Medicine and Health Sciences Commons^™

Disseminated Xanthogranuloma With Gab2::Braf Fusion And Mitf Pathogenic Variant: A Rare Case Report, Pauline Xu

Graduate Medical Education Research Journal

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Aberrant Erg Staining In Atypical Fibroxanthoma: A Potential Diagnostic Pitfall, Pauline Xu

Graduate Medical Education Research Journal

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Facilitating Living Kidney Donation: Retrospective Evaluation Of Weight Loss Interventions To Support Kidney Donation, Julia Dumitrescu, Roslyn Mannon, Scott Westphal, Ashley Brabec, Regina Rau, Amy Olsen, Taylor Cidlik

Graduate Medical Education Research Journal

Background. Living kidney donor transplantation provides recipients with kidney failure with an excellent graft function and survival. Donation of a kidney entails a thorough medical and psychosocial evaluation. Obesity is an increasingly prevalent medical condition and a known risk factor for the development of chronic kidney disease post-donation. Accepting overweight and obese individuals as living kidney donors remains controversial. The purpose of this study was to review the impact of obesity on the determination of candidates for living kidney donation at a single transplant center.

Methods. We performed a retrospective chart review of living kidney donors evaluated over 5 …

Hand Knob Stroke, The Ultimate Mimic Of Peripheral Mononeuropathy: A Case Report, Larry A. Osborne Jr, Stephen Chien

Graduate Medical Education Research Journal

Background. Hand knob strokes present with unilateral motor weakness of the hand, distal arm, or a particular group of fingers with or without paresthesia. This condition can easily be misdiagnosed as a peripheral mononeuropathy without a high level of suspicion and a thorough history and physical exam. We present a case of hand knob stroke that mimicked an ulnar mononeuropathy.

Case. A 100-year-old male with a history of untreated hypertension, Stage 3A Chronic Kidney Disease, and prediabetes presented to the hospital five hours after symptom onset with resolving acute left hand weakness and paresthesia. Symptoms began the night prior with …

Effects Of Cross-Curricular Instruction On Clinical Education Outcomes For Speech-Language Pathology Graduate Students, Michele Dacy, Kimberly Smith

Journal on Empowering Teaching Excellence

Access the online Pressbooks version of this article here.

Cross-curricular instruction is the process of combining information from two or more subjects within a single discipline in order to help students integrate the knowledge and skills they learn from separate courses. The purpose of this study was to examine how cross-curricular instruction impacted speech-language pathology (SLP) graduate students' knowledge, confidence, and clinical skills related to the assessment of patients with co-occurring diagnoses of dementia and dysphagia. Twenty-three SLP master's students completed a questionnaire before and after receiving cross-curricular instruction on how to assess dysphagia in persons with dementia. The questionnaire …

Exercise-Induced Gene Expression Profiles In Adults With Obesity: A Systematic Review Of Molecular Adaptation, Brandon Galvan, Luis Alberto Flores, Flor Isela Torres-Rojo, Natanael Cervantes-Hernández, Cinthia Verónica Villegas-Balderrama, Liliana Aracely Enríquez-Del-Castillo

Baltic Journal of Health and Physical Activity

Background: Obesity is a multifactorial and chronic condition characterized by excess adiposity and systemic low-grade inflammation. Exercise exerts metabolic and anti-inflammatory effects partly mediated through gene expression modulation in skeletal muscle and adipose tissue. However, heterogeneous responses among obese individuals suggest that genetic and epigenetic mechanisms shape exercise adaptation. Objective: This systematic review aimed to identify the genes and molecular pathways modulated by physical exercise in adults with obesity, and to classify them according to their biological functions across different exercise modalities. Methods: Following PRISMA guidelines, randomized controlled trials were searched in PubMed, SpringerLink, Science Direct, Cochrane, LILACS, Web of …

The Effects Of Ballistic Resistance Training On Upper-Limb Power And Reaction Time In Youth Épée Fencers, Mahmoud Sallam, Mazin Hasan Alhasany, Hachin Chani, Ghofran Bashir, Bushra Al-Hammashi, Gaffar Saad, Hussein Hashos, Amr Hamza, Mariola Gepfert

