Medicine and Health Sciences Commons^™

Optimized Catheter System Demonstrates Utility For Endomyocardial Delivery Of Cardiopoietic Stem Cells In Target Patients With Heart Failure, Jozef Bartunek, Andre Terzic

The Texas Heart Institute Journal

No abstract provided.

St-Segment Elevation Myocardial Infarction And Bleeding Complications In Jak2-Negative Polycythemia, Priscilla Duran Luciano, Vanessa Sabella-Jiménez

The Texas Heart Institute Journal

Thrombotic and bleeding complications are major causes of morbidity and mortality in patients with polycythemia vera, who predominantly present with an alteration in the JAK2 gene. Because of their hypercoagulable state and risk of hemorrhage, patients with polycythemia vera who present with an acute myocardial infarction pose a challenge to physicians. This case report describes the presentation and treatment of a Hispanic patient with JAK2 V617F-negative primary polycythemia who developed cardiac arrest and ST-segment elevation myocardial infarction owing to complete occlusion of the left anterior descending artery as well as bleeding complications and postmyocardial pericarditis.

Using An Artificial Intelligence (Ai) Tool (Chatgpt) To Identify The Main Indications And Side Effects Of Drugs In Patient Medical Records, Mai Elzieny, Zhenhong Qu

Conference Presentation Abstracts

Context: Drug history is important clinical information for the correct histologic diagnosis of a wide variety of nonneoplastic diseases, such as hepatitis, gastritis, and colitis. As pathologists, however, keeping a strong knowledge of all drugs (and variations of drug names) can be challenging. Using online databases to find relevant drug information one at a time is very time-consuming.

Design: Sixty-seven drugs were collected from the medical records of 5 randomly selected patients. ChatGPT (https://chat.openai.com/chat) was instructed to identify (1) the main clinical indications, and (2) the major side effects of each drug, using the prompt “List the major indications and …

Cell-Based Noninvasive Prenatal Testing (Cbnipt)-A Review On The Current Developments And Future Prospects, Mohamad Ali Maktabi, Liesbeth Vossaert, Ignatia B Van Den Veyver

Center for Medical Ethics and Health Policy Staff Publications

Considering the diagnostic limitations of cfDNA-based noninvasive prenatal testing (NIPT), scientists have long been interested in isolating and analyzing rare intact fetal and trophoblast cells from maternal blood or endocervical samples to diagnose fetal genetic conditions. These cells may be scarce and difficult to isolate, but they are a direct source of pure fetal genetic material. In this review, we summarize the history of cell-based NIPT, present an updated review on its current developments, evaluate its genetic diagnostic potential, and discuss its future prospects for clinical use.

Closing The Gap For Children With Ocd: A Staged-Care Model Of Cognitive Behavioural Therapy With Exposure And Response Prevention, Lara J Farrell, Allison M Waters, Eric A Storch, Gabrielle Simcock, Iain E Perkes, Jessica R Grisham, Katelyn M Dyason, Thomas H Ollendick

Center for Medical Ethics and Health Policy Staff Publications

Childhood obsessive-compulsive disorder (OCD) is among the most prevalent and disabling mental health conditions affecting children and adolescents. Although the distress and burden associated with childhood OCD are well documented and empirically supported treatments are available, there remains an unacceptable "treatment gap" and "quality gap" in the provision of services for youth suffering from OCD. The treatment gap represents the large number of children who never receive mental health services for OCD, while the quality gap refers to the children and young people who do access services, but do not receive evidence-based, cognitive behavioural therapy with exposure and response prevention …

Common Rituals In Obsessive-Compulsive Disorder And Implications For Treatment: A Mixed-Methods Study, Caitlin M Pinciotti, Nyssa Z Bulkes, Brenda E Bailey, Eric A Storch, Jonathan S Abramowitz, Leonardo F Fontenelle, Bradley C Riemann

Center for Medical Ethics and Health Policy Staff Publications

Obsessive-compulsive disorder (OCD) is characterized by engagement in rituals that serve to obtain certainty and prevent feared outcomes. Exposure and response prevention is most effective when rituals are resisted, yet existing self-report measures of OCD limit identification of the full range of possible rituals, and little is known about how rituals might cluster together and predict worsened severity and poorer treatment outcomes. In a retrospective sample of 641 adult patients who received intensive OCD treatment, the present study used a mixed-methods approach to (a) identify and validate treatment provider-identified rituals using the Yale-Brown Obsessive-Compulsive Scale, (b) identify clustering patterns of …

