Polycystic Ovarian Syndrome: A Clinical Review, Amanda Nettles

Lynchburg Journal of Medical Science

Polycystic ovarian syndrome (PCOS) is a pervasive condition that affects women all over the world. It presents with a wide variety of symptoms like menstrual irregularity, hyperandrogenism, and polycystic ovarian morphology. Although generally considered to be solely a reproductive disorder, PCOS impacts metabolic, psychological, and cardiovascular health, and increases the risk for those diagnosed for other complications. Although PCOS is relatively common, it remains greatly misunderstood, which makes diagnosing the condition even more complex. Risk factors taken into consideration include genetics, environment, and lifestyle. The pathophysiology of PCOS focuses on dysfunction of the hypothalamic-pituitary-ovarian axis, insulin resistance, and inflammation. There …

Evolution Of Btk Inhibitors, Dena Mathew

Lynchburg Journal of Medical Science

The purpose of this clinical review evaluates the evolution of bruton’s tyrosine kinase (BTK) inhibitors in becoming the standard of care in treating chronic lymphocytic leukemia (CLL). The first-generation BTK inhibitor ibrutinib has demonstrated superior efficacy over traditional chemotherapy in several randomized clinical trials in terms of progression free survival (PFS). However, due to cardiovascular toxicities of atrial fibrillation (afib), hypertension (HTN), and bleeding, have led to drug discontinuation. Second-generation BTK inhibitors, acalabrutinib and zanubrutinib have demonstrated reduced rates in cardiovascular toxicities due to improved BTK receptor selectivity, as seen in three head-to-head ibrutinib clinical trials. The emergence of BTK …

Management Of Electrolyte Abnormalities In The Emergency Department, Todd W. Jones

Lynchburg Journal of Medical Science

The objective of this article review is to discuss standard treatment options and review emerging therapies for the more common electrolyte abnormalities. The number of emergency departments (ED) in the United States has declined over the past 15 years, which has created overcrowding. This makes it more difficult to prioritize patients based on severity. The importance of this topic is to assist providers in taking quick action on patients presenting with critical electrolyte levels in busy EDs. A literature search using PubMed from 2019 to 2024 identified numerous articles that supported the purpose. This review will discuss the various electrolyte …

Testosterone: The Forgotten Female Hormone, Katherine A. Horner Pa-C

Lynchburg Journal of Medical Science

ABSTRACT

The purpose of this article is to review the current and past use of testosterone as a replacement hormone for women in peri- and early postmenopause. Healthcare providers are often not educated about testosterone as a sex hormone with profound effects on the female body. Yet, clinicians who treat women in the 4th and 5th decades of life should be familiar with the function of testosterone, clinical symptoms associated with declining levels, women’s perceptions about peri- and postmenopause as well as side effects of testosterone, and the implications of its use as a replacement hormone on other body systems. …

Common Misconceptions In Hormone Therapy (Ht) Treatment In Menopause, Miranda Zuhlke

Lynchburg Journal of Medical Science

ABSTRACT
The purpose of this review is to address the misconceptions surrounding Hormone Therapy (HT) in menopause largely surrounding the findings from Women’s Health Initiative (WHI). The review explores the history of HT, the risks and benefits, along with current guidelines for HT and non-hormonal options. A comprehensive search was conducted using electronic databases focusing on the effect of HT on breast cancer, cardiovascular health, bone health, and quality of life. Studies that analyzed the implications from the WHI were included as well as the North American Menopause Society (NAMS) current recommendations and guidelines for treatment options in menopause. Findings …

Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell

Lynchburg Journal of Medical Science

Epistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.^1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.^2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is …

Screening For Prodromal Symptoms Of Schizophrenia In Primary Care Settings, Thomas S. Christy

Lynchburg Journal of Medical Science

Schizophrenia is a debilitating mental health disorder with severe and wide-ranging consequences. Early detection of prodromal symptoms (subtle warning signs preceding full-blown psychosis) can significantly improve patient outcomes. Primary care settings, where early intervention is typically most feasible, lack standardized tools to screen for prodromal symptoms of schizophrenia, however. This review examines existing psychosis screening questionnaires to determine their suitability for primary care use. In addition to highlighting the significant role of primary care providers in managing mental health conditions, this review outlines the challenges associated with recognizing early signs of schizophrenia, particularly in resource-limited settings, and therefore why utilizing …

Does Combining Methadone With Psychotropics Further Increase The Risk Of Qtc Prolongation? Considerations For Ekg Monitoring., Christine A. Rowland

