Southern Medical Journal最新文献

{"title":"Bridging the Gap: Examining Physician Assistant Practice Patterns to Address Kentucky's Health Care Workforce.","authors":"Virginia Valentin, Daniel Potter","doi":"10.14423/SMJ.0000000000001847","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001847","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to provide a description of the physician assistant (PA) workforce in Kentucky and the perspective of current Kentucky PA students regarding factors to influence rural work. This study intends to provide insights into the practice patterns of Kentucky PAs and alumni and desires of current students to assist policy leaders in understanding the impact that PAs could have on this medically underserved part of the country.</p><p><strong>Methods: </strong>The Kentucky Board of Medical Licensure database of licensed PAs and physicians was used to locate all currently practicing PAs in Kentucky and PA graduates from a large public university in Kentucky, 2016-2022. These practice locations were used to demonstrate movement of PA alumni before school matriculation, current practice areas by Health Professional Shortage Area and Medically Underserved Areas/Populations by counties and area of specialty. A cross-sectional survey was given to PA students at a large public university in Kentucky aimed at assessing the perceptions and influential factors regarding the PA profession and personal employment opportunities among PA students.</p><p><strong>Results: </strong>There are 1649 PAs who have active licenses in Kentucky and practice in 92 counties with 28 counties with no PAs; 42.5% of Kentucky PAs serve primary care Health Professional Shortage Areas and 20.0% serve in Medically Underserved Areas/Populations. The most common areas of practice are emergency medicine (14.5%) and internal medicine (14.5%). PAs from rural areas had significantly higher odds of holding a rural license compared with those from metropolitan areas (odds ratio, 6.42; <i>Z</i> = 6.76; <i>P</i> < 0.00001). Students reported choosing the PA profession due to length of education, work-life balance, and career mobility.</p><p><strong>Conclusions: </strong>Addressing the critical healthcare access issue in the southern United States will require innovation and utilization of the entire healthcare team. With 34% of PAs working in rural counties in Kentucky, policy leaders need to focus on methods to incentivize the next generation of PA providers to rural counties. As the dependency on nonphysician providers increases, future policy decisions and research needs to center around PA practice patterns and understanding of the needs of the next generation of providers.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"400-405"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access and Use of Green and Blue Spaces for Memory and Physical Health.","authors":"Julia Kay Wolf, Jeralynn S Cossman","doi":"10.14423/SMJ.0000000000001845","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001845","url":null,"abstract":"<p><strong>Objectives: </strong>The coronavirus disease 2019 pandemic exacerbated mental and physical health issues in the United States. Due to various lockdown procedures to curb the spread of the virus, indoor gatherings were severely restricted, intensifying stress and anxiety.</p><p><strong>Methods: </strong>We used nationally representative data from the 2021 Crime, Health, and Politics Survey sampled from the National Opinion Research Center's AmeriSpeak panel. To explore pandemic-safe options to relieve negative health outcomes, we studied how access to and use of green and blue spaces were related to self-rated physical and mental health (ie, memory) during the pandemic.</p><p><strong>Results: </strong>Most of the logistic regressions show no relationships between access to green or blue spaces and the health outcomes (except for access to blue spaces and physical health), but we find positive associations between use of green and blue spaces with overall physical health and memory.</p><p><strong>Conclusions: </strong>Access to green or blue spaces is not necessarily enough to create a relationship with overall physical health and memory-actually using these areas is a key component to their association with positive health outcomes.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"389-393"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Outreach: A Strategy to Increase Recruitment of Latinx Medical Students into Otolaryngology.","authors":"Pablo C Ochoa, Tissiana Vallecillo, Semirra Bayan","doi":"10.14423/SMJ.0000000000001843","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001843","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"406-407"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of hs-CRP in Post-MI Sequelae: Insights into Mechanisms and Clinical Significance.","authors":"Yash Vardhan Trivedi, Parth Munjal, Bhupinder Singh, Rhea Kanwar, Aachal Gupta, Rohit Jain","doi":"10.14423/SMJ.0000000000001848","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001848","url":null,"abstract":"<p><p>High-sensitivity C-reactive protein (hs-CRP) is a key marker of inflammation, predominantly produced by hepatocytes and various tissues, including intracardiac tissue, atherosclerotic plaques, and vascular smooth muscles. The biomarker serves as a crucial element of innate immunity and rises in response to various disease processes, including infections and cancers. This rise is triggered by the release of cytokines, primarily interleukin-6, tumor necrosis factor, and interleukin-1β. The utility of hs-CRP in clinical practice is being further explored, particularly regarding its role in cardiovascular disease, a leading cause of morbidity and mortality globally. Studies have demonstrated that elevated hs-CRP levels are associated with an increased risk of myocardial infarction (MI) and other cardiovascular events. hs-CRP has been suggested to play a role in the development of atrial and ventricular arrhythmias post-MI, although further research is needed to fully clarify this relationship. hs-CRP has been proposed as a potential biomarker for the early detection of post-MI events and be used for cardiovascular disease risk stratification, categorizing individuals into low-, intermediate-, and high-risk groups. In this study, we discuss the role of hsCRP in predicting adverse outcomes in various cardiovascular conditions, highlighting its potential as a valuable biomarker in clinical practice.