Medicine and Health Sciences Commons^™

Virginia 2023 Election Alters Power In The General Assembly, Chuck Duvall, Tripp Perrin, Missy Wesolowski

Virginia Dental Journal

The recent 2023 elections have resulted in Democrats narrowly controlling both chambers of the Virginia legislature, leading to significant turnover and new leadership. The VDA emphasizes the importance of building relationships with the new legislators to advance their advocacy efforts.

We’Re Taking On The Fight For Fairness And Transparency, Laura Givens

Virginia Dental Journal

The Virginia Dental Association (VDA) is advocating for increased transparency and accountability in dental insurance by requiring carriers to disclose their actual loss ratios annually. Dentists are encouraged to support this initiative by contacting legislators, joining the VDA Grassroots Network, and contributing to the VDA PAC.

Advocating For Transparency And Better Patient Care, Ryan Dunn

Virginia Dental Journal

Ryan Dunn, CEO of the VDA, emphasizes the importance of transparency and advocacy in dental care. He highlights the challenges faced by dentists due to insurance companies, including inadequate reimbursement rates and claim denials. The VDA is pushing for legislation requiring insurance companies to disclose how premiums are used for patient care, aiming to help patients and employers make informed decisions. The VDA also seeks regular meetings with insurers to address business practices that hinder patient care. Dunn encourages VDA members to stay engaged and support legislative efforts to improve oral healthcare in Virginia.

Let Me Introduce Myself - Leslie Hicks, Leslie Hicks

Virginia Dental Journal

Leslie Hicks, the Manager of Member Relations at the Virginia Dental Association (VDA), is dedicated to developing and managing membership outreach and engagement efforts. With a background in accounting and experience in building professional relationships, she aims to reinvigorate recruitment efforts and strengthen the VDA community. Leslie emphasizes active listening and addressing the needs of both current and prospective members. She is excited about the "Lead 3" program, which encourages current members to recruit new ones, fostering peer-to-peer mentorship and professional growth.

Where We Have Been And Where We’Re Going In 2024, Gary Oyster Dds

Virginia Dental Journal

Gary D. Oyster, DDS, reflects on his tenure as the 16th district trustee of the American Dental Association (ADA) and highlights significant changes. Key initiatives include the formation of the Strategic Forecasting Committee to enhance responsiveness, the partnership with the Forsyth Institute to boost research capabilities, and efforts to engage new dentists and dental students to reverse declining membership. The ADA is also transitioning to Salesforce/Fonteva for better membership data management and adopting a flexible Financial Operating Plan to quickly adapt to program changes. Workforce shortages and dental benefits programs remain ongoing challenges. The ADA aims to thrive through collaboration …

Farewell, Richard F. Roadcap Dds

Virginia Dental Journal

Dr. Richard Roadcap reflects on his 16-year tenure as Editor of the Virginia Dental Journal, highlighting the transition from analog to digital publishing and the sense of community he aimed to create. He expresses gratitude to his Managing Editor Shannon Jacobs, publishers Dr. Terry Dickinson and Ryan Dunn, and his supportive wife Norma. He acknowledges the contributions of the Journal’s Editorial Board and thanks the VDA staff. As he steps down, he introduces Dr. Sarah Friend as the new Editor and hopes the Journal continues to thrive.

The Professional Student, Sarah Friend Dds

Virginia Dental Journal

Dr. Sarah Friend, a dentist, shares her journey of embracing new technology through a fellowship in forensic dentistry. Despite initial challenges and reliance on younger colleagues for tech support, she highlights the importance of continuous learning and adapting to technological advancements in the dental field. She encourages fellow professionals to expand their comfort zones, learn new techniques, and stay current to succeed in the evolving world of dentistry.

Challenges And Change, Dustin Reynolds Dds

Virginia Dental Journal

Dr. Dustin Reynolds, President of the Virginia Dental Association (VDA), reflects on the past three months and outlines key challenges and initiatives for 2024. He emphasizes the importance of supporting dental education programs to address workforce shortages and highlights the need for legislative support for interstate licensure compacts and transparency in dental insurance. Dr. Reynolds also discusses the impact of staffing challenges on dental practices and the importance of innovative technology in shaping the future of dentistry. He remains optimistic about improving access to oral healthcare in Virginia.

