Medicine and Health Sciences Commons^™

Friend Or Foe? Recent Strategies To Target Myeloid Cells In Cancer, Mehdi Chaib, Subhash C. Chauhan, Liza Makowski

School of Medicine Publications

The tumor microenvironment (TME) is a complex network of epithelial and stromal cells, wherein stromal components provide support to tumor cells during all stages of tumorigenesis. Among these stromal cell populations are myeloid cells, which are comprised mainly of tumor-associated macrophages (TAM), dendritic cells (DC), myeloid-derived suppressor cells (MDSC), and tumor-associated neutrophils (TAN). Myeloid cells play a major role in tumor growth through nurturing cancer stem cells by providing growth factors and metabolites, increasing angiogenesis, as well as promoting immune evasion through the creation of an immune-suppressive microenvironment. Immunosuppression in the TME is achieved by preventing critical anti-tumor immune responses …

Whatever Happened To Evidence-Based Practice During Covid-19?, Helene J. Krouse

School of Medicine Publications

Contemporary medical practice is grounded in rigorous scientific evidence in concert with best clinical practices and informed shared decision making with patients. During these times of uncertainty, disruption, and even anxiety, it becomes critical that we engage with our patients and communities in thoughtful dialogue and realistic expectations regarding treatments surrounding COVID-19. The hope for a “miracle” cure and urgency to return back to normal times can stimulate irrational thought and behavior and even desperate measures by individuals or groups. It becomes especially important that we continue to use reasonable, informed clinical judgment in discussing the various options with patients.

A Career Eulogy Reflective Exercise: A View Into Early Professional Identity Formation, William Crump, R. Steve Fricker, Allison Crump-Rogers

Marshall Journal of Medicine

Introduction

Beginning medical students have a very early idea of what their physician identity will be. Providing a brief structured opportunity to reflect on the end of their career can be an important first step in identity formation.

Methods

A reflective exercise was used in the summer prior to beginning medical school as each class of students at a regional rural medical school began a summer prematriculation program from 2015-2019. Students wrote what they wished to be said about them at the end of their career using a “Career Eulogy.” Identifiers were removed and narratives were coded into recurring text …

When Treating Sick Joints Harms Lungs, Ixekizumab Induced Pleural Effusion, Rami Batarseh, Kyle Smith, Mohammed Al-Ourani, Amro K. Al-Astal

Marshall Journal of Medicine

Immunological therapies have provided a multitude of new and effective treatment strategies for various disease states. While monoclonal antibody therapy benefits many patients, side effects are widely variable. here we present a case of pleural effusion complicating psoriatic arthritis treatment.

Secondary Scoliosis From A Retroperitoneal Ganglioneuroma In A 9-Year-Old Female: Case Report, Andrew J. Weaver, Keitaro Nakamoto, Daniel A. Beals

Marshall Journal of Medicine

Ganglioneuromas are rare benign tumors that tend to be asymptomatic until large enough to compress adjacent structures. These tumors are often found during childhood during evaluations for other pathologies. Retroperitoneal ganglioneuromas may be a secondary cause of scoliosis. Here, we present a case of a child who was found to have a retroperitoneal ganglioneuroma during an evaluation for scoliosis.

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The Opioid Epidemic In The United States: A Call For Practice Change In Pediatric Outpatient Surgeries, Emma Bacharach, Osama Al-Omar

Marshall Journal of Medicine

No abstract provided.

Complete Response To Stage Iv Colorectal Adenocarcinoma With Disease-Free Survival At 24 Months: Case Report And Overview Of The Literature, Madison N. Crank 6746693, Arslan Iqbal, Michael Abdelmasseh, Mohamed Alsharedi, Doreen Griswold, Alysia Browne, Juan R. Sanabria

Marshall Journal of Medicine

Over 150,000 new cases of colon cancer were diagnosed in the US in 2019. Stage and age at diagnosis are important prognostic factors for overall survival (OS). For the age group 70-79, the OS for females with poorly differentiated stage IV colon cancer at 1, 2 and 5 years after surgery is 39%, 15%, and 2%, respectively. We present a case of a 77-year-old female with significant cardiac history. She was diagnosed with stage IV colorectal cancer complicated with enteric fistula. Due to her initial performance status and comorbidities, she was not a candidate for surgery or systemic chemotherapy. Nonetheless, …

Macrophage Activation Syndrome As A Complication Of Systemic Lupus Erythematosus In An Adult Male, Rajesh Gopalarathinam, Vamsee Chirumamilla, Balachandran Vaidyanathan

Marshall Journal of Medicine

Macrophage activation syndrome (MAS) is a rare life-threatening complication that sometimes occurs in patients with systemic lupus erythematosus (SLE) and other connective tissue diseases. This syndrome is universally fatal without treatment, and therefore, prompt diagnosis and initiation of treatment is of vital importance.

