. Jefferson, Parisa Kaviany, Lila C. Kertz, Kirsten Kloepfer, Allyson Larkin, Sydney Leibel, Tanya Martinez-Fernandez, Samira Naime, Robert D. Pesek, Dinesh K. Pillai, Deepa Rastogi, Katherine Rivera-Spoljaric, Kristie R. Ross, Franziska J. Rosser, Tregony C. Simoneau, Jade Tam-Williams, Kelan G. Tantisira, William Anderson, Jonathan M. Gaffin, Theresa W. Guilbert, Erick Forno Jul 2026

Current Practices And Variations Among Pediatric Severe Asthma Programs In The United States-The North American Severe Pediatric Asthma Consortium., Kristina Gaietto, Nadia Krupp, Avani V. Shah, Erhan Ararat, Samantha H. Averill, Sachin Baxi, Matejka Cernelc-Kohan, Jeffrey M. Chambliss, Heather De Keyser, Monica Federico, Bob Geng, Akilah A. Jefferson, Parisa Kaviany, Lila C. Kertz, Kirsten Kloepfer, Allyson Larkin, Sydney Leibel, Tanya Martinez-Fernandez, Samira Naime, Robert D. Pesek, Dinesh K. Pillai, Deepa Rastogi, Katherine Rivera-Spoljaric, Kristie R. Ross, Franziska J. Rosser, Tregony C. Simoneau, Jade Tam-Williams, Kelan G. Tantisira, William Anderson, Jonathan M. Gaffin, Theresa W. Guilbert, Erick Forno

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Severe and difficult to treat asthma in children is a complex condition causing significant morbidity and associated healthcare costs. While treatment guidelines exist for severe asthma, optimal treatment approaches for the pediatric population are less well established. Furthermore, best practices regarding real world management and implementation of guidelines for the severe pediatric asthma population are lacking. In order to provide care for this population, institutions around the United States have developed multidisciplinary severe pediatric asthma programs (SPAPs). In recent years, the North American Severe Pediatric Asthma Consortium (NASPAC) was established as a mechanism for SPAPs to collaborate and share …


Precise-Dyad: A Prospective Cohort Study Linking Maternal And Infant Health Trajectories In Sub-Saharan Africa, Marie-Laure Volvert, Robin Owino, Angela Koech, Onesmus Wanje, Isaac Mwaniki, Joseph Mutunga, Emily Mwadime, Geoffrey Omuse, Moses Mukhanya, Marvin Ochieng, Grace Mwashigadi, Agnes Mutua, Marleen Temmerman, Melissa Gladstone, Amina Abubakar, Helen Nabwera Jul 2026

Precise-Dyad: A Prospective Cohort Study Linking Maternal And Infant Health Trajectories In Sub-Saharan Africa, Marie-Laure Volvert, Robin Owino, Angela Koech, Onesmus Wanje, Isaac Mwaniki, Joseph Mutunga, Emily Mwadime, Geoffrey Omuse, Moses Mukhanya, Marvin Ochieng, Grace Mwashigadi, Agnes Mutua, Marleen Temmerman, Melissa Gladstone, Amina Abubakar, Helen Nabwera

Centre of Excellence in Women and Child Health

Purpose The PREgnancy Care Integrating Translational Science, Everywhere (PRECISE)-DYAD Study is a prospective observational cohort designed to investigate health outcomes among mother-child pairs (dyads) over the first 3 years of life in two contexts from sub-Saharan Africa. The primary objective of the study was to explore the effects of selected placenta-related complications, such as pregnancy hypertension, fetal growth restriction and preterm birth, on (1) Child health and development, and (2) Women’s health and well-being, including outcomes after stillbirth.

Participants The PRECISE-DYAD Study enrolled women (and their children) originally recruited into the PRECISE pregnancy cohort study in The Gambia and Kenya …


Why Pronatalism Fails The Planetary Health Test, Celine Delacroix, Marleen Temmerman, Nandita Bajaj, Ann Moore, Phoebe Barnard, William Ripple, William Rees, Michael Gerrard, Diana Coole, Robert Engelman Jul 2026

Why Pronatalism Fails The Planetary Health Test, Celine Delacroix, Marleen Temmerman, Nandita Bajaj, Ann Moore, Phoebe Barnard, William Ripple, William Rees, Michael Gerrard, Diana Coole, Robert Engelman

Centre of Excellence in Women and Child Health

No abstract provided.