Lynchburg Journal of Medical Science

Co-occurring mental health and substance use disorders affect millions of American adults, with opioid use disorder (OUD) being a significant concern. Methadone Maintenance Treatment (MMT) is widely used for OUD, but both methadone and several psychotropic medications increase the risk of QTc prolongation, a precursor to life-threatening arrhythmias such as Torsades de pointes (TdP). Despite the potential risks, there are no definitive guidelines for EKG monitoring in individuals prescribed both methadone and psychotropics, leaving clinicians with an ethical dilemma regarding treatment decisions. This article reviews recent literature on the risk factors for QTc prolongation, focusing on the combined impact of …

A Clinical Overview Of Endometriosis, Adriane Strawn

Lynchburg Journal of Medical Science

Endometriosis, the finding of endometrial tissue in areas of the body other than the interior of the uterus, affects about 10% of menstruating women worldwide and is a common reason for dysmenorrhea and infertility. The underlying pathophysiology is not fully known but thought to be mostly due to retrograde menstruation through the oviducts into the abdominopelvic cavity. Other major pathogenic theories include vascular and lymphatic spread and coelomic metaplasia. Patient symptoms may include dysmenorrhea, dyschezia, dyspareunia, pelvic pain, infertility, and fatigue, but patients can also be asymptomatic. Endometriosis is difficult to diagnose, and although it is possible to visualize certain …

Testosterone Replacement Therapy In The Middle-Aged Male, Gina N. Demilt

Lynchburg Journal of Medical Science

The purpose of this review was to investigate the use of testosterone supplementation in the middle-aged male with a focus on the pathophysiology of testosterone throughout the lifespan, current supplementation options and their adverse effects, and the overall benefit of supplementing to enhance quality of life. A comprehensive search of electronic databases was conducted identifying studies that assessed clinical outcomes, pathophysiology, supplementation options, adverse effects and benefits of treatments. The findings suggested that testosterone levels naturally decline with age with most men developing symptoms of hypogonadism around age 60. Testosterone supplementation outside of current guidelines is not recommended, however men …

Effective Interventions For Preventing Burnout In Health Education Students, Heidi Vonderheide

Lynchburg Journal of Medical Science

This article aims to investigate effective interventions to reduce burnout in health education students. A comprehensive electronic literature search of PubMed and Google Scholar identified articles discussing the prevalence and effects of burnout in health care providers and students, as well as interventions to reduce burnout and improve the quality of life of health education students. The findings suggest pass-fail grading, physical exercise, mindfulness training, and mental health programming significantly reduce burnout among health education students. Significant variability in both intervention design and outcome measurement highlights the limitations of the findings and underscores the need for future research. Effective burnout …

Optimizing Interventions For Major Depressive Disorder And Provider Burnout: Self-Speak Exercise Dosing (Sed), Laureen Maloney-Gepfert

Lynchburg Journal of Medical Science

ABSTRACT

Major Depressive Disorder (MDD) is ranked highest among mental illnesses in the United States (US) and significantly contributes to the mental health care crisis. Patients experience resistance to pharmacologic interventions, side effects, co-morbidities, and mental health provider shortages. Subsequently, 33 % of Serious Mental Illnesses (SMIs) are being redirected to Primary Care Providers (PCPs). Concurrently, prescriber mental health is in crisis. Growing workloads for physicians and Advanced Practice Providers (APPs) have increased provider burnout syndrome (BOS). Major Depressive Disorder and BOS are positively affected by exercise, Cognitive Restructuring (CR), and Behavioral Activation (BA). Sports medicine and psychology research shows …

Roadmap To Better Mental Health Care, James R. Kilgore, James C. Somers, Jenna Rolfs, Everett Allen, Tom Colletti, Blake Rogers, Maggie Banger, Nikoleta Delis, Debra S. Munsell Dhsc, Pa-C

Lynchburg Journal of Medical Science

This article will describe the current providers involved in delivering mental health services, the projected needs for mental health providers in the next decade, and interventional strategies that may enhance their delivery of care. By adopting comprehensive, patient-centered interdisciplinary strategies, and utilizing new and innovative tools and pharmaceutical agents healthcare providers can mitigate the adverse effects of lack of access and the delivery of mental health care.

