Medicine and Health Sciences Commons^™

Ikaneat: Protocol For A Randomized Controlled Trial Of Megestrol As A Component Of A Pediatric Tube Weaning Protocol., Sarah T. Edwards, Paul E. Hyman, Hayat Mousa, Amanda Bruce, Jose Cocjin, Kelsey Dean, Kandace Fleming, Rebecca Swinburne Romine, Ann M. Davis

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Although tube feeding routinely saves the lives of children who do not eat by mouth, chronic tube feeding can be a burden to patients, caregivers, and families. Very few randomized trials exist regarding the best methods for weaning children from their feeding tubes.

METHODS: The current paper describes a randomized controlled trial of an empirically supported outpatient treatment protocol for moving children from tube to oral eating called iKanEat. Specifically, we describe the methods of randomized double-blind, placebo-controlled trial which includes a 4-week course of megestrol, the only medication used in the iKanEat protocol, to determine whether the addition …

Mast Cell Involvement In Fibrosis In Chronic Graft-Versus-Host Disease, Ethan Strattan, Gerhard Carl Hildebrandt

Markey Cancer Center Faculty Publications

Allogeneic hematopoietic stem cell transplantation (HSCT) is most commonly a treatment for inborn defects of hematopoiesis or acute leukemias. Widespread use of HSCT, a potentially curative therapy, is hampered by onset of graft-versus-host disease (GVHD), classified as either acute or chronic GVHD. While the pathology of acute GVHD is better understood, factors driving GVHD at the cellular and molecular level are less clear. Mast cells are an arm of the immune system that are known for atopic disease. However, studies have demonstrated that they can play important roles in tissue homeostasis and wound healing, and mast cell dysregulation can lead …

Movement In Stillness, Shalini Chaliki

HCA Healthcare Journal of Medicine

These images feature the Lower Antelope Canyon which was originally called Hasdestwazi, a Navajo word that means “spiral rock arches.” After hundreds of years, monsoons, winds, and flash floods eroded the slot canyon into the geological wonder that it is today. It enchants tourists and engulfs visitors as it flows around them in every direction. Just east of Page, Arizona, the massive sandstone formation is sacred to the Navajo Nation for its representation of Mother Nature’s many gifts and the passage to time; it is also a reminder that things are larger and greater than ones’ self. While these photos …

Hands, Marc Perlman

HCA Healthcare Journal of Medicine

“Hands” is inspired by my first encounter with a donor in the cadaver lab during my first year of medical school. This poem highlights the intimate relationship between the medical student and their “first patient” and captures the factors that helped me realize the grandeur of the dissecting experience. Through an awareness of the donor’s hands, I became viscerally aware that the cadaver is a real human being who donated their corporeality to help students learn. The bilateral vulnerability of this experience is a critical milestone in the development of health care providers. Given the recent transition from in-person to …

Trauma Recidivism In An Aging Population: Who Is Most At Risk?, Ryan Taylor, Austin Mccrea, Nayda Parisio Poldiak, Keely Muertos, Saptarshi Biswas, Christoph Kaufmann

HCA Healthcare Journal of Medicine

Background

Repeated episodes of trauma, particularly in older adults, result in increased morbidity and mortality. This study investigates trauma recidivism in our adult population to identify which patients in our region are more likely to become recidivists.

Materials and Methods

This 4 year retrospective study (2013 to 2017) examines all patients 18 years of age or older with multiple hospital admissions for trauma, comparing patients ages 65 and older (older adults) to those ages 18 to 64 (younger adults). Exclusion criteria consisted of those younger than 18 and/or had a home zip code outside of the study region. Data included …

Methamphetamine Associated Cardiomyopathy In Pregnancy: The Distinctions And The Implications, Ashan Hatharasinghe, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction

Methamphetamine associated cardiomyopathy (MAC) and peripartum cardiomyopathy (PPCM) are both rare obstetric conditions. Literature regarding methamphetamine associated cardiomyopathy in the obstetric population is limited, and it can be difficult to make the distinction between the two given the similarities in clinical presentation. However similar, there are significant distinctions in the pathophysiology of these two that can help clinicians with the management process.