Congenital Heart Disease In Infants Of Diabetic Mothers (Pediatrics Hospital Based Study), Esraa Ali Mathboob Mahdi, Basil M. Hanudi Jul 2026

Congenital Heart Disease In Infants Of Diabetic Mothers (Pediatrics Hospital Based Study), Esraa Ali Mathboob Mahdi, Basil M. Hanudi

Iraqi Postgraduate Medical Journal

Background: Infants born to diabetic mothers are at elevated risk for neonatal complications, including metabolic, hematologic, respiratory, cardiac, and neurological disorders. Notably, insulin-dependent diabetes increases the likelihood of congenital heart diseases (CHDs). Aim: This study aimed to determine the incidence and associated factors of cardiac complications among neonates born to diabetic mothers and to identify the prevalent patterns of congenital heart defects in this population. Methods: An analytical cross-sectional study was conducted over a 10-month period (July 1, 2020 to April 30, 2021) at the Neonatal Care Unit of Child’s Central Teaching Hospital. The study included 100 neonates admitted within …


Effectiveness Of Vocational Therapy On Psychotic Symptoms Of Patients With Schizophrenia, Iman Ahmed Jumaa, Naamah Shlaibah Humaidi Jul 2026

Effectiveness Of Vocational Therapy On Psychotic Symptoms Of Patients With Schizophrenia, Iman Ahmed Jumaa, Naamah Shlaibah Humaidi

Iraqi Postgraduate Medical Journal

AbstractBackground: Schizophrenia is a severe mental disorder often resulting in significant functional impairment. While antipsychotic medications are the cornerstone of treatment, complementary therapies are needed to address residual symptoms and improve functional outcomes.Aims and Objectives: This study aimed to evaluate the effect of adding a structured vocational therapy program to standard drug therapy in patients with schizophrenia.Materials and Methods: A prospective was conducted with 100 inpatients at Al-Rashad Hospital. Participants were divided into two cohorts: an intervention cohort (n=50) that received vocational therapy plus drug therapy and a control cohort (n=50) that received drug therapy alone. The Positive and Negative …


Association Between Cesarean Scar Niche Characteristics And Menstrual Irregularities: A Cross-Sectional Study, Ridab Ali Saeed, Ahmed R. Shaker Jul 2026

Association Between Cesarean Scar Niche Characteristics And Menstrual Irregularities: A Cross-Sectional Study, Ridab Ali Saeed, Ahmed R. Shaker

Iraqi Postgraduate Medical Journal

ABSTRACT:Background: Cesarean section is a prevalent obstetric procedure with potential complications, including the formation of uterine niches or isthmoceles. These defects are associated with irregular menstrual cycles and adverse gynecological outcomes.Aim of the Study: To evaluate the association between cesarean scar niches and menstrual irregularities, and examine whether niche size and myometerial thickness are linked to menstrual irregularities.Patients and Methods: This cross-sectional observational study included 200 women with a history of cesarean section. Participants were divided into regular and irregular menstrual cycle groups and further categorized by the presence or absence of uterine niches. Clinical and demographic data were collected, …


Neonatal And Maternal Outcomes In Pregnancies With Sonographically Diagnosed Nuchal Cord: A Prospective Cohort Study, Eman Muhammad Ramadan, Samar Sarsam Jul 2026

Neonatal And Maternal Outcomes In Pregnancies With Sonographically Diagnosed Nuchal Cord: A Prospective Cohort Study, Eman Muhammad Ramadan, Samar Sarsam

Iraqi Postgraduate Medical Journal

ABSTRACT:Background: Nuchal cords, where the umbilical cord encircles the fetal neck, are a common obstetric finding, potentially impacting neonatal and maternal outcomes. Their clinical significance remains debated.Aim of the Study: To evaluate the prevalence of nuchal cords in pregnancies at Al Elwiya maternity teaching hospital and to evaluate the association between nuchal cord presence and effects on neonatal and maternal outcomes.Patients and Methods: A prospective, single-center, cohort study was conducted at Al-Elwiya Maternity Teaching Hospital from first of January to first of December 2024. It included 600 pregnant women in the study 107 had an ultrasound diagnosed with nuchal cords. …


