SMJ // December 2016, Volume 109 - Issue 12

Original Article

Demographic and Clinical Characteristics of a Predominantly Hispanic Population with Inflammatory Bowel Disease on the US–Mexico Border

Objectives: Information regarding Hispanics with inflammatory bowel disease (IBD) is scarce. In this study we aimed to describe a predominantly Hispanic population with IBD in a city located along the US–Mexico border and to identify clinical or demographic differences between Hispanics and non-Hispanics. Methods: Retrospective cohort analysis of patients with…

Perspectives

The Other Sylvian Fissure: Exploring the Divide Between Traditional and Modern Bedside Rounds

If he could see the harvest of seeds sown some 400 years ago, Franciscus Sylvius would have reason to smile. Born in Europe in 1614, during the sunset of Shakespeare’s career, Sylvius rose to medical prominence for his work in neuroanatomy, and even the greenest of medical students today remember…

Original Article

Teaching Evidence-Based Physical Diagnosis: Six Bedside Lessons

Evidence-based physical diagnosis is an essential part of the bedside curriculum. By using the likelihood ratio, a simple measure of diagnostic accuracy, teachers can quickly adapt this approach to their bedside teaching. Six recurring themes in evidence-based physical diagnosis are fully reviewed, with examples, in this article.

Original Article

Prevalence of Osteopenia and Osteoporosis in Patients with Noncystic Fibrosis Bronchiectasis

Objective: The objective of our study was to define the prevalence of osteoporosis and osteopenia in patients with noncystic fibrosis bronchiectasis (NCFB). Methods: We conducted a retrospective chart review of all patients with physician-diagnosed NCFB evaluated at Mayo Clinic Florida between January 1, 2011 and June 3, 2013. Results: A…

Perspectives

Point-of-Care Ultrasound in Internal Medicine: Challenges and Opportunities for Expanding Use

The physical examination taught to medical students has not changed significantly in decades and the methods currently used would be as familiar to a physician training in the 1940s as they are to my students today. A major exception to this continuity is the introduction of point-of-care ultrasound (POCUS)—a US…

Invited Commentary

Commentary on “Association Between Maternal-Perceived Psychological Stress and Fetal Telomere Length”

In this issue of the Southern Medical Journal, Salihu and colleagues present evidence of significantly shortened fetal telomere lengths in pregnant women who scored high on the Perceived Stress Scale.1 Typically, telomere shortening occurs over time and has been associated with cell apoptosis, premature aging, and degenerative diseases such as…

Original Article

Perceptions of the Exercise Is Medicine Initiative in a Geographically Defined Deep South Population

Objectives: To examine the population’s perceptions of the Exercise Is Medicine (EiM) initiative, as well as factors that influence the accurate perception of the EiM. Methods: Participants (N = 179; 24 primary care advanced-level practitioners, 79 exercise science students, and 76 people from the general population) residing in Oxford, Mississippi,…

Editorial

Bedside Medicine: Back to the Future?

There is a newfound interest in bedside diagnosis; however, we are hesitant to call it a movement. Perhaps the best signal that the pendulum is swinging back comes from the Institute of Medicine’s report Improving Diagnosis in Health Care,1 which states, “There are growing concerns that traditional “bedside evaluation” skills…

Perspectives

Patient-Centered Teaching in a Technology-Dominated Era

Medical education today should provide physicians with the capacity to serve the needs of the patients of tomorrow. Many in the medical community have called for increased attention to anticipated future challenges, including changes in healthcare delivery and rapid advancements in technology,1–4 yet patients remain at the center of our…

Invited Commentary

Commentary on “Prevalence of Osteopenia and Osteoporosis in Patients with Noncystic Fibrosis Bronchiectasis”

In this issue of the Southern Medical Journal, Diehl and Johnson’s small retrospective study looks specifically at adults with noncystic fibrosis bronchiectasis (NCFB) and considers possible contributing factors such as the use of proton pump inhibitors (PPIs) and inhaled corticosteroids (ICSs).1 It is unique in that previous studies investigated patients…

Original Article

Association Between Maternal-Perceived Psychological Stress and Fetal Telomere Length

Objective: Our study aimed to investigate the association between maternal-perceived psychological stress and fetal telomere length. Methods: We recruited women in labor upon hospital delivery admission. Based on responses to the Perceived Stress Scale, we categorized participants as having “high,” “normal,” or “low” perceived stress. We collected umbilical cord blood…

Original Article

Integrating Behavioral Health into Pediatric Primary Care: Implications for Provider Time and Cost

Objectives: Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study…

Perspectives

See ME Differently

Editor’s Note: In November 2016 at the Southern Medical Association’s (SMA) Annual Scientific Assembly, Randy Glick, SMA’s Executive Director, introduced the organization’s vision to “See ME Differently.” The following perspective details some of the shifts in the continuing medical education landscape and how the SMA is embracing the opportunities that…

Editorial

Back to the Past for the Future of Medicine: Special Series on Bedside Medicine

The Southern Medical Journal is pleased and honored to publish a special series on bedside medicine and to welcome Drs Andrew Elder and Abraham Verghese as the guest editors. These two world-class humanists, clinicians, and medical educators are leading the effort to re-emphasize the critical importance of the physical examination…

Original Article

Transfusion Requirements in ESRD Patients Admitted with GI Hemorrhage Undergoing Inpatient Endoscopy

Objectives: To date there are no studies evaluating the utilization of blood products in patients with end-stage renal disease (ESRD) with gastrointestinal (GI) hemorrhage. This study estimated transfusion needs and determined predictors available at the time of admission for patients with ESRD admitted to a university hospital with GI bleeding…

Original Article

The Value of Physical Examination: A New Conceptual Framework

The physical examination defines medical practice, yet its role is being questioned increasingly, with statistical comparisons of diagnostic accuracy often the sole metric used against newer technologies. We set out to highlight seven ways in which the physical examination has value beyond diagnostic accuracy to reaffirm its place in the…

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