Medicine and Health Sciences Commons^™

The Relationship Between Individualised Speed Thresholds And Changes In Aerobic Fitness In Elite Professional Youth Soccer Players. A Case Study, Ronan Kavanagh, Kevin Mcdaid, David Rhodes, Jill Alexander, Damian Harper, Rafael Oliveira, Kieran Berry, Mark Connor, Piotr Zmijewski, Ryland Morgans

Baltic Journal of Health and Physical Activity

Background: This study aimed to examine the dose-response relationship between training load and aspects of physical fitness in English Premier League (EPL) U23 soccer players. Materials and Methods: Seven male EPL U23 outfield soccer players (age 20.1±1.1 years) participated in this study and performed the Bronco test on five occasions within one season. Individualised running thresholds were employed using maximal aerobic speed (MAS), anaerobic speed reserve (ASR) and maximal sprint speed (MSS) values utilising a GPS system. Results: No significant differences in the Bronco performance between the tests (p > 0.05, ES = 0.101) were observed. Distance covered above 30% …

Anatomy In Ink, Gabriel Scally

HCA Healthcare Journal of Medicine

In the intersection of medicine and art lies a profound synergy that nurtures both professional and personal well-being. This piece embodies this connection through a detailed and abstract representation of the human body and its complexities. At the center of the piece, the gross anatomical depiction of the head and neck serves as a nod to the foundational knowledge in medicine. Surrounding this central figure is an intricate conglomeration of medical elements, including the inner ear canal, a fetus, a hand, an eye, the brain, nerves, chemical elements, microbiology, and excerpts from the Hippocratic Oath, tying together aspects from basic …

Harmonizing Innovation: The Beatles, Emi, And The Birth Of Computed Tomography Imaging, Matthew A. Daniel, Alexander Holland, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Computed tomography (CT) imaging has become a cornerstone of modern medical diagnostics, thanks to the groundbreaking work of Sir Godfrey Hounsfield. However, the significant role played by his employer, Electric and Musical Industries (EMI), in providing financial support for his research is often overlooked. In this paper, we explore the connection between EMI's success in the music industry, particularly its signing of the Beatles, and Hounsfield's pioneering work on CT imaging. EMI’s success in the music industry provided the financial stability for Hounsfield's research endeavors. In 1971, he developed the first CT scanner, which revolutionized diagnostic medicine. His collaboration with …

Ethical Considerations Of Percutaneous Endoscopic Gastrostomy Tube Placement In A Patient With Creutzfeldt-Jakob Disease And Advanced Dementia, Toni Habib, Niamh Siobhán Mulrooney, Yisroel Grabie, Mohammad Maruf, Sophia Kasapira

HCA Healthcare Journal of Medicine

Background

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative condition that is not easily diagnosed and has no curative treatments available, essentially requiring palliative measures, including tube feeding. Nonetheless, data shows that the endoscope used for percutaneous endoscopic gastrostomy (PEG) tube insertion can be a vector for CJD transmission.

Case Presentation

We discuss the case of an elderly patient diagnosed with CJD, requiring tube feeding. Multiple specialists were consulted, and they were unable to reach an agreement on the best approach. Eventually, the hospital ethics committee intervened, and the family agreed to comfort measures only. This case report sheds light …

The Black Fungus: A Rare Case Of Pulmonary Mucormycosis, Stephanie Wong, Elsa Lesley Tchouambou Pougoue, Joanna Polanco, Betty Kirimi, Choudhry Poonam

HCA Healthcare Journal of Medicine

Background

Mucormycosis, commonly known as the "black fungus," is a severe infection affecting multiple organ systems, including the skin, brain, lungs, and gastrointestinal tract. This case report is focused on pulmonary mucormycosis, which is frequently observed in organ transplant recipients. Diagnostic challenges arise from nonspecific symptoms.

Case Presentation

Our case involved a 61-year-old male with a history of renal transplantation. The patient initially presented with a persistent cough and bloody sputum and was treated unsuccessfully for a presumed fungal infection. A lung biopsy confirmed pulmonary mucormycosis, emphasizing the heightened vulnerability of immunocompromised individuals.

Conclusion

This case highlights the intricate nature …

Plasma Cell-Rich Lymphoid Neoplasm In An Endocervical Polyp Of The Uterine Cervix In A Perimenopausal 52-Year-Old Woman, Anjali Patel, Jacqueline Haas, Angela Kueck

HCA Healthcare Journal of Medicine

Background

The adaptive immune system consists of T and B lymphocytes, with some B lymphocytes further differentiating into plasma cells that secrete antibodies and make up the humoral immune system. Extramedullary plasmacytoma, mucosa-associated lymphoid tissue (MALT) lymphoma, and plasmablastic lymphoma are all plasma cell-rich lymphoid neoplasms that rarely present in the female genital tract. To date, few case reports of these malignancies arising within the uterine cervix exist.