Clinical Findings and Outcomes

This case involves a 35-year-old Hispanic G6P5005 at 37 weeks gestation presenting with acute respiratory failure secondary to acute decompensated heart failure with reduced ejection fraction and superimposed preeclampsia leading to urgent cesarean …

Trichobezoer: An Unusual Presentation With Congestive Heart Failure, Madeeha Malik, Fatima Javed, Bassam Helou, Furrukh Malik

HCA Healthcare Journal of Medicine

Trichobezoars are impactions of hair that accumulate in the gastrointestinal track and are most often located in the stomach. They are often associated with psychiatric illnesses like trichotillomania and trichophagia, which usually occurs in young and adolescent females. Gastric trichobezoars (GT) are the most common variety of bezoar found in the stomach. The most common complications that arise alongside GT include gastric erosion, ulceration or perforation of the small intestine. Gastric outlet obstruction, obstructive jaundice, pancreatitis and death have been reported, though these complications are rare. We report a 40-year-old female who presented to the hospital with dyspnea on exertion …

A Case Of Rare Subtype Of Multiple Myeloma: Secondary Plasma Cell Leukemia, Chandra Sanwal, Aftab Mahmood, Michael Bailey, Krutika Patel, Antonio Guzman

HCA Healthcare Journal of Medicine

Plasma cell leukemia is a rare, aggressive form of multiple myeloma with the presence of circulating plasma cells in the peripheral blood. There are two types of plasma cell leukemia, primary and secondary, depending on if there was previous evidence of multiple myeloma. The diagnostic criterion of plasma cell leukemia is based on a percentage (>20%) or an absolute number of (≥2 x 109/L) plasma cells in the peripheral circulation. We present the clinical course of a rare case of secondary plasma cell leukemia in a patient from the time of initial diagnosis of multiple myeloma, its remission period …

Pancoast Syndrome Due To High Grade Anaplastic Tumor, Christian Almanzar, Seth Maxwell, Mauricio Gomez, Omar Ansari, Luis Silva

HCA Healthcare Journal of Medicine

The Pancoast tumor is an uncommon type of lung cancer that arises from within the superior sulcus. With most clinical manifestations occurring due to mass effect, Pancoast syndrome is a known complication that includes shoulder and arm musculoskeletal pain, Horner’s syndrome and neurological complications of the upper extremities, including weakness and atrophy. Even though adenocarcinoma is the most common cause of Pancoast syndrome among lung cancers, other malignancies can be responsible as well. Treatment is similar to that of other standard NSCLC treatments that include chemotherapy, radiation, immunotherapy and surgery. Here we report a patient with Pancoast syndrome secondary to …

Esophageal Cancer Complicated By A Distal Acquired Esophagopulmonary Fistula, Alexander D. Lake, Yousef Almuzaini, Aaron Jaffe, Joseph Staffetti, Mukesh Patel

HCA Healthcare Journal of Medicine

Esophageal respiratory fistulas, commonly found as a tracheoesophageal fistula (TEF), are abnormal connections between the esophagus and trachea. These can be congenital (infants) or acquired (malignancy). A more rare form of an esophageal respiratory fistula is an abnormal connection between the esophagus and the lung parenchyma—also known as an esophagopulmonary fistula. In our case, we present a middle-aged male with a history of esophageal cancer undergoing chemotherapy and radiation presenting into the intensive care unit for increasing shortness of breath and vomiting after eating found to have a rare form of a TEF causing his symptoms.

