Medicine and Health Sciences Commons^™

Thrower’S Fracture With Subsequent Compartment Syndrome Requiring Emergent 2 Compartment Upper Extremity Fasciotomy, Andrew Wise, Darwin Ang

HCA Healthcare Journal of Medicine

Introduction

A thrower’s fracture is a mid-to-distal third humerus fracture that commonly presents as an audible pop with severe arm pain sustained during the throwing motion. Although thrower’s fracture has been described previously in the literature, this report is the first to demonstrate compartment syndrome as its potential sequel.

Case Presentation

A 25-year-old semi-professional pitcher presented to the emergency department with severe right arm pain following a pitch. He described hearing an audible pop with subsequent severe pain. He was found to have elevated compartment pressures in his upper arm and was rushed to the operating room for a 2 …

Unveiling The Complexity Of Nocardia Septic Arthritis In An Immunocompromised Patient: A Case Report, Steven A. Kessler, Meghan R. Mansour, Ali Khreisat, Mamon Tahhan

HCA Healthcare Journal of Medicine

Background

Nocardiosis is the systemic manifestation of Nocardia infection, often found in immunocompromised individuals. Nocardia are transmitted via inhalation or skin wounds, disseminating hematogenously to organs and rarely, joints. We present a patient with immunosuppression who developed gout of the knee with superimposed Nocardial septic arthritis and a possible subsequent systemic infection.

Case Presentation

A 74-year-old man presented with left lower extremity swelling and pain. He was taking immunosuppressive medication for antineutrophilic cytoplasmic antibody-positive vasculitis. A week prior, an arthrocentesis test was positive for gout. He received prednisone without improvement. A repeat arthrocentesis was positive for Nocardia farcinica septic arthritis. …

Idiopathic Granulomatous Lobular Mastitis: A Case Report, Wendy M. Timirau, Esra Sari, Maham Shahid, Nilmarie Guzman, Augusto Villegas

HCA Healthcare Journal of Medicine

Introduction

Idiopathic granulomatous mastitis (IGM), also known as nonpuerperal mastitis or granulomatous lobular mastitis, is a rare, benign, chronic inflammatory breast disease first characterized in 1972. IGM is characterized by sterile noncaseating lobulocentric granulomatous inflammation, usually affecting parous premenopausal women with a history of lactation.

Case Presentation

We present a 38-year-old African American woman presenting to our continuity clinic complaining of a painful right breast mass discovered during a self-breast examination. An initial right breast ultrasound demonstrated an area of concern with asymmetry, architectural distortion, and a questionable mass correlating to a 5.1 cm hypoechoic mass at the 12:30 position. …

The Placement Of A Single-Incision Mini-Sling For The Treatment Of Complete Intrinsic Sphincter Deficiency In An Adolescent Female: A Case Report, Norman Bebla, Dylan Gallegos

HCA Healthcare Journal of Medicine

Introduction

Intrinsic sphincter deficiency (ISD) is associated with a patient history of urethral injury or childbirth. Suburethral sling placement for ISD has been found to be beneficial in patients with this diagnosis. ISD in the pediatric population is rare and surgical management may prove difficult. ISD requires intensive counseling on available treatment options for this unique population.

Case Presentation

This report is on the use of the single-incision mini-sling for complete ISD in an adolescent patient. The patient was a 15-year-old nulligravid female who was found to have idiopathic complete intrinsic deficiency based on a multi-channel urodynamic study. Despite conservative …

Atypical Hemolytic Uremic Syndrome Following Influenza B: A Case Report, Kathryn E. Mcgraw, Amanda P. Porter, Alyssa M. Moffitt, Marina E M Golden, Heather Stewart

HCA Healthcare Journal of Medicine

Background

Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy that presents with a triad of hemolytic anemia, thrombocytopenia, and acute kidney impairment. It can be attributed to mutations in an array of different complement proteins leading to the overactivation of the complement system, the most impacted being the alternative pathway. Though rare, influenza B has been documented as a potential trigger to the development of aHUS.