Case Presentation

This case report describes a 52-year-old perimenopausal woman who presented to her primary obstetrician-gynecologist for an annual exam with the complaint of light spotting following an endometrial ablation that occurred …

Terlipressin-Induced Hyponatremic Seizures In A Patient With Congenital Hepatic Fibrosis, Luca Gauci, Jorge Gafa, Suzanne Cauchi, Jurgen Gerada

HCA Healthcare Journal of Medicine

Introduction

Acute variceal bleeding from portal hypertension is one of the most serious complications with a mortality rate of 15% to 25%. Terlipressin is a vasopressor that controls variceal bleeding by lowering the portal pressure and reducing blood flow to the varices.

Case Presentation

We report a case of a patient with acute variceal bleeding, treated endoscopically and with terlipressin, who developed severe hyponatremia and seizures requiring admission to intensive care. Clinical and biochemical improvements were noticeable upon the cessation of terlipressin, with an eventual discharge from the hospital.

Conclusion

Prompt management of acute variceal bleeding with both endoscopic and …

Blind Nasal Intubation As A Rescue Strategy In Difficult Airway Management, Riaz Chowdhury, Ashalatha K. Nair, Dheeraj Kamalam, Rohit Jaishankar

HCA Healthcare Journal of Medicine

Background

Airway management in emergency situations poses significant challenges, particularly in patients with difficult airway anatomy or comorbid conditions. Blind nasal intubation has been explored as a rescue technique when conventional methods fail. Masseter muscle rigidity (MMR), characterized by significant jaw muscle stiffness, is a recognized complication following succinylcholine administration that can complicate traditional approaches to securing an airway.

Case Presentation

A 75-year-old man with multiple comorbidities, including hypertension, prior stroke with paralysis, dementia, and a seizure disorder, presented with acute hypercapnic hypoxemic respiratory failure requiring emergent intubation. Orotracheal intubation failed due to trismus despite etomidate, succinylcholine, and rocuronium. Nasal …

Sustained Supraventricular Tachycardia While In Active Phase Labor, Austin Gold, Mona Sadek

HCA Healthcare Journal of Medicine

Background

Supraventricular tachycardia (SVT) is one of the most common tachyarrhythmias found in young women, and SVT can be exacerbated by pregnancy. The symptoms associated with SVT frequently overlap with physiologic changes and symptoms of pregnancy which can lead to delayed or missed diagnosis.

Case Presentation

We describe the presentation and the acute management of a patient who had sustained SVT that developed during the active phase of labor. We then detail the varying management approaches of SVT in pregnancy and labor as well as refractory management options. Maternal monitoring will also be discussed as this case shows how an …

The “Wearing Off” Phenomenon For Rasagiline, Entacapone, Carbidopa, And Levodopa In The Setting Of Parkinson’S Disease, Ryan Cromwell, Tevin Um

HCA Healthcare Journal of Medicine

Background

Parkinson’s disease is a primary neurological dysfunction syndrome in which the body’s natural production of dopamine is reduced. Therapeutic intervention for this disease primarily includes medications that increase the body’s natural production of dopamine. These medications can have side effects, requiring constant titration based on the patient’s symptoms.

Case Presentation

We report a case study of a 75-year-old man diagnosed with Parkinson’s disease who had a profound acute exacerbation of psychological symptoms following modifications to his dopaminergic treatment regimen. Initially, the patient was prescribed carbidopa/levodopa, rasagiline, and carbidopa/levodopa/entacapone. However, the treatment plan was adjusted due to the worsening of …

An Unusual Presentation Of Subcutaneous Inguinal Hematoma Mimicking Ovarian Torsion: A Case Report, Chrystal Stallworth, Timothy Kremer, Victoria Panzanaro

HCA Healthcare Journal of Medicine

Background

Ovarian or adnexal torsions occur when an ovary rotates around one of the supporting ligaments, often the infundibulopelvic (IP) ligament. This rotation can cause the blood flow to the ovary to be hindered, and this decrease in perfusion can often present as adnexal pain, nausea, and vomiting. A significant risk factor for developing an ovarian torsion is the presence of an ovarian mass, such as a cyst. The diagnosis of ovarian torsion is a medical emergency, but symptoms typically resolve with prompt surgical intervention. Hematomas occurring within or around the inguinal region have been reported to occur primarily after …

Risk Factors Associated With Worse Outcomes In Trauma Patients Aged 55 And Older, Hector Mendez, Ilko Luque, Nicole Yordán López, Carlos Parra, Kelvin Chan, Mariel A. Javier, Marcela Ramirez, Orlando Morejón

HCA Healthcare Journal of Medicine

Background

Prior studies have shown an increase in mortality in trauma patients after 55 years of age. However, it is less certain which pre-existing comorbidities (PECs) are associated with poorer outcomes. The purpose of this study was to identify the risk factors associated with poor outcomes and death in patients 55 years old and older admitted for trauma.