Baltic Journal of Health and Physical Activity

Background: Explosive power and rapid reaction time are crucial in fencing. Ballistic resistance training (BRT) may improve these qualities but is rarely applied in fencing. Materials and methods: To assess the effects of an eight-week BRT program on upper-limb power and reaction time in youth Egyptian épée fencers, nineteen male fencers (aged 16.6 ± 1.5) were randomly divided into a BRT group (n = 10) and a control group (n = 9). The BRT group added three weekly 30-minute sessions of "Ballistic Six" exercises to regular fencing training. Tests before and after included: tennis ball throw (power), armed …

Predicting In-Hospital Mortality In Patients With Hypertensive Emergency: A Retrospective Cohort Study, Jay Satasiya, Bs, Devin Vasoya, Md, Darius Farzad, Md

The Medicine Forum

Approximately 1.3 billion adults worldwide have hypertension.¹ Between 2006 and 2013, there was a two-fold increase in Emergency Department visits for hypertensive emergency.² The prevalence of hypertensive emergency ranges from 0.08% to 0.76% in patients presenting to the Emergency Department.^1,3-6 The estimated incidence of hospitalization with a hypertensive emergency is 111 per 100,000 patients.^1,7 Hypertensive emergency is also associated with significant morbidity and mortality, often leading to ischemic stroke, pulmonary edema, acute heart failure.^3-6 In-hospital mortality among patients with hypertensive emergency varies between 0.48% and 12.5%.^5,7 This retrospective cohort study aims to further clarify …

Reading Burney’S Mastectomy Letter: Presentist Thinking And Personal Responses In The Classroom, Heather Meek

ABO: Interactive Journal for Women in the Arts, 1640–1830

Frances Burney’s mastectomy letter, in its graphic and detailed depiction of the operation she underwent without anesthetic in 1811, does not always lend itself immediately to standard, scholarly classroom discussion. It tends, rather, to incite unusually intimate responses, as well as conversations about medicine and health today. In my teaching of the letter in literature courses at Université de Montréal over the course of the past 13 years, I have found that students are inclined to seize upon the subject of breast cancer as especially contemporary in its relevance and to share their own anecdotal knowledge of the disease. I …

Diastole, Charlaine Chen

HCA Healthcare Journal of Medicine

Diastole is the space between heartbeats. It is in this space that the heart actively rests, refills. These periods of relaxation are what allow the next heartbeat to occur. A heart without diastole is in heart failure. In medical training, we are raised on the myth that constant effort equals devotion, that rest is a luxury. A sense of guilt riddles me when I take a sick day, or when I feel I am not doing enough, fast enough. This work is a meditation on the nature of rhythm, and the rhythm of nature. These quiet spaces are not signs …

Between Rounds And Resolve, Faizan Sheraz

HCA Healthcare Journal of Medicine

“Between Rounds and Resolve” is a narrative poem chronicling the introspective journey of an internist transitioning toward a subspecialty in gastroenterology. Through poetic reflection, the piece captures the emotional cadence of clinical rounds, the quiet resilience forged in patient care, and the evolving sense of purpose that guides a physician toward deeper specialization. This work explores themes of identity, transformation, and professional growth, offering a humanistic lens on the road less traveled within medicine. It aims to resonate with readers, navigating their own paths of change, reaffirming the value of reflection and resolve in shaping a meaningful career in health …

Enhancing Clinical Care Quality Through 1-On-1 Quality Improvement Education In Family Medicine, Jude K A Des Bordes, Shira K. Goldstein, Nahid J. Rianon

HCA Healthcare Journal of Medicine

Background

Ongoing improvement and evaluation of clinical care are essential to maintaining high standards. The Accreditation Council for Graduate Medical Education (ACGME) requires all accredited family medicine programs to provide quality improvement (QI) education. Given competing educational demands, residency programs must adopt innovative approaches to teaching QI. This article describes an individualized approach to QI education that we implemented in our family medicine residency program and the outcome of its evaluation.

