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Southern Medical Journal

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https://www.readbyqxmd.com/read/28257551/video-assisted-thoracoscopic-versus-open-lobectomy-costs-and-outcomes
#1
Peter M Rodgers-Fischl, Jeremiah T Martin, Sibu P Saha
OBJECTIVES: Video-assisted thoracoscopic (VATS) lobectomy is considered a promising surgical therapy for the diagnosis and treatment of non-small-cell lung carcinoma. The issue of whether VATS is superior to open thoracotomy remains controversial, however. We sought to determine whether the use of VATS lobectomy for diagnosing and treating non-small-cell lung carcinoma would improve patient outcomes at our institution. METHODS: A retrospective review of electronic and paper medical charts identified 109 consecutive operations for all patients undergoing thoracotomy or VATS lobectomy performed at the University of Kentucky Chandler Medical Center for fiscal years 2013 and 2014...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257550/tolerability-of-switch-to-macitentan-from-bosentan-in-pulmonary-arterial-hypertension
#2
Zeenat Safdar, Aishwarya Thakur, Adaani Frost
OBJECTIVES: Pulmonary arterial hypertension (PAH) is a progressive disease that can be treated with several medications. Macitentan, an endothelin receptor antagonist (ERA), has received approval as a PAH therapy. We report our data regarding the tolerability in patients with PAH who were switched from bosentan to macitentan. METHODS: At the Baylor Pulmonary Hypertension Program, 24 patients with PAH who had been taking bosentan and were switched to macitentan were identified in this retrospective study...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257549/analysis-of-intensive-care-unit-admission-and-sequelae-in-patients-intravenously-abusing-extended-release-oral-oxymorphone
#3
Matthew W Wilson, Alex K Bonnecaze, Ajay Dharod, Peter J Miller
OBJECTIVES: Prescription drug abuse is a major public health problem in the United States, with the rate of opioid-related deaths nearly quadrupling between 2000 and 2014. Extended-release oral oxymorphone hydrochloride (Opana ER) is a long-acting opioid prescribed for chronic pain; however, it also has the potential to be abused via intravenous injection. This retrospective review sought to analyze specific complications and sequelae requiring intensive care unit resources for patients intravenously abusing extended-release oral oxymorphone...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257548/comparison-of-qtc-and-troponin-levels-in-st-elevation-mis-compared-with-non-st-elevation-mis
#4
Nathan Henrie, Bryan Harvell, Amy A Ernst, Steven J Weiss, Scott Oglesbee, Dusadee Sarangarm, Lorenzo Hernandez
OBJECTIVES: ST elevation myocardial infarctions (STEMIs) and non-ST elevation myocardial infarctions (NSTEMIs) have differences that can be important to differentiate. Our primary hypothesis was that corrected QT (QTc) duration and troponin I levels were higher in STEMIs compared with NSTEMIs. The objective of our study was to compare STEMIs with NSTEMIs for QTc duration and troponin levels. METHODS: This was a retrospective case-control study of all STEMIs and a random sample of NSTEMIs during a 1-year period...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257547/on-does-timing-of-internal-medicine-residency-interview-affect-likelihood-of-matching
#5
Jon-Erik C Holty, Jim Qiwei Ho, Ware G Kuschner
No abstract text is available yet for this article.
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257546/commentary-on-effects-of-starting-a-gastroenterology-fellowship-training-program-on-quality-measures-of-colonoscopy
#6
David Friedel
No abstract text is available yet for this article.