Spirituality And Ptsd Outcomes Among Service Members And Military Veterans, Jennifer Urbina Dmsc, Pa-C

Lynchburg Journal of Medical Science

Post-traumatic stress disorder (PTSD) is a prevalent and debilitating condition among military service members and veterans, often co-occurring with moral injury (MI) and spiritual distress (SD). While conventional PTSD treatments include cognitive behavioral therapy (CBT), exposure-based therapies, and pharmacological interventions, growing evidence suggests that spirituality may play a vital role in improving PTSD outcomes. This paper explores the integration of spirituality in PTSD treatment, examining its potential to mitigate symptoms, enhance resilience, and facilitate post-traumatic growth. Military chaplaincy, spiritually integrated therapies, and Department of Defense (DoD) holistic health models provide frameworks for addressing the spiritual dimensions of PTSD. Studies indicate …

Image Quality Analysis Of Head Cts Obtained On A New Portable Scanner Compared To Stationary Ct, Mara M. Kunst, Juan E. Small, Sebastian E. Flacke, Joseph D. Burns, Maximilian Smith, Christoph D. Wald

The Lahey Journal

Background/Purpose: The use of mobile head CT scanning in the ICU setting has both clinical and economic advantages, particularly if able to provide image quality close or equal to fixed CT scanners.

The purpose of the study is to evaluate the image quality of a new portable CT scanner, compared to a fixed CT platform.

Materials/Methods: Inpatients (n=11), age> 60 requiring head CT evaluation were enrolled and consented to obtain an additional head CT on the portable CT, following their fixed exam.

Nine patients were able to complete the study; seven patients received duplicate exams with matched imaging technique, and …

Comparing Testosterone Suppression In Intramuscular And Subcutaneous Leuprolide Acetate Formulations, Annalise Mcdonald, Kali Sullivan, Cara Cloghessy, Benjamin Sweigart, Brendan J. Connell

The Lahey Journal

Introduction

Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer. Leuprolide acetate (LA) is a common ADT, manufactured as an intramuscular injection, Lupron® (LA-IM), and a subcutaneous injection, Eligard® (LA-SC) with the goal of testosterone < 50 ng/dL. We investigated for differences in testosterone suppression between the two formulations in patients with prostate cancer.

Methods

Clinical data was abstracted from our medical records system for patients with prostate cancer who started leuprolide acetate between January 2016 through March 2022 with a subsequent testosterone value checked. Primary endpoint was the proportion of subjects with testosterone levels < 50mg/dL, with secondary endpoints including the proportion of subject achieving testosterone levels < 20ng/dL and median testosterone levels.

Results

525 subjects were included. The LA-IM and LA-SC groups were balanced for age and race but the doses of leuprolide differed …

Assessing The Impact Of Covid-19 Pandemic On Surgical Trends Of Ophthalmology Residents Graduating After 2020, Max Liu, Meghana Kalavar, Vamsee Vemulapalli, Mustapha Tahiru, Thuy Le, Andrew J. Hendershot

Journal of Academic Ophthalmology

Purpose: To examine the effects of the COVID-19 pandemic on surgical volumes of ophthalmology residents who completed training after 2020. Methods: Aggregated average case logs of primary surgeon and surgeon + assist (S+A) procedures for graduating ophthalmology residents in the U.S. between 2012 and 2023 were gathered from the Accreditation Council for Graduate Medical Education (ACGME). Trends for primary surgeon and S+A procedures were assessed. The annual percent change in primary surgeon and S+A procedures was determined using linear regression to compare changes over three time periods: 2012-2019, 2019- 2020, and 2020-2023. Results: Total cases as a primary surgeon and …

Cross-Sectional Analysis Of International Rotations Among Ophthalmology Residency Programs, Malcolm M Kates, Riley Ct Duke, Krupa H. Patel, Russell W Read

Journal of Academic Ophthalmology

Background: Applicants to ophthalmology residency programs have increasingly expressed interest in international surgical rotations. As such, ophthalmology residency program directors (PDs) have expanded international offerings to meet this desire but the true number of residency programs with international offerings is unknown. Methods: In February 2023, the official residency websites of all 125 accredited US-based ophthalmology residency programs were analyzed for any mention of international rotations. Websites were identified using a Google™ search by entering the program name and “ophthalmology residency.” All websites were surveyed for information regarding international rotations including the presence/absence of an international rotation and any additional information …

The Relationship Between Open Access Article Publishing And Short-Term Citations In Ophthalmology, Hassaam S Choudhry, Carter Burton, Luis Cupertino, Matthew Montani, Riya Patel, Sri Guttikonda, Albert S Khouri