Methods

Guided by a logic model and evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, this quasi-experimental 1-group pre-test-post-test study (July 2022-June 2023) involved all second-year …

Assessment And Intervention For Health Behavior Change In Primary Care Across The Lifespan: A Guide For Residents In Primary Care Specialties, Stacy A. Ogbeide, Alexis Ramos, Bridget Murphy, Angel Ogbeide

HCA Healthcare Journal of Medicine

More than 45% of Americans have at least 1 chronic disease, with chronic disease also being a leading cause of death in the United States. In primary care settings, about 75% of visits are for management of multiple chronic diseases. Due to the increasing medical complexity of patients who present to primary care, these numbers make it more challenging for Primary Care Clinicians (PCCs) to manage these conditions alone and point to the need for innovative solutions to chronic disease care. One evidence-based innovation is team-based care to improve the treatment of these conditions. Clinicians such as clinical pharmacists, registered …

Autoimmune Hemolytic Anemia Associated With Leptospirosis: A Rare Complication, Anum Waqar, Furqan Mazhar, Mahrukh Afzal, Sadia Razzaq, Sana Ijaz

HCA Healthcare Journal of Medicine

Introduction

Autoimmune hemolytic anemia (AIHA) is rare but potentially life-threatening complication of leptospirosis, a zoonotic infection caused by the Leptospira species. Autoimmune hemolytic anemia occurs when the immune system targets red blood cells, resulting in hemolysis and anemia. The relationship between leptospirosis and AIHA is uncommon and often under-recognized, which can delay diagnosis and management. This case highlights the importance of considering hematologic complications in leptospirosis.

Case Presentation

A 23-year-old male presented with low-grade fever, productive cough, shortness of breath, jaundice, and pallor for 15 days. On examination, he was pale and icteric with bilateral chest crepitations. Laboratory studies showed …

A Case Report Of Mesalazine-Induced Pulmonary Injury In A Patient With Ulcerative Colitis, Vasileios Paraschou, Vasileios Papavasileiou, Ilektra Voulgareli, Vasilios Tzilas

HCA Healthcare Journal of Medicine

Introduction

Mesalazine (5-aminosalicylic acid) is widely used as a first-line therapy for ulcerative colitis (UC) due to its efficacy and safety profile. Rarely, it can cause pulmonary toxicity with variable clinical and radiologic manifestations, making diagnosis challenging.

Case Presentation

We report the case of a 52-year-old woman with UC who developed persistent fever and progressive exertional dyspnea following escalation of mesalazine dosage. Imaging revealed diffuse bilateral ground-glass opacities, while infectious and UC-related pulmonary causes were excluded. Pulmonary function testing demonstrated restriction and markedly reduced diffusing capacity. Following mesalazine discontinuation and initiation of corticosteroid therapy, the patient experienced rapid symptomatic, functional, …

An Unusual Case Of Bilateral Upper And Lower Oral Cavity Cysts In A Newborn, Frances Rodriguez Lara, Jillian L. Chen, Jennifer N. Shehan, Jessica R. Levi

HCA Healthcare Journal of Medicine

Background

Oral mucosal lesions in newborns have a broad differential diagnosis, ranging from benign, transient conditions to potential early signs of systemic disease. Most of these lesions are resolved without intervention, but delayed recognition can lead to complications, such as airway obstruction. Early identification is crucial for appropriate management. This case report discusses an unusual presentation of multiple oral mucosal cysts in a newborn, emphasizing the challenges of diagnosis and management.