Case Presentation

We discuss a 10-year-old girl with a history of aHUS who was found to have a repeat episode of aHUS following an influenza B infection. There have only been a few …

Steroid-Dependent Recurrent Iga Vasculitis In A 19-Year-Old Woman, Hannah Berrett, Shivangi Gohil, Rebecca Kurian, Patricia Neyman

HCA Healthcare Journal of Medicine

Background

Immunoglobulin A (IgA) vasculitis is common in children and typically resolves spontaneously. However, when presenting in adults, it is more likely to be severe and recurrent.

Case Presentation

We present the case of a 19-year-old female patient with recurrent steroid-dependent IgA vasculitis. She had a history of a prolonged episode of IgA vasculitis in childhood. She presented to our hospital with proteinuria and a painful, palpable purpuric rash on her bilateral lower extremities. She was treated with high-dose intravenous steroids. When steroids were tapered, the patient had a recurrence of her painful rash. Over several months, she developed steroid-induced …

Clinical And Radiological Identification And Management Of Sapho Syndrome, Obyda Al-Housni, Jessica M. Alonso, Matthew Thornburg, Enny Cancio

HCA Healthcare Journal of Medicine

Introduction

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an autoinflammatory disease whose acronymic name stands for the symptoms commonly seen in the disease. These symptoms typically occur simultaneously, in different combinations, in patients during exacerbations of the disease. SAPHO syndrome is a rare disease, most frequently seen in patients aged 30 to 50. It is estimated to be found in 1 in 10 000 persons in White populations, with an even lower incidence seen in non-White populations.

Case Presentation

A post-menopausal woman with a medical history of SAPHO presented to the emergency department with left foot pain and …

Man On The Mound: Pictures Of A Pitcher In Pain, Jean Medina, Matthew Campanella, Elliot Mendelsohn, Carl Mitchell, Murtaza Akhter

HCA Healthcare Journal of Medicine

Atraumatic ball thrower's humerus fracture is an uncommon, and poorly understood injury pattern. The majority of these cases are seen in untrained and younger individuals. A missed diagnosis could severely impact a patient's quality of life, as management is operative in most cases. Here, we present the case of a young patient, suffering an atraumatic "ball thrower's" fracture. We present images of this exceedingly rare injury pattern and showcase original artwork with a proposed mechanism of injury.

Characteristics Of Patients Hospitalized To Community Hospitals With Malignant Brain Tumors And Factors Associated With Discharge Destination, Se Won Lee, Thanapath D. Thantacheva, Denny Mack

HCA Healthcare Journal of Medicine

Background

Our main objective was to compare the characteristics and hospital outcomes of patients with primary and metastatic brain malignancies and to investigate the associated factors related to hospital outcomes.

Methods

We conducted a retrospective, cross-sectional study of 1628 patients with brain malignancies from 8 community hospitals between 2017 and 2022 who were identified using International Classification of Disease codes. A stepwise logistic regression was used to identify demographics and clinical characteristics associated with in-hospital mortality and home discharge.

Results

The median age was 65 years old, with 72.5% of patients having metastatic brain malignancies. After 7.2 days of hospital …

A Post-Suicide Survey: The Perspective We Have Been Missing, Matthew Larsen, Cassandra Sauther, Ryan Sauther, Justin Solomon

HCA Healthcare Journal of Medicine

Background

Suicide is a major problem in the United States and in the state of Idaho. Prevention data are lacking for suicide primarily because information about those who completed suicide is not attainable. There are no published data from surveying the family members of the deceased. Our objective was to learn more about those who died by suicide by surveying family members or close contacts of the deceased.

Methods

We conducted a descriptive study using a 77-question survey to obtain information about those who died by suicide, with the survey being completed by their loved ones. Survey questions addressed the …

A Survey Of Post-Graduate Satisfaction With Orthopaedic Residency Training At A Single Institution, Jared L. Sain, Craig R. Louer, Robert J. Esther, Christopher W. Olcott

HCA Healthcare Journal of Medicine

Background

The Accreditation Council for Graduate Medical Education (ACGME) has called for self-study within residency programs. Post-graduate surveys allow the graduate to reflect upon their residency experience after years of autonomous practice. Despite their potential utility, a standardized assessment of residency training from the perspective of orthopaedic alumni does not exist. In this study, we aimed to create, analyze, and share with our alumni a post-graduate survey based on ACGME core competencies.

