Medicine and Health Sciences Commons^™

Longitudinal Meta-Cohort Study Protocol Using Systems Biology To Identify Vaccine Safety Biomarkers, Joann Diray-Arce, Ana C Chang, Sara Moradipoor, Donato Amodio, Bruce Carleton, Wan-Chun Chang, Nigel W Crawford, Meagan Karoly, Annmarie Hoch, Kerry Mcenaney, Tahir S Kafil, Mahitha Donthireddy, Sarah K Steltz, Simon D Van Haren, Asimenia Angelidou, Kinga K Smolen, Hanno Steen, Jessica Lasky-Su, Huyen Tran, Peter Liu, C Buddy Creech, Clare L Cutland, Helen Petousis-Harris, Ishac Nazy, Rae S M Yeung, Sonali Kochhar, Steve Black, Nicholas Wood, Dale Nordenberg, Paolo Palma, Inna G Ovsyannikova, Richard B Kennedy, Gregory A Poland, Al Ozonoff, Robert T Chen, Ofer Levy, Karina A Top, International Network Of Special Immunization Services (Insis) Members

Faculty, Staff and Students Publications

The International Network of Special Immunization Services (INSIS) was established to investigate the causes and risk factors of rare adverse events following immunizations (AEFIs) and develop immunization strategies for mitigating or preventing risk for individuals with prior AEFIs or at risk of AEFIs. INSIS integrates clinical data with multi-omic technologies (e.g., transcriptomics, proteomics, metabolomics) through a global consortium of clinical networks, leading immunology, pharmacogenomics teams to uncover the molecular mechanisms behind AEFIs. The network ensures accurate and standardized data collection and analysis through rigorous data management and quality assurance processes. INSIS also implements harmonized case definitions and protocols for collecting …

Factors Associated With Erectile Dysfunction In Men With Lower Urinary Tract Symptoms (Luts): A Symptoms Of Lower Urinary Tract Dysfunction Research Network (Lurn) Study, Devin Boehm, Abigail R. Smith, Sarah A. Mansfield, Kathryn E. Flynn, Richard J. Fantus, Alexander P. Glaser, Brian T. Helfand, Margaret Helmuth, Tara N. Morgan, H. Henry Lai, Aruna V. Sarma, Claire C. Yang, Ziya Kirkali, James W. Griffith

2020-Current year OA Pubs

BACKGROUND: Erectile function (EF) and its associated covariates have not been extensively studied in a large covariate of patients seeking treatment for lower urinary tract symptoms (LUTS). Our objective is to determine the relationship between urinary symptoms and comorbidities with erectile dysfunction (ED) in 447 treatment-seeking men with LUTS.

METHODS: Data from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) observational cohort study were analyzed using multivariable logistic regression models to quantify the relationship between LUTS and ED. Models also included anxiety, depression, obesity, cardiovascular disease (CVD), diabetes, and medication use.

RESULTS: Men reporting sexual activity were younger …

Drug-Drug Interaction Between Dolutegravir And Artemether-Lumefantrine In Hiv And Malaria Mono- And Co-Infections: A Pharmacogenetic Analysis From Ghana, Nicholas Ekow Thomford, Tracy Kellermann, Joel Adu Twum, John Anyimadu, Charné Dixon, Dennis Sappor, Dee Blackhurst, Prince Amoah Barnie, Oksana Ryabinina, Samuel Badu Nyarko, Robert Peter Biney, Martins Ekor, George B Kyei

2020-Current year OA Pubs

BACKGROUND: Human Immunodeficiency Virus and malaria are significant public health challenges in sub-Saharan Africa, contributing substantially to morbidity and mortality in the region. The trajectory of HIV and malaria mono- and coinfections may be different with presentations of drug-drug and disease-disease interactions. Current medications of artemether-lumefantrine and dolutegravir (DTG) -based anti-retroviral therapy which are the preferred drugs are metabolised by CYP2B6, CYP3A4/5 and UGTs which are polymorphic and may contribute to drug disposition and clinical outcomes. This study investigated the pharmacogenetic effects of co-administration of arthemeter-lumfantrine and DTG in HIV-malaria mono and coinfection.

