Digital Commons Network^™

Idiosyncratic Drug Induced Liver Injury Secondary To Ciprofloxacin: A Reminder To Always Check Medication History, Xavier Zonna, Conor Banta, Erika Anson Md

Advances in Clinical Medical Research and Healthcare Delivery

A 38-year-old Caucasian male with no significant past medical history presented to the emergency department with complaints of nausea, vomiting, abdominal pain, and jaundice of 2 days duration. He noticed this in addition to pruritus, fever, and malaise. He had severe transaminitis and hyperbilirubinemia on laboratory evaluation. He was admitted for acute liver injury of an unknown etiology. He had taken a course of ciprofloxacin days prior to presentation for UTI at an outlying facility. Serologies were also concerning possible autoimmune liver disease with elevated Anti-Nuclear Antibody and equivocal Anti Smooth Muscle Antibody. Liver biopsy was negative for any autoimmune …

Rare Presentation Of Omental Tuberculosis With Drug-Induced Jaundice In A Teenage Female: A Case Report, Archana Venkatesan, Krishna Ravi

Advances in Clinical Medical Research and Healthcare Delivery

Omental tuberculosis (TB) is a rare form of abdominal TB, often presenting with nonspecific symptoms that mimic malignancies. We report a case of a 16-year-old female from India who presented with abdominal distension, vomiting, weight loss, and amenorrhea. Imaging revealed an abdominal mass, and a diagnosis of omental TB was confirmed via histopathology. This case highlights the diagnostic challenge posed by such atypical presentations, especially in TB-endemic regions. The patient also developed rifampicin-induced jaundice, which resolved upon drug cessation and supportive care. Anti-TB therapy was cautiously reintroduced at a modified dose. This report underscores the need for high clinical suspicion, …

Literally Heartburn: A Case Report Exploring Potential Preventive Measures Of Esophageal Injury After Radiofrequency Ablation For Atrial Fibrillation, Venkat Arutla, Chengu Niu, Prajjwol Bhatta, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Esophageal injury (EI) after radiofrequency ablation (RF) for atrial fibrillation (AF) is a feared complication due to its extreme variability in presentation and very high mortality rate. The incidence of EI after RF ablation also varies widely among the literature. The diagnosis and management of EI is a combination of swift clinical recognition, confirmatory computed tomography (CT) imaging, and prompt surgical repair. This case discusses a 56-year-old male with past medical history of AF who presented to the hospital with complaints of chest pain, shortness of breath and nausea after undergoing recent RF ablation for AF. Imaging revealed an esophageal …

Bilateral Nephrectomy For Refractory Hypertension In A Patient With Esrd On Intermittent Hemodialysis, Kavya Balusu, Vijay Sheldon, Arjun Sekar

Advances in Clinical Medical Research and Healthcare Delivery

In nearly 20 percent of patients with end-stage renal disease (ESRD), hypertension remains poorly controlled despite pharmacological therapy and volume reduction through dialysis. Further, morbidity from hospitalization for hypertensive crisis is significantly higher in patients with ESRD than in patients without ESRD. For those who fail conventional therapies for hypertension, therapeutic bilateral nephrectomy can be considered as a last resort option. With appropriate candidate selection, patients are expected to have improved quality of life. We describe the case of a 37-year-old African American male with ESRD on intermitted hemodialysis who underwent bilateral nephrectomy for the management of hypertension refractory to …

Bilateral Congenital Radioulnar Synostosis - Case Report, Derek A. Diangelis, Matthew J. Hudson

Advances in Clinical Medical Research and Healthcare Delivery

A 2-year-old male presented to an orthopedic outpatient office due to a supination defect in both of his upper limbs. X-rays of the affected limbs revealed fusion of the proximal radioulnar joints indicating congenital radioulnar synostosis (CRUS). CRUS is abnormal development of the upper limbs occurring during weeks 3—7 of embryological development. Causes of CRUS include genetic syndromes and spontaneous mutations. Treatment options include nonoperative and surgical treatments, however, treatment is controversial due to a lack of clinical evidence. Proposed screening methods could help improve detection rates and improve clinical management. This report aims to increase awareness of CRUS and …

Pembrolizumab-Induced Primary Adrenal Insufficiency: A Rare But Life-Threatening Endocrine Irae, Syeda Sarah Raza, Mehr A. Orakzai, Abdullah A. Orakzai

Advances in Clinical Medical Research and Healthcare Delivery

Pembrolizumab, a PD-1 checkpoint inhibitor, is widely used in the treatment of various malignancies. While it improves overall survival, it can lead to immune-related adverse events (irAEs), including rare endocrine disorders such as primary adrenal insufficiency (PAI). We present a case of PAI induced by Pembrolizumab in a 75-year-old man, emphasizing the importance of early recognition and timely management.