Methods

The survey was developed by full-time orthopaedic faculty and reviewed by a survey methodologist to ensure clarity and an ideal survey format. In May 2020, the survey …

Management Targeted Genetic Evaluation Of An Idiopathic Neuropathy Cohort Through Attrv Amyloidosis Screening, Kristy A. Fisher, Santiago Diaz, Jeffrey Gelblum, Charles Brock, Niraja Suresh, Meghan Towne

HCA Healthcare Journal of Medicine

Background

While the reported prevalence of polyneuropathies is 1%-3%, the incidence of hereditary transthyretin amyloidosis in the United States is estimated to be 1 in 100 000 individuals. Polyneuropathies are known to be difficult to treat and lead to significant morbidity. The aim of pain management is symptomatic treatment, with varying approaches to progression prevention being based on the causative pathophysiology.

We assessed the prevalence of hereditary amyloid transthyretin variant (ATTRv) amyloidosis, a progressive autosomal dominant multisystem disease caused by the abnormal formation and extracellular deposition of transthyretin protein fibrils in various tissues, in an idiopathic polyneuropathy population by using …

A Clinical Review On Spinal Epidural Abscess: Epidemiology, Pathophysiology, Diagnosis, And Management For Emergency Medicine And Hospitalist Physicians, Madeline A. Guy, Jeffrey S. Guy

HCA Healthcare Journal of Medicine

Spinal epidural abscess (SEA), a critical surgical emergency, demands prompt recognition and intervention to prevent severe complications and fatalities. The incidence of SEA is notably increasing, particularly among individuals with diabetes, intravenous drug use, or a history of invasive spinal procedures. Although SEA can manifest through various clinical symptoms, the presence of its classic triad—back pain, fever, and neurological deficits—is noteworthy despite its occurrence in only 10% to 13% of cases. Identifying this triad is vital due to its high specificity for SEA, which is essential to guiding swift diagnostic and therapeutic actions in a condition where early intervention is …

A Pilot Physician Mentoring Program In A Large Hospital System, Crista C. Keller Md

HCA Healthcare Journal of Medicine

This article summarizes the development and implementation of a mentoring program designed to support and educate physicians new to practice in a large, outpatient hospital system. The program addresses organizational, operational, and financial elements of medical practice. Topics include efficiency and time management, coding education, leadership, and burnout. These topics are often not directly addressed in medical education, yet are crucial to physician well-being. The article describes the program structure, initial feedback, and recommendations for program replication and expansion.

An Acknowledgement To The Hca Healthcare Journal Of Medicine's Reviewers And Editors For The First Half Of 2024, Graig Donini, Bruce Deighton

HCA Healthcare Journal of Medicine

The HCA Healthcare Journal of Medicine would like to thank those behind the scenes who make this publication possible. Our journal would not be possible without the assistance of our peer reviewers, authors, and board members.

Acute Kidney Injury Induced Lithium Toxicity With Concomitant Neuroleptic Malignant Syndrome, Yin Ye Lai, Normaizuwana M. Mokhtar, Intan Nureslyna Samsudin, Subashini C. Thambiah

BioMedicine

Lithium, despite being an indispensable agent in the treatment of psychiatric disorders, has a narrow therapeutic index and needs to be carefully administered. Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication due to central dopaminergic blockade. This case report illustrates the challenges in lithium therapy particularly related to the development of NMS when further risk factors such as polypharmacy and dehydration are present. We report a case of a 50-year-old man with underlying bipolar affective disorder who was previously able to tolerate olanzapine and lithium well, however developed chronic lithium toxicity due to diminished lithium elimination in …

Loss Of Tyrosine 211 Phosphorylation Of Proliferating Cell Nuclear Antigen (Pcna) Enhances Postnatal Mammary Gland Development, Yi-Chun Shen, You-Zhe Lin, Wan-Rong Wu, Pei-Le Lin, Chien-Ching Liao, Feng-Chi Chung, Chia-Yun Chen, Ching-Yu Weng, Shao-Chun Wang

