Medicine and Health Sciences Commons^™

Exploring The Locker, Haley Bagley

Counseling and Family Therapy Scholarship Review

This article is an effort to foster grace and to create genuine, humble community. A new sense of community, that is not conditional on our abilities to censor ourselves to be more palatable to those around us. Instead, the birth of a new way of relating that considers our deep inner selves that feel shame, remember traumas, and cower in fear of these experiences. Perhaps most of all, this article is an invitation to explore our deepest inner selves, and the cost of censoring this self. This exploration is not a leisurely dive into the corners of ourselves that lie …

An Essay Concerning The Possibility Of A Unified Theory Of Counseling, Lance Kair

Counseling and Family Therapy Scholarship Review

The Object-Oriented Ontology of Graham Harman, also known as Object-Oriented Philosophy, presumes to describe an ontology of all objects, including human beings. This essay shows how the discipline of counseling can benefit from such an ontology of objects. To move into this particular case of an Object-Oriented Ontology of human beings, and to distinguish, initially, at least, between the object that we are now concerned with, or will be soon, and the universe of subjectivity, I propose that we refer to universal objects, which is to indicate objects that exist in the universe, however we might define it. In this …

The Role Of Practice-Based Evidence And Feedback Informed Treatment For Improving Therapy Outcomes, Daryl Mahon

Counseling and Family Therapy Scholarship Review

Attrition rates and deterioration of counselling and psychotherapy clients are two major concerns for those delivering psychological therapies across differential modalities. While a variety of correlations are said to contribute to attrition and deterioration such as, client, therapist and clinical level, identifying and improving outcomes for this cohort of people in routine practice is difficult. Even with the addition of hundreds of empirically supported treatments added to the profession, outcomes have not improved in line with these new approaches. Methods to limit the extent of poor outcomes has been established in the extent literature, thus, practice-based evidence is put forward …

Introducing Feedback Informed Preference Accommodation (Fipa): A Case Study In Clinical Practice, Daryl Mahon

Counseling and Family Therapy Scholarship Review

Psychotherapy is a successful modality for those who engage in and complete a course of treatment. However, attrition rates and negative outcomes make up a significant and under discussed proportion of clinicians’ case load in routine practice. Innovative and novel methods to address these issues have been identified within the extant literature. However, their uptake can be impacted by issues such as utility and brevity. The present paper seeks to establish a framework for integrating Feedback Informed Treatment (FIT) and the Cooper-Norcross Inventory of Preferences (C-NPI) in clinical practice. That is, using the C-NPI for initial preference accommodation and following …

Infective Endocarditis Caused By Klebsiella Oxytoca In A Patient With Hemodialysis: A Care-Compliant Case Report And Review Of The Literature, Hanane Aissaoui, Youssef Hdidou, Ramia Bougrine, Nabila Ismaili, Noha Elouafi

Journal of the Saudi Heart Association

The rarity of endocarditis due to Klebsiella species limits its recognition. We report the case of a 63-year-old man, known to have a tight calcified aortic stenosis presenting with acute heart failure associated with high fever. Klebsiella oxytoca endocarditis was diagnosed based on three sets of positive blood cultures together with fluttering vegetation (11 mm x 14 mm) on the middle segment of the anterior leaflet of the mitral valve. After 6 weeks of intravenous ceftriaxone and gentamicin bi-therapy, the patient had completely recovered. This case illustrates how sporadic this condition is, for which early assessment and proper treatment are …

Postpartum Opioid Use Following Vaginal Deliveries With No Or Minor Obstetric Perineal Lacerations, Samantha Richardson, Todd W. Gress, Amanda Pauley, David C. Jude

Marshall Journal of Medicine

Introduction

Recommendations for management of pain following vaginal delivery are not specific and do not differentiate patients based on the degree of perineal trauma. Our objective is to describe patterns of postpartum opioid use in women with no or minor perineal trauma.