Physicians’ Emotional Intelligence: Improving Performance While Reducing Burnout, Miriam Zylgerblait Lisigurski, Umair Shaikh, Brian Toston

HCA Healthcare Journal of Medicine

Today’s physicians are being confronted with an increasing number of challenges and opportunities as our evolving healthcare system progresses into the future. The expectation is not only to provide the best clinical care, but also to satisfy metrics, fulfill budgets, achieve high patient satisfaction levels and accomplish institutional requirements in order to be considered good providers. All these additional demands seem to be affecting not only the clinical performance of physicians but also their wellness, increasing the risk of burnout, depression and suicide.

Leadership, Anthony Pearson-Shaver, Evan Layton

HCA Healthcare Journal of Medicine

Though they become responsible for leading teams and supervising more junior learners early in their career, physicians receive little formal leadership training. The “see one, do one, teach one” approach to behavioral modeling and mentorship does not serve the modern young physician well. The complex nature of modern healthcare demands that physicians learn to work within the teams they will often come to lead. Within these teams, members often look to physicians to fill leadership roles. This review will examine effective leadership as defined by the business community, review attempts to incorporate leadership training into graduate medical education programs and …

An Acknowledgement To The Hca Healthcare Journal Of Medicine’S Reviewers And Editors For The 2nd Half Of 2020, Bruce Deighton, Hossein Akhondi, D. Scott Lind, Graig Donini

HCA Healthcare Journal of Medicine

As the HCA Healthcare Journal of Medicine reaches the end of our first year in publication, we want to thank those who have provided invaluable support for the journal from July to December 2020. Our journal would not have been possible without the assistance of our reviewers, authors and board members.

The Need For Physician Leaders, Seth W. Wolk

HCA Healthcare Journal of Medicine

Almost all care in a healthcare organization flows through their physicians, who are usually viewed as the de facto leaders in almost all clinical settings. Physicians have a disproportionate impact on how care is delivered and also have a disproportionate responsibility to lead change. Effective organizational physician leaders create an environment in which their colleagues are able to successfully exercise their skills and knowledge and are convinced that their efforts contribute to improved patient care.

Combined Posterior And Anterior Approaches For Cervical Intradural Disc Herniation: A Case Report, Yu-Hsiang Lin

BioMedicine

Intradural disc herniation (IDH) is an extremely rare condition. The authors report the case of a 53-year-old female who had neck and right shoulder pain associated with right-sided hemiparesis and hyperesthesia. Magnetic resonance imaging (MRI) of the cervical spine (C-spine) revealed central mass-like lesions that caused the compression of the right side of the spinal cord. The posterior surgical approach was used to remove two pieces of IDH. After surgery, the muscle strength in the right upper limb improved from Grade 0/5 to 4+/5 without surgery-related complications. Although there are some reports in literature on the radiologic features of cervical …

Contralateral Recurrent Laryngeal Nerve Palsy In Revision Anterior Cervical Discectomy And Fusion (Acdf): A Cautionary Tale, Chenghan Wu, Eugene Wei Ren Yang, Kelvin Kah Ho Lor

BioMedicine

Revision anterior cervical spine surgery has a higher risk of recurrent laryngeal nerve palsy (RLNP). We describe a unique case of an isolated RLNP contralateral to the side of the surgical approach in a patient who underwent revision anterior cervical discectomy and fusion (ACDF) for cervical myelopathy, and in whom pre-operative laryngoscopic evaluation had excluded a pre-existing occult RLNP. Scarring around the recurrent laryngeal nerve at the previous surgical site may have rendered it less mobile, resulting in it being more susceptible to compression from an inflated endotracheal tube (ETT) cuff or traction from surgical retractors. This case illustrates that …

Immunological And Anti-Oxidant Profiles Of Malarial Children In Abuja, Nigeria, Idris Nasir Abdullahi, Sanusi Musa, Anthony Uchenna Emeribe, Musa Muhammed, Jelili Olaide Mustapha, Halima Ali Shuwa, Shamsuddeen Haruna, Sharafudeen Dahiru Abubakar, Olusoji Matthew Billyrose, Mustapha Bakare

BioMedicine

Background:

The clinical symptoms, cellular immune response, and serum cytokine homeostasis during falciparum malaria among children living in endemic regions depend on the parasite densities. This study aims to evaluate the CD4⁺ and CD8⁺ T cells, leucocytes subpopulations, IL-6, IL-10 and biomarkers of oxidative stress among children infected with varying grades of malaria attending the University of Abuja Teaching Hospital and National Hospital, Abuja, Nigeria.