Integrating Social Determinants Of Health Into Ethical Digital Simulations, Kristin Kostick-Quenet, Vasiliki Rahimzadeh, Sharmila Anandasabapathy, Meghan Hurley, Anika Sonig, Amy Mcguire

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Treatment Of Low Back Pain Elicited By Middle Cluneal Neuralgia: Case Report And Literature Review Of Interventional Treatments, Colton Reeh, Royce Copeland, Loc Lam, Christian Vangeison, Andrea M Trescot, Emanuel Narcis Husu

Faculty, Staff and Students Publications

Background: Cluneal neuralgia is increasingly becoming recognized as an etiology of low back pain. The majority of the literature on cluneal nerve interventions describes modalities targeting the superior cluneal nerves with little emphasis on the middle cluneal nerves.

Case report: A 21-year-old woman with a medical history of congenital myelomeningocele with tethered cord at L5-S1, status post 3 decompressive releases, presented to the clinic with chronic low back pain and associated sacroiliac paresthesia. Over 11 months, she underwent 7 ultrasound-guided bilateral middle cluneal nerve blocks, without corticosteroid, resulting in significant, immediate pain relief sustained for 4 to 6 weeks.

Conclusions: …

Retrospective Evaluation Of The Covid-19 Contact Tracing Program At The Maine Center For Disease Control And Prevention, Elisabeth Brewington Mha, Mph, Ben K. Greenfield Phd, Jessica Purser Phd

Journal of Maine Medical Center

Introduction: Despite the widespread use of contact tracing efforts throughout the COVID-19 pandemic, there are limited findings available about best practices and recommendations. The Maine Center for Disease Control and Prevention contracted staff to conduct COVID-19 contact tracing from August 2020 through February 2022. A retrospective evaluation of this program was conducted to share lessons learned with public health and health care leaders for future use.

Methods: Contracted contact tracing staff participated in facilitated discussions structured by the Strengths, Weaknesses, Opportunities, and Threats analysis framework. Three sessions were recorded and transcribed, and qualitative analysis through thematic review and evaluation coding …

Covid: The Sound Of Silence, Saptarshi Biswas

HCA Healthcare Journal of Medicine

COVID brought its toll of deaths. Something the human race has not experienced in recent times. Something almost unimaginable in the modern world! But having joined a new hospital and moved to a sleepy old town, COVID gave me a sense of solitude I have not experienced for eons. There are times you wonder at the endless ocean in front of you and communicate with your inner soul.

And Yet, Angelina Hong

HCA Healthcare Journal of Medicine

As healthcare workers, invested in the wellbeing of our patients while also hoping to grow as individuals, we sometimes tend to view our jobs as a rigid duality—we are either “in love” with our practice and persevere flawlessly through all hardship, or we are “burnt out,” coldhearted, and defeated by the heavy workload and expectations of medicine.

In reality, we all sit somewhere in the middle of a blurry spectrum, balancing out physical, mental, and emotional pain with the immense honor of saving and cherishing human life, while simultaneously struggling to reconcile our altruistic goals with realistic but necessary human …

Disabilities And Medicine: From Stairs To Stares, Christopher Denham

HCA Healthcare Journal of Medicine

The current state of medicine has done little to correct the imbalance of underrepresented groups in the physician workforce. In this editorial, a psychiatric resident physician retells his experience as an individual who is completing his medical training while being affected by a neuromuscular disorder and how it impacts his daily life. The primary goal of this paper is to elucidate the need for greater representation and understanding of the disabled physician workforce.

Eruptive Sebaceous Hyperplasia: A Case Report And Review Of The Literature, Carsten Z. Steinmetz, Amanda Getz, Andras Schaffer, Stephen K. Richardson

HCA Healthcare Journal of Medicine

Introduction

Eruptive sebaceous hyperplasia (ESH) is a benign process characterized by the acute onset and rapid proliferation of sebaceous glands, typically on the face. Although historically attributed to cyclosporine therapy, the preponderance of reports over the past 2 decades suggests a more complex etiology. There is increasing thought a combination of multiple medications as well as a genetic component contribute to ESH’s clinical presentation. Despite these theories, the exact cause of ESH in immunosuppressive therapy is poorly understood.

