Medicine and Health Sciences Commons^™

Chylothorax After Coronary Artery Bypass Surgery. Report Of A Case And Review Of The Literature, Imran Khan, Zahid M. Khan, Abdelbasset El Refy, Ahmad Mahmood El Badry, Tarig Faisal Babiker

Journal of the Saudi Heart Association

Chylothorax after coronary artery bypass grafting is a rare complication and leads to increased mortality and morbidity. Because of the rarity of this complication, its management is debatable. We present the case of a 41 years old male patient who had a left sided chylothorax after coronary artery bypass grafting. The patient was managed conservatively with low fat diet and drainage of the chylothorax. A thorough search of the literature published on the subject was done and treatment strategies employed by various authors were studied. Various treatment options are conservative management with chest tube drainage, octreotide and low-fat diet or …

Removal Of Unusual Multiple Aortic Valve Fibroelastoma Using Right Mini-Thoracotomy, Muhammed Tamim Tamim, Marwan Sadek, Khaled Al-Faraidy, Donya Al-Hassan

Journal of the Saudi Heart Association

Papillary Fibroelastomas are rare, primary cardiac tumors. They are typically diagnosed as an incidental finding but can also present as thrombo-embolic events. We present the case of 78-years- old man who presented to emergency room with a cerebrovascular event (CVE). Transesophageal echocardiography (TEE) revealed e presence of a mass on the aortic valve. Intra-operatively, two masses where found: one was highly mobile attached to left ventricular (LV) side of the left coronary cusp, another small size mass attached to the non-coronary cusp, and there was suspicion of a mass attached to the mitral valve. The two masses were surgically excised …

Myocardial Infarction Caused By An Enclosed Thrombus In A Patent Foramen Ovale, Meriem Boumaaz, Iliyasse Asfalou, Amine Hamami, Maha Raissouni, Zouhair Lakhal, Aatif Benyass

Journal of the Saudi Heart Association

Paradoxical embolism in coronary artery is a rarely diagnosed clinical entity. In the majority of reported cases; the diagnostic of this pathology is « presumptive » based on certain criteria. It can be considered “proven” when the embolus is found lodged in the abnormal communication between the venous and arterial circulation; which is very rare. We herein report a case of myocardial infarction caused by a proven paradoxical coronary embolism through a patent foramen ovale. The authors highlight through this paper the contribution of echocardiography and particularly transesophageal echocardiography, especially if performed soon after presentation, for early diagnosis.

Massive Hemoptysis And Recurrent Infective Endocarditis In Intravenous Drug User: A Case Report, Mutlaq Almutairi, Yasser Ahmed El-Ghoneimy, Abdulaziz Omar Alghamdi, Hashem Abdulkarim Alkhamis, Ziyad Abdulmohsen Altayyar, Khalid Mohsen Houbani

Journal of the Saudi Heart Association

Intravenous drug use (IDU) poses a high risk of serious complications such as infective endocarditis (IE), which carries high morbidity and mortality rates. Mycotic pulmonary artery aneurysms (MPAA) are rarely associated with right-sided IE, especially in the setting of IDU. It is a potentially fatal complication as it can lead to severe hemorrhage if the aneurysm ruptures. We report the case of a young male with a history of current IDU and tricuspid valve replacement post complicated IE 2 years ago. The patient initially presented with massive hemoptysis and fever. Chest computed tomography (CT) showed a lobulated lesion in the …

Medical School Watercooler Newsletter - May 24, 2020, Lindsey Lyle

Watercooler Newsletter

This is the May 24, 2020 edition of the Frederick P. Whiddon College of Medicine's Newsletter - Watercooler.

Contents Include:

USA Health surgery resident wins regional paper competition

YouTube channel goes behind the scenes of emergency medicine

Third-year students to return to clinical rotations

Lee receives AAST research scholarship

Faqs For Administrators And Leaders At Community- And Faith-Based Organizations, Centers For Disease Control And Prevention

Pandemic Response and Religion in the USA: Health

This is the Frequently Asked Questions webpage from the Centers for Disease Control and Prevention designed to help places of worship prevent the spread of COVID-19 in their congregations. The FAQ page includes prevention strategies, community outreach strategies, and how to decide if services should be in person or virtual. Issues such as discrimination and marginalized populations are discussed on the FAQ page.

