Objectively Measured Physical Activity and All-Cause Mortality Among Cancer Survivors: National Prospective Cohort Study

Objective: The understanding of the effects of physical activity on all-cause mortality among cancer survivors is limited. We attempted to draw a relation between physical activity and survival among those with a diagnosis of cancer.Methods: Data from the 2003–2006 National Health and Nutrition Examination Survey was used, with follow-up...

Outcomes in an Interdisciplinary Diabetes Clinic in Rural Primary Care

Objective: The purpose of this study was to evaluate the effectiveness of an interdisciplinary diabetes team model of care in assisting patients to achieve improved glucose control in a primary care rural setting.Methods: A family medicine clinic at a rural university medical center developed an interdisciplinary diabetes team clinic...

Mycobacterium fortuitum Meningitis: Approach to Lumboperitoneal Shunt Infection

Mycobacterium fortuitum is a rare, opportunistic pathogen most frequently contracted through contact with a contaminated source. An immunocompetent 26-year-old female patient presented to our institution with an infected lumboperitoneal (LP) shunt presenting as continued nonhealing wounds. After multiple debridements, shunt revisions, and wound closure failures, infectious disease specialists were...

Evaluating the Burnout-Thriving Index in a Multidisciplinary Cohort at a Large Academic Medical Center

Objectives: There has been significant discussion about the quality of burnout research, especially with regard to abbreviated measurements of burnout and/or well-being. The purpose of this study was to compare a single-item, investigator-developed question measuring perceived well-being with validated multi-item measures of burnout and well-being.Methods: Between 2016 and 2017,...

Is Endurance Exercise Safe? The Myth of Pheidippides

With the increase in participation in endurance events in the general population, patient concern may arise as to whether endurance exercise is safe. Acute but not chronic increases in blood urea nitrogen, creatinine, and urine albumin occur in endurance exercise. Iron-deficiency anemia may be observed in female athletes. Upper...

CME Article: Characteristics of Syncope Admissions Among Hospitals of Varying Teaching Intensity

Objectives: Previous work suggests that hospitals’ teaching status is correlated with readmission rates, cost of care, and mortality. The degree to which teaching status is associated with the management of syncope has not been studied extensively. We sought to characterize the relation between teaching status and inpatient syncope management....

Development of a Vertically Integrated Trainee Program: Linking Future and Young Physicians

Organizations representing a wide spectrum of health and healthcare settings, such as healthcare disciplines, clinical and scientific professional organizations within disciplines, hospitals, and academic medical centers, are facing many challenges and concerns. Organized medical associations such as local, state, and national associations are not immune from similar concerns faced...

Awareness of Birth Cohort Hepatitis C Testing Recommendation Among Baby Boomers: An Exploratory Survey Study

Objectives: To examine population awareness of the Centers for Disease Control and Prevention’s (CDC) hepatitis C virus (HCV) testing recommendation for the 1945 to 1965 birth cohort and explore the factors associated with awareness of the testing recommendation, its association with HCV testing, and respondents’ data sources about the...

Trauma Providers’ Perceptions of Frailty Assessment: A Mixed-Methods Analysis of Knowledge, Attitudes, and Beliefs

Objectives: Quality improvement in geriatric trauma depends on timely identification of frailty, yet little is known about providers’ knowledge and beliefs about frailty assessment. This study sought to understand trauma providers’ understanding, beliefs, and practices for frailty assessment. Methods: We developed a 20-question survey using the Health Belief Model...

On “Improving Underrepresented Minority in Medicine Representation in Medical School”

To the Editor: We sincerely thank Campbell et al for their article exploring the importance of and the need to improve the representation of underrepresented minorities in medical school.1 This is a societally shifting paradigm and a task-shifting agenda that must be brought to the forefront of medical...

Contraceptive Methods and the Impact of Menstruation on Daily Functioning in Women with Sickle Cell Disease

Objectives: Women with sickle cell disease (SCD) are living longer as a result of advances in the care of their underlying disease. With the population growing of women living with SCD, reproductive health issues in this population have become an emphasized area of medical care. We sought to describe...

Impact of Holidays on Pediatric Trauma Admissions to a Community Hospital in South Florida

Objectives: The data from temperate regions indicate increases in pediatric traumatic injuries during the spring and summer months with anticipated admission spikes on warm weather holidays; hospitals in southern subtropical regions should not anticipate the same trends. The objectives of this study were to identify holiday-specific spikes in pediatric...

Improving Documentation of Obstetric Anal Sphincter Injuries (OASIS) Using a Standardized Electronic Template at Two University-Affiliated Institutions

Objectives: Adequate repair is vital to reduce the long-term sequelae of obstetric anal sphincter injuries (OASIS). Sufficient documentation is necessary to reflect the quality of care provided, to guide future management, and to reduce medicolegal liability. With the advent of electronic health records, proper methods of documentation can be...

Advanced Prescription of Emergency Contraceptive Pills Among Adolescents and Young Adults

Objective: To examine healthcare providers’ adherence to professional recommendations for advanced prescription of emergency contraceptive pills (ECPs). Methods: We conducted a retrospective chart review of 432 visits by 282 unique nonpregnant women 14 to 25 years of age seen at an obstetrics and gynecology teaching clinic to determine the...

Commentary on “Lessons Learned from Building a Pediatric-to-Adult Sickle Cell Transition Program”

In their article “Lessons Learned from Building a Pediatric-to-Adult Sickle Cell Transition Program,” which appears in this issue of the Southern Medical Journal, Smith and colleagues highlight the challenges of the healthcare transition for this already high-risk population.1 The problem cannot be...

Flexible Sigmoidoscopy Rather than Colonoscopy Is Adequate for the Diagnosis of Ipilimumab-Associated Colitis

Objectives: Treatment with ipilimumab, a cytotoxic T lymphocyte antigen-4 approved for metastatic melanoma can result in clinically significant immune-mediated drug injury in the form of colitis. Timely diagnosis and response are essential for optimal management. The aims of our study were to determine the percentage of our patients with...

Lessons Learned from Building a Pediatric-to-Adult Sickle Cell Transition Program

Objective: More effective transitions and transfers of young people with sickle cell disease (SCD) into the adult healthcare setting is a focus of both primary care and specialty care medical organizations. Effective transition and transfer requires six core elements: establishing a policy, tracking progress, administering transition readiness assessments, planning...

A 5-Step Framework for the Assessment and Remediation of a Struggling Medical Learner in the Clinical Environment

Struggling medical learners are not uncommon, comprising between 7% and 15% of trainees in >90% of all US internal medicine training programs across a spectrum of size, geographic location, and academic affiliation.1,2 Interactions with such learners present a unique set of challenges to clinical...

Antibiotic Prophylaxis for Cesarean Delivery Among Alabama Providers

Objectives: A multicenter, randomized controlled trial has demonstrated the benefit of adding azithromycin to routine preoperative antibiotics in unscheduled cesarean deliveries (CDs) to prevent surgical site infections. We sought to describe and identify barriers to the implementation of azithromycin prophylaxis for CDs by Alabama healthcare providers. Methods: We conducted...

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

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 data exist on the utility and safety of single balloon enteroscopy (SBE) in patients with cardiac...