Case Presentation

To our knowledge, we report the third case of ESH arising in multimodality immunosuppressive therapy, consisting of tacrolimus, mycophenolate mofetil, …

Acute Esophageal Necrosis And Duodenal Disease In The Setting Of Recently Initiated Chemotherapy, Kulveer Dabb, Ryan Jansen Van Rensburg, Heba Yusuf, Daniel Klein, Alexander D. Lake, Mohamed Kaif

HCA Healthcare Journal of Medicine

Introduction

Acute esophageal necrosis (AEN), commonly referred to as “black esophagus” or Gurvits syndrome, is a rare condition characterized by diffuse black mucosa in the distal esophagus. Most often, the patient is an older male with multiple comorbidities, presenting with upper gastrointestinal bleeding. The exact pathogenesis is unclear, but it is often thought to be secondary to acute vascular hypo-perfusion or ischemia of the esophageal mucosa in critically ill patients with certain secondary comorbid conditions such as renal insufficiency, diabetes mellitus, dyslipidemia, coronary artery disease, malnourishment, alcohol abuse, or association with an underlying malignancy.

Case Presentation

We present a case …

How Did That Get There? A Case Series Of Adolescent Foreign Bodies, Justin Ian Hanson, Paul Bomar, Sarah Kleist, Denver Rogalla, Lori Crihfield, Scott Gutovitz

HCA Healthcare Journal of Medicine

Introduction

Pediatric foreign bodies (FBs) come in many shapes and sizes, and the method by which they enter the body can greatly impact the level of acuity at presentation. Most FBs in children are found in those younger than 5 years old, but the following 3 cases were found in adolescent patients.

Case Presentation

We report on 3 adolescent patients who presented to a single community-based emergency department with the chief complaint of abdominal pain and were found to have complications of abdominal FBs. If undiagnosed, the initial indolent courses of FBs can lead to serious complications, as shown in …

Who Left The Hospital Against Medical Advice During The Early Covid-19 Pandemic?, Bryan Werner, Se Won Lee

HCA Healthcare Journal of Medicine

Background

Patients leaving against medical advice (AMA) presents a challenge to hospitals as they try to manage costs and improve patient outcomes in an ever-increasing competitive market. Investigating AMA discharges that occurred during the early COVID-19 pandemic presents a unique opportunity to better understand this phenomenon and be better prepared for the future.

Methods

This retrospective analysis of 34 379 patients from a nationwide private healthcare system across 20 states analyzed patients during the early stages of the pandemic who chose to leave against medical advice (AMA) after being admitted with COVID-19 infection and identified several patient characteristics associated with …

An Unusual Presentation Of Infective Endocarditis, Ethan J. Peterson, Jordan Jackson, Syed M. Zaidi, Jorge Perez

HCA Healthcare Journal of Medicine

Introduction

Leukocytoclastic vasculitis is the inflammation of small blood vessels due to leukocyte migration that comprises a wide range of differentials. It can be caused by autoimmune disorders, infections, neoplasms, or certain medications and warrants prompt recognition and therapy for optimal patient outcomes.

Case Presentation

Here we present a case of a 37-year-old male who presented with a painful, petechial rash on his torso and extremities. Skin biopsy revealed leukocytoclastic vasculitis, thereby prompting a comprehensive investigation into the underlying etiology leading to the diagnosis of Pseudomonas aeruginosa infective endocarditis.

Conclusion

Pseudomonas aeruginosa is a rare cause of infective endocarditis with …

Covid-19 Disease Characterization And Outcomes Comparison In Pediatrics, Rachel Rowland, Abigail Schauble, Brendon Cornett

HCA Healthcare Journal of Medicine

Background

It has been reported that children experience less severe COVID-19 symptoms than adults; however, the literature that supports this idea is evolving. The purpose of this study was to retrospectively characterize hospitalized COVID-19-positive pediatric patients with a focus on the assessment of risk factors for poorer outcomes, mortality, and evaluation of interventions utilized and associated clinical outcomes.

Methods

We conducted a multi-center retrospective chart review of patients 18 years old or younger who were COVID-19 positive and admitted to any US HCA Healthcare Pediatric service line between January 1, 2020, and November 30, 2020. We identified 6081 children across …

Video Documentation As A Measure Of Written Documentation Accuracy In Emergency Medical Service Field Intubations, Christopher S. Keller, Christopher Dilger, Shih-Chin Chou, Rasheed Lawal, Shane Jenks

HCA Healthcare Journal of Medicine

Introduction

Quality improvement (QI) is a major focus of all departments and fields of health care, including emergency medical services. The chaotic and rapidly evolving atmosphere in which paramedics must practice can lead to inconsistency between what is documented and the actual events. This leads to difficulty when trying to evaluate the practitioners and when implementing a QI program. In this study, we evaluated the prevalence of discrepancy between the video and written record for Rapid Sequence Intubation (RSI) performed in the field as a demonstration of the utility of video documentation in QI.