Reflections On West Virginia's Early Covid-19 Experience, Stephen M. Petrany, Deb Koester, Robert Walker

Marshall Journal of Medicine

No abstract provided.

Navigating The Unknowns Of Covid-19, Larry Dial, Beth L. Hammers

Marshall Journal of Medicine

No abstract provided.

Leadership Challenges And Collaborative Opportunities Unveiled Through Covid-19, Gayle Brazeau

Marshall Journal of Medicine

No abstract provided.

Providing Dental Care In The Current Covid-19 Crisis, Raj Khanna

Marshall Journal of Medicine

Dental procedures typically generate aerosol. With the current covid19 crisis this is a serious problem for providers and patients. The commentary addresses some of the problems and possible solutions for providing dental care in the current covid-19 crisis.

The Eagle And The Phoenix, Clay Marsh

Marshall Journal of Medicine

No abstract provided.

The Covid-19 Crisis: How Rural Appalachia Is Handling The Pandemic?, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

Creative Writing In Residency Training, Julia Fashner

HCA Healthcare Journal of Medicine

Residents compose notes for medical purposes on a daily basis. As part of wellness, I have done creative writing during didactic time with family medicine residents. I present some of the poems that have been created.

Nicaraguan Homeowner Showing Gratitude For Concrete Flooring As Part Of A Public Health Mission Trip, Breonna Kinnison

HCA Healthcare Journal of Medicine

I’m Bree Kinnison, a fourth-year medical student and aspiring psychiatrist. When I’m not studying, I enjoy painting using acrylics. This painting depicts a very fond memory of mine. After completing the medical portion of our mission trip in Nicaragua, we began our public health portion. Along with fellow students, I laid concrete flooring in this woman’s house. For all 76 years of her life, she had never experienced anything other than a dirt floor in her home. Traditional dirt flooring in Nicaraguan homes is responsible for many preventable illnesses. When shown the final product, she reached out and hugged the …

Development And Validation Of A Scale To Measure Nurse/Medical Resident Physician Collaboration, Bruce St. Amour, W. Brady Dehart

HCA Healthcare Journal of Medicine

Introduction: The purpose of this pilot study is to investigate the reliability of an interprofessional collaboration measurement scale used for nursing interactions with resident physicians. To date, the collaboration between nurses and residents has not been adequately investigated and a validated tool specifically for this purpose is not yet available. Our objective is to adapt a previously validated interprofessional scale for health care settings to the specific nurse/resident physician collaboration.

Methods: In 2019, nurses from two hospitals were contacted via email and were invited to complete an anonymous survey that asked about the nurses’ interaction and collaboration with resident physicians. …

Transitioning To Value-Based Diabetes Care: A Call For Action Derived From Primary Care Providers In South Florida, Francois Sainfort, Julie A. Jacko, Johannes Vieweg

HCA Healthcare Journal of Medicine

Background: In Florida, 2.4 million people have diabetes and 5.8 million are pre-diabetic. Not only has the prevalence of diabetes doubled over the past 20 years from 5.2 in 1992 to 11.2 in 2014, but the Centers for Disease Control and Prevention expects 1 out of every 3 adults will have diabetes by the year 2050. In addition, in every year since 1996, Florida well exceeds the national levels in terms of prevalence of diabetes, and the gap is getting wider. A study was conducted to gather information from key physician stakeholders as to how to address unmet needs of …

The Spectrum Of Large Adrenal Masses: A Case Series, Jo Cooke-Barber, Sarah E. Hatef, Analise Mcgreal, Andrew Schwemmer, Christopher Senkowski

HCA Healthcare Journal of Medicine

Background: Adrenocortical carcinoma (ACC) is a rare malignancy that is challenging to diagnose and has important implications for surgeons who approach this disease. Despite its rarity, it must always be in the differential diagnosis when investigating and treating large adrenal masses. We aim to demonstrate the complexities of this disease through a review of five recent patients at a single tertiary care center.

Methods: A series of five patients are described, each of whom presented to a single institution as referrals for "large adrenal mass" in the past sixteen months. Their pre-operative diagnosis, radiographic findings, the operative approach and the …

Acute Disseminated Encephalomyelitis, Ashan Hatharasinghe, Hossein Akhondi, Don Pepito

HCA Healthcare Journal of Medicine

Introduction: Acute Disseminated Encephalomyelitis (ADEM) is a rare autoimmune demyelinating disorder of the central nervous system. Clinical manifestations include encephalopathy, motor deficits, ataxia, and meningeal signs. In most cases, ADEM is preceded by either vaccination or viral illness. Here, we present a case with neither of the two predisposing elements.