Use Of The Bethesda System For Reporting Thyroid Cytopathology In Thyroid Nodules Incoordination To The Appropriate Surgical Intervention, Rusul Abid Kareem, Basim Rassam Ghadhban Jul 2026

Use Of The Bethesda System For Reporting Thyroid Cytopathology In Thyroid Nodules Incoordination To The Appropriate Surgical Intervention, Rusul Abid Kareem, Basim Rassam Ghadhban

Iraqi Postgraduate Medical Journal

Background: The thyroid nodule refers to an abnormal growth of thyroid cells. Although the vast majority of thyroid nodules are benign, a small proportion of thyroid nodules are malignant. In order to diagnose and treat malignant thyroid nodules at the earliest stage, most of them need radiological and cytological evaluation. Fine-needle aspiration (FNA) using The Bethesda System for reporting thyroid cytopathology.Aim of study: To evaluate the significance of the Bethesda classification in detecting malignant thyroid nodule and relate the appropriate surgical intervention accordingly.Methods: prospective, case control study was conducted in Baghdad teaching hospital, 2nd floor. from 1st of December 2021 …


The Role Of Apparent Diffusion Coefficient Value Measurement In The Differentiation Of Ischemic Stroke From Multiple Sclerosis In The Brain, Jenan Mohammed Khalid, Amer Murad Gebur Jul 2026

The Role Of Apparent Diffusion Coefficient Value Measurement In The Differentiation Of Ischemic Stroke From Multiple Sclerosis In The Brain, Jenan Mohammed Khalid, Amer Murad Gebur

Iraqi Postgraduate Medical Journal

Differentiating acute ischemic stroke from active multiple sclerosis (MS) plaques using conventional MRI can be challenging due to overlapping radiological features. The Apparent Diffusion Coefficient (ADC) provides a quantitative measure of water diffusion, potentially offering a solution to this diagnostic dilemma. This study aims to evaluate the role of ADC value measurements in distinguishing between acute ischemic stroke and acute demyelinating MS lesions. This cross-sectional study was conducted at a tertiary care center in Iraq from November 2024 to July 2025. All participants underwent a standardized brain MRI protocol on a 1.5-T scanner. ADC values were measured by manually placing …


Evaluating The Usefulness Of 24-Hour Video Eeg Monitoring In Dr. Sa’Ad Alwitry’S Hospital, Baghdad, Iraq, Ebtehal Dhiyaa, Akram Mohammad Al-Mahdawi, Muataz Fairooz Abd Jul 2026

Evaluating The Usefulness Of 24-Hour Video Eeg Monitoring In Dr. Sa’Ad Alwitry’S Hospital, Baghdad, Iraq, Ebtehal Dhiyaa, Akram Mohammad Al-Mahdawi, Muataz Fairooz Abd

Iraqi Postgraduate Medical Journal

Background: Video electroencephalography (VEEG) monitoring, which combines EEG with synchronized video recording, is a valuable but resource-intensive tool for evaluating seizure disorders. While its role in diagnosis and classification is established, its specific impact on altering provisional diagnoses and guiding treatment remains underexplored.Objective: To assess the diagnostic utility of 24-hour inpatient VEEG monitoring in confirming or modifying provisional diagnoses and reducing misdiagnosis in patients with paroxysmal events.Methods: A retrospective analysis was conducted on 192 patients who underwent VEEG monitoring at Dr. Saad Alwitry Hospital between January and December 2018. Patient records were reviewed to assess the impact of VEEG on …


Esophageal Stricture Post Congenital Tracheoesophageal Fistula Repair, Zaid A. Zaid, Momtaz Al-Nima Jul 2026

Esophageal Stricture Post Congenital Tracheoesophageal Fistula Repair, Zaid A. Zaid, Momtaz Al-Nima

