W. Lester, L. Andrews, Emma M. Nellhaus, S. Murray, S. Loudin, T. Davies
Neonatal abstinence syndrome (NAS) is seen at a very high rate at our institution in Huntington, West Virginia, and the majority of exposures are polysubstance in nature. Polysubstance can have different meanings for different regions. At our institution, polysubstance is any combination of opioids, gabapentin, methamphetamine, cocaine, marijuana, benzodiazepines, nicotine or other neuroactive substances with three to four substances being the norm. Rapidly changing combinations of drug use and the lack of literature creates a difficult situation for clinicians who are often reliant on treatment recommendations that lack references or conclusive data supporting the clinical approaches. Elucidating withdrawal symptoms consistent with in utero exposures to particular drug combinations is difficult. Many substances induce similar withdrawal symptoms in neonates and the vast majority of cases present as polysubstance exposure. Standard methodology often leads to a research approach which isolates populations and substance of exposure to determine the individual effects on the neonate. In some drug combinations, like opioid and gabapentin exposure, the substances in concert create symptoms and complications that are not observed with either drug alone. The history of responses to substance use epidemics has been to handle each drug as a separate disease process; this is no longer a viable option. The following is a review of the literature available discussing individual substance withdrawal characteristics in neonates combined with the clinical insight gained at our hospital from treating such high rates of complex polysubstance exposure.
{"title":"Symptomology Associated with in Utero Exposures to Polysubstance in an Appalachian Population.","authors":"W. Lester, L. Andrews, Emma M. Nellhaus, S. Murray, S. Loudin, T. Davies","doi":"10.33470/2379-9536.1212","DOIUrl":"https://doi.org/10.33470/2379-9536.1212","url":null,"abstract":"Neonatal abstinence syndrome (NAS) is seen at a very high rate at our institution in Huntington, West Virginia, and the majority of exposures are polysubstance in nature. Polysubstance can have different meanings for different regions. At our institution, polysubstance is any combination of opioids, gabapentin, methamphetamine, cocaine, marijuana, benzodiazepines, nicotine or other neuroactive substances with three to four substances being the norm. Rapidly changing combinations of drug use and the lack of literature creates a difficult situation for clinicians who are often reliant on treatment recommendations that lack references or conclusive data supporting the clinical approaches. Elucidating withdrawal symptoms consistent with in utero exposures to particular drug combinations is difficult. Many substances induce similar withdrawal symptoms in neonates and the vast majority of cases present as polysubstance exposure. Standard methodology often leads to a research approach which isolates populations and substance of exposure to determine the individual effects on the neonate. In some drug combinations, like opioid and gabapentin exposure, the substances in concert create symptoms and complications that are not observed with either drug alone. The history of responses to substance use epidemics has been to handle each drug as a separate disease process; this is no longer a viable option. The following is a review of the literature available discussing individual substance withdrawal characteristics in neonates combined with the clinical insight gained at our hospital from treating such high rates of complex polysubstance exposure.","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47341976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esophageal adenocarcinoma has seen increased incidence due to gastroesophageal reflux disease, smoking, and obesity. There are no established guidelines for screening of esophageal cancer and many patients present late in their disease process. Most early stage adenocarcinoma of the esophagus is treated with neoadjuvant chemotherapy and radiation, followed by surgical resection. We describe a case of locally advanced esophageal cancer where the patient had a relatively insignificant response to neoadjuvant chemotherapy and radiation, who was then treated by open direct resection of the esophagus and proximal stomach (three field McKeown approach) with lymphadenectomy. There were no surgical complications such as anstomotic leak or chylothorax. Pathology showed T2N0 disease. The mainstay of esophageal resection continues to be minimally invasive procedures for early stage esophageal malignancy; however, locally advanced esophageal cancer in the mediastinum occasionally requires an open direct approach. We felt that this was a necessary procedure due to the large mass effect of the tumor, and a preoperative staging of T2N3. In this case, despite recent advancements, there was a limited response of the cancer to neoinduction therapy. Surgery was necessary to both assess and treat this cancer, proving that older, established therapy is still relevant.