2020-05-24_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

2020-05-24_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was captured from the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_99207---,00.html.

The website contained the table Count of Confirmed COVID-19 Cases by Date of Onset , sorted by Michigan Preparedness Region. It also contained 18 charts, including the count of confirmed Covid-19 cases by date of onset in the state overall as well as in each preparedness region,and the normalized rate of Covid-19 cases per 1,000,000 residents in both the state and in each preparedness region.

2020-05-24_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

2020-05-24_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., with COVID-19 results included as of 10 a.m.

Note on cumulative counts: This report is provisional and subject to change. As public health investigations of individual cases continue, there will be corrections to the status and details of referred cases that result in changes to this report. City of Detroit and Wayne County are reported separately.
Note on the deaths: Deaths must be reported by health care …

Community And Faith-Based Organizations: Plan, Prepare, And Respond, Centers For Disease Control And Prevention

Pandemic Response and Religion in the USA: Law and Public Policy

No abstract provided.

Unplugging: An Evidence-Based Project To Reduce Screen Time And Improve Healthy Media Use In The Adolescent Population, Erica Persichetti

Doctor of Nursing Practice Final Manuscripts

Abstract

Background:Excessive media use is an emerging health concern amongst the pediatric population. The American Academy of Pediatrics (AAP) recommends less than 2 hours per day of recreational screen time, yet the national average is between 7 to 9 hours per day for adolescents. A media-saturated lifestyle has consequences on a child’s mental, physical, and emotional health. Despite guidelines stating media use should be assessed at annual well-visits, only 16% of providers are following this recommendation. This gap in care leaves many families with a limited understanding of the impact of media on their child's health and represents a …

Assessing Oral Health Status, Practice, And Access To Care Among War-Affected Refugees In San Antonio, Texas, David Cappelli, Rami Saadeh, Annaliese Cothron, Magda De La Torre

Dental Medicine Faculty Research

Objectives: Refugees encounter several health disparities including oral health problems. This study evaluated the self-reported oral health status, practices, and access to care of adult refugees living in San Antonio, Texas, United States. Materials and Methods: Adult refugees ( n = 207) who accessed services from two centers in San Antonio, completed this survey. Multivariate logistic regression was used to examine the relationship of the refugees’ demographics with oral health status, practices, and access to care. Results: Oral pain in the previous 12 months was common among refugees having been reported by almost 58.9% of the survey participants; 43% reported …

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

Anti-Aggregation Effects Of Phenolic Compounds On Α-Synuclein, Kenjiro Ono, Mayumi Tsuji, Tritia R. Yamasaki, Giulio M. Pasinetti

Neurology Faculty Publications

The aggregation and deposition of α-synuclein (αS) are major pathologic features of Parkinson's disease, dementia with Lewy bodies, and other α-synucleinopathies. The propagation of αS pathology in the brain plays a key role in the onset and progression of clinical phenotypes. Thus, there is increasing interest in developing strategies that attenuate αS aggregation and propagation. Based on cumulative evidence that αS oligomers are neurotoxic and critical species in the pathogenesis of α-synucleinopathies, we and other groups reported that phenolic compounds inhibit αS aggregation including oligomerization, thereby ameliorating αS oligomer-induced cellular and synaptic toxicities. Heterogeneity in gut microbiota may influence the …

Religious, Socio-Cultural Norms And Gender Stereotypes Influence Uptake And Utilization Of Maternal Health Services Among The Digo Community In Kwale, Kenya: A Qualitative Study, Vernon Mochache, George Wanje, Lucy Nyaga, Amyn Lakhani, Hajara El-Busaidy, Marleen Temmerman, Peter Gichangi

Obstetrics and Gynaecology, East Africa

Background: Maternal health outcomes in resource-limited settings are typically influenced by supply-side factors affecting the provision of quality health services. The extent to which demand-side factors contribute to this influence is unclear. We aimed to explore how individual and community-wide factors influenced uptake and utilization of maternal health services among the Digo community residing in Kwale County of coastal Kenya.