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257545/effects-of-starting-a-gastroenterology-fellowship-training-program-on-quality-measures-of-colonoscopy
#7
Sherif Elhanafi, Rahul Chhana, Indika Mallawaarachchi, Wynee Lou, Gabriela Rangel, Hongfei Fang, Rinkal Patel, Alok Kumar Dwivedi, Marc J Zuckerman, Mohamed O Othman
OBJECTIVES: Adenoma detection rate (ADR) is the most established indicator of the quality of screening colonoscopy. The effect of gastroenterology (GI) fellows on the quality of screening colonoscopies has been evaluated previously; however, the effect of starting a new GI fellowship program on the quality of screening colonoscopies has not been studied. The aim of our study was to assess the effects of starting a GI fellowship program and the participation of fellows in screening colonoscopies on ADR and other measures of quality...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257544/navigating-clinical-ethics-using-real-case-constellations-to-guide-learners-and-teachers-in-medicine
#8
Katherine Wasson, Mark Kuczewski, Michael P McCarthy, Kayhan Parsi, Emily E Anderson, Paul Hutchison
Case-based learning is a staple of clinical ethics education in medicine. The sources for medical educators generally are lengthy case books or single, often rare, case analyses in the literature. Busy clinicians may not have the time or inclination to sift through case books to find suitable teaching material, and the latter present unusual cases that many physicians may never encounter in their own practice. Relatively few articles present multiple cases involving ethical issues that are likely to appear in everyday practice in an accessible format for teaching...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257543/free-lung-cancer-screening-trends-toward-a-twofold-increase-in-lung-cancer-prevalence-in-the-underserved-southeastern-united-states
#9
Erika L Simmerman, Norman B Thomson, Thomas A Dillard, Zhonglin Hao, Ramses F Sadek, Samir N Khleif, Carsten Schroeder
OBJECTIVES: The National Lung Screening Trial (NLST) reported that the prevalence of lung cancer in individuals at high risk for the disease is 1%, and that screening these individuals using low-dose helical computed tomography of the chest saves lives. To increase screening accessibility in the underserved southeastern United States, we developed a free lung screening program, modeled after the Lahey Hospital & Medical Center Free Lung Screening Program, for individuals meeting National Comprehensive Cancer Network high-risk criteria...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257542/disparities-in-cancer-survivorship-indicators-in-the-deep-south-based-on-brfss-data-recommendations-for-survivorship-care-plans
#10
Renee A Desmond, Bradford E Jackson, John W Waterbor
OBJECTIVES: The purpose of this investigation was to describe cancer survivorship based on the Behavioral Risk Factor Surveillance System (BRFSS) cancer survivorship modules in Alabama, Georgia, and Mississippi, conducted in 2012 and 2014, and to investigate disparities across the US Deep South region. METHODS: The optional BRFSS cancer survivorship module was introduced in 2009. Data from Alabama (2012), Georgia (2012), and Mississippi (2014) were assessed. Demographic factors were analyzed through weighted regression for risk of receiving cancer treatment summary information and follow-up care...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257541/risk-factors-for-outpatient-use-of-antibiotics-in-children-with-acute-respiratory-illnesses
#11
Sophie R Zhao, Marie R Griffin, Barron L Patterson, Rachel L Mace, Dayna Wyatt, Yuwei Zhu, H Keipp Talbot
OBJECTIVES: Antibiotics for acute respiratory illness (ARI) constitute most pediatric medication use and contribute to the emergence of antimicrobial resistance. We investigated antibiotic prescription risk factors for ARI in pediatric clinics and clinical follow-up in individuals prescribed and not prescribed antibiotics. METHODS: In this observational study, we enrolled children ages 2 to 17 years old presenting with ARI with fever to two academic pediatric primary care outpatient clinics during influenza season 2013-2014...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257540/water-load-test-in-children-with-chronic-abdominal-pain-or-obesity-compared-with-nonobese-controls
#12
Rami Arrouk, Aryn Karpinski, Teri Lavenbarg, John Belmont, Richard W McCallum, Paul Hyman
OBJECTIVE: Satiety is the perception of satisfied fullness and represents a summation of neural and hormonal influences. Satiety can be assessed by drink tests, including water load. The objective of our study was to confirm the difference in water load volume between nonobese control children and children with functional dyspepsia (FD), children with irritable bowel syndrome (IBS), and obese children. METHODS: A total of 158 children ages 6 to 13 years participated in the study...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257539/sexually-transmitted-infection-risk-among-women-is-not-fully-explained-by-partner-numbers
#13
Christina A Muzny, Hanne S Harbison, Erika L Austin, Jane R Schwebke, Barbara Van Der Pol, Edward W Hook