Materials and Methods:

This case-control study involved blood samples collected from 165 children (between 5 -12 years). This comprised 45 children with mild malaria, 40 each with moderate, severe malaria and apparently healthy …

The Effect Of Melatonin On Quality Of Sleep In Patients With Sleep Disturbance Admitted To Post Coronary Care Units: A Randomized Controlled Trial, Mohammad Zaman Kamkar, Mehran Mahyar, Seyedmahrokh A Maddah, Homeira Khoddam, Mahnaz Modanloo

BioMedicine

Background and Objectives: Patients with cardiovascular disease who required to be admitted in coronary care units (CCU) would have sleep deprivation. During the admission, some factors such as continuous ambient light exposure can suppress melatonin release, in consequence sleep deprivation will be occurred and hinder the progress of patients' treatment. The aim of study was to evaluate the effect of melatonin on the sleep quality of patients admitted to post-CCU.

Materials and Methods: This randomized clinical trial was carried out on 110 patients admitted to post-CCU at SayyadeShirazi Hospital, Gorgan, Iran. Patients with a poor sleep quality (Pittsburgh …

Predicting Mental Health Of Prisoners By Artificial Neural Network, Elahe Allahyari, Mozhgan Moshtagh

BioMedicine

Introduction: Maintaining and improving prisoners’ health and their rehabilitation can be effective steps towards eliminating health inequalities and approaching the UN’s Sustainable Development Goals. Accordingly, identifying protective factors and health barriers of this vulnerable group and changing the prison into an environment that can deliver health interventions tailored to the needs of inmates can provide the basis for attaining justice in health.

Purpose: This study builds on an artificial neural network model to determine the effect of demographic, psychological, criminological, and physical activity factors on prisoners’ general health.

Methods: The study detected the patterns between variables using a neural network …

Inhibitory Effects Of Nigella Sativa Seed Oil On The Testosterone-Induced Benign Prostatic Hyperplasia In Rats, Arezo Sadeghimanesh, Sajedeh Gholipour, Akram Torki, Hossein Amini-Khoei, Zahra Lorigooini, Solomon Habtemariam

BioMedicine

Background: Benign prostatic hyperplasia (BPH) is the most prevalent disease of the prostate in elderly men. Since Nigella sativa has been reported to show various pharmacological effects, this study was conducted to examine the effect of N. sativa seed oil on experimental BPH.

Methods: The oil was extracted using the cold-pressing method. Fifty rats were divided into five groups of 10 each as follows: Group 1 orally (p.o.) received normal saline; groups 2-5 were castrated and subcutaneously received 5 mg/kg testosterone propionate for four weeks. Group 2, namely, BPH model, underwent no further treatment, Groups 3 and …

Analysis Of Covid-19 Prevention And Treatment In Taiwan (Review), Yu-Jen Chiu, Jo‑Hua Chiang, Chih-Wei Fu, Mann-Jen Hour, Hai-Anh Ha, Sheng-Chu Kuo, Jen-Jyh Lin, Ching-Chang Cheng, Shih‑Chang Tsai, Yu‑Shiang Lo, Yu‑Ning Juan, Yih-Dih Cheng, Jai-Sing Yang, Fuu‑Jen Tsai