Methods: Between March and December 2015, we conducted 5 focus group discussions (FGDs) and 15 in-depth interviews (IDIs) with members of the Digo community predominant in Kwale county, Kenya. Respondents were sampled purposively and included female (pregnant and …

Peptic Ulcer Perforation After Cesarean Section; Case Series And Literature Review, Mahboobeh Shirazi, Mehnoosh Tork Zaban, Sriharsha Gummadi, Marjan Ghaemi

Department of Radiology Faculty Papers

BACKGROUND: Peptic ulcer perforation in the early post-cesarean period is rare but may result in maternal mortality.

CASE PRESENTATION: Four cases of post-cesarean peptic ulcer perforation are presented. In all four patients, presentations include peritoneal signs such as acute abdominal pain and progressive distention, hemodynamic instability and intraperitoneal free fluid by ultrasound. Laparotomy and repair were done in all 4 cases. There were 2 maternal deaths. We also have reviewed English literature for the similar cases reported from 1940 to March 2019.

CONCLUSION: New onset tachycardia, abdominal pain and progressive distension after cesarean section without congruent changes in hemoglobin should …

Substantial And Sustained Reduction In Under-5 Mortality, Diarrhea, And Pneumonia In Oshikhandass, Pakistan: Evidence From Two Longitudinal Cohort Studies 15 Years Apart, C L. Hansen, B J J. Mccormick, Iqbal Azam Syed, K Ahmed, J M. Baker, E Hussain, A Jahan, A F. Jamison, N Samji, Oshikhandass Diarrhea And Pneumonia Project, Anita K. M. Zaidi, Ahmed Jan

Community Health Sciences

Background: Oshikhandass is a rural village in northern Pakistan where a 1989-1991 verbal autopsy study showed that diarrhea and pneumonia were the top causes of under-5 mortality. Intensive surveillance, active community health education and child health interventions were delivered in 1989-1996; here we assess improvements in under-5 mortality, diarrhea, and pneumonia over this period and 15 years later.
Methods: Two prospective open-cohort studies in Oshikhandass from 1989 to 1996 (Study 1) and 2011-2014 (Study 2) enrolled all children under age 60 months. Study staff trained using WHO guidelines, conducted weekly household surveillance and promoted knowledge on causes and management of …

2020-05-23_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was captured from the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_99207---,00.html.

The website contained the table Count of Confirmed COVID-19 Cases by Date of Onset , sorted by Michigan Preparedness Region. It also contained 18 charts, including the count of confirmed Covid-19 cases by date of onset in the state overall as well as in each preparedness region,and the normalized rate of Covid-19 cases per 1,000,000 residents in both the state and in each preparedness region.

2020-05-23_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

2020-05-23_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., with COVID-19 results included as of 10 a.m.

Note on cumulative counts: This report is provisional and subject to change. As public health investigations of individual cases continue, there will be corrections to the status and details of referred cases that result in changes to this report. City of Detroit and Wayne County are reported separately.
Note on the deaths: Deaths must be reported by health care …

Consistency Of Ever Reported Risky And Sensitive Behaviors Among Early Adolescents In A Nationally Representative Longitudinal Study: Results From The First 2 Waves Of The Longitudinal Cohort Study Of The Filipino Child, 2016 To 2018, Nel Jason L. Haw

Health Sciences Faculty Publications

Background: An ongoing cohort study on adolescents in the Philippines presents a unique opportunity to update current literature by measuring the level of reporting consistency on these behaviors and determine predictors of reporting inconsistency.

Methods: This study was a secondary analysis of the first 2 waves of the Longitudinal Cohort Study on the Filipino Child (LCSFC), a nationally representative cohort of Filipino adolescents throughout the Sustainable Development Goals (SDGs) implementation period, that is, age 10 in 2015 until age 24 in 2030, to measure the impact of SDG-oriented policies on the country’s future economic and health outcomes. This …

Interim Guidance For Communities Of Faith, Centers For Disease Control And Prevention

Pandemic Response and Religion in the USA: Health

This article from the CDC offers guidelines for religious groups and organizations that are beginning to reopen and hold in-person services as stay-at-home orders are lifted. Guidelines include hygiene tips, disinfecting practices, the use of face masks, and other safe practices designed to keep houses of worship safe as they reopen. Other guidelines include policies for houses of worship to put in place for their congregants upon reopening, such as the use of worship materials.