METHODS: Malaria and HIV mono- and coinfected …

Gambaran Faktor Risiko Waktu Terapi Radiasi Yang Berkepanjangan Pada Pasein Kanker Payudara: Studi Cross-Sectional Di Rsup Dr. Kariadi Tahun 2023, Zahra Zetira Muchtar, Asri C. Adisasmita, Dion Firli Bramantyo

Jurnal Epidemiologi Kesehatan Indonesia

In Indonesia, there were more than 58,000 new breast cancer cases with nearly 23,000 deaths in 2020. Radiotherapy is one of the adjuvant therapy modalities for breast cancer. Interruptions of more than five days increase the risk of local recurrence. This study aimed to describe the risk factors associated with prolonged overall treatment time (OTT) in breast cancer patients at Dr. Kariadi General Hospital during 2023. This was a cross-sectional study using bivariate logistic regression analysis to examine the association between national holidays, deterioration of general condition, age, residence, and type of surgery prior to radiation therapy with prolonged OTT. …

Covered Stent Salvage For Iatrogenic Vertebral Artery Injury In Traumatic Cervical Spine Injury: A Case Report And Literature Review, Tzu-Hao Yen, Wei-Liang Chen, Ying-Lin Tseng, You-Pen Chiu, Hui-Ru Ji, Jeng-Hung Guo, Cheng-Di Chiu

BioMedicine

We report the case of a 70-year-old woman who sustained complex traumatic injuries in a motor vehicle accident, including cervical spine fractures and a high suspicion of traumatic vertebral artery injury (VAI). Initial digital subtraction angiography (DSA) revealed no evidence of vertebral artery (VA) involvement. She subsequently underwent anterior cervical discectomy and fusion (ACDF); however, an iatrogenic injury to the right VA occurred intraoperatively, necessitating emergent endovascular stenting for vascular repair. This case underscores the importance of comprehensive preoperative imaging, intraoperative vigilance, and coordinated multidisciplinary management in cervical spine trauma with potential vascular involvement.

Endoscopic Management Of Ureteric Stenosis And Calculi In Bilateral Incomplete Renal Duplication: A Case Study, Hafeez Sohaib Ahmad Warraich, Zirwa Younis, Jawairia Warraich, Khizra Warraich

BioMedicine

Renal duplication anomalies are one of the most frequent congenital urological conditions in the general population all over the world. Bilateral incomplete duplication, however, is exceedingly rare. We present a case of a 29-year-old female with bilateral incomplete duplex kidneys complicated by mid-ureteric stenosis on the right side and calculi in the left ureter and upper moiety of the left duplex kidney. Diagnostic imaging, including ultrasound, computed tomography (CT), and intravenous urography (IVU) confirmed these findings. The patient underwent successful bilateral ureteroscopy (URS) and left-sided retrograde intra-renal surgery (RIRS) for management of the above mentioned complications related to the duplex …

Effect Of Garcinol Against Arsenic-Induced Neurobehavioral Alterations And Liver And Kidney Dysfunction In Albino Mice, Abdulmohsen I. Algefare

BioMedicine

The extended exposure to inorganic arsenic is commonly linked to brain damage through oxidative and apoptotic processes. The compound known as Garcinol (GCL) has garnered significant interest due to its potential advantages for human well-being. Nevertheless, the ability of GCL to protect against toxicity generated by arsenic in the brain has not yet been investigated. Hence, our study aimed to examine the neuroprotective effectiveness of GCL in mitigating the detrimental impacts of sodium arsenite (SA) on behavioral patterns, the molecular mechanisms, apoptotic markers, and oxidative stress parameters in the brain, liver, and kidney of mice. The mice were categorized into …

Investigating The Association Between Hyperthyroidism And The Risk Of Herpes Zoster In A Cohort Study In Taiwan, Shih-Wei Lai, Yu-Hung Kuo, Kuan-Fu Liao

BioMedicine

Background: The aim of this cohort study was to investigate the association between hyperthyroidism and the likelihood of developing herpes zoster in Taiwan.