Methods

Trauma patients (age ≥ 55) were studied retrospectively from the local trauma registry at HCA Florida Kendall Hospital, a level 1 trauma center (2020–22). We collected the subject’s age, gender, PECs, and outcome data. Then we performed multiple logistic regression to …

Updating A Rural Clinic In Tiburón, Haiti, Akankcha Alok, Mohamed Bakhit, Djenie Helne, Philipe Milord, Marcellas Socrate, Camil Clermont, Marie A. Kima

HCA Healthcare Journal of Medicine

Background

Tiburón is a small fishing village in Haiti with a clinic overseen by the Oblate missionaries and the Ministry of Public Health and Population (MSPP). This village was hugely impacted by Hurricane Matthew in 2016, leading to increased health care demands. The clinic was inaccessible from the furthest parts of the village and lacked basic medication supplies and adequate manpower. We aimed to reinforce the infrastructure and update the clinic using a multifaceted approach.

Methods

We developed a quality improvement project to strengthen the clinic's infrastructure and modernize its facilities with a comprehensive approach focused on enhancing health care …

Synthetic Versus Biologic Mesh For Complex Open Ventral Hernia Repair: Three-Year Follow-Up Of A Pilot Randomized Controlled Trial, Nalia H. Dhanani, Nicole B. Lyons, Kyung Hyun Lee, Oscar A. Olavaarria, Aris R. Arakelians, Julie L. Holihan, Lillian S. Kao, Ali Siddiqui, Connor Hogan, Tunmi Anwoju, Zuhair Ali, Mike K. Liang

HCA Healthcare Journal of Medicine

Background

Biologic mesh is often used in complex hernia repair, but there has been limited clinical evidence to date to support this practice. The aim of this study was to compare clinical and patient-reported outcomes of biologic versus synthetic mesh for complex open ventral hernia repair (OVHR) at 3 years.

Methods

Patients from a single center, randomized, controlled, pilot trial comparing biologic versus synthetic mesh in complex OVHR were followed for 3 years. The primary outcome focused on major complications, namely mesh infections, hernia recurrences, reoperations, and deaths. Secondary outcomes included surgical site infections, surgical site occurrences, and patient-reported outcomes. …

Impact Of A Comprehensive Palliative Quality Improvement Initiative (Icu-Pal) In A Medical-Surgical Intensive Care Unit, Aunie M. Danyalian, Michele M. Iguina, Manjot Malhi, Umair Shaikh, Sanaz B. Kashan, Dionne Morgan, Daniel Heller, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Early palliative care practice implementation in the intensive care unit (ICU) improves advance care planning, promotes patient and family satisfaction, and decreases health care costs. The consensus for protocolized palliative care delivery is unknown. We assessed the impact of a qualitive improvement educational intervention that promotes the identification of critically ill patients who will benefit from early expert palliative care interventions.

Methods

In this observational study, we examined the impact of an educational intervention that promoted (1) early detection of palliative care triggers (PCT) during ICU multidisciplinary rounds (MDRs), (2) admission and 48-hour pain assessment, and (3) family meetings …

A New Paradigm In Hospital Medicine: Evaluating The Effects Of Geographical Cohorting On Health Care Delivery, Vasu Gupta, Bhupinder Singh, Kanishk Aggarwal, Ayushi Garg, Rhea Kanwar, Fnu Anamika, Inder Preet Kaur, Rohit Jain

HCA Healthcare Journal of Medicine

Background

Geographical cohorting in hospital settings represents a significant shift from traditional patient rounding practices and aims to enhance the efficiency of health care delivery. This model assigns hospitalists to a particular inpatient unit, where most of their patients are located. While this model has several benefits, including streamlining health care procedures, optimizing resource allocation, and fostering better provider communication, its implementation is not without its challenges.

