Medicine and Health Sciences Commons^™

N Y State Dent J March 2025

The New York State Dental Journal

In the March 2025 issue, the reader will find the following feature articles:

• Manifestations of Trigeminal Neuralgia Secondary to Multiple Sclerosis in Dentoalveolar Region: Case Report and Literature Review
• Arteriovenous Malformation Presenting as a Disfigured and Throbbing Face: Case Report
• Stress of Dental Students

This issue includes regular columns with regional news impacting the New York membership including: editorial and perspectives columns, legal, association activities, component news, continuing education opportunities, and classifieds.

In this month's update from the New York State Dental Foundation, readers will find a call to action in the article "Volunteers Needed to Join Effort to Alleviate …

Awareness On Environmental Air Pollution Among Adults In Rural Mysuru, Rakesh M, Jesymol Joy, Sunil Kumar D

Digital Journal of Clinical Medicine

Introduction

Air pollution is a major environmental threat and one of the main cases of death among all risk factors known so far. Health effects also include preterm and low-birthweight, asthma as well as cognitive and neurological impairment basically having the potential to impact our whole body, way beyond our lungs. The proposed study focusses on to assess the awareness on air pollution and factors associated with it among adults in South Mysuru which can put a light on the preventive measures and policies to be taken by the individuals as well as the authorities.

Methodology

A Community-based cross-sectional study …

An Intractable Problem: Creative Solutions Are Needed To Solve The Dental Hygienist Shortage In New York State, Stuart L. Segelnick Dds, Ms

The New York State Dental Journal

The dental workforce shortage is well documented. Whether it is dental assistants or dental hygienists, it hasn’t been easy finding good help. The ADA and California Dental Association recommend offering higher salaries, flexible and lighter schedules, health insurance, paid holidays and vacations, retirement funds, paying for continuing education, better dental office culture and growth opportunities. Providing these benefits and adjusting your dental practice may very well lead to success in hiring, but could be detrimental to your business. Maybe it’s time we look far outside the box for solutions.

Volunteers Needed To Join Effort To Alleviate Pain And Restore Hope, Stacy Mcilduff Cfre

The New York State Dental Journal

The New York State Dental Foundation is pleased to share an inspiring opportunity for dentists to make a difference for one of the most underserved groups in the Hudson Valley community — approved and documented refugees who are being resettled with the help of private citizens through the community sponsorship model. Hearts & Homes for Refugees (HHR) is a grassroots organization dedicated to supporting refugee families who arrive with documentation. We are inviting dental professionals to join the effort to alleviate dental pain and restore hope for those who have endured extraordinary hardship.

Manifestations Of Trigeminal Neuralgia Secondary To Multiple Sclerosis In Dentoalveolar Region: Case Report And Literature Review, Eliahu Zaghi Ba, King Chong Chan Dmd, Ms, Frcd(C)

The New York State Dental Journal

Multiple sclerosis (MS) is a chronic central nervous system disease of inflammation and demyelination. Presentation can vary tremendously but, typically, involves neurologic deficits, including weakness, pain, numbness and motor dysfunction. MS can also affect the dentoalveolar region. We describe a patient with MS who clinically presented with “electric” and “shooting, pulling” pain in the left maxillary region. The pain subsided following a course of gabapentin, leading to the diagnosis of trigeminal neuralgia secondary to MS. This report aims to review various common dentoalveolar manifestations of MS.

The New Professional: Best Practices For Leaving A Job: A Guide To A Smooth Transition, Amrita Patel D.D.S.

The Journal of the Michigan Dental Association

The article provides guidance for associate dentists on executing a professional job transition. It emphasizes the importance of careful decision-making, thorough contract review, and maintaining professional relationships throughout the resignation process. Key recommendations include evaluating the decision objectively, understanding contractual obligations, providing appropriate notice, documenting ongoing patient care, and maintaining a positive attitude. The article stresses that a well-managed departure can protect one's professional reputation and future career opportunities.

Harnessing General Purpose Ai In Dental Practice: Strategic Solutions For A Burdened Workforce, Christopher J. Smiley D.D.S.

The Journal of the Michigan Dental Association

Artificial intelligence (AI) is reshaping dental practice administration by enhancing efficiency and providing solutions to address workforce shortages. Free-to-use generative AI (GenAI) tools, such as ChatGPT and Claude, can streamline routine tasks, support creative workflows, and reduce the burden on office teams. However, dental professionals must understand AI’s limitations and ethical boundaries, including risks to patient confidentiality and the potential for inaccurate or misleading outputs. Proprietary dental-specific AI systems demonstrate a safer approach by providing specialized diagnostic support and practice analytics in more secure environments to meet HIPAA standards. Yet even these dentistry-based AI solutions carry a risk of bias …

Online Reviews: Myths, Tips, And Tricks, Anish Gupta D.D.S.

