Issue - Southern Medical Association

Perspectives

Busting the Medical Trust? Professional Self-Regulation and the Imperatives of Competition

Whereas medical professionalism is rooted in a tradition of self-regulation, the American constitutional structure is based on states’ inherent powers to protect the public’s health and safety. For more than 100 years, state legislatures have accommodated these dual prerogatives by turning to practicing physicians to regulate the practice of medicine…

Original Article

Impact of Evidence-Based Guidelines on Outcomes of Hospitalized Patients With Clostridium difficile Infection

Objectives: Clostridium difficile infection (CDI) is the most common healthcare-associated infection in the United States. Clinical practice guidelines for the treatment of CDI were updated in 2010 by the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America. An institutional guideline for the classification and management…

Original Article

Feasibility of Canine Therapy Among Hospitalized Pre–Heart Transplant Patients

Objectives: Canine-assisted therapy (CAT) has been used in many settings with much success, yet no study has assessed its feasibility and receptiveness in hospitalized patients awaiting heart transplantation. Methods: Patients admitted to our institution with a status I for heart transplantation during a 12-month period (April 2014–April 2015) were prospectively…

Original Article

Prevalence of Pancreatic Steatosis at a Pediatric Tertiary Care Center

Objectives: Pancreatic steatosis in adults has been proposed to be associated with obesity; however, data on pancreatic steatosis in children are lacking. Our study aimed to measure the prevalence of pancreatic steatosis in children and to examine its association with obesity and nonalcoholic fatty liver disease. Methods: This is a…

Invited Commentary

Commentary on “Stress Ulcer Prophylaxis in Hospitalized Patients, Subsequent Use in Primary Care and Physicians’ Opinions About Acid-Suppressive Therapy”?

Acid-suppressive therapy (histamine 2 receptor antagonist [H2] or proton pump inhibitors [PPIs]) is one of the most prescribed treatments in both inpatient and outpatient settings in the United States (eg, esomeprazole, with 18.6 million prescriptions in 2014)1 and Europe. Increasing medical literature data, however, have shown the appearance of serious…

Review Article

Statin-Associated Diabetes Mellitus: Review and Clinical Guide

A small but significant link between new-onset diabetes mellitus (NOD) and statin therapy was noted with rosuvastatin users in the Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin study. Since then multiple analyses have further confirmed this association, with most studies demonstrating a modest…

Perspectives

Community Paramedicine and Mobile Integrated Health Care: Existing Resources Bringing New Benefits

Internationally, Emergency Medical Services (EMS) providers often serve to not only provide emergency care and transportation but also act as a bridge between inpatient and outpatient care, typically through programs that provide a variety of home-based services arranged in conjunction with a physician’s oversight. Interestingly, one of the earliest projects,…

Original Article

Stress Ulcer Prophylaxis in Hospitalized Patients, Subsequent Use in Primary Care, and Physicians’ Opinions About Acid-Suppressive Therapy

Objectives: Stress ulcer prophylaxis (SUP) is not indicated in most hospitalized patients. This study determined the prevalence of the use of proton pump inhibitors (PPI) and histamine receptor 2 blockers (H2B) in hospitalized patients, continued PPI/H2B use after discharge, and physicians’ opinions about SUP. Methods: A retrospective electronic chart review,…

Original Article

Light-Intensity Physical Activity and Medical Multimorbidity

Objectives: No study has examined the association between objectively measured light-intensity physical activity (LIPA) and multimorbidity (≥2 chronic diseases) in a national sample of US adults. I undertook this examination. Methods: Data from the 2005–2006 National Health and Nutrition Examination Survey were used (N = 2048 adults 20 years old…

Original Article

Do Gestational Age Dating Criteria Matter in Medically Indicated Late Preterm, Early-Term, and Full-Term Inductions of Labor?

Objectives: To assess short-term neonatal respiratory morbidity from inductions of labor (IOL) in well-dated (WD) pregnancies (dating ultrasound [US] 35 weeks. There were no differences in maternal or other neonatal outcomes between the WD and NWD pregnancies. Conclusions: In our cohort of medically indicated IOL, a dating US before 20…

Review Article

Utility of the Shock Index and Other Risk-Scoring Tools in Patients with Gastrointestinal Bleeding

Patients with upper gastrointestinal (GI) bleeding frequently require hospitalization and have a mortality rate that ranges from 6% to 14%. These patients need rapid clinical assessment to determine the urgency of endoscopy and the need for endoscopic treatment. Riskscoring tools, such as the Rockall score and the Glasgow-Blatchford score, are…

Original Article

Management of Cocaine-Induced Myocardial Infarction: 4-Year Experience at an Urban Medical Center

Objectives: In 2008, the American Heart Association and the American College of Cardiology released guidelines for the management of cocaine-induced myocardial infarction (CIMI). We hypothesized that CIMI patients are likely to receive less invasive and more conservative management than patients with MI without history of cocaine use. Methods: We conducted…

Invited Commentary

Commentary on “Busting the Medical Trust? Professional Self-Regulation and the Imperatives of Competition”

The practice of medicine is changing. In recent years physicians have had to adapt to digital record keeping, practice acquisitions, and new reimbursement modalities. In the midst of that tumult, it is understandable why most physicians were not riveted by the progress of the North Carolina State Board of Dental…