Methods

This is a retrospective cohort study describing the characteristics of opioid analgesia usage among women with no or minor perineal lacerations at the time of vaginal delivery in a university affiliated regional hospital.

Results

For the 6-month study period, 433 patients were eligible for inclusion. Of these, 423 (97.69%) were ordered as needed narcotics during their post-partum …

Reducing Overtreatment Of Urinalysis In Obstetric Triage Patients, Emelia Winston, Rachel Marteney, Erin Casey, Kevin Conway

Marshall Journal of Medicine

Introduction

Overtreatment of asymptomatic bacteriuria (ASB) is a major issue that has been coming to the forefront in recent decades. Studies have shown that it can lead to adverse side effects, extra costs, and antimicrobial resistance. The purpose of this study was to determine the number of patients presenting to obstetric triage who were overtreated for a urinalysis (UA) and to see if an educational intervention could reduce the incidence of overtreatment for suspected ASB.

Methods

This was a retrospective chart review analyzing UA results and outcomes of OB triage patients that came through labor and delivery before and after …

Chronic Abdominal Pain In A Geriatric Patient: A Rare Case Of A Spigelian Hernia, Thomas D. Wright, Olumayowa Dayo, Lynne J. Goebel

Marshall Journal of Medicine

We present a case of Spigelian hernia in a 77-year-old patient to highlight the difficulty in making this diagnosis and to raise awareness of this rare condition among physicians who care for geriatric patients with chronic bouts of abdominal pain. The patient presented to the emergency department with a two-day complaint of abdominal pain after three years of similar recurrent attacks. Results of the physical examination and computed tomography (CT) of the abdomen were consistent with a left-sided Spigelian hernia. Operative repair was performed using robotic-assisted reduction and the patient recovered without any complications.

Hyperkalemia Secondary To Prophylactic Heparin Use In A Trauma Patient: Case Report, Marco Custodio, Errington C. Thompson

Marshall Journal of Medicine

This case report describes a complex trauma patient who develops hyperkalemia secondary to heparin. Heparin is a commonly used drug in trauma patients. Physicians need to be aware of this potentially harmful adverse reaction in these high-risk patients.

Reccurent Reversible Encephalopathy With Ataxia And D-Lactic Acidosis In Short Bowel Syndrome, Abdul Rana, Salman Assad, Sucharita Katikala, Shuja Asad Malik, Mahmoud Abouzid, Mehar Zahid, Swaroopa Pulivarthi

Marshall Journal of Medicine

The short gut syndrome can lead to multiple metabolic disorders along with chronic malnutrition. Such patients can develop changes in mental status due to metabolic alterations. We present a case of eleven years old male who presented to the hospital with an altered mental state. There were repeated admissions to the hospital with a similar complain with non-conclusive cerebrospinal fluid analysis and normal neuroimaging findings. The patient suffered from chronic malnutrition and multiple hospitalizations with altered mental status, encephalopathy. However, he responded well to bicarbonate therapy and prophylactic metronidazole treatment.

An Unusual Metastatic Site Of Head And Neck Cancer; Case Report And Literature Review, Abdulrauf A. Salamah, Moftah M. Sharad, Mohamed Sultan

Marshall Journal of Medicine

The annual occurrence of Head and Neck caner (HNC) is documented to be more than 650,000 cases with 330,000 deaths. In the United States, it represents 3% of all malignancies and affects 53,000 Americans. Metastasis to the lung, liver and bones are considered the most common locations. Herein, We are reporting a case of HNC and an unusual synchronous gastric metastasis found on an upper gastrointestinal endoscopy (EGD) after CECT scanning of Abdomen shows only the mass that related to stomach fundus and MRI pelvic no mass could be seen. Both cancers were poorly differentiation on histopathology, which raises the …

Blocking Serine Protease (Tmprss2) By Bromhexine; Looking At Potential Treatment To Prevent Covid-19 Infection, Ramin Tolouian, Audrey C. Tolouian, Mohammadreza Ardalan

Marshall Journal of Medicine

Not applicable. Manuscript is being submitted under Viewpoints category.