Case Presentation

A 1-day-old male was evaluated at Boston Medical Center for cystic oral lesions identified during newborn screening. The infant was born at 36 weeks and 2 days’ …

Navigating Complex Esophageal Perforations: A Case-Specific Approach To Successful Outcomes, Harsimran Kalsi, Anushree Rai, Kobina Essilfie-Quaye, Neeka Akhavan, Yaseen Perbtani, Tony S. Brar

HCA Healthcare Journal of Medicine

Esophageal perforation is a life-threatening condition requiring prompt diagnosis and effective management. While self-expanding metal stents (SEMS) are a first-line treatment, persistent leaks often necessitate adjunctive endoscopic interventions. A structured, multimodal approach is critical for optimizing outcomes and avoiding surgical intervention. A 44-year-old man developed an iatrogenic esophageal perforation following surgical leiomyoma enucleation. Initial treatment with overlapping fully covered self-expanding metal stents (FC-SEMS) failed to achieve closure, necessitating endoscopic suturing for defect reinforcement. Despite suturing, persistent leakage required placement of a larger-diameter FC-SEMS, secured with an endoscopic fixation system to prevent migration. Serial imaging confirmed successful defect closure, allowing the …

Using Mohs Micrographic Surgery To Treat A Large, Pedunculated Trichoblastoma On The Upper Cutaneous Lip, Richard G. Bindernagel Jr., Addie Walker, Richard Miller

HCA Healthcare Journal of Medicine

Trichoblastomas are uncommon adnexal tumors that usually occur on the face. We report a case of a 62-year-old White man with a large, asymptomatic, slow-growing lesion that had been on his right upper cutaneous lip for 15 years. A 2 cm pink, pedunculated nodule with telangiectasia was seen on examination. A shave biopsy was consistent with trichoblastoma: a circumscribed-appearing dermal tumor of basaloid cells arranged in cords and islands within a cellular stroma, focal epidermal connection, and papillary mesenchymal bodies. The patient elected for treatment with Mohs micrographic surgery (MMS) given the length of time that the tumor had been …

Impact Of Pre-Existing Psychiatric Conditions On Trauma Outcomes: A National Analysis, Kelly Mckenney, Marie Ugo, Sindhura Kompella, Clara Alvarez, Ilko Luque

HCA Healthcare Journal of Medicine

Background

Understanding the impact of psychiatric pre-existing conditions (PsyPECs) on trauma outcomes is crucial, as trauma is the leading cause of mortality for Americans aged 1-45. Although previous regional studies have shown higher mortality rates and longer hospital length of stay (H-LOS) for injured patients with PsyPECs, this has not been studied at the national level. The purpose of this study is to identify the PsyPECs associated with mechanism of injury and other outcomes in adult patients admitted for trauma in the United States’ trauma centers.

Methods

Data were extracted from the National Trauma Data Bank (NTDB). There were 5301 …

Time For A New Whole-Person Care Pathway For Chest Pain Admissions, Dana Kajan, Sabbir Mirza, Alexander M. Ruiz, Anthony Degennaro, Mohamad S. Saad

HCA Healthcare Journal of Medicine

Background

Emergency department (ED) visits for chest pain are common and costly, and ED workup often shows no clear cardiac etiology in low-risk patients. Emerging evidence suggests that social determinants of health (SDOH) such as loneliness, social isolation, and food insecurity contribute to cardiovascular outcomes and chest pain presentations.

Methods

We interviewed 114 patients (>18 years) presenting with chest pain and a thrombolysis in myocardial infarction (TIMI) score less than 4 at our community teaching hospital ED. Structured questionnaires assessed the SDOH triad of loneliness, social isolation, and food insecurity. Dependent variables included systolic blood pressure (SBP) at admission, …

Does Staff Education Increase Sequential Compression Device Utilization: A Retrospective Study, Devin Q. John, Vincent Lee, Akshay V. Daji, Hans Lapica, Connor Donley, Matthew J. Mccrosson, Nino Coutelle, Carlos Fernandez, Diego Lima

HCA Healthcare Journal of Medicine

Background

Venous thromboembolism (VTE) is a significant perioperative safety concern among orthopedic patients, with an incidence of 0.4%-1.0% and a substantial risk of chronic complications. Sequential compression devices (SCDs) are recommended for VTE prophylaxis, yet compliance remains suboptimal due to staff misconceptions. This study evaluates the impact of a resident-led educational intervention on SCD utilization among nursing staff in orthopedic postoperative care.