Iraqi Postgraduate Medical Journal

Background: It’s a narrowing of > 50% of the esophagus lumen or as a narrowing detected on a contrast study , or at esophagostomy in combination with symptomsTracheoesophageal fistula (TEF) is a relatively rare congenital anomaly occurring in one in 2500-3000 live births (3)Moreover, the life expectancy of the patients without proper treatment may be measured in weeksAim of study: evaluation of the demographics, surgical details, and postoperative outcomes of pediatric patients undergoing surgery for Tracheoesophageal Fistula (TEF) repair.Methods: The study was conducted at Pediatric Teaching Hospital/Medical City from December, 2022, to November , 2023. A total of 35 cases post …


Immunohistochemical Expression Of Estrogen Receptor In Papillary Thyroid Carcinoma With Lymph Node Metastasis, Furqan J. Albderi, Kaswer M. Altoriahi Jul 2026

Immunohistochemical Expression Of Estrogen Receptor In Papillary Thyroid Carcinoma With Lymph Node Metastasis, Furqan J. Albderi, Kaswer M. Altoriahi

Iraqi Postgraduate Medical Journal

Background: Papillary thyroid carcinoma (PTC) is the most common well-differentiated thyroid malignancy. The female predominance of PTC suggests a potential role for estrogen signaling, mediated through estrogen receptors (ER), in thyroid carcinogenesis and progression.Objective: This study aimed to evaluate estrogen receptor protein expression in papillary thyroid carcinoma with lymph node metastasis and to analyze its association with clinicopathological parameters.Methods: A retrospective study was conducted on 50 formalin-fixed, paraffin-embedded thyroid and corresponding lymph node tissue specimens from Iraqi patients with PTC and lymph node metastasis. ER expression was assessed by immunohistochemistry. Associations between ER expression and clinicopathological variables were analyzed using …


Evaluation Of Peripheral Nerves In Patients With Acromegaly By Electrodiagnostic Study, Taiseer Saad Musa, Farqad Bader Hamdan, Abbas Mahdi Rahmah Jul 2026

Evaluation Of Peripheral Nerves In Patients With Acromegaly By Electrodiagnostic Study, Taiseer Saad Musa, Farqad Bader Hamdan, Abbas Mahdi Rahmah

Iraqi Postgraduate Medical Journal

Background: Acromegaly is a rare multisystem disorder caused by excess growth hormone (GH) and insulin-like growth factor 1 (IGF-1), typically from a pituitary somatotroph adenoma. Neurological complications, particularly peripheral neuropathies, are common but under-investigated.Objectives: To evaluate peripheral nerve involvement in Iraqi patients with acromegaly and assess the impact of IGF-1 levels, disease duration, adenoma size, and other clinical variables on nerve function.Methods: A cross-sectional study included 41 acromegalic patients (≥25 years) who underwent detailed neurophysiological testing. Patients were classified as metabolically controlled or uncontrolled based on IGF-1 levels.Results: IGF-1 and GH levels were significantly lower in the controlled group (p<0.001), while other clinical variables showed no significant differences. Neurophysiological findings revealed significantly reduced sensory and motor amplitudes, prolonged latencies, and slower conduction velocities in the uncontrolled group. IGF-1 levels correlated positively with sensory and motor latencies and negatively with conduction velocities and CMAP amplitudes. Larger adenoma size and presence of diabetes were also associated with worse nerve parameters. Deep X-ray therapy and surgical excision showed beneficial associations with median nerve conduction velocity.Conclusion: Peripheral nerve dysfunction, including carpal tunnel syndrome and polyneuropathy, is more severe in metabolically uncontrolled acromegaly. Macroadenomas and poor biochemical control are linked with worse neurophysiological outcomes.


Family Medicine In Iraq: Bridging The Gap Between Training And Practice For Health System Reform, Eman A. Al-Kaseer Jul 2026

Family Medicine In Iraq: Bridging The Gap Between Training And Practice For Health System Reform, Eman A. Al-Kaseer

Iraqi Postgraduate Medical Journal

No abstract provided.


