Moral Controversy and Working with Colleagues with a Shared Ethical/Moral Outlook: A National Survey of US Primary Care Physicians

Commentary on “Moral Controversy and Working with Colleagues with a Shared Ethical/Moral Outlook: A National Survey of US Primary Care Physicians”

The finding that in the midst of moral conflict, physicians who are more religious or with a high sense of calling may prefer to work most closely with colleagues who share similar ethical and moral perspectives is not entirely surprising, as detailed in the article by Choi and colleagues...

CME Article: Moral Controversy and Working with Colleagues with a Shared Ethical/Moral Outlook: A National Survey of US Primary Care Physicians

Objectives: This study assesses physicians’ attitudes on the importance of working with colleagues who share the same ethical or moral outlook regarding morally controversial healthcare practices and examines the association of physicians’ religious and spiritual characteristics with these attitudes.Methods: We conducted a secondary data analysis of a 2009 national...

Commentary on “What Defines an Honors Student? Survey of Pediatric and Internal Medicine Faculty Perspectives”

In “What Defines an Honors Student? Survey of Pediatric and Internal Medicine Faculty Perspectives,” in this issue of the Southern Medical Journal, Schmit and colleagues seek to explicate how attendings think.1 How do these evaluators recognize excellence (honors) for a third-year medical student...

What Defines an Honors Student? Survey of Pediatric and Internal Medicine Faculty Perspectives

Objective: Although considerable emphasis is placed on the attainment of honors in core medical school clerkships, little is known about what student characteristics are used by attending physicians to earn this designation. The purpose of this study was to evaluate what values and characteristics that attending physicians consider important...

Health Behaviors in Rural Appalachia

Objectives: To better understand the disproportionate burdens from cancer, cardiovascular disease, diabetes mellitus, stroke, and other chronic conditions related to energy balance, we studied diet and physical activity patterns in younger and older adults in rural Appalachia by using a nonclinical, cross-sectional, community-based sampling approach.Methods: A total of 651...

Noncarbapenems for the Treatment of Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase-Producing Bacteria

 Objectives: Urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are resistant to many conventional therapies, including third-generation cephalosporins. Carbapenems are considered first-line agents for ESBL infections, but their use is associated with increased multidrug resistance and should be reserved when absolutely necessary. Because of the increased rates...

OPEN: Developing and Piloting a Tool to Identify Food Insecurity in Older Adults

Objective: The literature shows that food insecurity (FI) can negatively affect the trajectory of many chronic illnesses. FI can be acutely severe for older adults, but screening for FI is not regularly performed in the hospital setting. Our goal was to develop a tool to screen for FI upon...

Weight-Bearing Physical Activity Influences the Effect of Vitamin D on Bone Turnover Markers in Patients with Intellectual Disability

Objectives: Individuals with intellectual disabilities (IDs) are at increased risk for low bone mass and fragility fractures, and those who are nonambulatory may be at even higher risk. Patients with IDs often are vitamin D deficient, but there is little information concerning how vitamin D treatment of patients with...

Prevalence and Predictors of Pulmonary Embolism in Hospitalized Patients with Syncope

Objectives: Approximately one in six patients hospitalized with syncope have pulmonary embolism (PE), according to the PE in Syncope Italian Trial study. Subsequent studies using administrative data have reported a PE prevalence of <3%. The aim of the study was to determine the prevalence and predictors of PE in...

Commentary on “A Dose-Response Analysis of Crystalloid Administration during Esophageal Resection”

In this issue of the Southern Medical Journal, Smith and Nossaman retrospectively examined patient records for 100 consecutive esophageal surgeries to assess intraoperative intravenous fluid with outcomes.1 They found a dose-response relation associating intraoperative crystalloid administration with decreased length of stay and adverse...

A Dose-Response Analysis of Crystalloid Administration during Esophageal Resection

Objectives: The purpose of this retrospective study was to investigate the role of intraoperative crystalloid administration on postoperative hospital length of stay (phLOS) and on the incidence of previously reported adverse events in 100 consecutive patients who underwent esophageal resection.Methods: The role of previously reported patient demographics, clinical characteristics,...

Assessing the Availability of Pharmacotherapy Options for Tobacco Cessation in Tennessee’s Substance Use Facilities

Objectives: Smoking is deadly and exacerbates comorbid health conditions, especially among those with co-occurring substance use disorders. Tennessee does not require substance abuse treatment facilities to concurrently provide tobacco-cessation treatment options or limit smoking on facility property as a standard for licensure. This study examines the relation between Tennessee...

Choice of Intravenous Crystalloid Fluid and Mortality in Critically Ill Adult Patients

Objectives: Intravenous balanced crystalloid fluid therapy may improve mortality and other outcomes in critically ill adult patients, but data are conflicting. We conducted a meta-analysis and literature review to evaluate the impact of intravenous balanced crystalloid, as compared with normal saline, fluid therapy on outcomes in critically ill adult...

Commentary on “An Updated Approach to Evaluation and Treatment of Helicobacter pylori Infection”

This issue of the Southern Medical Journal contains an important and timely review of Helicobacter pylori diagnosis and treatment.1 Since its discovery in 1983, H. pylori infection has been found to be the main cause of peptic ulcer disease, chronic gastritis, gastric cancer, and mucosa-associated lymphoid tissue...

An Updated Approach to Evaluation and Treatment of Helicobacter pylori Infection

Helicobacter pylori is a chronic bacterial infection that can lead to peptic ulcer disease, chronic gastritis, and gastric cancer. Its prevalence in the United States is lower than in most of the world, although specific populations are at particular risk for disease-related complications, including those with lower socioeconomic status...

Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults in Baltimore, Maryland

Objectives: Adults with perinatally acquired human immunodeficiency virus (PHIV) infection may be at increased risk for nonacquired immunodeficiency syndrome (AIDS) diseases, including systemic hypertension (HTN). The purpose of this study was to examine the prevalence of HTN among young adults with PHIV compared with recently infected and uninfected young...

Healthcare Access, Pregnancy Intention, and Contraceptive Practices Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee

Objectives: Women with substance use disorders often experience unique challenges to obtaining contraception and adhering to user-dependent methods. As a result, this at-risk population of women tends to have higher than average rates of unintended pregnancy. The objective of this study was to describe contraceptive use, pregnancy intentions, and...

The Costs of Applying to Residency: One Institution’s Efforts to Increase Transparency

Objectives: To provide students at our own institution with more accurate and granular data regarding the costs associated with applying for residency.Methods: We created an electronic survey with >28 different fields delineating the costs associated with applying for residency. Demographic data, costs broken down by type of expenditure, and...

OPEN: Effect of Local Smoke-Free Ordinances on Smoking Prevalence in Kentucky, 2002–2009

Objectives: Many local communities in Kentucky, a state with one of the highest smoking prevalence rates in the United States, have enacted smoke-free ordinances that prohibit smoking in workplaces and enclosed buildings open to the public. Research has shown that such ordinances are clearly beneficial for public health, but...