December 2018, Volume 111 - Issue 12

Maternal/Perinatal Outcome in Women with Sickle Cell Disease: A Comparison of Two Time Periods

John N. Chang, MD, Everett F. Magann, MD, Sarah A. Novotny, MD, Chad E. Cooley, MD, C. Heath Gauss, MS, Marc R. Parrish, MD, John C. Morrison, MD

Abstract: Objective: To compare pregnancy outcomes in women with sickle cell disease from recent deliveries with a similar group delivered earlier. Methods: During a 12-year period (2005–2016), data from pregnant women with hemoglobin SS or SC were collected from three university...

(pp 742-745)

Uremic Pericarditis: Distinguishing Features in a Now-Uncommon Clinical Syndrome

Daniel Restrepo, MD, Muthiah Vaduganathan, MD, MPH, Andrew Z. Fenves, MD

Abstract: We present the case of a 47-year-old man with a history of diabetes mellitus and diabetic nephropathy who was admitted to our hospital with acute uremic myopericarditis. Echocardiography demonstrated a fibrinous pericardial effusion. The patient was initiated on...

(pp 754-757)

Medical Student H&Ps: Do You Have to Observe Them All At Once?

David M. Mills, MD, Michele K. Friesinger, MA, Sherron M. Jackson, MD, Patricia G. McBurney, MD

Abstract: Objectives: Direct observation of medical students’ history and physical examination (H&P) skills by attendings is essential in ensuring trainees’ competence. This study compared whether partial observations by multiple pediatric attendings across various clinical...

(pp 727-732)

Physician Advance Care Planning Experiences and Beliefs by General Specialty Status and Sex

Marjorie A. Bowman, MD, MPA, Kaitlyn Steffensmeier, MD candidate 2018, Marisa Smith, MD candidate 2018, Adrienne Stolfi, MSPH

Abstract: Objectives: Advance care planning (ACP) involvement could be substantially different by physician specialty or sex group, with implications for training and methods to increase ACP activities. The objective of this article is to compare primary care physicians (PCPs) and...

(pp 721-726)

Prehospital Airway Management in Iraq and Afghanistan: A Descriptive Analysis

Steven G. Schauer, DO, MS, Jason F. Naylor, PA-C, Joseph K. Maddry, MD, Denise M. Beaumont, DNAP, CRNA, Cord W. Cunningham, MD, MPH, Megan B. Blackburn, PhD, Michael D. April, MD, DPhil

Abstract: Objectives: Airway failures are the second leading cause of potentially preventable death on the battlefield. Improvements in airway management depend on identifying current challenges. We sought to build on previously reported data on prehospital, combat airway management....

(pp 707-713)

Demographic and Practice Characteristics of Physicians Who Care for Medically Underserved People: A National Survey

Jonathan J. Labbe, BA, Hyo Jung Tak, PhD, Junmo Kwon, , Thomas Joseph, MD, Joseph Abraham, MD, John D. Yoon, MD

Abstract: Objectives: Few national studies have examined the influence of role models as a potential predictor for caring for medically underserved (MUS) patients. This study tested associations between previous physician role model exposure and caring for MUS populations, as well as...

(pp 763-766)

Impact of an Innovative Psychiatric Consultation Liaison Model on Provider Satisfaction with Care of Behaviorally Complex Patients

Linden Spital, MSN, CRNP, Robert Chang, MD, Anupama Goyal, MBChB, MPH

Abstract: Objectives: The increasing behavioral acuity and complexity of hospitalized patients overwhelms providers’ capacity to effectively manage their behaviors. Hospitals must train their providers in how to cope with these behaviors to provide high-quality care. In addition to...

(pp 772-775)

Commentary on “Prehospital Airway Management in Iraq and Afghanistan: A Descriptive Analysis”

G. Richard Holt, MD, MSE, MPH, MABE, DBioethics

Abstract: In this issue of the Southern Medical Journal, Schauer and associates address the vitally important issue of airway management in combat casualty care.1 Using data from the Department of Defense Trauma Registry, the authors provide qualitative information on the “what,...

(pp 714-715)

Influences on Primary Care Provider Imaging for a Hypothetical Patient with Low Back Pain

Hai H. Le, , Matthew DeCamp, , Amanda Bertram, , Minal Kale, , Zackary Berger,

Abstract: Objective: How outside factors affect physician decision making remains an open question of vital importance. We sought to investigate the importance of various influences on physician decision making when clinical guidelines differ from patient preference. Methods: An...

(pp 758-762)

Stress Electrocardiography vs Radionuclide Myocardial Perfusion Imaging among Patients Admitted for Chest Pain: Comparison of Teaching and Nonteaching Hospital Services

Karishma Samtani, MD, Abdulfatah Issak, MD, Jared Liston, MD, Ronald J. Markert, PhD, Dean Bricker, MD

Abstract: Objectives: The American Board of Internal Medicine Foundation’s Choosing Wisely initiative has identified the routine use of stress cardiac imaging among lower-risk patients as an expensive test that should be questioned by both physicians and patients. The objectives of...

(pp 739-741)

Teaching to Teach: An Effective and Feasible Teaching Curriculum for Internal Medicine Interns

Anna K. Donovan, MD, MS, David R. Linz, MD, Doris M. Rubio, PhD, Melissa A. McNeil, MD, MPH, Carla L. Spagnoletti, MD, MS

Abstract: Objectives: New competency requirements from the Accreditation Council for Graduate Medical Education have prompted greater emphasis on developing residents’ teaching skills. Many residents make their first foray into teaching during internship, making it an important yet...

(pp 733-738)

Invasive Mechanical Ventilation

James M. Walter, MD, Thomas C. Corbridge, MD, Benjamin D. Singer, MD

Abstract: Invasive mechanical ventilation is a potentially lifesaving intervention for acutely ill patients. The goal of this review is to provide a concise, clinically focused overview of basic invasive mechanical ventilation for the many clinicians who care for mechanically...

(pp 746-753)

Adverse Events in the Efficacy of Crotalidae Polyvalent Immune Fab Antivenom vs Placebo in Recovery from Copperhead Snakebite Trial

Michael E. Mullins, MD, Charles J. Gerardo, MD, Sean P. Bush, MD, S. Rutherfoord Rose, PharmD, Spencer Greene, MD, Eugenia B. Quackenbush, MD, Brandon Lewis, DO, Victoria E. Anderson, MPH, Kurt C. Kleinschmidt, MD, Richard B. Schwarz, MD, Nathan P. Charlton, MD, Eric A. Toschlog, MD, Kapil Sharma, MD, David A. Denning, MD, Eric J. Lavonas, MD

Abstract: Objective: To compare the incidence of hypersensitivity reactions following copperhead envenomation treated with Fab antivenom (FabAV) or placebo. Methods: Patients with copperhead snakebites received treatment and follow-up in a prospective, randomized, double-blind,...

(pp 716-720)

Commentary on “A Misguided Venture: Presidential Fitness and the Duty to Warn”

Manuel Cepeda, MD

Abstract: For >40 years, the Tarasoff duty to warn of a threat to kill has become an accepted part of medical care. The use of this warning by physician political activists is new. In this response to the editorial by Kels and Kels1 in this issue of the Southern Medical...

(pp 770-771)

A Misguided Venture: Presidential Fitness and the Duty to Warn

Charles G. Kels, JD, Lori H. Kels, MD, MPH

Abstract: A small but vocal cadre of mental health professionals has questioned President Donald Trump’s fitness for office and claimed that his mental state is dangerous.1,2 These experts have frequently cited a “duty to warn” as the ethical basis for their outspokenness.3 The...

(pp 767-769)