The Journal of the Michigan Dental Association

Online reviews are a source of reputation marketing which are valuable to the practice of dentistry. Reviews bring patients in and provide social proof for your practice. We discuss what makes a good review, tips to get reviews, and dispel certain myths regarding online reviews.

Exploring Ada Commons, The Ada’S New Home For Tripartite Publications, Alisun Dekock

The Journal of the Michigan Dental Association

ADA Commons is a searchable, open-access database designed to centralize and expand access to dental publications across the ADA tripartite, including state and local dental societies. This resource allows users to explore current and archived issues of various dental journals, including the Journal of the Michigan Dental Association (JMDA), facilitating research, professional development, and historical reference.

Build Your Practice With Dental Revenue Cycle Management, Robert Mcdermott

The Journal of the Michigan Dental Association

This article explores the essential role of Dental Revenue Cycle Management (RCM) in ensuring the financial success and sustainability of a dental practice. Many dentists, especially those new to solo practice, struggle with managing the business side of dentistry, particularly the complexities of RCM. The article outlines the key steps of RCM, including patient scheduling, insurance verification, claims submission, and payment processing, emphasizing how a well-managed system ensures steady cash flow and enhances patient experience. Key challenges in RCM include lack of formal business training, evolving insurance regulations, and the risk of delayed reimbursements, which can threaten a practice’s viability. …

Dentistry And The Law: How To Handle Visits Or Contacts By An Ice Agent, Daniel Schulte J.D.

The Journal of the Michigan Dental Association

The article addresses how dental practices should handle visits from Immigration and Customs Enforcement (ICE) agents following the January 2025 revocation of the "sensitive locations" policy. While ICE agents can enter public areas without warrants, they require judicial warrants, administrative warrants, or subpoenas to access private areas. Practices should verify agents' identities, follow established law enforcement policies, and protect patient information under HIPAA guidelines. The article recommends developing comprehensive policies and training staff to handle law enforcement visits appropriately.

Successful Repair Of Right Atrial Rupture Secondary To Blunt Chest Trauma: A Case Report And Discussion, Joshua D. Mohs, Owen G. Alvine, Sam C. Jensen

Aesculapius Journal (Health Sciences & Medicine)

This case report discusses a successfully treated right atrial rupture secondary to blunt chest trauma. Secondary cardiovascular collapse requiring resuscitation occurred following suture repair of the 3 cm atrial laceration in the operating room (OR). Here we present a 15-year-old male who arrived by emergency medical services (EMS) to the emergency department (ED) as a level 1 trauma activation following a motor vehicle accident. Imaging scan showed a right hemothorax. Persistent labile blood pressures necessitated a thoracotomy. Exploration revealed a 3 cm laceration in the right atrium and prompt suture repair of the laceration was followed by secondary cardiovascular collapse. …

The Relationship Between Individualised Speed Thresholds And Changes In Aerobic Fitness In Elite Professional Youth Soccer Players. A Case Study, Ronan Kavanagh, Kevin Mcdaid, David Rhodes, Jill Alexander, Damian Harper, Rafael Oliveira, Kieran Berry, Mark Connor, Piotr Zmijewski, Ryland Morgans

Baltic Journal of Health and Physical Activity

Background: This study aimed to examine the dose-response relationship between training load and aspects of physical fitness in English Premier League (EPL) U23 soccer players. Materials and Methods: Seven male EPL U23 outfield soccer players (age 20.1±1.1 years) participated in this study and performed the Bronco test on five occasions within one season. Individualised running thresholds were employed using maximal aerobic speed (MAS), anaerobic speed reserve (ASR) and maximal sprint speed (MSS) values utilising a GPS system. Results: No significant differences in the Bronco performance between the tests (p > 0.05, ES = 0.101) were observed. Distance covered above 30% …

Anatomy In Ink, Gabriel Scally

HCA Healthcare Journal of Medicine

In the intersection of medicine and art lies a profound synergy that nurtures both professional and personal well-being. This piece embodies this connection through a detailed and abstract representation of the human body and its complexities. At the center of the piece, the gross anatomical depiction of the head and neck serves as a nod to the foundational knowledge in medicine. Surrounding this central figure is an intricate conglomeration of medical elements, including the inner ear canal, a fetus, a hand, an eye, the brain, nerves, chemical elements, microbiology, and excerpts from the Hippocratic Oath, tying together aspects from basic …