Endovascular Thrombectomy In Medium And Distal Vessel Occlusions: A Focused Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Shahram Majidi, Amol Mehta, Sami Al-Kasab, Kaustubh Limaye, Adam A. Dmytriw, Adam De Havenon, Farhan Siddiq, Robin Novakovic, Alexandra L. Czap, Ameer E. Hassan Jul 2026

Endovascular Thrombectomy In Medium And Distal Vessel Occlusions: A Focused Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Shahram Majidi, Amol Mehta, Sami Al-Kasab, Kaustubh Limaye, Adam A. Dmytriw, Adam De Havenon, Farhan Siddiq, Robin Novakovic, Alexandra L. Czap, Ameer E. Hassan

School of Medicine Publications

Background: The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke from distal- and medium-vessel occlusion (DMVO) for endovascular thrombectomy (EVT). The intended audiences are prehospital care providers, physicians, and allied health professionals.

Methods: The Society of Vascular and Interventional Neurology Guidelines and Practice Standards committee formed a writing group to conduct a structured literature review on EVT for DMVO-related acute ischemic stroke and to draft practice recommendations in accordance with the Society of Vascular and Interventional Neurology Guidelines and Practice Algorithm. A structured literature search was conducted …


Integrative Oncology For Prostate Cancer: A Narrative Review, Kevin T. Liou, Nicole A. Metri, Robert U. Newton, Divya Ajay, Eleanor M. Walker, Channing J. Paller Jul 2026

Integrative Oncology For Prostate Cancer: A Narrative Review, Kevin T. Liou, Nicole A. Metri, Robert U. Newton, Divya Ajay, Eleanor M. Walker, Channing J. Paller

Research outputs 2022 to 2026

Prostate cancer is most common malignancy among men in the United States. As men are now living longer with prostate cancer due to advances in treatment, there exists a growing need to manage the long-term physical and psychological sequelae of this disease, which range from genitourinary dysfunction to cardiometabolic and psychosocial consequences. Over half of men with prostate cancer report unmet needs in symptom management. Integrative oncology, a patient-centered, evidence-informed field combining lifestyle, natural product, and mind–body interventions with conventional treatments, offers a promising approach to prostate cancer symptom management. This review summarizes the current landscape of integrative oncology research …


Timing Matters: Safe And Timely Insulin Administration, Katlyn Lenox Jul 2026

Timing Matters: Safe And Timely Insulin Administration, Katlyn Lenox

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely insulin administration is essential for safe inpatient diabetes management and is strongly associated with improved glycemic control and fewer adverse events. Despite ADA recommendations to administer insulin within 30 minutes of point‑of‑care (POC) glucose testing, internal data showed only 44% compliance, with an average delay of 44 minutes. These delays increased the risk of hypo‑ and hyperglycemia and highlighted the need for workflow redesign and strengthened nursing processes.

Aim of the Project: To increase the percentage of insulin doses administered within 30 minutes of POC glucose testing, reduce adverse glycemic events, enhance patient safety, and align practice with …


Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer Jul 2026

Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and the American College of Obstetricians and Gynecologists identify immediate, uninterrupted skin-to-skin contact as a standard of care that improves neonatal stability, breastfeeding outcomes, and maternal satisfaction. Despite these recommendations, timely initiation following cesarean birth remains inconsistent. At the project site, skin-to-skin initiation averaged 72 minutes after birth, exceeding the 10-minute benchmark, and exclusive breastfeeding rates were below the national standard of 70%. Contributing barriers included workflow variability, unclear role expectations, and inconsistent communication.

Aim of the Project: The aim of the project was to improve infant and maternal …


Determinants Of Early Mortality After Congenital Heart Surgery: A 7-Year Single-Center Experience In Saudi Arabia, Saud Abdulaziz Bahaidarah, Jowana Mahmoud Aljinaid, Amal Ahmad Alzahrani, Jana Mohammad Banjer, Lujain Abdulsalam Kofiyah, Nesmah Amin Noaman, Rahaf Adel Badkook, Raghad Abdulaziz Aljabri, Raghad Saeed Alghamdi, Renad Mohammed Alamoudi, Sarah Salem Bawazir, Gaser Abdelmohsen Abdelmohsen Jun 2026

Determinants Of Early Mortality After Congenital Heart Surgery: A 7-Year Single-Center Experience In Saudi Arabia, Saud Abdulaziz Bahaidarah, Jowana Mahmoud Aljinaid, Amal Ahmad Alzahrani, Jana Mohammad Banjer, Lujain Abdulsalam Kofiyah, Nesmah Amin Noaman, Rahaf Adel Badkook, Raghad Abdulaziz Aljabri, Raghad Saeed Alghamdi, Renad Mohammed Alamoudi, Sarah Salem Bawazir, Gaser Abdelmohsen Abdelmohsen

Journal of the Saudi Heart Association

Objectives:

To determine predictors of early mortality among pediatric patients undergoing congenital heart surgery at a tertiary care center in Saudi Arabia.