Journal of Academic Ophthalmology

Purpose: In recent years academic journals have increasingly transitioned to a paid open access (OA) model. The present study aims to identify whether OA or subscription access (SA) influences short-term citations of articles in ophthalmology. Methods: The Dimensions database was queried in October 2022 for articles published in 2019 in the following journals with both open and subscription access options: Ophthalmology, American Journal of Ophthalmology, JAMA Ophthalmology, Graefe's Archive for Clinical and Experimental Ophthalmology, and British Journal of Ophthalmology. Article access, citations, country, article type (review, letter/viewpoint/comment, original investigation), study type (basic science/animal model, case report/series, clinical trial, NA, observational) …

Implementing Standardized Patients In Simulation In Undergraduate Nursing Education, Taylor A. Murray

SACAD: Scholarly Activities

Abstract

The integration of standardized patients (SPs) in simulation-based learning has emerged as a transformative approach in undergraduate nursing education. By providing nursing students with the opportunity to engage with trained actors simulating real-life patient scenarios, SPs offer a safe and controlled environment to develop essential clinical skills. This research explores the impact of SPs on promoting student confidence and enhancing their practical skills in nursing practice. Implementing SPs into nursing education not only supports students in refining their assessment and communication abilities but also prepares them for the complexities of patient care in real-world settings. Ultimately, this study aims …

The Incidence Between Carpal Tunnel Syndrome (Cts) And De Quervain’S Tenosynovitis (Dqt) Using Electrophysiological And Ultrasonography Study., Shaimaa M. Abd El Aziz, Lamis Safwat

Journal of Medicine in Scientific Research

One of the most common entrapment neuropathies affecting the upper limbs is carpal tunnel syndrome (CTS). de Quervain tenosynovitis (DQT) is a condition that affects the wrist's first dorsal compartment and is characterized by tendon entrapment and thickening of sheaths around the abductor pollicis longus and extensor pollicis brevis. The association of idiopathic CTS and idiopathic DQT has been studied in a few researches. In this study, we would like to summarize the most recent knowledge about the occurrence of CTS and DQT on the same hand using electrophysiological and ultrasonography studies.

Does Coronary Artery Bypass Grafting Surgery Affect The Right Ventricular Function Postoperatively?, Ahmed A Faragalla, Ahmed M Elshiemy, Sherif A Elhindawy, Ahmed A Abdelhamid

Journal of Medicine in Scientific Research

Background A well-established benefit of coronary artery surgery (CABG) is to improve the left ventricular (LV) performance meanwhile, its impact on the right ventricular (RV) chamber is obscure and an issue of continuous investigations. Aim This study explores the influence of CABG on the RV performance. Methods This study employed a prospective longitudinal, observational design to evaluate function in 30 patients undergoing isolated CABG. Echocardiography with a transthoracic approach was accomplished preoperatively, one week and one-month post-surgery. The myocardial performance index (Tei index), tricuspid annular plane systolic excursion (TAPSE), and peak systolic (Sm) and early diastolic (Em) myocardial velocities at …

Sonographic Evaluation Of An Urachal Remnant: A Case Report, Courtney Gushi

SACAD: Scholarly Activities

Urachal anomalies are rare and often identified incidentally during diagnostic imaging studies, such as sonography. These anomalies are being detected with increasing frequency due to advancements in cross-sectional medical imaging. Sonography is a key diagnostic modality due to its lack of radiation, cost-effectiveness, and widespread ability. Urachal anomalies have the potential to undergo pathological changes, leading to inflammation, infection, and even malignancy. Therefore, it is imperative for sonographers to be proficient in identifying and understanding sonographic characteristics of urachal abnormalities.

Exploring The Causes Of Plwha Non-Adherence With Antiretroviral Therapy: Implications For Practice In The Post-Covid-19 Era, A Phenomenological Study, Adriani Suwito, Evi Hasnita, Nurhayati -. Nurhayati, Oktavianis -. Oktavianis

The Qualitative Report

One of the goals of HIV/AIDS health services is to combat patients’ non-adherence with medication. This is the key to providing effective care for these patients. If a patient is rebellious or undisciplined in following his treatment regimen, the consequences can include decreased production, increased morbidity, and even death. However, in the post-COVID-19 period, where health protocol adherence remains strong, there are concerns regarding the potential spread of HIV/AIDS. The purpose of this qualitative phenomenon study is to investigate the factors that contribute to non-adherence to medicine in HIV/AIDS patients during the post-COVID-19 condition to remove barriers to patient treatment. …