OBJECTIVES: Increased sexual partner numbers may contribute to sexually transmitted infection (STI) risk for some but not all women. This study compared women reporting having four or more partners during the preceding year (multiple partnership group) with those reporting having one partner (single partnership group) with regard to sexually risky behaviors and other modifiable predictors of STI risk. We also compared the prevalence of bacterial vaginosis, trichomoniasis, chlamydia, gonorrhea, syphilis, herpes simplex virus type 2, and human immunodeficiency virus among groups...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257538/multidisciplinary-approach-to-complicated-pregnancy
#14
Josip Andelo Borovac, Josko Bozic, Tina Ticinovic Kurir, Nikola Zaja, Kresimir Kolic, Vedran Hrboka
A nulliparous pregnant woman in her mid-20s and in the 32nd week of gestation presented to the emergency department with severe headache and vomiting. She had an uneventful medical history; however, the physical examination upon hospital admission revealed a hypertensive emergency, papilledema, and 2+ dipstick proteinuria. Upon establishing the diagnosis of preeclampsia, aggressive therapy with corticosteroids, antihypertensive medication, and seizure prophylaxis was initiated. Hemodynamic stability was achieved within 24 hours and the patient remained in the observation unit located within the gynecology clinic...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257537/primary-ovarian-insufficiency-current-concepts
#15
Gretchen Collins, Bansari Patel, Suruchi Thakore, James Liu
A potential consequence of chemotherapy is the destruction of oocytes, resulting in primary ovarian insufficiency (POI) in young patients; this often results in secondary amenorrhea and necessitates hormone replacement therapy. Regardless of the etiology of POI, the chance of pregnancy is low in this patient population. Given the extent to which oocyte depletion or dysfunction is variable, there is the possibility of spontaneous ovulation on hormone replacement therapy and subsequent pregnancy, however. If pregnancy is not desired, contraception always should be discussed...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28158886/resident-and-faculty-perceptions-of-chart-stimulated-recall
#16
Stephen R Holt, Andre N Sofair
OBJECTIVES: Chart-stimulated recall (CSR) is a case-based interviewing technique advocated by the Accreditation Council for Graduate Medical Education as an assessment tool across a variety of clinical competencies, yet resident and faculty perceptions of this exercise have not been reported previously. The authors incorporated a CSR exercise into an internal medicine residency program and sought to assess the perceptions of residents and faculty participants. METHODS: Faculty met weekly with night float residents at the end of their shift...
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28158885/breaking-bad-delirium-methamphetamine-and-boric-acid-toxicity-with-hallucinations-and-pseudosepsis
#17
Kayla Johnson, Joanna L Stollings, E Wesley Ely
OBJECTIVES: A 30-year-old patient presented with hallucinations and profound shock. He was initially misdiagnosed as having severe sepsis; once ingestions were considered, he was diagnosed as potentially having arsenic toxicity. SUMMARY: The clinical story reveals many instructional lessons that could aid in the evaluation and management of future patients. This man presented with large amounts of blue crystals around his nose and lips from inhaling and eating boric acid (an ant poison) so he could, as he put it, kill the ants "pouring into my mouth and nose and up into my brain...
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28158884/commentary-on-factors-associated-with-routine-recommendation-of-mammography-for-women-aged-40-to-49-provider-characteristics-and-screening-influences
#18
Albert S Braverman
No abstract text is available yet for this article.
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28158883/factors-associated-with-routine-recommendation-of-mammography-for-women-aged-40-49-provider-characteristics-and-screening-influences
#19
Kathryn A Martinez, Abhishek Deshpande, Allison L Ruff, Shari D Bolen, Kathryn Teng, Michael B Rothberg
OBJECTIVES: Despite the US Preventive Services Task Force recommendation against screening mammography in women younger than 50 years, rates remain high, suggesting that screening recommendations may be motivated by other factors. The objective of this study was to understand provider-reported influences on screening recommendations for women 40 to 49 years old at average risk for breast cancer. METHODS: An online survey of primary care providers was conducted at four health centers in Cleveland, Ohio in 2015...
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28158882/missed-opportunities-for-preventing-perinatal-transmission-of-human-immunodeficiency-virus-florida-2007-2014
#20
Mary Jo Trepka, Soumyadeep Mukherjee, Consuelo Beck-Sagué, Lorene M Maddox, Kristopher P Fennie, Diana M Sheehan, Maithri Prabhakar, Dan Thompson, Spencer Lieb
OBJECTIVES: Despite declining numbers of perinatally exposed infants, an increase in perinatal human immunodeficiency virus (HIV) infections from 2011 to 2013 prompted this study to identify missed perinatal HIV prevention opportunities. METHODS: Deidentified records of children born from 2007 through 2014, exposed to HIV perinatally, and reported to the Florida Department of Health were obtained. Crude relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with perinatal transmission, nondiagnosis of maternal HIV infection, and nonreceipt of antiretroviral medication were calculated...
February 2017: Southern Medical Journal
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