Methods

We used a systematic retrospective …

Fascial Defect Closure During Ventral Hernia Repair: A Systematic Review Of Randomized Controlled Trials, Shin Jeong, Tunmi A. Anwoju, Oscar A. Olavarria, Natalia Cavagnaro, Naila H. Dhanani, Nicole B. Lyons, Zuhair Ali, Mike K. Liang

HCA Healthcare Journal of Medicine

Background

During minimally invasive ventral hernia repair (VHR) it is unknown if a fascial defect closure, as opposed to a bridged repair (current care), is beneficial for patients. We sought to systematically review the published literature on the role of fascial defect closure during minimally invasive VHR.

Methods

PubMed, Embase, Scopus, Cochrane, and Clinicaltrials.gov were reviewed for randomized controlled trials (RCTs) that compared fascial defect closure with bridged repair. The primary outcome was major complications defined as deep/organ-space surgical site infections (SSIs), reoperations, hernia recurrences, or deaths. Secondary outcomes included SSI, seroma, eventration, hernia recurrence, post-operative pain, and quality of …

An Acknowledgement To The Hca Healthcare Journal Of Medicine's Reviewers And Editors For The First Half Of 2023, Bruce Deighton, Hossein Akhondi, Barbara L. Gracious, David Scott Lind, Graig Donini

HCA Healthcare Journal of Medicine

The HCA Healthcare Journal of Medicine would like to thank those behind the scenes who make this publication possible. Our journal would not be possible without the assistance of our peer reviewers, authors, and board members. We also announce our inclusion in PubMed Central.

Medical School Watercooler Newsletter - August 31, 2023, Lindsey Lyle

Watercooler Newsletter

This is the August 31, 2023 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents include:

• More than 200 books donated in memory of pediatrician Cindy Sheets, M.D.
• Internal medicine residents place fourth in academic competition
• Meet a Med Student: Anthony Fant
• IDEAMED exposes local youth to careers in medicine

Computational And Experimental Investigation Of Elemental Sulfur And Polysulfide, Jyoti Sharma

Dissertations

Petroleum processing results in the generation of significant quantities of elemental sulfur (S₈), leading to a surplus of sulfur worldwide. Despite its abundance and low cost, the use of sulfur in value-added organic compound synthesis is limited due to its unpredictable and misunderstood reactivity. This dissertation aims to address this issue by tackling it from two angles. Firstly, by utilizing Density Functional Theory (DFT) calculations, the reactivity of sulfur in the presence of nucleophiles is studied. This facilitates the identification of organic polysulfide intermediates that can be generated under different conditions, as well as the corresponding reactivity for …

Bertumbuh Berkembang: Modul Pemberian Makan Bayi Dan Anak (Pmba), Hikmah Kurniasari

Pengembangan Profesional

Pemberian Makanan Bayi dan Anak (PMBA) yang optimal akan meningkatkan kesempatan hidup dan pertumbuhan anak; juga daya tangkap untuk menguasai keterampilan serta pengetahuan yang mereka perlukan sebelum memulai pendidikan di tahun-tahun awal sekolah. Tidak hanya bagi bayi dan anak, pemenuhan gizi yang baik juga amat penting bagi ibu hamil dan menyusui. Selain penjelasan lengkap seputar PMBA dan kesehatan ibu hamil/menyusui, modul ini juga menjelaskan kepercayaan lokal yang kepercayaan lokal yang terkadang menimbulkan misinformasi dan menghambat akses bagi ibu, bayi, dan anak untuk mendapatkan nutrisi yang dibutuhkan. Modul ini akan bermanfaat bagi kader layanan kesehatan (Posyandu) untuk menyampaikan informasi yang tepat …

The Noloco Strategy For Essential Hypertension, F. Matthew Mihelic Md

Faculty Publications

Ninety-nine percent of all “essential” hypertension can be controlled by using the NoLoCo strategy, without causing any significant side-effects and without an increase in insulin resistance. NoLoCo stands for Norvasc (amlodipine), Lozol (indapamide), and Cozaar (losartan), but the medicines are considered and used in reverse order.