Successful Treatment Of A Cervical Ectopic Pregnancy With Single-Dose Methotrexate Therapy, Hannah Dearworth, Jesse Cottrell

Marshall Journal of Medicine

Ectopic pregnancies implanted in the cervix account for less than 1 percent of all extra-uterine pregnancies. Due to the limited incidence of cervical ectopic pregnancies, there are no established guidelines for medical versus surgical management. We report a case of a cervical ectopic pregnancy with a fetal heartbeat successfully treated with single dose methotrexate therapy.

Black Lung: Old Disease, New Lessons, Mohammed I. Ranavaya Ii, Mohammed Ranavaya, Natavoot Chongswatdi

Marshall Journal of Medicine

Previous to 2016, cases of progressive massive fibrosis secondary to mining exposure had dwindled and were considered nearly eradicated. However, over 40 new cases were recently discovered in Kentucky, indicating a resurgence of a previously rare disease. We herein report a case of a 44-year-old male underground coal miner from Appalachia with fifteen years coal mining dust exposure who presented with four years of productive cough, dyspnea upon exertion and wheezing for an occupational pneumoconiosis evaluation. Since 2016, he suffered a precipitous decline in lung function consistent with restrictive lung disease and concomitant progression from simple coal workers’ pneumoconiosis to …

Case Report On Leiomyosarcoma Of The Vulva: A Rare Pathology, Samantha A. Smith, Nadim Bou Zgheib, Andrea M. Vallejos, Jonathan D. Cuda

Marshall Journal of Medicine

Leiomyosarcoma (LMS) of the vulva is rare. However it is the most common histologic subtype of vulvar sarcoma, accounting for approximately 1% of all vulvar malignancies. ^[1-8] Whether genetics and epigenetics play a role in pathogenesis is unclear. ^[1] The tumor is slow-growing with non-specific symptoms, has high metastatic potential, and follows a bimodal age distribution. ^[1-8] Diagnosis and prognosis are based upon immunohistochemical expression and criteria from early literature. ^[1,3,5-7] The most common therapeutic approach involves radical vulvectomy with lymph node resection. The value of adjuvant chemotherapy and radiation remains unknown. ^[1,3,5-8] Our case describes a 46-year-old Caucasian G2P2 …

Eradication Of Stage Iv Gastric Cancer: Case Report, Ibrahim Mohammed, Cherishma Nagisetty, Arslan Iqbal, Michael Abdelmasseh, Doreen Griswold, Muhammad Omer Jamil, Juan R. Sanabria

Marshall Journal of Medicine

Background. Gastric cancer has a low overall survival rate worldwide, and surgery still remains the intent to cure option on early stages of disease. HER-2 positive cancers may have a survival advantage. We present a patient with stage IV gastric cancer HER-2 positive responsive to Herceptin, free of detectable disease two years after surgery.

Patient Presentation. 70 years old Caucasian male complained of left-sided chest pain. Upon evaluation, he was diagnosed with HER-2 positive adenocarcinoma of the stomach at the pylorus with two liver metastases. Near complete response was observed with Herceptin and Cis-platinum based chemotherapy followed by 80% distal …

All The Easy Jobs Are Filled": The Enduring Promise Of A Life In Medicine, Maurice A. Mufson

Marshall Journal of Medicine

N/A

How Covid Has Illuminated The Pitfalls Of A Single-Payer System In The Us, Tamela J. White, Nicholas Wright

Marshall Journal of Medicine

Health care quality measures are impacted by resources invested into outcomes. COVID-19 has had a direct impact upon quality outcomes, the same illuminating just some of the problems with the concept of a single-payer health care system. The US government's inefficiencies in attempting to run the single-payer system known as IHS in context with its repeated failures in managing the COVID-19 crises along with the economic impact of the same, is but one call for strong leadership to dispel the myth that a single-payer system is a panacea for America.