Va Dent J January, February And March 2024

Virginia Dental Journal

The latest issue of the Virginia Dental Journal (Volume 101, Number 1) highlights significant advancements and challenges in Virginia's dental community. A central feature is a farewell to Dr. Richard Roadcap, who reflects on his impactful 16-year tenure as editor. The issue includes a compelling research study on patient and parent perspectives regarding craniofacial care, with a focus on treatment access, outcomes, and the role of telehealth. Advocacy efforts take center stage with updates on legislative initiatives aimed at increasing transparency in dental insurance and improving patient care access. Additional columns emphasize the importance of embracing technological advancements in dentistry, …

The Impact Of Asymmetry In Lower Limb Muscle Strength And Power On Straight-Line Running Speed In Female Soccer Players, Dariusz Skalski, Magdalena Prończuk, Kinga Łosińska, Michał Spieszny, Maciej Kostrzewa, Piotr Aschenbrenner, Adam Maszczyk

Baltic Journal of Health and Physical Activity

The aim of this study was to investigate and determine the impact of asymmetries in muscle strength and power between the right and left lower limbs on straight-line running speed in female soccer players.30 right-footed female soccer players playing in the Ekstraliga participated in the study. The Modulus. Number formula was used to avoid negative results and to assess only the difference in relative strength and power between the lower limbs, not the dominance of one of them. A result equal to or below the threshold defined group G1 "with lower asymmetry," and a result above the threshold defined group …

Behind The Curtain, Angelina Hong

HCA Healthcare Journal of Medicine

One of my favorite themes in medicine is the concept of identity. Medicine is layered. It is continually saving lives, expanding in capabilities, and recruiting new students. But how does it shape us, and where does one draw the line between self and profession?

Physicians are classically a symbol of hope and healing. But medicine is challenging physically, emotionally, and spiritually. Add on top of that the daily burdens of our personal lives, and the responsibility can become quite heavy, making it difficult to walk with a smile every day. There is a time to stand behind a “curtain”, for …

Lyrical Stillness, Madhav Patel

HCA Healthcare Journal of Medicine

“Lyrical Stillness” is a poem I wrote during my radiation oncology rotation, during which I was provided the opportunity to learn more about multidisciplinary cancer care while delving deeper into radiotherapy. Cancer can be an overwhelming disease process physically, psychologically, and emotionally. Patients undergoing treatment often experience stress and anxiety with the uncertainty of their prognoses. In this poem, I describe a patient receiving radiation therapy whom I enjoyed speaking to about his favorite hobby: bird watching. During his subsequent radiation treatment sessions, I decided to play a CD of mockingbirds singing in a tropical forest, in the hopes it …

Apocrine Breast Cancer With Psammoma Bodies In A Male Patient, Alena Bashinskaya, Eric W. Baum, Michael B. Morgan

HCA Healthcare Journal of Medicine

Introduction

While male breast carcinoma is a relatively uncommon occurrence, its incidence is on the rise, potentially attributed to sporadic pathophysiological mechanisms, primarily involving hormonal imbalances. Invasive apocrine carcinoma represents a small fraction of global breast malignancies, with limited instances reported among male patients in the literature. The clinical presentation of an apocrine breast carcinoma closely resembles that of other breast cancer subtypes, as it is most often described as a solitary ulcerative nodular lesion occupying a retro-areolar region of the breast. Herein, we describe a novel case of an apocrine male breast carcinoma metastasizing to the skin, given that …

Hemophagocytic Lymphohistiocytosis In A Critically Ill Patient: A Case Report Of A Potentially Fatal Entity, Ali Khreisat, Inna Mikaella Sta Maria, Giovi Grasso-Knight, Meghan Mansour

HCA Healthcare Journal of Medicine

Background

Hemophagocytic lymphohistiocytosis (HLH) is a non-neoplastic proliferation and macrophage activation that induces cytokine-mediated bone marrow suppression and features of intense phagocytosis in the bone marrow and liver, leading to multi-organ dysfunction and ultimate failure. The diagnosis of HLH in an intensive care setting is challenging, and it is associated with high morbidity and mortality. HLH-94 is the standard protocol for treatment, consisting of dexamethasone and chemotherapy like etoposide.

