Prenatal Contraceptive Counseling by Video

Objective: Effective postpartum contraception can improve interpregnancy intervals. Opportunities exist for counseling and education during prenatal care. Few studies have assessed the use of multimedia as a tool to improve long-acting reversible contraception (LARC) use postpartum. The objective of this study was to evaluate whether LARC-focused video counseling during prenatal care increases uptake of postpartum LARC and overall contraception...

Commentary on “Evaluation of Patients for Zika Virus Infection in a Travel Clinic in the Southeast United States, 2016”

In 2016, the World Health Organization declared the ongoing Zika virus outbreak in the Americas, the Caribbean, and the Pacific a public health emergency of international concern after identifying a causal association between Zika virus infection and microcephaly in newborns, among other central nervous system abnormalities, and adverse pregnancy outcomes (miscarriage, stillbirth) in pregnant women.1 This World Health...

Patients’ Perceptions of the Role of Physicians in Questioning and Educating in Firearms Safety: Post-FOPA Repeal Era

Objectives: In this study, we determined patients’ attitudes toward discussing firearms and issues of firearms safety with emergency department physicians. We assessed whether patients feel discriminated against should physicians discuss firearms safety, and whether they believed that physician counseling may change how patients store firearms. Methods: From June to October 2017, we conducted a cross-sectional institutional review...

Evaluation of Patients for Zika Virus Infection in a Travel Clinic in the Southeast United States, 2016

Objectives: Zika virus is an emerging infection that has posed vexing challenges to the US public health system. Improved characterization of patients with possible and confirmed infection is needed to better understand risks for infection in US travelers and to inform evolving evaluation guidelines. Methods: We performed a retrospective electronic health record review of patients evaluated for Zika virus infection at an academic travel...

Children’s Age, Family Conflict, and Children’s HbA1c: Are Girls and Boys Different?

Objective: This study examined the relation between children’s sex, age, family conflict, and children’s glycated hemoglobin A1c (HbA1c). Methods: Parents of children with type 1 diabetes mellitus were recruited from the diabetes clinic of a midwestern children’s hospital. The survey included demographics and the Diabetes Family Conflict Scale (DFCS). The index child’s HbA1c was obtained. Results: DFCS was significantly associated...

Impact of Inpatient Consults by a Family Medicine Teaching Service

Objectives: Inpatient consult rates by family physicians significantly affect many aspects of medical care. Limited research has investigated the consultant rate by family medicine residents and their impact on length of stay (LOS) and direct cost. This study examines the inpatient consultant rate of family medicine residents. Methods: We conducted a retrospective electronic chart review of consults associated with hospitalizations on a...

A Brochure to Improve Understanding of Incomplete Mammogram Results Among Black Women at a Public Hospital in Miami, Florida

Objectives: Black women are at increased risk of being called back for additional studies after a screening mammogram. With focus group input, we developed a brochure to improve awareness of the frequency of abnormal results. This study explored the brochure’s acceptability and effect on understanding risk and breast cancer fears among black mammography patients at an urban safety-net breast imaging center in Miami, Florida. Methods: A...

Uterine Surrogacy is Morally Equivalent to Selling a Kidney

To the Editor: Uterine surrogacy is accepted in the United States, but it is illegal for an individual to financially benefit from donating a kidney to another person. Both provide the gift of life. For surrogacy, it is a newborn child; for transplantation it is longer life expectancy1 and an increased quality of...

Radiologic versus Endoscopic Placement of Gastrostomy Tube: Comparison of Indications and Outcomes at a Tertiary Referral Center

Objectives: Percutaneous gastrostomy tube placement is performed in patients requiring long-term enteral nutrition. Although both endoscopic and fluoroscopic techniques may be used, there are inherent risks and potential complications associated with both procedures that are not generally known to referring physicians. The purpose of this study was to compare and contrast indications for placement and procedurally related complications between...

Ebola 101

To the Editor: Ebola virus (EBOV) is a zoonotic filovirus, with fruit bats being the animal reservoir. In recent years, there has been an Ebola epidemic in western Africa, yielding a public health crisis.1 Transmission of the virus to humans requires the direct contact of mucous membranes with the body fluids or tissues of infected...

Commentary on “Prenatal Contraceptive Counseling by Video”

Advances in technology can provide novel platforms for delivering health information and have the potential to transform patient education and counseling. The study by Staley et al in this issue of the Southern Medical Journal examines the impact of video counseling during prenatal care on the uptake of postpartum long-acting reversible contraception...

CME Article: Clinical Utility of Routine Chest X-Rays During the Initial Stabilization of Trauma Patients

Objectives: The Advanced Trauma Life Support (ATLS) course encourages the use of chest x-ray (CXR) to identify injuries that may change clinical management during the initial stage of trauma resuscitations. Several studies have failed to show benefit for the routine use of CXR without a clinical indication, however. We sought to validate these findings by determining the incidence of clinically significant findings discovered on a portable...

Frequency, Timing, and Types of Medication Ordering Errors Made by Residents in the Electronic Medical Records Era

Objectives: To describe associations between resident level of training, timing of medication orders, and the types of inpatient medication ordering errors made by internal medicine residents. Methods: This study reviewed all inpatient medication orders placed by internal medicine residents at a tertiary care academic medical center from July 2011 to June 2015. Medication order errors were measured by pharmacists’ reporting of an error via...

Editor’s Response

We have elected to publish Dr McCartney’s Letter to the Editor, wherein he advocates for an open market for the sale of kidneys for transplantation, to again stimulate thought and discussion regarding the ethical nuances of organ...

Healthcare Professionals and In-Flight Medical Emergencies: Resources, Responsibilities, Goals, and Legalities as a Good Samaritan

Common in-flight emergencies include syncope, respiratory symptoms, nausea/vomiting, cardiac symptoms, and seizures. Flight conditions, such as changes in air pressure and humidity, can exacerbate existing chronic medical conditions. In 2017, US airlines carried 849.3 million passengers. Undoubtedly, there were many requests for in-flight medical assistance. Whenever a medical event occurs, it is standard procedure that an announcement be made...

A Misguided Venture: Presidential Fitness and the Duty to Warn

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 rallying cry of an obligation to protect the public from a dangerous president has inspired a medical conference at Yale,4 an eponymous online movement,5 and a best-selling...

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

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 Journal, I first comment on the aim of physician activism to achieve political goals using medical constructs such as the duty to warn. I then focus on the current use of the Tarasoff...

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

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, placebo-controlled trial of FabAV or placebo. The treatment allocation ratio was 2:1 (FabAV:placebo). All of the included patients received at least one dose of study treatment....

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

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 underrecognized opportunity to develop basic teaching skills. In addition, in the current graduate medical education climate, residents’ tasks are compressed into an even...

Invasive Mechanical Ventilation

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 ventilated patients. Attention is given to how common ventilator modes differ in delivering a mechanical breath, evaluation of respiratory system mechanics, how to approach acute...