BioMedicine

The intricately orchestrated progression of mammary tissue development involves the precise coordination of gland differentiation and cellular proliferation. Nevertheless, the understanding of the role and regulatory mechanisms governing the DNA replication machinery in mammary gland development remains limited. Given the essential role of DNA replication in the viability of living cells, any genetic disturbance to its replicative function, in any form, will impede organ development. This circumstance poses a technical challenge in elucidating the potential function of cell proliferation in mammary morphogenesis. PCNA is crucial in DNA replication, playing a pivotal role in the development of complete eukaryotic organisms. The …

Effect Of Inulin From Dahlia Tubers (Dahlia Variabilis) Extract On Insulitis Severity And Insulin Expression In Diabetic Rats, Ismawati Ismawati, Saryono Saryono, Mukhyarjon Mukhyarjon, Ilhami Romus, Veni Dayu Putri, Sri Yanti, Fitri Dyna, Nada Idzdihari Adesti

BioMedicine

Background: Dahlia (Dahlia variabilis), a widely cultivated ornamental plant in Indonesia, is known to contain 84.08% inulin in its tubers. Numerous studies have demonstrated the antidiabetic potential of inulin from various plant sources. However, most of the research is in the form of a mixture of inulin with other active substances, and no one has analyzed the effects of inulin derived from dahlia tubers. This study examines the effect of inulin from dahlia tuber extract on blood glucose levels, serum insulin expression, pancreatic tissue insulin expression, homeostatic model assessment of insulin resistance (HOMA-IR), and the extent of …

Effect Of Mucuna Pruriens Seed Extract On Depression-Like Behavior Derived From Mild Traumatic Brain Injury In Rats, Alfonso Mata-Bermudez, Ricardo Trejo-Chávez, Marina Martínez-Vargas, Adán Pérez-Arredondo, María De Los Ángeles Martínez-Cárdenas, Araceli Diaz-Ruiz, Camilo Rios, Héctor Alonso Romero-Sánchez, Agustino Martínez-Antonio, Luz Navarro

BioMedicine

Background: Traumatic brain injury (TBI) is a severe health problem for which there is no specific treatment, leading to neurological or neuropsychological consequences. One of the most described disorders, even after mild TBI (mTBI), is depression, related to mechanisms involving reactive oxygen species (ROS). The Mucuna pruriens (M. pruriens) plant has various antioxidant, neuroprotective, and anti-inflammatory properties.

Purpose: There is insufficient evidence of M. pruriens use for the treatment of neurobehavioral and depressive impairments induced by TBI and of the mechanisms underlying this effect, so we aimed to evaluate the ability of shortterm administration of M. pruriens extract …

Effect Of Alantolactones On Cardiac Parameters Of Animals Under Artificially Induced Oxidative Stress, Mishal Fatima, Hina Andaleeb, Tanzila Rehman, Ouz Gul, Shanza Azeezz, Huzaifa Rehman, Haq Nawaz

BioMedicine

Purpose: Phytochemicals have been found effective in reducing the oxidative stress and damage to cardiovascular and other tissues. In this study, the effects of alantolactone (AL) on cardiac parameters in rabbits exposed to artificially-induced oxidative stress were investigated. Method: The oxidative stress was induced in a group of White New Zealand rabbits by injecting 40% hydrogen peroxide solution (1 ml/kg body weight) thrice with an interval of 72 h. The hydrogen peroxide-treated animals were orally treated with AL extracted from the roots of Inula helenium (1 ml/kg repeated thrice after 72 h). Blood samples were taken before and after the …

Polyphenols In Bee Products And Prevention Of Cell Senescence, Siti Nuriah Mohd Noor, Marahaini Musa, Ahmad Azlina, Siew Hua Gan, Kannan Thirumulu Ponnuraj

