SMJ // February 2017, Volume 110 - Issue 2

Original Article

Association Between Multiple Modifiable Risk Factors of Cardiovascular Disease and Hypertension among Asymptomatic Patients in Central Appalachia

Objectives: The central Appalachian region of the United States is disproportionately burdened with cardiovascular diseases (CVD) and associated risk factors; however, research to inform clinical practice and policies and programs is sparse. This study aimed to examine the association between multiple modifiable risk factors for CVD and hypertension in asymptomatic…

Perspectives

Planning for the Next Epidemic

Recent American public health concerns have included two emerging viral infection threats, zika and Ebola, and the recrudescence of the measles virus. Zika confirms the opinion that even when a disease vector, such as a mosquito, for a viral disease is well defined, it may be difficult to eliminate that…

Original Article

Predictors of the Need for Therapeutic Intervention in Older Adult Patients With a Nonvariceal Gastrointestinal Bleed

Objective: Gastrointestinal bleeding (GIB) is a common cause of hospitalization in the older adult population. The aim of the study was to identify factors that are associated with the need for a therapeutic intervention in patients older than 65 years with nonvariceal GIB. Methods: This is a retrospective cohort study…

Invited Commentary

Commentary on “Factors Associated with Routine Recommendation of Mammography for Women Aged 40 to 49: Provider Characteristics and Screening Influences”

The data presented by Martinez and colleagues1 in this issue of the Southern Medical Journal suggest that many or most primary care physicians continue to recommend screening mammography for women in their 40s at normal risk for cancer, despite the lack of evidence for its efficacy.

Review Article

Hereditary Angioedema: Implications of Management

Hereditary angioedema (HAE) is a genetic condition that is characterized by frequent episodes of localized angioedema. It is a rare disorder that a primary care provider, otolaryngologist, dermatologist, or rheumatologist may encounter only occasionally. This disease is being reviewed because of the significant advances in further understanding the genetics, biology,…

Review Article

Psoriasis and Cardiomyopathy: A Review of the Literature

Psoriasis is an idiopathic chronic immune-mediated skin condition in which the body’s immune system undergoes several derangements, including increased antigen presentation by T cells and increased T-helper cell type 1 cytokines, resulting in skin lesions as well as arthritis. Despite that cardiovascular involvement in psoriasis is common and reported in…

Original Article

Factors Associated with Routine Recommendation of Mammography for Women Aged 40–49: Provider Characteristics and Screening Influences

Objectives: Despite the US Preventive Services Task Force recommendation against screening mammography in women younger than 50 years, rates remain high, suggesting that screening recommendations may be motivated by other factors. The objective of this study was to understand provider-reported influences on screening recommendations for women 40 to 49 years…

Original Article

Resident and Faculty Perceptions of Chart-Stimulated Recall

Objectives: Chart-stimulated recall (CSR) is a case-based interviewing technique advocated by the Accreditation Council for Graduate Medical Education as an assessment tool across a variety of clinical competencies, yet resident and faculty perceptions of this exercise have not been reported previously. The authors incorporated a CSR exercise into an internal…

Original Article

ASA Classification Pre-Endoscopic Procedures: A Retrospective Analysis on the Accuracy of Gastroenterologists

Objectives: Before an endoscopic procedure, an evaluation to assess the risk of sedation is performed by the gastroenterologist. To risk stratify based on medical problems, the American Society of Anesthesiologists (ASA) classification scores are used routinely in the preprocedure evaluation. The objective of our study was to evaluate among physicians…

Original Article

Missed Opportunities for Preventing Perinatal Transmission of Human Immunodeficiency Virus, Florida, 2007–2014

Objectives: Despite declining numbers of perinatally exposed infants, an increase in perinatal human immunodeficiency virus (HIV) infections from 2011 to 2013 prompted this study to identify missed perinatal HIV prevention opportunities. Methods: Deidentified records of children born from 2007 through 2014, exposed to HIV perinatally, and reported to the Florida…

Original Article

Timeliness of Treatment Initiation and Associated Survival Following Diagnosis of Non–Small-Cell Lung Cancer in South Carolina

Objectives: Non–small-cell lung cancer (NSCLC) patient survival depends on a number of factors, including early diagnosis and initiation of treatment. Standard treatment options for patients with NSCLC include surgery, radiation therapy, and chemotherapy. The objective of this study was to evaluate the impact that the initiation of timely treatment has…

Multidisciplinary Clinical Case Study

Breaking Bad Delirium: Methamphetamine and Boric Acid Toxicity with Hallucinations and Pseudosepsis

Objectives: A 30-year-old patient presented with hallucinations and profound shock. He was initially misdiagnosed as having severe sepsis; once ingestions were considered, he was diagnosed as potentially having arsenic toxicity. Summary: The clinical story reveals many instructional lessons that could aid in the evaluation and management of future patients. This…

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