Methods:

This retrospective cohort study included 955 pediatric patients who underwent congenital heart surgery at King Abdulaziz University Hospital, Jeddah, between January 2017 and December 2023. Demographic, clinical, operative, and postoperative variables were collected.

Results:

Overall mortality was 4.9%. Mortality was higher among neonates and infants and among patients with RACHS categories 4–6. Non-survivors had longer cardiopulmonary bypass times and more frequent delayed chest closure. Postoperative complications, including the need for extracorporeal membrane oxygenation (ECMO), depressed cardiac function, …


Facilitating Living Kidney Donation: Retrospective Evaluation Of Weight Loss Interventions To Support Kidney Donation, Julia Dumitrescu, Roslyn Mannon, Scott Westphal, Ashley Brabec, Regina Rau, Amy Olsen, Taylor Cidlik Jun 2026

Facilitating Living Kidney Donation: Retrospective Evaluation Of Weight Loss Interventions To Support Kidney Donation, Julia Dumitrescu, Roslyn Mannon, Scott Westphal, Ashley Brabec, Regina Rau, Amy Olsen, Taylor Cidlik

Graduate Medical Education Research Journal

Background. Living kidney donor transplantation provides recipients with kidney failure with an excellent graft function and survival. Donation of a kidney entails a thorough medical and psychosocial evaluation. Obesity is an increasingly prevalent medical condition and a known risk factor for the development of chronic kidney disease post-donation. Accepting overweight and obese individuals as living kidney donors remains controversial. The purpose of this study was to review the impact of obesity on the determination of candidates for living kidney donation at a single transplant center.

Methods. We performed a retrospective chart review of living kidney donors evaluated over 5 …


Exercise-Induced Gene Expression Profiles In Adults With Obesity: A Systematic Review Of Molecular Adaptation, Brandon Galvan, Luis Alberto Flores, Flor Isela Torres-Rojo, Natanael Cervantes-Hernández, Cinthia Verónica Villegas-Balderrama, Liliana Aracely Enríquez-Del-Castillo Jun 2026

Exercise-Induced Gene Expression Profiles In Adults With Obesity: A Systematic Review Of Molecular Adaptation, Brandon Galvan, Luis Alberto Flores, Flor Isela Torres-Rojo, Natanael Cervantes-Hernández, Cinthia Verónica Villegas-Balderrama, Liliana Aracely Enríquez-Del-Castillo

Baltic Journal of Health and Physical Activity

Background: Obesity is a multifactorial and chronic condition characterized by excess adiposity and systemic low-grade inflammation. Exercise exerts metabolic and anti-inflammatory effects partly mediated through gene expression modulation in skeletal muscle and adipose tissue. However, heterogeneous responses among obese individuals suggest that genetic and epigenetic mechanisms shape exercise adaptation. Objective: This systematic review aimed to identify the genes and molecular pathways modulated by physical exercise in adults with obesity, and to classify them according to their biological functions across different exercise modalities. Methods: Following PRISMA guidelines, randomized controlled trials were searched in PubMed, SpringerLink, Science Direct, Cochrane, LILACS, Web of …


Assessment And Intervention For Health Behavior Change In Primary Care Across The Lifespan: A Guide For Residents In Primary Care Specialties, Stacy A. Ogbeide, Alexis Ramos, Bridget Murphy, Angel Ogbeide Jun 2026

Assessment And Intervention For Health Behavior Change In Primary Care Across The Lifespan: A Guide For Residents In Primary Care Specialties, Stacy A. Ogbeide, Alexis Ramos, Bridget Murphy, Angel Ogbeide