Methods

Our methodology for researching geographical cohorting involved a comprehensive literature review of peer-reviewed studies, surveys, and retrospective analyses. We utilized academic databases, such as PubMed, JSTOR, and Google Scholar, to identify relevant …

Acute Exacerbation Of Idiopathic Pulmonary Fibrosis In The Setting Of Acute Eosinophilic Pneumonia, Duncan A. Mckinney, Noah R. Kosnik, Shahzeib Syed, Gretchen Junko

HCA Healthcare Journal of Medicine

Idiopathic pulmonary fibrosis (IPF) is a progressive disease characterized by gradual destruction and replacement of pulmonary parenchyma with fibrous tissue, which occurs in conjunction with chronic inflammation. It is often considered a prototypical interstitial lung disease and is both the most prevalent and perhaps the most dangerous in that family. Although the disease is uncommon in the general population, its prevalence increases with age and is typically diagnosed around the age of 65. This does not preclude the development of IPF in younger individuals, and the mean survival is 2 to 5 years post-diagnosis regardless of age. Contemporary studies have …

Extended-Release Buprenorphine Could Overcome Barriers To Medical Treatment Of Opioid Use Disorder In At-Risk Populations, Scott A. Davis, Genevieve Verrastro, E Blake Fagan

HCA Healthcare Journal of Medicine

This article discusses how monthly extended-release buprenorphine can be used to improve the treatment of opioid use disorder (OUD). In particular, the use of monthly extended-release buprenorphine holds promise for patients who have recently been released from jail or prison and are battling OUD, those who are unstable and continue to use opioids illicitly, patients who are experiencing homelessness while also struggling with OUD, and those who are stable and want to be weaned off buprenorphine.

An Acknowledgement To The Hca Healthcare Journal Of Medicine's Reviewers And Editors For The 2nd Half Of 2024, Juan A. Sanchez, 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.

A New Chapter For The Hca Healthcare Journal Of Medicine: Elevating Our Impact And Vision, Juan A. Sanchez

HCA Healthcare Journal of Medicine

Dr Juan A Sanchez, the new editor-in-chief of the HCA Healthcare Journal of Medicine, shares his vision for elevating the journal's influence by publishing high-quality, impactful research. Moving forward, the journal will introduce new initiatives, including more special issues and invited editorial commentaries, to foster a dynamic academic environment. Dr Sanchez invites the medical community to contribute and engage with the journal to advance medical knowledge and improve health care outcomes.

Fluorescence Lifetime Imaging Ophthalmoscopy (Flio): A Novel Retinal Metabolic Biomarker For Multiple Sclerosis, Daniel Markowitz, Kylee Shivok, Elizabeth Affel, Ms, Jose S. Pulido, Md, Ms, Mba, Mph, Thomas P. Leist, Md, Phd, Gyorgy Hajnoczky, Md, Phd, Mahdi Alizadeh, Phd, Robert Sergott, Md

Farber Institute for Neuroscience Staff Papers and Presentations

Introduction

- Fluorescence lifetime imaging ophthalmoscopy (FLIO, Heidelberg Engineering, Figures 1 and 2), a novel in vivo retinal imaging biomarker, generates fluorescence decay lifetimes in 2 spectral channels corresponding to the following metabolic processes:

- Short Spectral Channel (SSC): 498 – 560 nm

• Corresponds to macular pigment, flavin adenine dinucleotide (FAD) and oxidative phosphorylation.

- Long Spectral Channel (LSC): 560 – 720nm

• Corresponds to predominantly lipofuscin and lysosomal function

- Based upon animal experimental models and clinical data, mitochondrial dysfunction has a role in the pathophysiology of both inflammatory and degenerative components of Multiple Sclerosis

Nursing Leaders’ Perceptions Of A Revised Patient Dismissal Policy, Judi L. Brendle

Walden Dissertations and Doctoral Studies

Patient aggression related to behavioral health and emotional issues is an ongoing concern in primary health care. Disruptive patient behaviors include a broad spectrum of outward conduct, from verbal violence to physical assault. The focus of the Doctor of Nursing Practice project was a quality improvement project. The purpose encompassed improving the perception of primary care nursing leaders and provider practice leadership by enhancing the current organizational policy on patient dismissal from practices. Analytical strategies included pre- and post-surveys to determine the perception of the nursing supervisors and provider practice leadership. Survey questions encompassed an understanding of the original policy, …

Thai Sugar-Sweetened Beverage Tax: Does It Really Help?, Sitaporn Suriya, Buraskorn Torut