Methods

This retrospective study was conducted at 2 hospitals (HCA Florida JFK Hospital and HCA Florida Palms West Hospital). Nursing staff participated in a single educational session addressing SCD benefits, application techniques, and operational protocols. Data on SCD …

Trends In Emergency Department Utilization After Metabolic And Bariatric Surgery In The United States, Andrew Sanders, Isabella Moncada, Sabrina Avanzato, Michelle Fakler, Michael Dombek, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

In this article, we sought to understand the factors associated with emergency department (ED) utilization by patients after metabolic and bariatric surgery (MBS). The hopes were that modifiable risk factors could be identified to reduce ED visits after MBS.

Methods

We analyzed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database (MBSAQIP) which is comprised of data from all nationally accredited bariatric centers in the United States. For our study, we included a population of 681 743 patients having undergone the 2 most common MBS procedures: sleeve gastrectomy (SG) and gastric bypass (GBP). Using logistic …

Are Combat Athletes Different Sleepers? A Pittsburgh Sleep Quality Index-Based Comparative Survey Across Athletic Populations, Zofia Tkocz, Małgorzata Hołda Dr, Michał Spieszny, Adam Zając, Robert Trybulski, Aleksandra Filip-Stachnik

Baltic Journal of Health and Physical Activity

Background: Sleep plays an important role in athletic performance, recovery, and cognitive function. The aim of this study was to compare sleep quality and selected sleep-related  variables in combat sports athletes and athletes from other sport disciplines . Materials and Methods: Ninety-eight competitive athletes participated in the study, including 52 combat sports athletes and 46 athletes  representing other sport disciplines. Sleep quality was assessed using the modified Pittsburgh Sleep Quality Index (PSQI) with a weekly recall period, global PSQI score and additional  variables, such as sleep duration, sleep latency, and habitual sleep-wake times, were analyzed using general linear models adjusted …

Detection And Diagnostic Screening Of Breast Cancer: A Systematic Review And Future Frontiers, Lama Yassine, Amira J. Zaylaa

BAU Journal - Science and Technology

A comprehensive evaluation of current and novel diagnostic techniques is necessary since the diagnosis of breast cancer is essential for improving treatment efficacy and raising long-term survival. Evidence from conventional imaging methods including mammography, ultrasonography, and magnetic resonance imaging is combined in this systematic review with advancements in liquid biopsies and current AI-based diagnostic tools. Using specific keywords related to breast cancer, early detection, imaging, biomarkers, and artificial intelligence, a thorough search was conducted in PubMed, Scopus, Web of Science, and IEEE Xplore. Reviews, case reports, and studies unrelated to breast cancer were excluded; only clinical, experimental, and computational research …

Can Gingival Crevicular Fluid Help In Diagnosing Pulp Inflammation? A Systematic Review, Wael Kassamany, Roula Abiad

BAU Journal - Science and Technology

This review aims to find if there’s a positive correlation between biological markers detected in human gingival crevicular fluid and pulp inflammation.

An electronic search of three databases; PubMed, EBSCOhost and Google Scholar was conducted using the keywords “tooth or teeth or pulp” AND “gingival crevice fluid or gingival crevicular fluid” for English articles published between the year 1990 and 2026. Information regarding study design, patients age range and gender distribution, sampling method used, types of biomarkers studied, assay test used, and key findings of each article were extracted and analyzed.