{"title":"Surgery for Esophageal Adenocarcinoma: Three field open McKeown procedure has a role in assessment and treatment of extensive locally advanced esophageal adenocarcinoma with a favorable clinical and pathological outcome.","authors":"M. Cooper, Paul Bown, Toni O Pacioles","doi":"10.33470/2379-9536.1205","DOIUrl":"https://doi.org/10.33470/2379-9536.1205","url":null,"abstract":"Esophageal adenocarcinoma has seen increased incidence due to gastroesophageal reflux disease, smoking, and obesity. There are no established guidelines for screening of esophageal cancer and many patients present late in their disease process. Most early stage adenocarcinoma of the esophagus is treated with neoadjuvant chemotherapy and radiation, followed by surgical resection. We describe a case of locally advanced esophageal cancer where the patient had a relatively insignificant response to neoadjuvant chemotherapy and radiation, who was then treated by open direct resection of the esophagus and proximal stomach (three field McKeown approach) with lymphadenectomy. There were no surgical complications such as anstomotic leak or chylothorax. Pathology showed T2N0 disease. The mainstay of esophageal resection continues to be minimally invasive procedures for early stage esophageal malignancy; however, locally advanced esophageal cancer in the mediastinum occasionally requires an open direct approach. We felt that this was a necessary procedure due to the large mass effect of the tumor, and a preoperative staging of T2N3. In this case, despite recent advancements, there was a limited response of the cancer to neoinduction therapy. Surgery was necessary to both assess and treat this cancer, proving that older, established therapy is still relevant.","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49023995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advancing Science through Diversity Begins with Cultural Immersion in Science Education","authors":"D. Shah","doi":"10.33470/2379-9536.1224","DOIUrl":"https://doi.org/10.33470/2379-9536.1224","url":null,"abstract":"","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44281447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are many causes of acute onset foot drop ranging from deep fibular nerve or sciatic nerve injury caused by trauma or a compressive mass such as a neuroma, to spinal cord disorders like disc herniation causing L4-5 radiculopathy. Even brain disorders like MS, stroke or ALS can result in foot drop and various muscular dystrophies affecting the tibialis anterior muscle responsible for foot dorsiflexion and eversion. We present a case of bilateral foot drop as a complication of rapid 70 lb weight loss which was described in literature previously as “slimmer’s palsy”.
{"title":"Bilateral foot drop linked to rapid intentional weight loss and long distance walking.","authors":"Morgan Aguirre, J. Gibson, Dominika Lozowska","doi":"10.33470/2379-9536.1207","DOIUrl":"https://doi.org/10.33470/2379-9536.1207","url":null,"abstract":"There are many causes of acute onset foot drop ranging from deep fibular nerve or sciatic nerve injury caused by trauma or a compressive mass such as a neuroma, to spinal cord disorders like disc herniation causing L4-5 radiculopathy. Even brain disorders like MS, stroke or ALS can result in foot drop and various muscular dystrophies affecting the tibialis anterior muscle responsible for foot dorsiflexion and eversion. We present a case of bilateral foot drop as a complication of rapid 70 lb weight loss which was described in literature previously as “slimmer’s palsy”.","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46221910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
2019 On Watson, Racism, and Standardized Tests Joseph I. Shapiro Author Affiliations Joseph I. Shapiro MD (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) The author has no financial disclosures to declare and no conflicts of interest to report. Corresponding Author Joseph I. Shapiro MD (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia)
约瑟夫·i·夏皮罗医学博士(马歇尔大学琼·c·爱德华兹医学院，西弗吉尼亚州亨廷顿)作者没有财务披露要申报，也没有利益冲突要报告。通讯作者Joseph I. Shapiro医学博士(马歇尔大学Joan C. Edwards医学院，西弗吉尼亚州亨廷顿)
{"title":"On Watson, Racism, and Standardized Tests","authors":"Joseph I Shapiro","doi":"10.33470/2379-9536.1219","DOIUrl":"https://doi.org/10.33470/2379-9536.1219","url":null,"abstract":"2019 On Watson, Racism, and Standardized Tests Joseph I. Shapiro Author Affiliations Joseph I. Shapiro MD (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) The author has no financial disclosures to declare and no conflicts of interest to report. Corresponding Author Joseph I. Shapiro MD (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia)","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45544841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. B. Patel, Rita H Hawarny, E. Saunders, M. Hettlinger, N. Nahar
Sarcomatoid carcinoma is a rare malignant tumor of unknown pathogenesis characterized by poorly differentiated carcinoma tissue containing sarcoma-like differentiation of either spindle or giant cell and rarely occurs in the gastrointestinal tract and hepatobiliary-pancreatic system. Primary hepatic sarcomatoid carcinoma accounts for only 0.2 % of primary malignant liver tumors, and 1.8% of all surgically resected hepatocellular carcinomas. The majority of hepatic sarcomatoid carcinoma cases appear to occur simultaneously with hepatocellular or cholangiocellular carcinoma. The preferred treatment for hepatic sarcomatoid carcinoma is surgical resection and the overall prognosis is poor. This case depicts a 62-year-old female who underwent initial resection of a cavernous hemangioma in 2010. Seven years after her initial diagnosis, she developed what was initially felt to be local recurrence of the hemangioma but additional diagnostic workup with a liver biopsy confirmed primary hepatic sarcomatoid carcinoma.