Methods: Using the National Health Insurance Research Database (NHIRD) in Taiwan, we selected individuals aged 20-84 who were newly diagnosed with hyperthyroidism between 2013 and 2020 as the hyperthyroidism group. These individuals were then matched with a control group without hyperthyroidism in a 1:1 propensity score matching for sex, age, and baseline comorbidities. The occurrence of herpes zoster was tracked in both groups until the end of the study period or until a diagnosis of herpes zoster …

An Investigation Into The Potent Anticancer, Antimicrobial, And Anti-Inflammatory Activities Of A Punica Granatum Nanoemulgel, Ahmad M Eid, Murad Abualhasan, Yara Khaliliya, Zeina Sinan, Aya Khaliliya

BioMedicine

Purpose: The objective of this study is to formulate a nanoemulgel using Punica granatum (P. granatum) seed oil and study the antibacterial, anticancer, and anti-inflammatory properties. Methods: The process to formulate a nanoemulsion from P. granatum seed oil involved using the self-nanoemulsifying technique, with Span 80 and Tween 80 serving as the emulsifying agents. Carbopol hydrogel was combined with the nanoemulsion to produce the nanoemulgel. The particle size, polydispersity index (PDI), rheological behavior, antibacterial, cytotoxic, and anti-inflammatory properties were subsequently examined.

Results: The nanoemulsion formulation with a PDI of 0.229 and a particle size of 189.44 nm was …

Metabolomics In Cancer Detection: A Review Of Techniques, Biomarkers, And Clinical Utility, Kavitha Liegelin Bernhardt, Janita R. T. Pinto

BioMedicine

Cancer poses a significant burden on global public health, contributing to high mortality rates worldwide. Ongoing diagnostic strategies have predominantly relied on imaging techniques, histopathological examination and molecular analyses which have limitations in sensitivity, and specificity. Early cancer detection is a pivotal determinant of successful treatment and patient survival rates. Metabolomic applications involve the comprehensive analysis of metabolites to understand the metabolic profile of an organism, tissue, or cell under different conditions such as lack of oxygen in tumors. The aim of this review is to provide an extensive approach of metabolomic applications in early cancer detection and to provide …

Recent Updates On Orally Disintegrating Films Regarding Design, Characterization, And Assessment, Asmaa Abdelaziz Mohamed, Firas Aziz Rahi

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Orally disintegrating films (ODFs) are a pharmaceutical dosage form that liquefies or disintegrates rapidly in the mouth without water, creating an attractive option for patients with difficulty swallowing. ODFs offer several advantages, including convenience, a faster onset of action, and enhanced patient compliance.The formulation of ODFs involves selecting suitable film-forming polymers, plasticizers, active pharmaceutical ingredients (APIs), and other excipients. Factors such as taste-masking, stability, and disintegration time are critical considerations in formulating ODFs. Characterization of Orally Disintegrating Films Characterization techniques such as thickness measurement, tensile strength testing, disintegration time determination, and surface morphology analysis are essential for assessing the physical …

Gc-Ms Analysis Of Bioactive Constituents From The Leaves Of Portulaca Afra Jacq. And Portulaca Grandiflora Hook, Sadeq S.K.Al-Taie, Noor F.M. Al-Kenane, Zaidon T. Al-Aqbi

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Portulaca afra and Portulaca grandiflora are traditional medicinal that grow as ornamental plants in Iraq. The present study was conducted for GC-MS analysis of the leaves of these plants to identify possible bioactive compounds. Seventy-nine compounds were recorded in the methanolic extract in Portulaca afra and ninety-two in Portulaca grandiflora. A literature survey revealed that some compounds 4-Vinylphenol, gamma-Sitosterol, Neophytadiene, n-Hexadecanoic acid, Octadecanoic acid, Phytol, Stigmasterol and Tetradecanoic acid possess a variety of biological qualities, including antioxidant, anti-inflammatory, anti-fungal, and anti-cancer effects.