BioMedicine

Sustaining the continuity of cells and their homeostasis throughout the lifespan is compulsory for the survival of an organism. Cellular senescence is one of mechanisms involved in cell homeostasis and survival, and plays both important and detrimental roles in the maintenance of malfunctioned and normal cells. However, when exposed to various insults (genetic, metabolic and environmental), the cells undergo oxidative stress which may induce premature senescence, or so-called stress-induced premature senescence. Many age-related diseases are associated with premature senescence. Hence, there is growing interest in the intake of natural sources such as dietary food, which has protective functions on human …

School Counselor Capacity Building: A Literature Review, Yulizar Yulizar, Ahman Ahman, Juntika Nurihsan, Ipah Saripah

Jurnal Kajian Bimbingan dan Konseling

Capacity describes the human ability to perform, maintain itself, and self-renew. The concept of capacity building is concerned with three distinct levels: the individual, the organizational, and the community level. The literature on capacity building for school counselors is quite diverse. Accordingly, a comprehensive review of the emerging literature is required. This study conducted a systematic literature review exploring the current state of knowledge regarding the capacity building of school counselors. This study was conducted in accordance with the Standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P), which guided the selection of 30 articles that met the …

The Role Of Indonesian Doctors As Content Creators In Fighting Health Hoaxes, Myths, And Stigma On Social Media, Lydia Okva Anjelia, Deddy Mulyana, Jenny Ratna Suminar

JURNAL KOMUNIKASI INDONESIA

Amidst the proliferation of disinformation and misinformation related to health on social media, the public must ensure that the sources of information are trustworthy. This research aims to explain the role of doctors in the fight against health hoaxes, myths, and stigma spread through social media. The study adopts qualitative research with a phenomenological approach to understand doctors' experiences and perceptions regarding their efforts to address health hoaxes, myths, and stigma on social media. Fifteen doctors as content creators in Jakarta and Bandung were selected as informants using purposive sampling. The data was collected through interviews, observation participation, and documentation …

Dental Health Status And Associated Factors In The Deprived Population Covered By Rural Dental Insurance Program In The Province Of Kerman/Iran, Asma Sabermahani, Mohammad Jafari Sirizi, Zinab Shaker, Rasool Hassanzadeh, Tayebeh Malekmohammadi, Naimeh Hasheminejad

Journal of Dentistry Indonesia

Tooth decay is a widespread disease with considerable financial and psychological costs. Objective: The aim of this study was to investigate dental health of a large sample of people covered by rural insurance program in Kerman province. Methods: A sample size of 5000 was determined among people living in villages and towns with a population of less than 20000 who are all covered by dental rural insurance program. The DMFT/dmft index was assessed in five target age groups using the WHO oral health measurement standard form. Demographic and socioeconomic status of participants was also recorded. The percentage of …

Hyaluronic Acid In Managing Deep Residual Pockets In Stage Iii-Iv Periodontitis: A Randomized Controlled Trial, Mohamad Adib Jaafar, Esther Voo Vui Ching, Sharul Nisha Ali, Jeyanthi Subramaniam, Yuhaniz Ahmad Yaziz

Journal of Dentistry Indonesia

Objective: The purpose of this study was to determine the adjunctive clinical effect of hyaluronic acid (HA) in the non-surgical treatment of subjects with residual pockets (≥ 6 mm) at the maintenance phase. Methods: 36 systemically healthy subjects in the periodontal maintenance phase were included in this 3-month randomized clinical trial. Subjects received a course of full-mouth, scaling and root debridement (SRD). In the test group (n = 18), HA 0.8% was applied subgingivally immediately after SRD. The control group (n = 18) was treated with SRD only. Subjects in both groups were required to apply HA 0.2% …

Analysis Of Bone Destruction Mechanism By Aggregatibacter Actinomycetemcomitans: A Systematic Review, Erik Idrus, Karenina Raihani Amalia Ardiman, Widya Lestari, Masita Mandasari, Sri Angky Soekanto