{"title":"Rare Sarcomatoid Carcinoma of the Liver in a patient with no history of Hepatocellular Carcinoma: A Case Report","authors":"K. B. Patel, Rita H Hawarny, E. Saunders, M. Hettlinger, N. Nahar","doi":"10.33470/2379-9536.1215","DOIUrl":"https://doi.org/10.33470/2379-9536.1215","url":null,"abstract":"Sarcomatoid carcinoma is a rare malignant tumor of unknown pathogenesis characterized by poorly differentiated carcinoma tissue containing sarcoma-like differentiation of either spindle or giant cell and rarely occurs in the gastrointestinal tract and hepatobiliary-pancreatic system. Primary hepatic sarcomatoid carcinoma accounts for only 0.2 % of primary malignant liver tumors, and 1.8% of all surgically resected hepatocellular carcinomas. The majority of hepatic sarcomatoid carcinoma cases appear to occur simultaneously with hepatocellular or cholangiocellular carcinoma. The preferred treatment for hepatic sarcomatoid carcinoma is surgical resection and the overall prognosis is poor. This case depicts a 62-year-old female who underwent initial resection of a cavernous hemangioma in 2010. Seven years after her initial diagnosis, she developed what was initially felt to be local recurrence of the hemangioma but additional diagnostic workup with a liver biopsy confirmed primary hepatic sarcomatoid carcinoma.","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42502555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Etiology of unprovoked subarachnoid hemorrhage (SAH) is predominantly from cerebral aneurysm rupture and manifests classically as a thunderclap headache. Orgasmic cephalgia may herald SAH given that 4-12% of SAH sufferers were found to have engaged in prior sexual activity. Precipitating causes of SAH leading to aneurysmal rupture may be the rise in blood pressure caused by physical activity. A CT angiogram (CTA) is used to reveal a source of the bleed but occasionally this is normal, and is labelled angiogramnegative SAH or non-aneurysmal SAH. In those cases digital subtraction imaging (DSA, conventional angiogram) is needed for verification. Herein we discuss an instance of angiogram negative SAH which occurred after sexual activity in a young male with a chronic cannabis habit.
{"title":"Angiogram negative subarachnoid hemorrhage in the setting of sexual intercourse and chronic cannabis use","authors":"D. May, Dominika Lozowska","doi":"10.33470/2379-9536.1211","DOIUrl":"https://doi.org/10.33470/2379-9536.1211","url":null,"abstract":"Etiology of unprovoked subarachnoid hemorrhage (SAH) is predominantly from cerebral aneurysm rupture and manifests classically as a thunderclap headache. Orgasmic cephalgia may herald SAH given that 4-12% of SAH sufferers were found to have engaged in prior sexual activity. Precipitating causes of SAH leading to aneurysmal rupture may be the rise in blood pressure caused by physical activity. A CT angiogram (CTA) is used to reveal a source of the bleed but occasionally this is normal, and is labelled angiogramnegative SAH or non-aneurysmal SAH. In those cases digital subtraction imaging (DSA, conventional angiogram) is needed for verification. Herein we discuss an instance of angiogram negative SAH which occurred after sexual activity in a young male with a chronic cannabis habit.","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43808656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Amro, Kanaan Mansoor, M. Amro, A. Sobeih, Mehiar El-Hamdani
Kounis syndrome (KS) is a hypersensitivity coronary disorder induced by various allergens. It is a rare condition which has been reported in every age group (2-90 years) and in every race and geographic location. Its incidence has been reported to range from 7.9 to 19.4 per 100,000. The presentation of the detrimental effects of KS on coronary arteries ranges from vasospastic angina to allergic myocardial infarction. Drugs are the major iatrogenic cause of KS, but virtually everything in the environment around us can cause KS. In recent years contrast mediums used in the radiologic investigation have come forth as a leading cause of anaphylaxis. Gadolinium is a rare earth metal that is used in contrast mediums for magnetic resonance imaging and is generally considered to be safe. This is a case of 52-year-old female who developed KS after receiving gadobenate dimeglumine, a gadolinium based contrast medium (GBCM) for MRI of the brain as a work up for metastatic renal cell carcinoma. Her EKG was remarkable for ST elevations in the inferior leads. Cardiac catheterization was preformed which did not reveal any significant obstructive coronary artery disease. Patient was treated with anti-histamines, corticosteroids and norepinephrine after which she recovered and discharged home stable. GBCM induced KS is very rare and to our knowledge this is the third case of Kounis syndrome reported in association with gadobenate dimeglumine.