Discussion: A 28-year-old Hispanic female presenting with substance use and suicidal ideation was placed on an involuntary psychiatric hold, started on olanzapine and scheduled for a psychiatric facility transfer. The following day, she was noted to have neurological deficits when ambulating. Computed tomography of the brain showed a right frontal …

The Role Of Nutrition In Promoting Gut Health And Treating Chronic Illness Through The Attenuation Of Inflammation, Allison Dalton

HCA Healthcare Journal of Medicine

Over the millennia, the human body and microorganisms such as bacteria, viruses, archaea, protozoa and parasites have coevolved together forming an intimate relationship. These microorganisms are found on the skin, in the mouth, genitourinary tract and most abundantly in the large intestine of the digestive tract. States of microbial dysbiosis contribute to chronic inflammation, which can lead to the pathogenesis and progression of numerous diseases. Micro- and macro-nutrients as well as dietary patterns like the Mediterranean diet can help improve health outcomes.

The Coronaviruses: Past, Present, Future, Kimball Kaufman, Shobhit Keswani, Cristobal Cintron, Hossein Akhondi

HCA Healthcare Journal of Medicine

The current coronavirus pandemic is unparalleled in recent memory and fundamentally unique. It has been more than a century since humanity fought the Spanish flu pandemic. That widespread disease devastated a World War I-ravaged population when there was a relative paucity of medical knowledge. Coronavirus, on the other hand, is now befalling upon a developed world with advanced infrastructure and health systems; wherein access to medical information and technology is abundant. Yet, it has proven to be a destroyer of economies and populations without geographical partiality.

This article is meant to be a broad analysis of the virus, which is …

A Look Back At Nrmp 2020 And The Road Ahead, Frederick M. Schiavone

HCA Healthcare Journal of Medicine

The 2020 Match has recently concluded. While the results give us some information about where the medical field is headed, the decision by the NBME and FSMB to change USMLE Step 1 score reporting to only a pass/fail outcome will also impact how residency programs navigate the NRMP in the years ahead.

Strange April, Joe Ricke

Reflections, Poetry, Photos, and other Writings

It's an essay about saying goodbye to my isolated April.

2020-04-30_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

The webpage was obtained from Michigan's Coronavirus Cumulative Data page, under the link Data About Places. Data is self-reported by hospitals daily to the EM Resource System per MDHHS Director Robert Gordon's Emergency Order.

Contains the tables Statewide Available Bed Tracking for COVID-19, COVID-19 Metrics, Statewide Available PPE Tracking for COVID-19 (Statewide Available PPE and Bed Tracking), as well as the tables PPE Days On Hand and Patient Census.

2020-04-30_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., with COVID-19 results included as of 10 a.m.

Note on cumulative counts: This report is provisional and subject to change. As public health investigations of individual cases continue, there will be corrections to the status and details of referred cases that result in changes to this report.
Note on the deaths: Deaths must be reported by health care providers, medical examiners/coroners, and recorded by local health departments …

2020-04-30_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was captured from the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_99207---,00.html.

The website contained the table Count of Confirmed COVID-19 Cases by Date of Onset , sorted by Michigan Preparedness Region. It also contained 18 charts, including the count of confirmed Covid-19 cases by date of onset in the state overall as well as in each preparedness region,and the normalized rate of Covid-19 cases per 1,000,000 residents in both the state and in each preparedness region.

2020-04-30_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services

Michigan COVID-19 Long Term Care Data

The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-526911--,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data is updated on an ongoing basis.

MDHHS has established a regional hub strategy to assist in reducing the spread of COVID-19 within nursing facilities. COVID-19 Regional Hubs have established units dedicated to treating COVID-19-affected individuals and have established appropriate staffing levels and protocols to support this level of care.
These case counts reflect current cases of COVID-19 among facility residents reported …

Examining Permeability And Contractility Of Skeletal Muscle In Castrated Male Mice, Evan Scott

Health Sciences Honors Papers

A common method of treating skeletal muscle injury is temperature therapy. Temperature affects one of the initial aspects of skeletal muscle healing, the increasing of vascular permeability. Previous data accumulated from the Ursinus College Skeletal Muscle Lab suggests that vascular permeability following temperature therapy is different between the anatomically intact male and female mice. However, there have not been any studies to date that are able determine the cause of these permeability differences following temperature treatment. In addition, it is currently unclear how increased vascular permeability affects skeletal muscle healing. A possible cause for these differences is the increased presence …

Transcriptional Upregulation Of Nlrc5 By Radiation Drives Sting- And Interferon-Independent Mhc-I Expression On Cancer Cells And T Cell Cytotoxicity., Lauren Zebertavage, Alejandro F Alice, Marka R Crittenden, Michael J. Gough

Articles, Abstracts, and Reports

Radiation therapy has been shown to enhance the efficacy of various T cell-targeted immunotherapies that improve antigen-specific T cell expansion, T regulatory cell depletion, or effector T cell function. Additionally, radiation therapy has been proposed as a means to recruit T cells to the treatment site and modulate cancer cells as effector T cell targets. The significance of these features remains unclear. We set out to determine, in checkpoint inhibitor resistant models, which components of radiation are primarily responsible for overcoming this resistance. In order to model the vaccination effect of radiation, we used a Listeria monocytogenes based vaccine to …