Case Presentation

We present the case of a 73-year-old woman who had a prolonged hospitalization for vomiting, diarrhea, and dehydration. Her conditions were complicated by acute refractory pancytopenia on the 12th …

Evaluation Of A Patient With A Severe Systemic Inflammatory Response To Nitrofurantoin, Brigitte Vanle, Timothy Beatty

HCA Healthcare Journal of Medicine

Background

Nitrofurantoin is a prevalent antibiotic used to treat urinary tract infections. Despite nitrofurantoin’s general safety, it can cause serious side effects, including acute pulmonary toxicity, fulminant hepatitis, and severe systemic inflammatory responses, which may mimic conditions such as ischemia and infection. However, reports of acute systemic inflammatory response syndrome after nitrofurantoin ingestion are uncommon in medical literature.

Case Presentation

This case describes a severe systemic inflammatory response syndrome in an 85-year-old woman presenting with hypoxia, altered mental status, and profound leukocytosis after exposure to a single dose of nitrofurantoin.

Conclusion

Herein we report on a patient with suspected bacteremia …

Veillonella Discitis: A Rare Presentation And Review Of Literature, Akankcha Alok, Vidya Sagar Kollu, Gautam Kalyatanda

HCA Healthcare Journal of Medicine

Background

Veillonella is an anaerobic gram-negative coccus found as a commensal organism in the oral, respiratory, gastrointestinal, and genitourinary tract of humans. Rarely, it can cause serious infections by the production of lipopolysaccharide, an endotoxin. Although most Veillonella infections occur in immunocompromised individuals, we herein describe cases of Veillonella discitis, a rare presentation of Veillonella, in immunocompetent patients.

Case Presentation

The first presented case was encountered in a patient admitted at our facility. All patient data were obtained from the hospital's electronic medical record system. Thereafter, a literature search and subsequent review was done on PubMed with the MEDLINE …

Clinical Variant Of Serpentine Supravenous Hyperpigmentation Following Subcutaneous Bortezomib Injection, Madelyn Richards, Stephen E. Weis

HCA Healthcare Journal of Medicine

Introduction

Bortezomib is a reversible proteasome inhibitor that is a first-line chemotherapeutic agent for multiple myeloma. Bortezomib can be administered intravenously or subcutaneously with similar efficacy. Subcutaneous administration has fewer side effects. Many cutaneous reactions have been associated with bortezomib treatment. These include morbilliform exanthems, erythematous nodules and papules, leukocytoclastic vasculitis, Sweet syndrome, and rarely Stevens-Johnson Syndrome.

Case Presentation

This paper reports the occurrence of serpentine supravenous hyperpigmentation (SSH) after subcutaneous administration of bortezomib. SSH is a rare, characteristic cutaneous reaction that has been reported following intravenous administration of chemotherapeutic agents. Intravenous administration of bortezomib rarely results in documented cases …

A Case Of Xylazine-Induced Necrotic Skin Ulcerations In An Iv-Drug User In Florida, Mark Zaki, Cynthia Dillon, Anjali Patel, Barbara Gracious

HCA Healthcare Journal of Medicine

Introduction

As illicit drug manufacturers find new ways to market their products and increase their profit margins, multiple contaminants have found their way into the illicit drug supply. The newest addition, xylazine, also known as “tranq,” has spread through the city of Philadelphia and has recently been gaining ground across the United States, including in the state of Florida.

Case Presentation

This case describes a 37-year-old male with a significant past psychiatric history of severe polysubstance intravenous (IV) use, including fentanyl and methamphetamine. He was comorbid with other mental and physical conditions and presented to the emergency department with acute …

Successful Treatment Of An Atypical Presentation Of Disseminated Retroperitoneal Seminoma: A Case Report, Mahmoud Abd-El-Hafez, Kylie Johnson, Joe Cates, Alosh Madala

HCA Healthcare Journal of Medicine

Background

Testicular seminoma is the most common malignant tumor of the testis. It occurs at a rate of 5 per 100 000 men, primarily between the ages of 15 to 34. While seminomas typically occur in the testis, other primary sites include the mediastinum, the retroperitoneum, or other extra-gonadal sites. Due to the curable nature of the malignancy (5-year survival rate > 95%), detection at early stages of the disease is key. This case presentation explores the delayed diagnosis and treatments of an atypical presentation of disseminated seminoma.