{"title":"Kounis Syndrome: A simple MRI with contrast turned into a life threatening condition","authors":"A. Amro, Kanaan Mansoor, M. Amro, A. Sobeih, Mehiar El-Hamdani","doi":"10.33470/2379-9536.1217","DOIUrl":"https://doi.org/10.33470/2379-9536.1217","url":null,"abstract":"Kounis syndrome (KS) is a hypersensitivity coronary disorder induced by various allergens. It is a rare condition which has been reported in every age group (2-90 years) and in every race and geographic location. Its incidence has been reported to range from 7.9 to 19.4 per 100,000. The presentation of the detrimental effects of KS on coronary arteries ranges from vasospastic angina to allergic myocardial infarction. Drugs are the major iatrogenic cause of KS, but virtually everything in the environment around us can cause KS. In recent years contrast mediums used in the radiologic investigation have come forth as a leading cause of anaphylaxis. Gadolinium is a rare earth metal that is used in contrast mediums for magnetic resonance imaging and is generally considered to be safe. This is a case of 52-year-old female who developed KS after receiving gadobenate dimeglumine, a gadolinium based contrast medium (GBCM) for MRI of the brain as a work up for metastatic renal cell carcinoma. Her EKG was remarkable for ST elevations in the inferior leads. Cardiac catheterization was preformed which did not reveal any significant obstructive coronary artery disease. Patient was treated with anti-histamines, corticosteroids and norepinephrine after which she recovered and discharged home stable. GBCM induced KS is very rare and to our knowledge this is the third case of Kounis syndrome reported in association with gadobenate dimeglumine.","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48891914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Amro, M. Amro, A. Sobeih, Obadah Aqtash, H. Hirzallah, M. Kanbour, A. Elhamdani, Alaa Gabi, Yazan Numan, M. Studeny, Mehiar El-Hamdani
Ahmed Amro, Mohammad Amro, Amal Sobeih, Obadah Aqtash, Hisham Hirzallah, Majd Kanbour, Adee El-Hamdani, Alaa Gabi, Yazan Numan, Mark Studeny, and Mehiar El-Hamdani Author Affiliations Ahmed Amro (Marshall University Joan C. Edwards School of Medicine) Mohammad Amro (Misr University for Science and Technology) Amal Sobeih (Al-Najah University School of Medicine, Nablus, Palestine) Obadah Aqtash (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Hisham Hirzallah ((Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Majd Kanbour (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Adee El-Hamdani (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Alaa Gabi (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Yazan Numan (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Mark Studeny (Marshall University) Mehiar El-Hamdani (Marshall University Joan C. Edwards School of Medicine)
Ahmed Amro、Mohammad Amro、Amal Sobeih、Obadah Aqtash、Hisham Hirzallah、Majd Kanbour、Adee El Hamdani、Alaa Gabi、Yazan Numan、Mark Studeny和Mehiar El Hamdany作者关系Ahmed Amro[马歇尔大学Joan C。Edwards医学院）Mohammad Amro（米斯尔科技大学）Amal Sobeih（巴勒斯坦纳布卢斯Al-Najah大学医学院）Obadah Aqutash（西弗吉尼亚州亨廷顿马歇尔大学Joan C.Edwards医学学院）Hisham Hirzallah。西弗吉尼亚州亨廷顿爱德华医学院）Majd Kanbour。爱德华医学院，西弗吉尼亚州亨廷顿）Mark Studeny（马歇尔大学）Mehiar El Hamdani（马歇尔大学Joan C.Edwards医学院）
{"title":"Trans-radial coronary intervention (TCI) using 5-Fr versus 6-Fr guiding catheters in the setting of acute coronary syndrome (ACS).","authors":"A. Amro, M. Amro, A. Sobeih, Obadah Aqtash, H. Hirzallah, M. Kanbour, A. Elhamdani, Alaa Gabi, Yazan Numan, M. Studeny, Mehiar El-Hamdani","doi":"10.33470/2379-9536.1210","DOIUrl":"https://doi.org/10.33470/2379-9536.1210","url":null,"abstract":"Ahmed Amro, Mohammad Amro, Amal Sobeih, Obadah Aqtash, Hisham Hirzallah, Majd Kanbour, Adee El-Hamdani, Alaa Gabi, Yazan Numan, Mark Studeny, and Mehiar El-Hamdani Author Affiliations Ahmed Amro (Marshall University Joan C. Edwards School of Medicine) Mohammad Amro (Misr University for Science and Technology) Amal Sobeih (Al-Najah University School of Medicine, Nablus, Palestine) Obadah Aqtash (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Hisham Hirzallah ((Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Majd Kanbour (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Adee El-Hamdani (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Alaa Gabi (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Yazan Numan (Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia) Mark Studeny (Marshall University) Mehiar El-Hamdani (Marshall University Joan C. Edwards School of Medicine)","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42962494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skin cancer is the most common form of cancer in the United States. The purpose of this study is to determine if a single grand rounds workshop impacts the use of dermoscopy in a family medicine residency training program. Dermoscopy is a non-invasive tool to allow for higher magnification of skin lesions thereby increasing the ability to assess qualities which are unable to be seen by the naked eye. This study utilized a preand post-workshop survey questionnaire to assess participant practices in evaluation, diagnosis, and management of skin lesions. Eighteen residents completed the survey prior to the grand rounds workshop. Nine residents completed the follow-up survey three-months post-workshop. The results showed that the frequency of dermoscopy use increased post-workshop (Pearson’s Chi Square=8.83, p=0.012; Fischer’s Exact=0.008) and residents felt dermoscopy decreased the need to refer skin lesions (Pearson’s Chi Square=9.11, p=0.028; Fischer’s Exact=0.023). However, there was no significant change in resident comfort level when using dermoscopy post-educational workshop (Pearson’s Chi Square=5.34, p=0.255; Fischer’s Exact=0.272).
癌症是美国最常见的癌症。本研究的目的是确定一次大型研讨会是否会影响皮肤镜检查在家庭医学住院培训项目中的使用。皮肤镜是一种非侵入性工具，可以对皮肤损伤进行更高的放大，从而提高评估肉眼无法看到的质量的能力。这项研究使用了研讨会前后的调查问卷来评估参与者在评估、诊断和管理皮肤损伤方面的做法。18名居民在大圆桌研讨会之前完成了调查。9名居民在研讨会后三个月完成了后续调查。结果显示，工作后使用皮肤镜检查的频率增加（Pearson’s Chi Square=8.83，p=0.012；Fischer’s Exact=0.008），居民认为皮肤镜检查减少了提及皮肤病变的需要（Pearson's Chi Square=9.11，p=0.028；Fischer‘s Exact=0.023）。然而，在使用皮肤镜检查的教育后研讨会时，住院医师的舒适度没有显著变化（Pearson’s Chi Square=5.34，p=0.255；Fischer’s Exact=0.272）。
{"title":"The use of Dermoscopy Following a one-day Workshop Among Family Medicine Residents","authors":"Dylan Maldonado, K. O'Hanlon","doi":"10.33470/2379-9536.1196","DOIUrl":"https://doi.org/10.33470/2379-9536.1196","url":null,"abstract":"Skin cancer is the most common form of cancer in the United States. The purpose of this study is to determine if a single grand rounds workshop impacts the use of dermoscopy in a family medicine residency training program. Dermoscopy is a non-invasive tool to allow for higher magnification of skin lesions thereby increasing the ability to assess qualities which are unable to be seen by the naked eye. This study utilized a preand post-workshop survey questionnaire to assess participant practices in evaluation, diagnosis, and management of skin lesions. Eighteen residents completed the survey prior to the grand rounds workshop. Nine residents completed the follow-up survey three-months post-workshop. The results showed that the frequency of dermoscopy use increased post-workshop (Pearson’s Chi Square=8.83, p=0.012; Fischer’s Exact=0.008) and residents felt dermoscopy decreased the need to refer skin lesions (Pearson’s Chi Square=9.11, p=0.028; Fischer’s Exact=0.023). However, there was no significant change in resident comfort level when using dermoscopy post-educational workshop (Pearson’s Chi Square=5.34, p=0.255; Fischer’s Exact=0.272).","PeriodicalId":93035,"journal":{"name":"Marshall journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46964585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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