Environmental Isolate Developing Antibiotic Resistance By Complementation, Mary Ridgeway, Ashley Fink, David Mitchell

Biology Faculty Publications

Antibiotic resistance is a growing concern within the scientific community. With few new antibiotics being introduced and an increasing number of resistant microbes, routine bacterial infections are becoming more difficult to treat in clinics and hospitals. The purpose of this study is to compare the ability of two environmental isolates – Staphylococcus aureus (S. aureus) and Exiguobacterium undae (E. undae) to grow in solutions of increasing concentrations of tetracycline and ciprofloxacin. After the bacteria showed grow in the solutions, antibiotic susceptibility was tested by examining zones of inhibition on Trypticase Soy Agar (TSA) plates. Our results …

Comparison Of Prevalence And Associated Factors Of Multisystem Health Symptoms Among Workers In The Gas Station Area, Thailand, Chan Pattama Polyong, Anamai Thetkathuek

Kesmas

This cross-sectional study aimed to compare the prevalence of multisystem health symptoms (MHS) of workers in gas station areas before and after their employment and examine the factors affecting the MHS of workers. Data were collected by an interview questionnaire from 200 workers inside and outside refueling areas at eight gas stations in Rayong Province, Thailand. This study found that employees had a statistically significant increase in the prevalence of current MHS in comparison to before starting work (p-value<0.05), with 31.5%. Working overtime for more than 6 hours per week led to respiratory symptoms (OR = 2.63, 95% CI = 1.14–6.07) and psychological symptoms (OR = 2.69, 95% CI = 1.12–6.49). Wearing respiratory protective equipment for less than three hours affected ear/throat/nose systems (OR = 4.26, 95% CI = 1.43–12.65). Petrol refueling resulted in liver (OR = 2.32, 95% CI = 1.4–12.65) and eye symptoms (OR = 2.57, 95% CI = 1.10–5.39). Therefore, gas station owners should set up enclosed rooms to reduce the duration of fuel exposure, and workers should wear personal protective equipment when refueling or near the dispenser.

Workload And Stress Level In Non-Covid-19 Zoning Nurses At National Central Public Hospital Jakarta, Zakiyah Zakiyah, Ulfah Nuraini Karim, Aliana Dewi, Siti Nuraini, Aan Sutandi, Rony Darmawansyah Alnur

Kesmas

The COVID-19 pandemic has increased the workload for nurses directly handling COVID-19 patients and those working in non-COVID-19 zones. As the number of COVID-19 cases rises, nurses face psychological problems, including stress. This study aimed to determine the relationship between workload and stress levels in a non-COVID-19 zoning ward using a cross-sectional approach and Spearman’s correlation test conducted on 94 nurses at one hospital in Jakarta, Indonesia, selected through simple random sampling. The workload questionnaire with 15 items and the DASS 42 questionnaire were used to measure stress levels. The results indicated that most nurses (73.4%) experienced a heavy workload. …

Engaging Patients In Opioid Use Disorder Treatment: A Mixed Methods Study Investigating Primary Care Team Perspectives On Approaches, Barriers, And Facilitators, Elizabeth J. Austin, Ulrich Koch, Monica S. Ruiz, Anna D. Ratzliff, Emily C. Williams, Yavar Moghimi

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Harms from opioid use disorder (OUD) cause significant morbidity and mortality, responsible for over 107,000 overdose-related deaths in 2022 and igniting an urgency to expand access to OUD-related care to new settings such as primary care. A critical element of successful OUD care is engaging patients throughout the OUD care continuum and ongoing retention, yet OUD care engagement rates in outpatient settings are hugely variable, ranging from 4%-70% for initial (14-30 day) treatment engagement, and markedly diminishing over time. The barriers that patients cite to engagement point to the need to deliver more patient-centered OUD care, yet little …

Major Factors Influencing The Utilization Of Maternal Health Services In Nepal, Kaitlyn Alessi, Michael Ierardi, Nadia Anderson, Sujan Babu Marahatta, Cyril Blavo

HPD Articles

According to the World Health Organization, maternal health services (MHS) include antenatal care, perinatal care, and postnatal care. MHS have been underutilized in Nepal and are contributing to an increased morbidity and mortality in the region leading to various adverse outcomes for both mothers and their newborns. Many of these adverse outcomes can be avoided with increased use of antenatal, perinatal, and postnatal checkups.