Biomarkers studied were substance P “SP”, neurokinin A “NKA”, …

Gambaran Penyebab Klaim Bpjs Rawat Inap Berstatus Pending Di Rumah Sakit Ciremai Kota Cirebon Tahun 2025, Jazim Shebrina Kharisma Sendy, Lina Khasanah, Bambang Karmanto, Maula Ismail Mohammad

Jurnal Ekonomi Kesehatan Indonesia

Pending claims involving BPJS Kesehatan remain a challenge in the healthcare financing system in Indonesia. This condition hinders the receipt of JKN funds by healthcare facilities. In general, pending claims arise due to inconsistencies in files, disease and/or action codes, or the determination of medical measures. The same problem also occurred at Tk. III Hospital 03.06.01 Ciremai, Cirebon City, with the continued discovery of pending inpatient BPJS claims in 2025. Based on these conditions, this study aims to describe the causes of pending inpatient BPJS claims based on administrative, coding, and medical aspects. This study aims to describe the causes …

Pendekatan Time-Driven Activity-Based Costing Dan Theoretical Framework Of Acceptability Untuk Estimasi Anggaran Layanan Home-Based Palliative Care Di Yogyakarta, Tatik Hariyanti, Firdaus Hafidz, Arif Budiarto

Jurnal Ekonomi Kesehatan Indonesia

Palliative care services delivered through a home care scheme in Indonesia are not yet included in the National Health Insurance (JKN) benefit package. Through a bridging guarantee scheme, since 2020 the Regional Government of the Special Region of Yogyakarta (DIY) has provided this service to the local population in accordance with applicable regulations. Therefore, a basis for budget allocation that considers the regional conditions of DIY is required. This study employed a mixed-methods approach with an explanatory sequential design, beginning with a quantitative study to estimate the prevalence of the population requiring palliative care services as well as the unit …

Analisis Pengelolaan Persediaan Obat Menggunakan Integrasi Abc–Fsn Dan Economic Order Quantity (Eoq) Di Rsud Haji Provinsi Jawa Timur, Rina Kartika Sari, Irwan Syahrir, Musa Gufron

Jurnal Ekonomi Kesehatan Indonesia

This study aims to analyze the performance of pharmaceutical inventory at RSUD Haji, East Java Province using an integrated ABC–FSN and Economic Order Quantity (EOQ) approach. A quantitative descriptive method was employed using secondary data from 560 drug items during January–December 2025. ABC analysis was used to identify the concentration of investment value, while FSN analysis was applied to evaluate drug movement patterns. Furthermore, EOQ was utilized to determine the optimal order quantity to minimize total inventory costs. The results show that the majority of inventory value is concentrated in category A (70.08%) and is dominated by fast-moving items (89.15%). …

Analisis Implementasi Clinical Pathway Terhadap Length Of Stay (Los) Dan Biaya Perawatan Pasien Anak Dengan Demam Berdarah Dengue (Dbd) Di Rsi Nu Demak, Akhmad Safi’I, Muhammad Zulfikar Asumta, Abdul Aziz

Jurnal Ekonomi Kesehatan Indonesia

Clinical pathway (CP) is a quality and cost control instrument in hospitals designed to ensure service standardization, efficiency of Length of Stay (LOS), and control of healthcare costs. Dengue Haemorrhagic Fever (DHF) in children is an infectious disease that often requires hospitalization, with considerable variation in LOS and treatment costs. This study aimed to assess the effectiveness of CP implementation on LOS and cost of care among pediatric DHF patients at Rumah Sakit Islam Nahdlatul Ulama (RSI NU) Demak. This research applied a quantitative approach using a retrospective descriptive-analytic design. Data were obtained from medical records of 34 pediatric DHF …

Analisis Pending Claim Pasien Rawat Inap Di Rumah Sakit Dharma Kerti Tabanan, Gusti Ayu Putu Putri Maha Dewi, Made Karma Maha Wirajaya, Putu Ayu Laksmini, Putu Ika Farmani

Jurnal Ekonomi Kesehatan Indonesia

In the BPJS health claim submission process, not all documents submitted by the hospital can be accepted immediately. Claims are declared ineligible or pending if the submitted files are incomplete or do not meet BPJS Kesehatan requirements. At Dharma Kerti Hospital, Tabanan, from August to October 2024, 16.7% or 130 of 779 inpatient claim files were recorded as pending. This study aims to analyze the factors that influence pending claims for inpatients in the period November 2024 to January 2025 by reviewing coding, medical, and administrative aspects. The study used a mixed methods approach, namely quantitative analysis of the claim …