Kesmas

A solution recommended by the World Health Organization to prevent and control noncommunicable diseases is the Sugar-Sweetened Beverage (SSB) tax. This study aimed to evaluate the Thai SSB tax efficiency affecting the change in post-tax individual-level consumption and find causal explanations for the people’s consumption behavior after the SSB tax was implemented. This study used a Productivity Model, and stratified random sampling was conducted by selecting 1,200 people. An in-depth interview was conducted to seek causal explanations for post-SSB tax consumption behavior with 15 key informants. The results revealed the SSB tax’s efficiency in terms of perception and understanding at …

Socio-Epidemiological Perspectives Of Sexual Trauma Experiences And Influential Factors On Sexual Orientation In Men Who Have Sex With Men, Rico Januar Sitorus, Misnaniarti Misnaniarti, Legiran Legiran, Rizma Adlia Syakurah, Diana Dewi Sartika, Asri Maharani, Retta Patresia

Kesmas

The complexity of sexuality and sexual trauma experiences, including harassment, unwanted touching, sexual urges, and forced sexual intercourse, should not be underestimated because of the tendency to initiate adverse psychosocial impacts. Sexual harassment can increase mental health risks, which may influence sexual orientation decisions. This quantitative study, using a cross-sectional design, aimed to determine a relationship between sexual trauma experiences and sexual orientation in men who have sex with men (MSM). This study population was MSM living in Palembang and Prabumulih City, with a sample size of 216 respondents. The proportion of respondents with homosexual orientation was 57.1%, and the …

Rotating Hinge Vs. Total Condylar “When To Decide”: A Surgical Algorithm, Benjamin Huang, Russell T. Nevins

Annual Research Symposium

Research symposium for general health topics

Single Stage Hinge Revision Total Knee Arthroplasty Of A Chronically Infected Knee: A Case Report, Benjamin Huang, Angel Oliver, Russell T. Nevins

Annual Research Symposium

No abstract provided.

Enhancing Periodontal Therapy With Non-Invasive Adjunctive Techniques A Comparative Literature Review, Stockton Stohl, Kamran H. Awan

Annual Research Symposium

No abstract provided.

Our Song: Virtual Group Songwriting With Medical Professionals, Seneca Block

Expressive Therapies Dissertations

This study investigated healthcare workers experiences in hospital provided virtual songwriting groups. Groups were led by a board-certified music therapist and prompted by one of three chosen themes from the hospital’s motto: to heal, to teach, to discover. Specifically, this work aimed to understand the role of songwriting as an arts-based intervention and its impact on aspects of workplace community with healthcare workers.

Post group interviews were conducted and analyzed, which resulted in the emergence of seven major themes including: Sense of Purpose, Point of Connection and Community, Positive Engagement and Collaboration, Enhancing Mood State and Evoking Emotions, Impact of …

Age-Based Variations In Frequent Emergency Department (Ed) Use Among Older Adults: An Analysis Using The New York University–Johns Hopkins University Emergency Department Algorithm (Nyu/Jhu-Eda), Uma Kelekar, Amel Ben Abdesslem, Debasree Das Gupta, Diep Tran, Jewel Shepherd, Sidney Carl Turner

Kinesiology and Health Science Faculty Publications

Population aging impacts the utilization of health services, especially in Emergency Departments (EDs). A rising share of older adults in the US report ED use, especially frequent ED use, defined as ≥ 4 visits annually. Prior works have examined frequent utilization of EDs among geriatric populations, but no study has focused on age-based trends or examined type of ED care sought by different age groups. Thus, using the 2017-2019 State Emergency Department Databases (SEDD), we examined how types of ED care influenced frequent ED utilization among geriatric patients in Maryland across the three age groups of youngest-old (65–74), middle-old (75–84), …

Reduction Of Prostate Cancer Risk: Role Of Frequent Ejaculation-Associated Mechanisms., Mohamed Hassan, Thomas W. Flanagan, Abdulaziz M. Eshaq, Osama K. Altamimi, Hassan Altalag, Mohamed Alsharif, Nouf Alshammari, Tamadhir Alkhalidi, Abdelhadi Boulifa, Siraj M. El Jamal, Youssef Haikel, Mossad Megahed

School of Medicine Faculty Publications

Simple Summary: There is considerable evidence to suggest that frequent ejaculation reduces the risk of prostate cancer. The more frequently ejaculation occurs without risky sexual behavior, the lower the risk of prostate cancer. The mechanisms regulating the reduction in PCa risk associated with frequent ejaculations are attributed to the suppression of the sympathetic nervous system, resulting in a relief of tension and a slowing of the division of prostate epithelial cells. It is suggested that ejaculation frequency affects gene expression in prostate tissue and subsequently influences the susceptibility of the tissue to tumor formation, leading to a reduction in the …