Journal of Dentistry Indonesia

Periodontitis is a disease marked by inflammation of the periodontium, caused by biofilms present in the oral cavity, and results in alveolar bone destruction. One of the main hallmarks of periodontitis is the presence of Aggregatibacter actinomycetecomitans, which is generally suppressed by antibiotic administration. The strategy to control A. actinomycetecomitans by small specific peptide inhibitors potentially halts the progression of alveolar bone damage while lowering the risk of antibiotic resistance. The detailed interaction mechanisms of A. actinomycetecomitans and bone cells are fundamental to discovering and constructing the specific inhibitor. Objective : To systematically review the mechanism of bone destruction by …

Role Of Titanium-Reinforced Platelet-Rich Fibrin In Periodontal Tissue Regeneration-A Systematic Review, Bhavya Manchala, Anurag Teju, Mohan Kumar Pasupuleti, Gautami S Penmetsa, Sruthima Gottumukkala, Venkata Lakshmi

Journal of Dentistry Indonesia

Objective: The objective of the study is to demonstrate the efficacy of Titanium reinforced platelet-rich fibrin (T-PRF) as the sole biomaterial amongst the biologics in periodontal regeneration of both soft and hard tissues. Methods: A PUBMED database search is conducted from August 2013 to August 2023. Only original articles, including Randomized controlled clinical trials, cross-sectional studies, prospective studies, and case-control studies, were included. The studies will be analyzed regarding the outcome of the association between T-PRF and periodontal regeneration of both hard and soft tissue. Results: From 35 articles identified, 8 RCTs were included. The use of …

Avicennia Marina Mangrove Plant Mediated Selenium Nanoparticles And Their Therapeutic Activity Against Oral Pathogens And Other Biological Properties, Kannan Kamala, Pitchiah Sivaperumal, Dhanraj Ganapathy

Journal of Dentistry Indonesia

In the last few decades nanoparticles are widely used in the control of many pathogenic bacteria, fungi, viruses, and cancer growth both in-vitro and in-vivo. A marine plant of Avicennia marina is widely used in traditional medicine for diabetes, inflammation and skin diseases. Objective: In general Avicennia marina has been used as a traditional medicine to treat various diseases and it has shown significant inhibition against various pathogen and the formation of free radicals. Also, the plant A.marina mediated selenium nanoparticles has therapeutic activity has promising to develop biocompatible new cost effective treatment for various oral diseases. Methods: …

Remineralization Potential Of Grape Seed Extract On Artificial Enamel Caries Lesions, Serif Alpcan Ozden, Esra Oz

Journal of Dentistry Indonesia

Objective: This study aimed at a comparative analysis of the remineralization potential of grape seed extract (GSE) alone, together with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and/or acidulated phosphate fluoride (APF). Methods: The samples were randomly divided into seven groups according to the treatment used: 25% GSE, 1.23% APF (Gelato APF gel), and CPP-ACP (GC Tooth Mousse). The samples in group 7 received no treatment as a control group. All specimens were subjected to pH cycling for two weeks. Surface microhardness analyses were performed at baseline, after demineralization and remineralization. Data were analyzed using one-way analysis of variance (ANOVA), …

In Silico Modelling And Docking Simulation Of Egfr-Targeted Diphtheria Toxin Chimera With Various Targeting Moieties, Muhammad Afif Naufal Bmed, Benedictus Ansell Susanto Bmed, Talitha Dinda Gunawan Bmed, Azhar Ridha Lukman Bmed, Alifa Rahma Rizqina Bmed, Muhammad Misbahul Fuad Bmed

Indonesian Journal of Medical Chemistry and Bioinformatics

Introduction: Cancer is a major etiology of death worldwide due to high mortality and suboptimal medicine. However, an emerging field, targeted therapy enabled a more selective and effective therapeutic action. This article aims to analyze in-silico the hypothetical targeted therapy agent that is combinations of conjugate consisting of EGFR targeting moieties and diphtheria toxin (DT-390).

Method: Our novel peptide is a conjugate of a novel EGFR targeting peptide and DT-390, forming a chimera. The tertiary structure was predicted using AlphaFold 2.0. The best IDDT scoring and stereochemistry profiles were utilized. The HADDOCK2.4 webserver modelled the docking between our …