‘Is The Patient Clear For Surgery?’ Takotsubo Cardiomyopathy Presenting As T-Wave Inversions In A Pre-Operative Ekg: A Case Report, Muhammad Hammad Sharif, Madeeha Khaleeque, Syed Faiz Abbas, Gaurav Sharma, Aditya Sanjeevi, Muhammad Hassan Jan, Atif Ahmed

Advances in Clinical Medical Research and Healthcare Delivery

Takotsubo cardiomyopathy (TC) can cause dynamic changes in the electrocardiogram (EKG) and troponin elevation which can be misinterpreted as an acute coronary event that can cause an unnecessary delay in the surgery and affect the outcomes of a non-cardiac surgery. We present a case of a patient with pre-operative T-wave inversions diagnosed with TC. A 90-year-old female presented with a femur fracture. Pre-operative EKG showed symmetric T-wave inversions in the inferior and pre-cordial leads. Delta troponin was unremarkable and she remained chest pain-free. Transthoracic echocardiogram (TTE) showed an ejection fraction of 60% with apical ballooning and basal hyperkinesis concerning for …

Incidence And Predictors Of Encephalopathy In Patients Admitted With Lower Urinary Tract Infections: A Nationwide Analysis, Purva Shah, Shiamak Cooper, Ali Jaan, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Background. There are no large-scale study assessing the incidence and predictors of encephalopathy in patients with UTI. Also, there is a lack of data on encephalopathy outcomes in patients hospitalized with UTI. We aim to evaluate the incidence, predictors, and impact of encephalopathy on the outcomes of LUTI hospitalizations

Methods. Retrospective cohort study using data from the National Inpatient Sample (NIS) database (2017–2020). We included adult patients (aged ≥18 years) admitted with a principal diagnosis of lower urinary tract infection (LUTI), utilizing the International Classification of Diseases, Tenth Revision, and Clinical Modifications (ICD-10- CM) codes. Multivariate logistic and linear regression …

Nstemi Or Pericarditis: Which Came First?, Trisha K. Mehta, Steven Clark, Garrett Barb, Magdelynn Mege, Umber Waseem

Advances in Clinical Medical Research and Healthcare Delivery

Myocardial infarction (MI) is a common cardiac event often occurring in patients with a history of cardiovascular disease. MI is classified by the presence of ST segment elevation (STEMI) or non-ST segment elevation (NSTEMI). Pericarditis is inflammation of the pericardium usually caused by a bacterial or viral infection. The patient under discussion is an 86-year-old male with a previous history of coronary artery disease (CAD), hypertension (HTN), hyperlipidemia, and percutaneous coronary intervention (PCI). He presented with a three-week history of exertional chest pain that abated with rest and worsened while supine. EKG and laboratory findings supported a diagnosis of NSTEMI, …

A Case Of Fatal Herpes Zoster Ophthalmicus And Encephalitis In An Immunocompetent Host With A Review Of Literature, Kellyn E. Wilkes, Rutwik Pradeep Sharma, Laurie Proia

Advances in Clinical Medical Research and Healthcare Delivery

Herpes zoster is a common disease that can have several complications. Here, we present a case of herpes zoster ophthalmicus with coexisting encephalitis that unfortunately resulted in patient mortality. A 70-year-old male with a past medical history of Parkinson’s disease and schizophrenia presented to the emergency department after being found altered at home. Physical exam was notable for left-sided crusted facial rash, left conjunctival injection, and purulent drainage coming from the right eye. Given the location and appearance of his rash, he was diagnosed with herpes zoster ophthalmicus. There was suspicion for encephalitis given his altered mental status but unfortunately, …

Ensuring Successful H. Pylori Test Of Cure: A Quality Improvement Initiative Focused On Post-Treatment Testing, Prajjwol D. Bhatta, Smriti Bhetuwal, Asim Pandey, Ahmed Shehadah, John Shrestha, Venkat Arutla, Chengu Niu, Himal Kharel, Abdullah Ahmed

Advances in Clinical Medical Research and Healthcare Delivery

Background

Eradication of Helicobacter. Pylori (HP) infection is crucial for preventing serious sequelae, such as peptic ulcer disease and gastric malignancies. The ACG guideline recommends mandatory re-testing to ensure HP eradication. However, studies have shown that only less than 25% of patients undergo eradication testing.

Objectives:

The main objective of this study is to evaluate the effectiveness of a simple educational intervention on test of cure compliance rate. Our target population includes patients with confirmed HP infection who were treated with HP eradication therapy.