When The Hospitalist Gets Hospitalized, Jay R. Lakhani

Marshall Journal of Medicine

Hospitalists have a unique opportunity to provide a compassionate environment for patients and families, who themselves are facing fear and uncertainty. Recently, I was able to experience hospitalization from the other side of the hospital bed. In this short article, I share a few lessons I am learning from my recent experiences with my father, my daughter, and my own experience.

Changing For The Better: Academic Scholars Find New Audience Through Video Abstracts, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

A Sound Approach: Hydroxychloroquine Reduces Mortality In Severe Covid-19, Marcus Zervos, Samia Arshad, Paul Kilgore, Zohra S. Chaudhry, Gordon Jacobsen, Dee Dee Wang, Kylie Huitsing, Indira Brar, George J. Alangaden, Mayur S. Ramesh, John E. Mckinnon, William O'Neill

Department of Pharmacy Practice

No abstract provided.

Epigenetic Effects On Health And Behavior, Peter Seivers

Nursing Student Class Projects (Formerly MSN)

Epigenetics plays a vital role in one’s health and behavior starting in utero and lasting until death. We look at why epigenetics is important and the mechanisms in which epigenetics works on one’s DNA. We will also see several of the disease processes in which we have research linking their causation directly to an epigenetic influence. The topic of epigenetics is quite large and growing and hence we have not sought to provide an exhaustive picture of the current research that is available. We feel the most important piece of this work is being able to connect the original study …

2020-07-31_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

Anesthesia Services In The Time Of Covid, James Chen, Daisy Sangroula, Katelyn Williams, Sydney Pham, Ozan Akca, Jiapeng Huang, Sean Clifford

The University of Louisville Journal of Respiratory Infections

Our hospital is a 400-bed, Level-1 trauma center with 78 intensive care unit (ICU) beds serving the greater Louisville metropolitan area. The COVID-19 pandemic forced our hospital to re-evaluate our core business operations and to develop a coherent response to a fluid situation. Between March 15 and May 15, 2020, the University of Louisville Hospital admitted more than 100 COVID-19 inpatients; approximately 30 were admitted to the ICU, and most required endotracheal intubation. The following review describes our Department of Anesthesiology \& Perioperative Medicine foci, actions, and rationale during the COVID-19 pandemic. While we hope not to experience another pandemic …

2020-07-31_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.

2020-07-31_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.

This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of care (POC) tests, look for current infection. Serology (antibody) tests are used to look for the possibility of previous infection.
Source: Michigan Disease Surveillance System (MDSS) and Vital Records

The website contained the tables …

Functional Training And Blood Flow Restriction: A Perspective View On The Integration Of Techniques, Marzo E. Da Silva-Grigoletto, Ezequias Pereira Neto, David George Behm, Jeremy P. Loenneke, Cauê Vazquez La Scala Teixeira

Faculty and Student Publications

No abstract provided.

Take A Deep Breath, Edward Stewart

Community Reflections

Email sent by Fr. Ed Stewart on his departure from SHU: Early on in the pandemic, Father Tony asked Campus Ministry and Volunteer Programs staff to come up with a way of reaching out to the wider SHU community during our dispersal. With that, the daily Take A Deep Breath reflections were born.

2020-07-31_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

Ultrasound Guided Intravenous Access In The Emergency Department, Lynieta Leisure

Doctor of Nursing Practice Scholarly Project

One-quarter of all emergency department visits in the United States results in peripheral intravenous line (PIV) placement for parenteral fluid administration (Fields, Piela, Au and Ku, 2014). When PIV access is delayed, critical care measures are also delayed. Meyer et al. (2014), reports the first attempt PIV access failure rate is approximately 25%. In the critically ill patient, timely PIV access may be the difference between survival and death. Difficult venous access is present in approximately one in ten ED patients requiring PIV access (Fields et al., 2014). The purpose of this scholarly project is to implement a quality improvement …