Can Coffee Combat Fatty Liver? A Review Of Emerging Evidence, Mohamed E. Abd El-Hack, Muhammad Arif, Vincenzo Tufarelli, Ayman A. Swelum

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

NAFLD (Non-alcoholic fatty liver disease) is an increasingly spread metabolic status characterized by increasing fat accumulation in the liver, obesity closely associated with it, sedentary habits and insulin resistance. Since there is currently no recognized pharmaceutical treatment, lifestyle changes continue to be the mainstay of treatment. Coffee, a globally consumed beverage rich in bioactive and useful compounds like caffeine, cafestol, kahweol, and chlorogenic acids, has emerged as a potential hepatoprotective agent. Evidence from epidemiological experiments, animal studies, and human trials suggests that regular coffee drinking may help decrease hepatic fat levels, improve antioxidant defenses, prevent inflammatory pathways, and prevent or …

In Silico Evaluation Of Nigella Sativa Phytocompounds As Potential Modulators Of Estrogen Receptor Alpha: A Molecular Docking And Admet Study, Murtala Muhammad Jibril, Samuel Otokpa Ede, Ekwere O. Ekwere

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Background: Reproductive dysfunction among women remains a pressing global health issue, often linked to hormonal imbalances involving estrogen receptor alpha (ERα). Nigella sativa has garnered scientific interest due to its diverse phytochemical composition and potential reproductive health benefits. Objective: This study aimed to evaluate selected bioactive compounds from Nigella sativa oil as potential modulators of ERα using advanced computational methods. Methods: A structure-based drug discovery approach was employed. Ten phytocompounds were identified through literature mining and subjected to molecular docking against ERα. Clomiphene citrate, a known selective estrogen receptor modulator (SERM), served as the reference ligand. Binding affinities were analyzed, …

Quality Of Life Among Type Ii Diabetes Mellitus Patients, Duaa Dhia Hameed Al-Baghdadi, Rajha Abdul Hassan Hamza

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Background: Type 2 diabetes mellitus (T2DM) is a significant public health concern Approximately 90% of people with diabetes worldwide have diabetes mellitus type 2. Methods: A cross-sectional study was conducted from October 23, 2023, to March 2, 2025, in Al-Najaf Al-Ashraf City to assess the quality of life among individuals with T2DM. A non-probability sampling technique (purposive sampling) was used to select 167 T2DM patients. Data were collected through a questionnaire, which consisted of three parts: Part I covered sociodemographic information, Part II focused on clinical data, and Part III addressed the quality of life among T2DM patients by using …

Advanced Database Searching, Sandra Y. Desjardins

Library Class: Lunch & Learn

Master the art of finding relevant research articles. This 30-minute class focuses on building strong search strategies using Medline, Web of Science, and Embase. Develop essential skills in concept building to uncover critical information for your research project.

Message In A Bottle, Saptarshi Biswas

HCA Healthcare Journal of Medicine

The title of the image is inspired by a famous old song by the British rock band The Police. The song featured Sting’s evocative lyrics and captures a profound sense of isolation and longing. The song tells the story of a castaway who sends out a distress signal, only to discover that he is not alone in his feelings of loneliness. Through its haunting melody and rhythmic pulse, the track conveys themes of connection and the human experience, illustrating how, despite physical separation, people share similar struggles and emotions. The metaphor of the bottle serves as a poignant reminder of …

Multi-Center Survey Of Medicine Residents And Self-Assessment On Cardiac Complications In Obstetric Patients, Kevyn Niu, Christie A. Tran, Robert J. Subbiondo Md, Olubenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Internal medicine (IM) residents receive significant cardiology training, and previous surveys have evaluated IM resident competency on obstetric (OB)-related subjects. However, there is minimal literature on self-reported competence of cardiac-specific complications in OB patients. Our study assessed self-reported comfort and competency regarding cardiovascular complications in OB patients with medical residents across several specialties.