HCA Healthcare Journal of Medicine

More than 45% of Americans have at least 1 chronic disease, with chronic disease also being a leading cause of death in the United States. In primary care settings, about 75% of visits are for management of multiple chronic diseases. Due to the increasing medical complexity of patients who present to primary care, these numbers make it more challenging for Primary Care Clinicians (PCCs) to manage these conditions alone and point to the need for innovative solutions to chronic disease care. One evidence-based innovation is team-based care to improve the treatment of these conditions. Clinicians such as clinical pharmacists, registered …


An Unusual Case Of Bilateral Upper And Lower Oral Cavity Cysts In A Newborn, Frances Rodriguez Lara, Jillian L. Chen, Jennifer N. Shehan, Jessica R. Levi Jun 2026

An Unusual Case Of Bilateral Upper And Lower Oral Cavity Cysts In A Newborn, Frances Rodriguez Lara, Jillian L. Chen, Jennifer N. Shehan, Jessica R. Levi

HCA Healthcare Journal of Medicine

Background

Oral mucosal lesions in newborns have a broad differential diagnosis, ranging from benign, transient conditions to potential early signs of systemic disease. Most of these lesions are resolved without intervention, but delayed recognition can lead to complications, such as airway obstruction. Early identification is crucial for appropriate management. This case report discusses an unusual presentation of multiple oral mucosal cysts in a newborn, emphasizing the challenges of diagnosis and management.

Case Presentation

A 1-day-old male was evaluated at Boston Medical Center for cystic oral lesions identified during newborn screening. The infant was born at 36 weeks and 2 days’ …


Navigating Complex Esophageal Perforations: A Case-Specific Approach To Successful Outcomes, Harsimran Kalsi, Anushree Rai, Kobina Essilfie-Quaye, Neeka Akhavan, Yaseen Perbtani, Tony S. Brar Jun 2026

Navigating Complex Esophageal Perforations: A Case-Specific Approach To Successful Outcomes, Harsimran Kalsi, Anushree Rai, Kobina Essilfie-Quaye, Neeka Akhavan, Yaseen Perbtani, Tony S. Brar

HCA Healthcare Journal of Medicine

Esophageal perforation is a life-threatening condition requiring prompt diagnosis and effective management. While self-expanding metal stents (SEMS) are a first-line treatment, persistent leaks often necessitate adjunctive endoscopic interventions. A structured, multimodal approach is critical for optimizing outcomes and avoiding surgical intervention. A 44-year-old man developed an iatrogenic esophageal perforation following surgical leiomyoma enucleation. Initial treatment with overlapping fully covered self-expanding metal stents (FC-SEMS) failed to achieve closure, necessitating endoscopic suturing for defect reinforcement. Despite suturing, persistent leakage required placement of a larger-diameter FC-SEMS, secured with an endoscopic fixation system to prevent migration. Serial imaging confirmed successful defect closure, allowing the …


Using Mohs Micrographic Surgery To Treat A Large, Pedunculated Trichoblastoma On The Upper Cutaneous Lip, Richard G. Bindernagel Jr., Addie Walker, Richard Miller Jun 2026

Using Mohs Micrographic Surgery To Treat A Large, Pedunculated Trichoblastoma On The Upper Cutaneous Lip, Richard G. Bindernagel Jr., Addie Walker, Richard Miller

HCA Healthcare Journal of Medicine

Trichoblastomas are uncommon adnexal tumors that usually occur on the face. We report a case of a 62-year-old White man with a large, asymptomatic, slow-growing lesion that had been on his right upper cutaneous lip for 15 years. A 2 cm pink, pedunculated nodule with telangiectasia was seen on examination. A shave biopsy was consistent with trichoblastoma: a circumscribed-appearing dermal tumor of basaloid cells arranged in cords and islands within a cellular stroma, focal epidermal connection, and papillary mesenchymal bodies. The patient elected for treatment with Mohs micrographic surgery (MMS) given the length of time that the tumor had been …


Impact Of Pre-Existing Psychiatric Conditions On Trauma Outcomes: A National Analysis, Kelly Mckenney, Marie Ugo, Sindhura Kompella, Clara Alvarez, Ilko Luque Jun 2026