Harmonizing Innovation: The Beatles, Emi, And The Birth Of Computed Tomography Imaging, Matthew A. Daniel, Alexander Holland, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Computed tomography (CT) imaging has become a cornerstone of modern medical diagnostics, thanks to the groundbreaking work of Sir Godfrey Hounsfield. However, the significant role played by his employer, Electric and Musical Industries (EMI), in providing financial support for his research is often overlooked. In this paper, we explore the connection between EMI's success in the music industry, particularly its signing of the Beatles, and Hounsfield's pioneering work on CT imaging. EMI’s success in the music industry provided the financial stability for Hounsfield's research endeavors. In 1971, he developed the first CT scanner, which revolutionized diagnostic medicine. His collaboration with …

Ethical Considerations Of Percutaneous Endoscopic Gastrostomy Tube Placement In A Patient With Creutzfeldt-Jakob Disease And Advanced Dementia, Toni Habib, Niamh Siobhán Mulrooney, Yisroel Grabie, Mohammad Maruf, Sophia Kasapira

HCA Healthcare Journal of Medicine

Background

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative condition that is not easily diagnosed and has no curative treatments available, essentially requiring palliative measures, including tube feeding. Nonetheless, data shows that the endoscope used for percutaneous endoscopic gastrostomy (PEG) tube insertion can be a vector for CJD transmission.

Case Presentation

We discuss the case of an elderly patient diagnosed with CJD, requiring tube feeding. Multiple specialists were consulted, and they were unable to reach an agreement on the best approach. Eventually, the hospital ethics committee intervened, and the family agreed to comfort measures only. This case report sheds light …

The Black Fungus: A Rare Case Of Pulmonary Mucormycosis, Stephanie Wong, Elsa Lesley Tchouambou Pougoue, Joanna Polanco, Betty Kirimi, Choudhry Poonam

HCA Healthcare Journal of Medicine

Background

Mucormycosis, commonly known as the "black fungus," is a severe infection affecting multiple organ systems, including the skin, brain, lungs, and gastrointestinal tract. This case report is focused on pulmonary mucormycosis, which is frequently observed in organ transplant recipients. Diagnostic challenges arise from nonspecific symptoms.

Case Presentation

Our case involved a 61-year-old male with a history of renal transplantation. The patient initially presented with a persistent cough and bloody sputum and was treated unsuccessfully for a presumed fungal infection. A lung biopsy confirmed pulmonary mucormycosis, emphasizing the heightened vulnerability of immunocompromised individuals.

Conclusion

This case highlights the intricate nature …

Plasma Cell-Rich Lymphoid Neoplasm In An Endocervical Polyp Of The Uterine Cervix In A Perimenopausal 52-Year-Old Woman, Anjali Patel, Jacqueline Haas, Angela Kueck

HCA Healthcare Journal of Medicine

Background

The adaptive immune system consists of T and B lymphocytes, with some B lymphocytes further differentiating into plasma cells that secrete antibodies and make up the humoral immune system. Extramedullary plasmacytoma, mucosa-associated lymphoid tissue (MALT) lymphoma, and plasmablastic lymphoma are all plasma cell-rich lymphoid neoplasms that rarely present in the female genital tract. To date, few case reports of these malignancies arising within the uterine cervix exist.

Case Presentation

This case report describes a 52-year-old perimenopausal woman who presented to her primary obstetrician-gynecologist for an annual exam with the complaint of light spotting following an endometrial ablation that occurred …

Terlipressin-Induced Hyponatremic Seizures In A Patient With Congenital Hepatic Fibrosis, Luca Gauci, Jorge Gafa, Suzanne Cauchi, Jurgen Gerada

HCA Healthcare Journal of Medicine

Introduction

Acute variceal bleeding from portal hypertension is one of the most serious complications with a mortality rate of 15% to 25%. Terlipressin is a vasopressor that controls variceal bleeding by lowering the portal pressure and reducing blood flow to the varices.

Case Presentation

We report a case of a patient with acute variceal bleeding, treated endoscopically and with terlipressin, who developed severe hyponatremia and seizures requiring admission to intensive care. Clinical and biochemical improvements were noticeable upon the cessation of terlipressin, with an eventual discharge from the hospital.