Methods

We surveyed 207 residents across 3 specialties and 3 teaching hospitals on 10 questions regarding their self-reported confidence in managing cardiovascular complications in OB patients, including practice setting, specific cardiac issues, and stages of labor. We received 42 responses. Results were obtained using Google Sheets …

Nondominant Right Coronary Artery Occlusion Leading To An Anterior St-Segment Elevation Myocardial Infarction, Taha Ahmed, Taylor Wood, Austin Harris, Rajan Desai, Garima Handa, Naoki Misumida, Amartya Kundu

HCA Healthcare Journal of Medicine

Background

A nondominant right coronary artery supplies a small portion of the myocardium. Albeit rare, an acute occlusion of a nondominant right coronary artery is believed to be inconsequential with minimal clinical relevance.

Case Presentation

We present a case of a middle-aged man who presented with chest pain and an electrocardiogram demonstrating anterior ST-segment elevation. An emergent coronary angiogram revealed acute thrombotic occlusion of the proximal nondominant right coronary artery with no significant obstructive atherosclerotic disease in the dominant left coronary circulation. Balloon angioplasty of the occluded vessel followed by implantation of a drug-eluting stent resulted in the resolution of …

Ovarian Dysgerminoma With Tubo-Ovarian Torsion In An 11-Year-Old Child: A Rare Occurrence But A Significant Differential Diagnosis In Acute Abdomen, Charu Chandra, Keeranmayee Mishra, Rahul Mangal, Chirag Doshi, Apurba Anshuman Mishra

HCA Healthcare Journal of Medicine

Background

Ovarian tumors are quite uncommon in the premenarchal age group, with the majority being functional cysts. Malignant tumors are unusual in this age group, making the diagnosis of ovarian malignancy in children quite challenging. Dysgerminoma is the most common malignant ovarian germ cell tumor in females. The clinical symptoms often include abdominal pain, distension, a palpable mass, reduced appetite, nausea, and vomiting.

Case Presentation

We discuss the case of an 11-year-old premenarchal girl who was brought to the emergency department with abdominal pain persisting for 3-4 days, which had intensified over the 24 hours before she arrived at the …

Brown Umbilical Nodule: A Case Of Primary Cutaneous Endometriosis, Richard G. Bindernagel Jr., Aleia Boccardi, Taylor C. Jindia, Parth Patel, Jaimie Bryan, Addie Walker, Summer Moon, Richard Miller

HCA Healthcare Journal of Medicine

Background

Endometriosis is a common condition in which endometrial glands and stroma are implanted outside the uterine cavity. Rarely, the skin can be involved.

Case Presentation

We describe a case of a 41-year-old woman who presented to the dermatology clinic complaining of a brown umbilical nodule with slight erythema. It was occasionally painful and hemorrhagic. She denied a history of endometriosis and abdominal surgeries. A shave biopsy of the nodule was consistent with a diagnosis of cutaneous endometriosis. The patient was referred to her gynecologist for further evaluation and treatment.

Conclusion

This unique case demonstrates primary cutaneous endometriosis in the …

Sevoflurane In Status Asthmaticus: A Case Report And Literature Review, Amelia L. Gurley, Thomas W. Church, Sana Hadyah, Brandon Abrajan, Julia Cheree Glavinic

HCA Healthcare Journal of Medicine

Background

Sevoflurane and other inhaled anesthetics are gradually entering provider awareness as rescue therapies for patients in refractory status asthmaticus. This paper documents a case report and a literature review involving the use of sevoflurane to treat status asthmaticus.