BioMedicine

Coronavirus disease 2019 (COVID‐19) has been spreading worldwide with a mind-boggling speed. According to a statement from World Health Organization (WHO), COVID-19 has infected more than six billions people and caused more than one and half million passing in the world. Based on previous experience with SARS, the Taiwanese government had decided to block viral transmission during its early stages. This review sums up the clinical characteristics, Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) viral infection process, diagnostic methods, preventive strategy, and the executive proportions of COVID-19, as well as the name-based mask distribution system (NBMDS) in Taiwan. We …

Perceived Critical Success Factors For Native American And Non-Native American Pre-Licensure Nursing Students In Northern New Mexico, Karen E. Nielsen

Doctor of Nursing Practice Scholarly Projects

Considering the consistent healthcare system load demands, nursing shortages persist, especially in remote areas of the United States. It is vital that students interested in attending nursing school and working in their home communities have expanded nursing program access and supports in order to supply the necessary nursing workforce in remote areas. Lack of diversity in the nursing profession weakens healthcare delivery. Native Americans are underrepresented as nursing students and employed nurses. Measures to provide a more diverse workforce should concentrate on recruitment, retention, and graduation rates of underrepresented minority nursing students. Limited research is available surrounding Native American nursing …

Medical School Watercooler Newsletter - February 26, 2021, Lindsey Lyle

Watercooler Newsletter

This is the February 26, 2021 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Chang appointed to Mobile County Board of Health
• USA College of Medicine invited to AMA consortium meetings
• Interest groups to host 'The skin You're In' docufilm series and discussion
• Students show that 'Kindness rocks' during Solidarity Week
• Meet a Med Student: Shrikar Iragavarapu
• Honoring Black history makers at the USA College of Medicine

The Virtual Mock Oral Examination: A Multi-Institutional Study Of Resident And Faculty Receptiveness., Joseph F. Goodman, Prashant Saini, Alexander J. Straughan, Christopher D. Badger, Punam Thakkar, Philip E. Zapanta

Surgery Faculty Publications

No abstract provided.

Biologically Guided Isolation And Admet Profile Of New Factor Xa Inhibitors Fromglycyrrhiza Glabraroots Usingin Vitroandin Silicoapproaches, Reham S. Ibrahim, Rahma S. R. Mahrous, Rasha M. Abu El-Khair, Samir A. Ross

Faculty and Student Publications

Selective factor Xa inhibitors effectively block coagulation cascade with a broader therapeutic window than multitargeted anticoagulants. They have evolved as a crucial part of prevention and treatment of thromboembolic diseases and in therapeutic protocols involved in many clinical trials in coronavirus disease 2019 (COVID-19) patients. Biologically-guided isolation of specific FXa inhibitors from licorice (Glycyrrhiza glabra) root extract furnished ten flavonoids. By detailed analysis of their1H,13C NMR and MS data, the structures of these flavonoids were established as 7,4′-dihydroxyflavone (1), formononetin (2), 3-R-glabridin (3), isoliquiritigenin (4), liquiritin (5), naringenin 5-O-glucoside (6), 3,3′,4,4′-tetrahydroxy-2-methoxychalcone (7), liquiritinapioside (8) and the two isomers isoliquiritigenin-4′-O-β-d-apiosylglucoside (9) …

Coronavirus Update 2-26-21, The Coronavirus Planning Team

University Briefings & Virtual Events

Pioneer Event Tent and Pioneer Pavilion Coming Soon! --Commencement 2021 --Commencement 2020.

2021-02-26_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 Hospitals. Data is self-reported by hospitals daily to the EM Resource System per MDHHS Director Robert Gordon's Emergency Order.

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

2021-02-26_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 …

Nothing Short Of A Culture Shock, Anonymous

Community Reflections

Primary source reflection paper for Western Civilization. We were in uncharted territories with new rules and restrictions. All of these new rules and cancellations happened at once and there was no true way to have been prepared.

Days With Extreme Highs And Lows, Anonymous

Community Reflections

This account shares my feelings and certain situations and events specific to those who graduated high school and started college during the pandemic. It also shares some of the common stressors during the beginning of the pandemic and interesting and unexpected situations.