Case Presentation

We present the unusual case of a 56-year-old male who had …

Hemophagocytic Lymphohistiocytosis Due To Ehrlichiosis: A Case Series, Ajay Iyer, Mattias D'Anna, Shruti Verma, Thomas Pritchard, Vladimir Begilman, Himal Bajracharya, Kaveh Naemi

HCA Healthcare Journal of Medicine

Background

Hemophagocytic lymphohistiocytosis (HLH) is an immunologic syndrome characterized by excessive inflammation and tissue injury due to uncontrolled activation of the phagocytic system. The underlying mechanism is a lack of downregulation of activated macrophages and lymphocytes by natural killer and T cells. Unfortunately, the diagnosis is often delayed or missed due to the rarity of the disease, decreased awareness, and clinical picture variability. Ehrlichiosis is becoming a more prevalent tick-borne illness in endemic regions and a relatively uncommon but increasingly considered cause of HLH.

Case Presentation

We describe the cases of 2 patients diagnosed with secondary HLH as per the …

Endovascular Repair Of A Superior Mesenteric Arteriovenous Fistula And Pseudoaneurysm After A Single Gunshot Wound To The Abdomen, Robert Ringersen Iii, Michael Shockley, Sanjiv Gray, Tracy Bilski, Julio Calderin, Philip Kondylis

HCA Healthcare Journal of Medicine

Background

Traumatic arteriovenous fistulas (AVFs) are rare entities, especially when referring to visceral arterioportal AVFs. Currently, there are no large epidemiological studies looking specifically at traumatic visceral AVFs. When traumatic AVFs have been discussed in the literature, it is in the form of case reports or case series and focused on peripheral AVFs. The following case is a presentation of a traumatic arterioportal AVF and its management with an endovascular approach.

Case Presentation

A 16-year-old adolescent boy presented tachycardic and hypotensive with a single gunshot wound in his left abdomen. Multiple operations were required. His intensive care unit course was …

Investigating The Effects Of Nosocomial Clostridioides Difficile Infection Among Acute Leukemia Patients: Insights From The 2020 National Inpatient Sample, Zubair Hassan Bodla, Mariam Hashmi, Fatima Niaz, Umer Farooq, Muhammad Jahanzeb Khalil, Farhan Khalid, Kipson Charles, Christopher L. Bray

HCA Healthcare Journal of Medicine

Background

Rising nosocomial Clostridioides difficile infections pose high risks, especially for immunocompromised leukemia patients, necessitating targeted research to enhance patient care and outcomes.

The objective of this study was to investigate the impact of nosocomial Clostridioides difficile infections (CDI) on patients hospitalized with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).

Methods

Our study was a retrospective analysis of adult patients hospitalized with a primary diagnosis of ALL or AML, using the Nationwide Inpatient Sample (NIS) database for 2020. Primary outcomes included the incidence of nosocomial CDI and all-cause inpatient mortality. Secondary outcomes included hospital length of stay, resource …

A Retrospective Data Analysis On Marine Animal Injuries At A Large, Multi-Site Medical System, Anthony Shadiack, J Burton Banks

HCA Healthcare Journal of Medicine

Background

With increasing numbers of human-animal interactions, there has been an increase in animal-related injuries. While canine bites are the most commonly reported animal injury, little data exists in regard to the other classes of animals, particularly marine life. The last comprehensive report on injuries related to noncanine bites and stings seen in emergency departments (EDs) across the US was between 2011 and 2015.

Methods

We performed a retrospective analysis from 2014-2019 on marine injuries from a large hospital network with over 180 hospitals, 100 freestanding EDs, and 170 urgent care centers to provide an update on the volume and …

Treatment Analysis Of Very Early And Early Onset Psychosis In The Youth Inpatient Setting, Acelyne Marie Summerson, Jordan Kalosieh, Sindhura Kompella, Clara Alvarez-Villaba, Yukthi Kodali

HCA Healthcare Journal of Medicine

Background

The United States Food and Drug Administration approved 6 atypical antipsychotics for pediatric treatment of schizophrenia. However, little has been published on the effectiveness of these medications in the acute treatment setting of adolescents with psychosis. Since the clinical uncertainty and poor prognosis proceeding the early onset of schizophrenia has a significant impact on a child’s development, there is a critical need for evidence-based data on this population. The aim of our study was to investigate the effect of various antipsychotics on young patients admitted to the inpatient ward presenting with acute psychosis.