Effect Of Feeding A Saccharomyces Cerevisiae Fermentation Product On Immune Response To Vaccines Against Newcastle Disease Virus, Avian Influenza Virus, And The Prevalence Of Chronic Respiratory Disease And Coccidiosis In Chickens Raised In A Low Biosecurity Production System, Bui Thi Hien, Ho Thi Dung, Pham Hoang Son Hung, Le Duc Thao, Nguyen Van Chao, Tran Quang Vui, Nguyen Thi Hoa, Anjan Mondal, Nsereko Victor, Le Dinh Phung

The Thai Journal of Veterinary Medicine

This study was carried out in a low biosecurity production system to explore the effects of a Saccharomyces cerevisiae fermentation product (SCFP) on immune responses to vaccination against Newcastle disease virus (NDV) and Avian influenza (H5N1) and prevalence of common diseases in chickens including chronic respiratory disease (CRD) and coccidiosis. One hundred and ninety two 1-day-old chickens were randomly assigned into control (a standard basal diet) and treatment (a standard basal diet containing 1.25 kg/MT of Diamond V XPC™ – a Saccharomyces cerevisiae fermentation product). Immunity data on antibody titers to NDV and H5N1 were collected at 3 weeks and …

Antibiotic Resistance Profile Of Enterobacteriaceae Isolated From Healthy Pigs In The Republic Of Armenia, Yura Shirvanyan, Irma Artushyan, Lilit Hovsepyan, Ashkhen Shirvanyan, Elmira Ghazaryan, Tigran Markosyan

The Thai Journal of Veterinary Medicine

The rising prevalence of antimicrobial resistance (AMR) among Enterobacteriaceae in livestock presents a significant threat to both animal and human health. This study investigates the antibiotic resistance profiles of Enterobacteriaceae isolated from 160 samples collected from the lymph nodes of healthy pigs in Armenia. Fifty isolates were identified, including Escherichia coli (24), Klebsiella spp. (10), Salmonella spp. (6), Raoultella ornithinolytica (4), Pseudomonas aeruginosa (4), and Proteus mirabilis (2). Resistance was evaluated using the disk diffusion method against 22 antibiotics from nine classes. Alarmingly, 94.5% of isolates were resistant to clarithromycin and 90.3% to erythromycin, while resistance to cephalothin and amoxicillin …

"The Role Of Venous Excess Ultrasound Score In Optimizing Acute Heart Failure Diagnosis And Prognosis, Saoussen Antit, Sarra Romdhane, Imen Mtiri, Lilia Zakhama

Journal of the Saudi Heart Association

Acute heart failure (AHF) is a critical condition with significant morbidity and mortality, necessitating timely and accurate diagnosis for effective management.

The Venous Excess Ultrasound (VExUS) score has emerged as a non-invasive diagnostic tool, aimed at evaluating venous congestion through ultrasound. This scoring system integrates assessments of the inferior vena cava, hepatic veins, portal veins, and renal venous flow to quantify congestion severity. By providing a real-time assessment of venous pressure, the VExUS score has shown potential in optimizing early diagnosis of AHF and predicting outcomes and overall prognosis.

Recent studies suggest that incorporating the VExUS score into clinical practice …

Spasticity And Pain And The Improvement Of Muscle Strength In Athletes With Partial Spinal Cord Injury, Dariusz Tadeusz Skalski, Kinga Łosińska, Magdalena Prończuk, Alicja Markiel, Jarosław Markowski, Jan Pilch, Joanna Motowidło, Petr Stastny, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Spasticity and chronic pain are common secondary complications following spinal cord injury (SCI), significantly impacting functional recovery and quality of life. Robot-assisted gait training (RAGT) using the Lokomat has been proposed as an effective rehabilitation method to improve motor function and reduce these symptoms. However, the impact of training frequency on rehabilitation outcomes remains unclear, particularly in athletes and physically active individuals. This study aimed to evaluate the effects of Lokomat training on spasticity reduction, pain alleviation, and improvements in gait function and lower limb muscle strength in athletes and physically active individuals with partial SCI. A total of 45 …

Predictors Of Outcomes In Pediatric Pulmonary Arterial Hypertension, Aditya Doni Pradana

Journal of the Saudi Heart Association

There is no abstract for this article type.

Shuffle, Dereck Daschke

Journal of Religion & Film

This is a film review of Shuffle (2025), directed by Benjamin Flaherty.