Conclusion

Prompt management of acute variceal bleeding with both endoscopic and …

Blind Nasal Intubation As A Rescue Strategy In Difficult Airway Management, Riaz Chowdhury, Ashalatha K. Nair, Dheeraj Kamalam, Rohit Jaishankar

HCA Healthcare Journal of Medicine

Background

Airway management in emergency situations poses significant challenges, particularly in patients with difficult airway anatomy or comorbid conditions. Blind nasal intubation has been explored as a rescue technique when conventional methods fail. Masseter muscle rigidity (MMR), characterized by significant jaw muscle stiffness, is a recognized complication following succinylcholine administration that can complicate traditional approaches to securing an airway.

Case Presentation

A 75-year-old man with multiple comorbidities, including hypertension, prior stroke with paralysis, dementia, and a seizure disorder, presented with acute hypercapnic hypoxemic respiratory failure requiring emergent intubation. Orotracheal intubation failed due to trismus despite etomidate, succinylcholine, and rocuronium. Nasal …

Sustained Supraventricular Tachycardia While In Active Phase Labor, Austin Gold, Mona Sadek

HCA Healthcare Journal of Medicine

Background

Supraventricular tachycardia (SVT) is one of the most common tachyarrhythmias found in young women, and SVT can be exacerbated by pregnancy. The symptoms associated with SVT frequently overlap with physiologic changes and symptoms of pregnancy which can lead to delayed or missed diagnosis.

Case Presentation

We describe the presentation and the acute management of a patient who had sustained SVT that developed during the active phase of labor. We then detail the varying management approaches of SVT in pregnancy and labor as well as refractory management options. Maternal monitoring will also be discussed as this case shows how an …

The “Wearing Off” Phenomenon For Rasagiline, Entacapone, Carbidopa, And Levodopa In The Setting Of Parkinson’S Disease, Ryan Cromwell, Tevin Um

HCA Healthcare Journal of Medicine

Background

Parkinson’s disease is a primary neurological dysfunction syndrome in which the body’s natural production of dopamine is reduced. Therapeutic intervention for this disease primarily includes medications that increase the body’s natural production of dopamine. These medications can have side effects, requiring constant titration based on the patient’s symptoms.

Case Presentation

We report a case study of a 75-year-old man diagnosed with Parkinson’s disease who had a profound acute exacerbation of psychological symptoms following modifications to his dopaminergic treatment regimen. Initially, the patient was prescribed carbidopa/levodopa, rasagiline, and carbidopa/levodopa/entacapone. However, the treatment plan was adjusted due to the worsening of …

An Unusual Presentation Of Subcutaneous Inguinal Hematoma Mimicking Ovarian Torsion: A Case Report, Chrystal Stallworth, Timothy Kremer, Victoria Panzanaro

HCA Healthcare Journal of Medicine

Background

Ovarian or adnexal torsions occur when an ovary rotates around one of the supporting ligaments, often the infundibulopelvic (IP) ligament. This rotation can cause the blood flow to the ovary to be hindered, and this decrease in perfusion can often present as adnexal pain, nausea, and vomiting. A significant risk factor for developing an ovarian torsion is the presence of an ovarian mass, such as a cyst. The diagnosis of ovarian torsion is a medical emergency, but symptoms typically resolve with prompt surgical intervention. Hematomas occurring within or around the inguinal region have been reported to occur primarily after …

Risk Factors Associated With Worse Outcomes In Trauma Patients Aged 55 And Older, Hector Mendez, Ilko Luque, Nicole Yordán López, Carlos Parra, Kelvin Chan, Mariel A. Javier, Marcela Ramirez, Orlando Morejón

HCA Healthcare Journal of Medicine

Background

Prior studies have shown an increase in mortality in trauma patients after 55 years of age. However, it is less certain which pre-existing comorbidities (PECs) are associated with poorer outcomes. The purpose of this study was to identify the risk factors associated with poor outcomes and death in patients 55 years old and older admitted for trauma.

Methods

Trauma patients (age ≥ 55) were studied retrospectively from the local trauma registry at HCA Florida Kendall Hospital, a level 1 trauma center (2020–22). We collected the subject’s age, gender, PECs, and outcome data. Then we performed multiple logistic regression to …

Updating A Rural Clinic In Tiburón, Haiti, Akankcha Alok, Mohamed Bakhit, Djenie Helne, Philipe Milord, Marcellas Socrate, Camil Clermont, Marie A. Kima

HCA Healthcare Journal of Medicine

Background

Tiburón is a small fishing village in Haiti with a clinic overseen by the Oblate missionaries and the Ministry of Public Health and Population (MSPP). This village was hugely impacted by Hurricane Matthew in 2016, leading to increased health care demands. The clinic was inaccessible from the furthest parts of the village and lacked basic medication supplies and adequate manpower. We aimed to reinforce the infrastructure and update the clinic using a multifaceted approach.