Design: Quality improvement pre-post intervention

Participants: Internal Medicine residents

Intervention: Educational training on the importance …

Mycobacterium Shimoidei: A Case Report Of A Rare Nontuberculous Mycobacterial Infection In An American Patient With A Favorable Outcome, Madison Baker, Farah Majdoub, Asad Nasir

Advances in Clinical Medical Research and Healthcare Delivery

Non-tuberculous mycobacteria (NTM) are common environmental pathogens, but they are an uncommon cause of illness. One such mycobacteria, Mycobacterium shimoidei, was discovered in 1968 and found to cause a respiratory illness in 1975. Since then, fewer than 100 cases have been reported worldwide. Symptoms can include cough, fever, weight loss, and hemoptysis This report describes an American patient with no travel history who was found to have significant pulmonary disease caused by this rare non-tuberculous mycobacteria.

Analysis Of Superior Economic Potential In South Tangerang City With Banten Province Comparator Using Location Quotient, Dynamic Location Quotient, And Shift Share Analysis Methods, Muhammad Qabus Abid Khairullah, Rastika Widiastuti, Cindy Adria Ananda Putri, Hayuning Anggrahita

Jurnal Geografi Lingkungan Tropik (Journal of Geography of Tropical Environments)

Gross Regional Domestic Product (GRDP) is a key indicator for understanding regional economic structure and dynamics. Differences in sectoral contributions reflect levels of specialization, competitiveness, and growth potential, making comparative and dynamic sectoral analyses essential for regional development planning. This study aims to identify leading, supporting, potential, and lagging economic sectors using Location Quotient (LQ), Dynamic Location Quotient (DLQ), and Shift Share Analysis by comparing the economic performance of South Tangerang City with Banten Province. The analysis is based on GRDP at constant prices by industrial sector for the period 2019-2023. LQ is applied to identify sectoral comparative advantages, DLQ …

Proceeding Book Of The 17th Indonesian Occupational Medicine Updates (Iomu), Perdoki .

Occupational and Environmental Medicine Journal of Indonesia

Bali, Indonesia, 16th - 18th May 2025

Older Adults And Suicide: Protective Pathways To Apply Shores In Counseling, Anna A. Ellenson, Jenny L. Cureton

Adultspan Journal

Older adult suicide (OAS) is a growing concern as the U.S. population continues to age and access to counseling expands. Despite legal and ethical requirements, counselors are often underprepared to address suicide in later life, especially through the lens of suicide protective factors (SPFs). This conceptual article introduces SHORES, a research-informed mnemonic (Skills and strategies for coping, Hope, Objections to suicide, Reasons for living/Restriction of means, Engaged care, and Support), to help counselors assess, intervene, and plan treatment with older adults. We review literature on OAS, highlight gaps in counselor training, and provide an application guide for using SHORES with …

Building School, Family, And Community Partnerships That Support Rural Diverse And Exceptional Learners, Jerrie L. Brooks, Brooke A. Moore, Megan S. Finnerty

The Rural Educator

Research demonstrates that school, family, and community partnerships are mutually beneficial, holding the potential to foster positive educational, emotional, and behavioral benefits for all students, especially diverse and exceptional students. Our qualitative study examined survey responses from 109 administrators, general and special educators, and parents in rural schools across western Kansas. We identified common barriers and successes to building parent partnerships related to communication, access, and attitudes about working with diverse and exceptional families. One major finding was the importance of “place”—rural communities are often close-knit and connected across generations. We propose a model that can be used by rural …

Rural Schools Of Choice: Virtual Charter Schools, Karen Eppley

The Rural Educator

No abstract provided.

“Oh! It’S Fine, We’Re Not Even Counting This Anyways”: Remote Educational Experiences Of Rural Families With A Child With A Disability During The Early Covid-19 Pandemic, Andrew M. Colombo-Dougovito, A. Josephine Blagrave, Aubrey Newland

The Rural Educator

Disparities in rural areas regarding technology, internet access, and higher teacher turnover were amplified as a plurality of schools across the US moved to remote instruction in early 2020 as a response to the COVID-19 pandemic. While rural communities often show a greater resiliency and resourcefulness in the face of tragedy than their (typically) more affluent suburban or urban neighbors, regardless of location, the needs of children receiving educational accommodations are often not met effectively or are ignored altogether. To understand if those educational needs were met for rural families early in the COVID-19 pandemic, an exploratory descriptive qualitative approach …

Challenges To Equity Leadership: Rural Leadership For Marginalized Students, Alex N. Oldham

The Rural Educator

This study examines the challenges and importance of equity-oriented leadership in rural schools. Equity, as opposed to equality, involves providing all students with the resources and support they need to succeed. Research indicates that equity-oriented leadership is crucial for creating positive school climates and improving student outcomes. However, implementing equity-oriented leadership in rural schools can be particularly challenging due to contextual factors and potential resistance from communities with differing values. The study explores the challenges and benefits of equity-oriented leadership in rural schools. While some principals express a desire to lead equitably and implement various initiatives to promote positive outcomes …