Case Presentation

A 27-year-old man presented to the emergency room in acute hypoxic respiratory failure due to status asthmaticus, refractory to multiple therapies and requiring intubation. He was successfully extubated following sevoflurane administration in the operating room, and his care was complicated by transient hypotension. A multidisciplinary effort was critical in ensuring successful and timely therapy.

Methods

We performed a literature …

Educational Point-Of-Care Ultrasound Discovers Adrenal Cortical Carcinoma, A Case Report: Clinical Implications And Review Of The Literature, Minh Q. Nguyen, Moshe Bengio, Vu H. Tran

HCA Healthcare Journal of Medicine

Introduction

Point-of-care ultrasound (POCUS) has become an indispensable tool for emergency physicians in assessing intra-abdominal pathology due to its real-time visualization, portability, and cost-effectiveness. While POCUS is not traditionally focused on adrenal gland assessment, incidental findings of adrenal masses during examinations have been reported. Our patient presented with a chronic obstructive pulmonary disease (COPD) exacerbation and was found to have a large adrenal mass, discovered incidentally, during thoracic ultrasound.

Case Presentation

This case report presents the discovery of an adrenal mass in a patient with respiratory distress due to a COPD exacerbation, emphasizing the importance of sonographers’ ability to identify …

A Complex Case Of A Large Fibroid Uterus Compressing The Inferior Vena Cava Causing Recurrent Deep Vein Thrombosis And Pulmonary Embolisms, Jessica Gil, Jessica Klingensmith, Lauren Hendrix, Patrick J. Stocker, Olugbenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Uterine fibroids have been found to increase the risk for venous thromboembolism. There have been other case reports linking large uterine fibroids, pulmonary embolisms, and deep vein thrombosis (DVT) together due to compression of blood vessels and increased venous stasis. This case report will discuss a case of a large fibroid uterus compressing the inferior vena cava causing a patient with few risk factors to have recurrent DVTs and pulmonary embolisms.

Case Presentation

The patient was a 35-year-old woman who presented with repeated unprovoked thrombosis episodes. The patient had a full workup after the first episode of DVT and …

Using Dexcom G7 In Critically Ill Infant With Hyperinsulinemia On High Frequency Oscillatory Ventilation Support, Chad E. Ward, Timothy Clark, Eric Velezquez

HCA Healthcare Journal of Medicine

Introduction

Life threatening hypoglycemia can occur during critical illness in infants with underlying hyperinsulinemia or metabolic conditions, such as glycogen storage diseases. Using a continuous glucose monitor (CGM) can provide insight into glycemic trends with this high-risk patient population in the intensive care setting. Barriers to usage of CGMs in the intensive care unit include familiarity with CGMs devices among staff, safety, and cost.

Case Presentation

We describe the first reported case of safely utilizing the newest Dexcom G7 continuous glucose monitor in an infant with hyperinsulinemia undergoing high frequency oscillatory ventilator (HFOV) support for acute respiratory distress syndrome (ARDS) …

A Case Report And Evaluation Of Intrauterine Gas Of Unknown Origin, Chrystal Stallworth, Diane Gilbertson, Michele L. Mccarroll, Timothy Kremer

HCA Healthcare Journal of Medicine

Introduction

Most reports of intrauterine or endometrial gas have been reported in the setting of underlying gynecologic malignancy or infection. The significance of this case report is to give a presentation of a patient presenting with intrauterine gas who subsequently was identified as having neither an infectious nor malignant cause for such a finding.

