February 2019, Volume 112 - Issue 2

Outcomes in Patients with Left Ventricular Assist Devices, Pacemakers, and Implantable Cardioverter Defibrillators Undergoing Single Balloon Enteroscopy

Brijesh Patel MD, Ashok Shiani MD, Andrea C. Rodriguez MD, Seth Lipka MD, Ashley H. Davis-Yadley MD, Kirbylee K. Nelson MD, Roshanak Rabbanifard MD, Ambuj Kumar MD, MPH, Patrick G. Brady MD

Abstract: Objectives: Obscure overt gastrointestinal bleeding can be challenging to evaluate in patients with electronic cardiac devices such as continuous flow left ventricular assist devices (LVADs), pacemakers (PPMs), and implantable cardioverter defibrillators (ICDs). Limited...

(pp 130-134)

Addressing Mental Health Needs among Physicians

Katherine Buck, PhD, LMFT, Aaron Grace, PsyD, Tina Runyan, PhD, ABPP, Lauren Brown-Berchtold, MD

Abstract: Physician burnout is a national phenomenon with far-reaching implications for health systems, patients, patient care, and clinicians.1–5 Burnout is related to clinically significant depression6 and anxiety7; doctors have overall prevalence rates of depression that are...

(pp 67-69)

Curing Health Care by Adding Value: How About a Physical Examination?

Robert C. Goldszer, MD, MBA

Abstract: New diagnostic technologies … telemedicine on your mobile phone … online portals for reviewing test results and scheduling appointments … electronic medical records … paperless physician’s office—these are cornerstones of the modern healthcare experience in the...

(pp 89-90)

Commentary on “Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015”

Mary Jane Burton, MD

Abstract: In response to the sentinel Institute of Medicine report on emerging infectious diseases,1 the Centers for Disease Control and Prevention (CDC) published a national strategy for infectious disease prevention in 19942 and created the Emerging Infection Program (EIP) in...

(pp 106-107)

What Attracts Medical Students to Primary Care? A Nominal Group Evaluation

Gustave Weiland, MD, Kathryn Cox, MS, Mary Katherine Sweeney, BS, Michael Belue, MA, Erin D. Snyder, MD, William D. Curry, MD, H. Hughes Evans, MD, PhD, B. Earl Salser, MD, Carlos A. Estrada, MD, MS

Abstract: Objective: To examine the perceptions of first-year medical students on their experiences in primary care. Methods: Nominal group technique sessions were conducted with first-year medical students for 5 years. Questions were designed to evaluate primary care experiences and...

(pp 76-82)

The Importance of Health and Social Services Spending to Health Outcomes in Texas, 2010–2016

J. Mac McCullough, PhD, MPH, Jonathon P. Leider, PhD

Abstract: Objectives: Public health and social services spending have been shown to improve health outcomes at the county level, although there are significant state and regional variations in such spending. Texas offers an important opportunity for examining nuances in the patterns...

(pp 91-97)

Cancer Risk Awareness among Uninsured Primary Care Patients

Akiko Kamimura, PhD, MSW, Samin Panahi, BS, Naveen Rathi, HBS, Shannon Weaver, HBS, Jeanie Ashby, MPH

Abstract: Objectives: Underserved populations are at risk of low cancer risk awareness. The purpose of this study was to examine cancer risk awareness and lifestyle issues among uninsured primary care patients in the United States. Methods: Data were collected using a...

(pp 112-117)

Can C-Reactive Protein Be Used to Predict Acute Septic Arthritis in the Adult Population?

Luke Thornton, MBBS, Neal Ormsby, MBBS, Victoria Allgar, PhD, BSc, Glyn Thomas, FRCS

Abstract: Objectives: The objective of this study was to establish whether C-reactive protein (CRP) could be used to predict native joint septic arthritis (SA) in the adult population. Methods: All patients who underwent native joint aspiration in accident and emergency settings...

(pp 108-111)

Comparison of Medical Student Communication Skills Measured by Standardized Patients During an OSCE and by Faculty During an In-Hospital Encounter

Mary Lacy, MD, Leonard Noronha, MD, Yuridia Leyva, MS, John Rush Pierce, MD, MPH

Abstract: Objectives: At our institution, learner communication skills during an objective structured clinical examination (OSCE) are measured by standardized patients (SPs) using the New Mexico Clinical Communication Scale (NM-CCS). Faculty physicians also conduct a direct...

(pp 70-75)

Signed, Sealed, Delivered: Increasing Patient Notification of Test Results in an Internal Medicine Resident Continuity Clinic

William Benton, MD, Erin D. Snyder, MD, Carlos A. Estrada, MD, MS, Teresa J. Bryan, MD

Abstract: Objectives: Informing patients of their test results is an important patient safety issue, yet many physicians perform dismally in this regard. Residents often face additional barriers to communicating test results to patients. We wanted to determine whether streamlining...

(pp 85-88)

OPEN: Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015

Scott Santibañez, MD, MPHTM, Kimberly Spencer Bellis, MPH, Allison Bay, MPH, Christina L. Chung, MPH, Kristy Bradley, DVM, MPH, Deborah Gibson, MPH, MT, Alvin Shultz, MPH

Abstract: Because clinicians may be the first to encounter cases of emerging infectious diseases, they need to be able to work together with public health departments to quickly identify and respond to infectious disease outbreaks. Infectious diseases are a constant threat in many...

(pp 101-105)

Healthcare Disparities in People with Disabilities: Is There a Cure?

Carolyn Ann Smith, MD, MPH, JD

Abstract: The National Prevention Council, formed under the Patient Protection and Affordable Care Act of 2010 (PL 111–148), identifies a health disparity as a difference in health outcomes across subgroups of the population that often is linked to social, economic, or...

(pp 98-100)

CME Article: Imaging in Acute Pyelonephritis: Utilization, Findings, and Effect on Management

Cason Pierce, MD, Angela Keniston, MSPH, Richard K. Albert, MD

Abstract: Objectives: To determine the frequency, timing, and types of imaging obtained in patients with a discharge diagnosis of acute pyelonephritis, and how often imaging findings affect therapy. Methods: This was a retrospective chart review of 1062 adults with a diagnosis of...

(pp 118-124)

Commentary on “What Attracts Medical Students to Primary Care? A Nominal Group Evaluation”

Jacob A. Mitchell, BS, José E. Rodríguez, MD

Abstract: Weiland and colleagues1 should be commended for their work in the area of primary care choice that appears in this issue of the Southern Medical Journal. As our nation struggles with a primary care provider shortage, new and innovative strategies are required. This article...

(pp 83-84)

An Underappreciated and Prolonged Drug Interaction Leads to Ineffective Anticoagulation

Kelly C. Rogers, PharmD, Daniel W. Neu, PharmD, Melanie C. Jaeger, PharmD, Rahman Shah, MD, Shannon W. Finks, PharmD

Abstract: A poorly understood significant drug–drug interaction compounded by ineffective communication among providers at times of care transition most likely contributed to multiple thromboembolic events in an 81-year-old patient. Increased awareness of drug interactions with...

(pp 125-129)