Impacts Of Literacy Programming During The Covid-19 And Recovery School Years, Julie Meredith

The Rural Educator

While numerous articles and research reports have focused on understanding the impact of COVID-19 recovery interventions on students in urban and rural schools, fewer have addressed the impact of school closures and efforts to recover lost learning time on children in rural schools. Children in rural areas faced challenges similar to their peers in urban and suburban areas, but infrastructure challenges in many rural places, such as lack of broadband, required tailored approaches guided by educators’ knowledge and connection to their communities. This article examines the impact of Save the Children’s school-age literacy program, supported by 21st Century Community Learning …

From Classroom To Field: Rural Teachers’ Integration Of Science And The Outdoors, Steph N. Dean, Julianne A. Wenner

The Rural Educator

This study explored how rural educators in the US use outdoor environments to enhance science instruction, addressing the educational marginalization of rural students. Using rural cultural wealth as a theoretical framework, we investigated how rural teachers integrate local nature-based resources and students’ out-of-school experiences into science learning. We conducted interviews and observations with rural teachers, using reflexive thematic analysis as our qualitative approach. Three key themes emerged that highlight the ways our participants use the outdoor environment to teach science: (a) harness rural community partnerships, (b) engage students through relational teaching, and (c) design learning opportunities that honor students as …

Empowering Rural Voices Through Deliberative Mini-Publics, Elizabeth B. Hinchcliff

The Rural Educator

This conceptual paper explores the tension between valuing and listening to community voices, while also providing a space wherein rural advocates and community members can come together to address difficult issues prevalent within rural schooling, through deliberative mini-publics. A multiplicity of reasons supports deliberative mini-publics, but I explore three in particular, the first being that they provide a space wherein an intentionally diverse set of community voices and perspectives can be shared, listened to, and explored. Second, the goal of any democratically deliberative space is to explore multiple perspectives as part of the process to seek solutions that contribute to …

Effective Education Prevents Readmission Rates, Taylor Johnson, Gabby Belanger, Ben Mittleman, Bella Ferguson

Nurse Residency

PICOT Question: In older adult patients, does nurse-driven education, compared with standard care, reduce hospital readmission rates?

Meeting Nurses Where We're At, Michal Brown, Kayley Mclaughlin, Lauren Damm

Nurse Residency

PICOT Question: For night shift nurses, how does implementing flexible shift-friendly educational strategies, such as reordered or alternatively scheduled sessions, compare with traditional morning in person education classes affect their ability to positively participate and engage in required education throughout the nurse residency program?

Situating Stillbirth Within A Reproductive Justice Methodology Amidst Perilous Politics, Jamie R. Abrams

Vanderbilt Law Review En Banc

No abstract provided.

A Multicultural Mosaic: Stillbirth And Healing Among Asian Women, Ederlina Co

Vanderbilt Law Review En Banc

No abstract provided.

Forging Alliances: Abortion, Pregnancy Loss, And A Shared Vision For Reproductive Freedom, Greer Donley

Vanderbilt Law Review En Banc

No abstract provided.

Stillbirth & The Law: A Brief Reply To Responses, Jill Wieber Lens

Vanderbilt Law Review En Banc

No abstract provided.

Coaching In Undergraduate And Graduate Medical Education: A Scoping Review Of Success Factors, Barriers, And Outcomes Data File, Binata Mukherjee, Jenna Pfleeger, Haidee Custodio, Maria Renee Roca, Gurupreet Khalsa, Clista Clanton

University Research Data and Datasets

The data in this file support the findings of the following study.

Purpose: Wanting to implement a sustainable learner coaching program in academic medicine and prior exposure to coaching initiatives raised questions including planning, implementation and assessment, and resource allocation. This scoping review examines coaching across medical learners, reported program elements, success factors, and barriers.

Methods: Following PRISMA-ScR guidelines, informed by Levac et al. on Arskey and O’Malley’s framework and Braun and Clarke’s thematic analysis, PubMed, Scopus, and ERIC was searched through May 2024. Articles were screened, data extracted, and coded. A mixed methods analysis included descriptive statistics and thematic …

The Comparator Argument In Trans-Healthcare Ban Cases, Craig Konnoth

UC Law Journal

As states have increasingly restricted gender affirming care for minors across the nation (reinforced by a recent Executive Order by President Trump), and though the Supreme Court ruled on one such state ban, a powerful argument has largely been overlooked. This argument emphasizes the fact that transgender minors are not alone in receiving gender affirming care. Cisgender minors also receive such care for precisely the same reasons as transgender minors— unwanted breast tissue development, undesired hair growth, unusual vocal development, and puberty onset. Indeed, cisgender children receive such care at higher numbers than trans children, and many of the medications …