Methods

We developed a quality improvement project to strengthen the clinic's infrastructure and modernize its facilities with a comprehensive approach focused on enhancing health care …

Synthetic Versus Biologic Mesh For Complex Open Ventral Hernia Repair: Three-Year Follow-Up Of A Pilot Randomized Controlled Trial, Nalia H. Dhanani, Nicole B. Lyons, Kyung Hyun Lee, Oscar A. Olavaarria, Aris R. Arakelians, Julie L. Holihan, Lillian S. Kao, Ali Siddiqui, Connor Hogan, Tunmi Anwoju, Zuhair Ali, Mike K. Liang

HCA Healthcare Journal of Medicine

Background

Biologic mesh is often used in complex hernia repair, but there has been limited clinical evidence to date to support this practice. The aim of this study was to compare clinical and patient-reported outcomes of biologic versus synthetic mesh for complex open ventral hernia repair (OVHR) at 3 years.

Methods

Patients from a single center, randomized, controlled, pilot trial comparing biologic versus synthetic mesh in complex OVHR were followed for 3 years. The primary outcome focused on major complications, namely mesh infections, hernia recurrences, reoperations, and deaths. Secondary outcomes included surgical site infections, surgical site occurrences, and patient-reported outcomes. …

Impact Of A Comprehensive Palliative Quality Improvement Initiative (Icu-Pal) In A Medical-Surgical Intensive Care Unit, Aunie M. Danyalian, Michele M. Iguina, Manjot Malhi, Umair Shaikh, Sanaz B. Kashan, Dionne Morgan, Daniel Heller, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Early palliative care practice implementation in the intensive care unit (ICU) improves advance care planning, promotes patient and family satisfaction, and decreases health care costs. The consensus for protocolized palliative care delivery is unknown. We assessed the impact of a qualitive improvement educational intervention that promotes the identification of critically ill patients who will benefit from early expert palliative care interventions.

Methods

In this observational study, we examined the impact of an educational intervention that promoted (1) early detection of palliative care triggers (PCT) during ICU multidisciplinary rounds (MDRs), (2) admission and 48-hour pain assessment, and (3) family meetings …

A New Paradigm In Hospital Medicine: Evaluating The Effects Of Geographical Cohorting On Health Care Delivery, Vasu Gupta, Bhupinder Singh, Kanishk Aggarwal, Ayushi Garg, Rhea Kanwar, Fnu Anamika, Inder Preet Kaur, Rohit Jain

HCA Healthcare Journal of Medicine

Background

Geographical cohorting in hospital settings represents a significant shift from traditional patient rounding practices and aims to enhance the efficiency of health care delivery. This model assigns hospitalists to a particular inpatient unit, where most of their patients are located. While this model has several benefits, including streamlining health care procedures, optimizing resource allocation, and fostering better provider communication, its implementation is not without its challenges.

Methods

Our methodology for researching geographical cohorting involved a comprehensive literature review of peer-reviewed studies, surveys, and retrospective analyses. We utilized academic databases, such as PubMed, JSTOR, and Google Scholar, to identify relevant …

Acute Exacerbation Of Idiopathic Pulmonary Fibrosis In The Setting Of Acute Eosinophilic Pneumonia, Duncan A. Mckinney, Noah R. Kosnik, Shahzeib Syed, Gretchen Junko

HCA Healthcare Journal of Medicine

Idiopathic pulmonary fibrosis (IPF) is a progressive disease characterized by gradual destruction and replacement of pulmonary parenchyma with fibrous tissue, which occurs in conjunction with chronic inflammation. It is often considered a prototypical interstitial lung disease and is both the most prevalent and perhaps the most dangerous in that family. Although the disease is uncommon in the general population, its prevalence increases with age and is typically diagnosed around the age of 65. This does not preclude the development of IPF in younger individuals, and the mean survival is 2 to 5 years post-diagnosis regardless of age. Contemporary studies have …

Extended-Release Buprenorphine Could Overcome Barriers To Medical Treatment Of Opioid Use Disorder In At-Risk Populations, Scott A. Davis, Genevieve Verrastro, E Blake Fagan

HCA Healthcare Journal of Medicine

This article discusses how monthly extended-release buprenorphine can be used to improve the treatment of opioid use disorder (OUD). In particular, the use of monthly extended-release buprenorphine holds promise for patients who have recently been released from jail or prison and are battling OUD, those who are unstable and continue to use opioids illicitly, patients who are experiencing homelessness while also struggling with OUD, and those who are stable and want to be weaned off buprenorphine.