Methods

A retrospective analysis was performed …

Assessment Of The European Hernia Society Classification Of Ventral Hernias And Clinical Outcomes, Oluwatunmininu A. Anwoju, Ashtyn Barrientes, Connor Hogan, Erik Askenasy, Jacob Greenberg, Keith Jerrod, Scott J. Roth, Zuhair Ali, Mike K. Liang

HCA Healthcare Journal of Medicine

Background

Ventral hernias are a common but heterogeneous disease. Communication among key stakeholders (eg, patients, clinicians, administrators, payers, and researchers) can be augmented by a widely utilized classification system. The European Hernia Society (EHS) developed an expert-opinion-based hernia classification system organized by hernia type (primary versus incisional) and size. We sought to assess what components of the EHS ventral hernia classification system were correlated to real-world clinical outcomes.

Methods

This was a multicenter cohort study. All hospitals contributing to the database were affiliated with 1 of 6 academic institutions. All adult patients who underwent ventral hernia repair over a 4-year …

Second Generation Antipsychotics And Cardiovascular Adverse Effects: Developing Evidence-Based Recommendations For Primary Care Medicine, Sana Borda, Ahn-Dao Lee, Paul F. Bell

HCA Healthcare Journal of Medicine

Background

Second-generation antipsychotic medications (SGAs) are often used by primary care physicians (PCPs) to treat multiple psychiatric diagnoses. SGAs have been connected to a number of adverse effects, including cardiovascular disease. Currently, there are no published evidence-based recommendations addressing SGAs and cardiotoxicity that are directed toward PCPs. This project aims to fill this gap.

Methods

Relevant search terms related to SGAs and cardiovascular disease were identified and then used to search databases (PubMed, PubMed Central, and AccessMedicine). Research studies obtained from the searches were narrowed to include systematic reviews and meta-analyses. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool was …

Sars-Cov-2 Vaccination Can Only Be Held Responsible For Thrombotic Thrombocytopenic Purpura After All Differentials Have Been Ruled Out, Josef Finsterer

HCA Healthcare Journal of Medicine

This letter to the editor addresses limitations to holding COVID vaccines responsible for the diagnosis of thrombotic thrombocytopenic purpura and discusses the potential differential diagnoses that must be considered.

Satisfaction Of Excellent Service Training Participants With The Kirkpatrick Model At Alia Hospital Depok, Nur Fadilah Dewi

Jurnal Vokasi Indonesia

The study aims to improve the quality of human resources and services at Alia Hospital Depok through evaluation of training programs. The approach used is the Donald Kirkpatrick model evaluation which is a common method used in evaluating the effectiveness of training. The main problem faced by Alia Hospital Depok is the lack of evaluation conducted on the training programs that have been held. Therefore, training evaluation needs to be considered to improve the quality of human resources and services provided. The research method used is a survey by distributing questionnaires to service excellent training participants to evaluate their reactions …

Learning Paradigms For Rhythm Detection And Generation Using Mathematical Models, Biophysical And Artificial Neural Networks, Prianka Bose

Dissertations

Humans possess an inherent ability to recognize evenly-spaced rhythms, known as isochronous rhythms, owing to the brain's predisposition to entrain to external auditory stimuli with regular temporal intervals. The central focus of this research is to understand how the brain learns and retains rhythmic time intervals in the context of music. This dissertation studies rhythm detection and generation through mathematical models, biophysical networks, and artificial neural networks, addressing both isochronous and non-isochronous patterns.

A primary focus of the thesis is on isochronous rhythms. In particular, given a perturbation to an isochronous rhythm such as a tempo change or phase shift …

A Case Report Of Long-Latency Evoked Diaphragm Potentials After Exposure To Acute Intermittent Hypoxia In Post-West Nile Virus Meningoencephalitis, Joseph F. Welch, Erica A. Dale, Jayakrishnan Nair, Paul W. Davenport, Emily J. Fox, Gordon S. Mitchell

Department of Physical Therapy Faculty Papers

We present a case report of a 42-year-old female with post-West Nile virus meningoencephalitis who exhibited unique, long-latency diaphragm potentials evoked by transcranial and cervical magnetic stimulation after exposure to acute intermittent hypoxia (AIH). The subject was recruited for a study investigating AIH effects on respiratory motor function in healthy individuals. She had contracted West Nile virus infection 5 years before assessment that resulted in hospitalization and persistent allodynia but was not reported to the research team. During the study, transcranial (TMS) and cervical (CMS) magnetic stimulation were performed before and 30-60 min after a single presentation of AIH [15, …