Pain And Spiritual Distress At End Of Life, Kathryn Lee Robinson

Dissertations

Purpose: The purpose of this study is to examine the relationship between unmanaged pain and spiritual distress in adults newly admitted to hospice.

Background/Rationale: Current evidence supports the presence of a positive relationship between increased physical pain and spiritual distress for those with advanced cancer and/or receiving palliative care services. Nonetheless, spiritual distress remains a relatively understudied area; anecdotally, assessment and management of physical symptoms often take precedence over interventions for spiritual distress in patients at end of life (EOL) on hospice. Research is needed to examine the relationships between physical pain, spiritual distress, and other relevant variables specific to …

Utilization Of Peer-Led Education To Enhance Advance Care Planning And Advance Directive Completion, Jenna Juenger

Doctor of Nursing Practice Final Manuscripts

Background: The integration of advance care planning (ACP) and palliative care (PC) into oncology plays a critical role in symptom management and quality of life. Studies reveal a large subset of oncology patients with unmet needs regarding ACP and advance directive (AD) completion. Successful ACP helps to promote congruent medical treatment with patients’ values and preferences and motivates patients to complete ADs.

Objective: An evidence-based practice project was conducted to assess the effectiveness of peer-led education to nursing staff to improve ACP and AD completion among inpatient oncology and PC patients

Design: A standardized survey created from the …

Recommended Syphilis And Hiv Testing After Positive Sti Testing, Katherine Cayce Monaghan Rn, Bsn

Doctor of Nursing Practice Final Manuscripts

Background: Historically primary and secondary syphilis were seen primarily among men who have sex with men and rates among women remained low and rarely increased. Recent research shows that between 2013–2017, the primary and secondary syphilis rate increased 72.7% in the U.S. and 155.6% among women. Patients diagnosed with syphilis have a two to five fold increased risk of acquiring human immunodeficiency virus (HIV). Additionally, positive testing for other sexual transmitted infections (STI) might be indicators of high risk sexual behaviors and exposures that place a person at greater risk for acquiring syphilis and HIV. A southern California university student …

Screening For Iron-Deficiency Anemia In The Pediatric Population (Ages 1-17) In Gonaïves, Haiti, Cara Rose Fratianni

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this pilot project is to screen for iron-deficiency anemia in pediatric patients (ages 1-17) in a primary school in Gonaïves, Haiti. Patients with anemia will be treated with oral supplemental iron for a period of four weeks according to WHO guidelines (WHO, 2011). All students will be treated empirically for helminths per WHO guidelines, unless treated elsewhere in the last six months (WHO, 2017). Nutritional status will also be assessed using MUAC according to WHO guidelines (2017).

Background Summary: Malnutrition contributes significantly to the problem of iron-deficiency anemia, with one in four children exhibiting stunting …

2020-05-23_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

Peer-Led Education Expedites De-Prescribing Proton Pump Inhibitors For Appropriate Veterans, Mary H. Bowman

Doctor of Nursing Practice Final Manuscripts

Costly proton pump inhibitors (PPIs) have been widely prescribed since the 1990’s for prevention and treatment of ulcers and gastroesophageal reflux disease (GERD). Evidence published since 2012 demonstrates risks associated with taking PPIs longer than eight weeks. Primary care providers (PCPs) mostly de-prescribe PPIs for persons not meeting criteria for long term use. Many patients resist discontinuation.

A three-month evidenced based practice (EBP) education project was conducted by a nurse practitioner to improve PCP peer de-prescribing successes with appropriate patients in an outpatient California based veteran Primary Care Clinic. Fifteen PCPs were pretested about usual care practices between two comparable …

Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd

Doctor of Nursing Practice Final Manuscripts

Background and Evidence Problem: As the population ages, there is an increase in the incidents of falls. Falls are the predominant cause of both nonfatal and fatal injuries among adults aged 65 years and older (Bergen et al., 2016). Extensive research has been conducted in fall prevention in hospitals, skilled nursing, and rehabilitation units. End-of-life care in a hospice setting presents a greater challenge in risk identification and prevention of falls. A local hospice had 457 falls between July 2018 to mid-March 2019 with a lack of consistent, detailed, fall education and documentation.

Evidence-Based Practice Intervention: Utilizing the American Geriatrics …