Impact Of Pre-Existing Psychiatric Conditions On Trauma Outcomes: A National Analysis, Kelly Mckenney, Marie Ugo, Sindhura Kompella, Clara Alvarez, Ilko Luque

HCA Healthcare Journal of Medicine

Background

Understanding the impact of psychiatric pre-existing conditions (PsyPECs) on trauma outcomes is crucial, as trauma is the leading cause of mortality for Americans aged 1-45. Although previous regional studies have shown higher mortality rates and longer hospital length of stay (H-LOS) for injured patients with PsyPECs, this has not been studied at the national level. The purpose of this study is to identify the PsyPECs associated with mechanism of injury and other outcomes in adult patients admitted for trauma in the United States’ trauma centers.

Methods

Data were extracted from the National Trauma Data Bank (NTDB). There were 5301 …


Time For A New Whole-Person Care Pathway For Chest Pain Admissions, Dana Kajan, Sabbir Mirza, Alexander M. Ruiz, Anthony Degennaro, Mohamad S. Saad Jun 2026

Time For A New Whole-Person Care Pathway For Chest Pain Admissions, Dana Kajan, Sabbir Mirza, Alexander M. Ruiz, Anthony Degennaro, Mohamad S. Saad

HCA Healthcare Journal of Medicine

Background

Emergency department (ED) visits for chest pain are common and costly, and ED workup often shows no clear cardiac etiology in low-risk patients. Emerging evidence suggests that social determinants of health (SDOH) such as loneliness, social isolation, and food insecurity contribute to cardiovascular outcomes and chest pain presentations.

Methods

We interviewed 114 patients (>18 years) presenting with chest pain and a thrombolysis in myocardial infarction (TIMI) score less than 4 at our community teaching hospital ED. Structured questionnaires assessed the SDOH triad of loneliness, social isolation, and food insecurity. Dependent variables included systolic blood pressure (SBP) at admission, …


Does Staff Education Increase Sequential Compression Device Utilization: A Retrospective Study, Devin Q. John, Vincent Lee, Akshay V. Daji, Hans Lapica, Connor Donley, Matthew J. Mccrosson, Nino Coutelle, Carlos Fernandez, Diego Lima Jun 2026

Does Staff Education Increase Sequential Compression Device Utilization: A Retrospective Study, Devin Q. John, Vincent Lee, Akshay V. Daji, Hans Lapica, Connor Donley, Matthew J. Mccrosson, Nino Coutelle, Carlos Fernandez, Diego Lima

HCA Healthcare Journal of Medicine

Background

Venous thromboembolism (VTE) is a significant perioperative safety concern among orthopedic patients, with an incidence of 0.4%-1.0% and a substantial risk of chronic complications. Sequential compression devices (SCDs) are recommended for VTE prophylaxis, yet compliance remains suboptimal due to staff misconceptions. This study evaluates the impact of a resident-led educational intervention on SCD utilization among nursing staff in orthopedic postoperative care.

Methods

This retrospective study was conducted at 2 hospitals (HCA Florida JFK Hospital and HCA Florida Palms West Hospital). Nursing staff participated in a single educational session addressing SCD benefits, application techniques, and operational protocols. Data on SCD …


Trends In Emergency Department Utilization After Metabolic And Bariatric Surgery In The United States, Andrew Sanders, Isabella Moncada, Sabrina Avanzato, Michelle Fakler, Michael Dombek, R. Wesley Vosburg Jun 2026

Trends In Emergency Department Utilization After Metabolic And Bariatric Surgery In The United States, Andrew Sanders, Isabella Moncada, Sabrina Avanzato, Michelle Fakler, Michael Dombek, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

In this article, we sought to understand the factors associated with emergency department (ED) utilization by patients after metabolic and bariatric surgery (MBS). The hopes were that modifiable risk factors could be identified to reduce ED visits after MBS.

Methods

We analyzed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database (MBSAQIP) which is comprised of data from all nationally accredited bariatric centers in the United States. For our study, we included a population of 681 743 patients having undergone the 2 most common MBS procedures: sleeve gastrectomy (SG) and gastric bypass (GBP). Using logistic …