Case Presentation

The patient is a 56-year-old postmenopausal woman who presented with “hip pain” and was found to have incidental intrauterine gas on a pelvic computed tomography. She underwent in-office and outpatient hysteroscopies with resection of a submucosal fibroid. Her final pathology was returned as benign, …

Recurrent, Acute Limb Ischemia Secondary To Arterial Thrombosis: A Devastating Complication In The Setting Of Severe Covid-19 Infection, Shaikh Afaq, Kyle S. Strouse, Sini Saju, Olugbenga Oyesanmi, Mohamad Eid, Salman Muddassir

HCA Healthcare Journal of Medicine

Background

COVID-19 infection, particularly with the Delta variant, has been associated with a heightened risk of thromboembolic events due to a profound hypercoagulable state. While venous thrombosis is more commonly reported, arterial thrombosis—including acute limb ischemia—has emerged as a serious complication with significant morbidity and mortality.

Case Presentation

We report the case of a 53-year-old man with severe COVID-19 pneumonia who developed recurrent acute limb ischemia secondary to an aortic mural thrombus. Despite therapeutic anticoagulation and multiple surgical interventions—including thrombectomy, angioplasty, and stenting—the patient experienced repeated episodes of arterial thrombosis. His clinical course was further complicated by pneumothorax and hemothorax, …

Understanding Challenges Faced By Female Graduate Medical Education Trainees: A Qualitative Content Analysis Of Physician Coaching Requests, Nathalie Dieujuste, Adrienne Mann, Kimiko Dunbar, Pari Shah Thibodeau, Tyra Fainstad, Brooke Dorsey Holliman

HCA Healthcare Journal of Medicine

Background

Physician burnout, particularly among female graduate medical education (GME) trainees, is a growing concern that affects physician wellness and patient safety. Professional coaching has shown promise in improving physician wellness. The Better Together Physician Coaching program (BT) is a web-based, group-coaching program, piloted using female GME trainees, aimed at improving key indicators of well-being, including burnout and impostor syndrome. In this qualitative study, we aimed to understand the challenges faced by female physician trainees shared in the pilot of the BT coaching intervention.

Methods

A total of 101 female physician trainees participated in the BT pilot. A sample of …

Converting Usmle Step 1 To Pass Or Fail: The Potential Impact On Applicants Who Are Female Or From Underrepresented Groups, Haris Ahmed, Peter Yu, Brendan Rosamond, Jonathan Lall, Scott Zimmerle, Said Maldonado, Nicole Lyons, Ashlynn N. Mills, Yoolim Alex Seo, Angelica C. Rodriquez, Jacqueline E. Levesque, Oluwatunmininu A. Anwoju, Zuhair Ali, Rajeev Raghavan, Mike Liang

HCA Healthcare Journal of Medicine

Background

In January 2022, the United States Medical Licensing Examination (USMLE) Step 1 exam became pass/fail and the transition to using USMLE Step 2 scores for residency interview screening appeared imminent. While this change was intended to result in holistic reviews of residency applicants, the impact remains unclear. In this study, we aimed to determine how USMLE scoring changes might affect female candidates and applicants from underrepresented groups (URM).

Methods

We performed a retrospective cross-sectional study of all applicants to a single institution. Data for applicants were extracted from their 2021-2022 residency applications and included age, race, sex, medical school, …

A Hard Problem: Managing Constipation In The Geriatric Population, William G. Jones, Veeraen Jonnalagadda, Alexandra E. Thomson, Victoria Grumbles, Chase Cottle, Christian Robertson, Maulikkumar Patel

HCA Healthcare Journal of Medicine

Constipation is a common condition among geriatric patients with different presenting symptoms and potential serious complications. Additionally, the condition causes a significant burden on our healthcare system. Here, we summarized recommendations from several societies, including the American College of Gastroenterology, American Geriatrics Society, and American Academy of Family Physicians to provide guidance on managing constipation with geriatric patients. Our aim was to emphasize the importance of prevention of constipation in this population and methods to do so. We also give recommendations on how to manage constipation when it does develop and how to manage it across different healthcare settings. These …