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"382-386"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online Interest in Colorectal Cancer Screening in Florida.","authors":"Raghuram V Reddy, Karla C Santoyo, Varun Hariharan, Jay Desai, Amalia Landa-Galindez","doi":"10.14423/SMJ.0000000000001846","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001846","url":null,"abstract":"<p><strong>Objective: </strong>Colorectal cancer (CRC) is the third most common cancer worldwide and the second most common cause of cancer death for men and women combined. It is estimated that in 2024, 53,010 people will have died from CRC. The objective of this study was to analyze online interest in CRC screening in Florida.</p><p><strong>Methods: </strong>Google Trends was queried for \"colorectal cancer screening,\" \"fecal occult blood test,\" and \"colonoscopy\" from 2004 to the present. The relative search volume (RSV) ranged from 0 to 100, with 0 meaning no interest and 100 signifying maximum popularity.</p><p><strong>Results: </strong>Google Trends analysis revealed variations in interest for CRC screening, fecal occult blood test as a screen, and colonoscopy across Florida metropolitan areas. Gainesville consistently ranked high for all three terms. Interest peaked for screening in 2009 and 2022, for fecal occult blood test in 2024, and for colonoscopy in 2007. Related search terms focused on screening guidelines, procedures, and preparation.</p><p><strong>Conclusions: </strong>Google Trends can provide a useful tool for evaluating interest in Florida for CRC screening, which is important because there are screening disparities across Florida counties compared with national and state averages. By identifying areas with lower search interest, healthcare providers and public health organizations can target community interventions based on the specific barriers faced by residents in each metropolis.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"365-369"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Adverse Effects of Artri King: A Systematic Review and Case Series.","authors":"Magnus Chun, Jenna Sutton, Jessica Chung, Jose Lazarte, Anna Horvath, Madison Elmer, Hazem Aboaid, Badrunnisa Hanif","doi":"10.14423/SMJ.0000000000001851","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001851","url":null,"abstract":"<p><p>There has been an uptrend in patients taking Artri King, an over-the-counter supplement marketed for joint pain despite Food and Drug Administration warnings of it containing undeclared substances such as diclofenac and dexamethasone. Despite the popularity of this supplement, there is a lack of awareness of the deleterious, adverse effects. To our knowledge, there has not been a systematic review evaluating outcomes of patients taking Artri King. A comprehensive literature search was performed from major databases from inception to June 17, 2024, including case studies or case series investigating outcomes of patients taking Artri King as a supplement or treatment. A total of 16 patients (12 female and 4 male) from 10 studies were included in our literature review, with four of those patients being from our home institution. Patients presented with a wide variety of chief complaints, but fragility fractures were the most common at our home institution. The average duration of Artri King use was 16.67 months (at our home institution) versus 13.35 months for the rest. Overall, 75% of the patients included were diagnosed as having Cushing syndrome. Serious adverse effects of taking Artri King include Cushing syndrome, adrenal insufficiency, and worsening hyperglycemia. Clinicians should obtain a thorough drug and supplement history, and we recommend informing patients of the serious adverse effects associated with Artri King and advise against its use.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"376-381"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complementary and Alternative Medicine Use among Heart Failure Patients in the Deep South.","authors":"Deborah Ejem, Kwaku Duah Oppong, Zehra Gok Metin, Rachel Wells, Elizabeth Sockwell, Salpy Pamboukian, Carolina Salvador, Senay Gul, Marie Bakitas","doi":"10.14423/SMJ.0000000000001850","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001850","url":null,"abstract":"<p><strong>Objective: </strong>Despite advancements in heart failure (HF) diagnostics and treatment, many palliative care patients with HF often seek complementary and alternative medicine (CAM) to improve quality of life and address unmet physical and emotional needs. This study aimed to explore the prevalence and patterns of CAM use among HF patients in a large academic medical ambulatory HF clinic in Alabama.</p><p><strong>Methods: </strong>This cross-sectional, descriptive study included HF patients from the University of Alabama at Birmingham HF clinic. Data collection involved CAM-related questions from the National Health Interview Survey, the Kansas City Cardiomyopathy Questionnaire, and sociodemographic variables. Descriptive statistics were computed for all study variables, and analyses were conducted using SPSS.</p><p><strong>Results: </strong>Among 250 HF participants, 49 (19.6%) reported CAM use. The mean age of CAM users was 65 years (±14.76). Most CAM users were White (69%), male (63%), married or partnered (60%), had some college education (67%), and identified as Protestant (22%). The mean Kansas City Cardiomyopathy Questionnaire clinical summary score among CAM users was 54.48. Herbal products and dietary supplements were the most common CAM forms (57%). Of the CAM users, 53% discussed CAM with their healthcare providers, and 43% obtained CAM information from them. Regarding reasons for CAM use, 44.1% used it for pain relief, 29.4% for specific conditions, 20.6% for overall wellness, and 17.6% to complement conventional medicine; 15% cited multiple reasons. No significant sociodemographic predictors of CAM use were found.</p><p><strong>Conclusion: </strong>CAM prevalence among HF patients in this cohort was relatively low compared with other populations. Herbal products and dietary supplements were the most common forms of CAM used. Further research is needed to assess the safety and efficacy of CAM, particularly herbal products and dietary supplements, in patients with HF.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"370-375"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preexposure Prophylaxis to Prevent HIV Acquisition: Perceptions among Sexual and Gender Minority Individuals in North Carolina.","authors":"Hayley E Cunningham, Dirk A Davis, Charles M Burns, Katherine Link, Sara LeGrand, Carly Kelley, Kathryn Whetten, Mehri S McKellar","doi":"10.14423/SMJ.0000000000001852","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001852","url":null,"abstract":"<p><strong>Objectives: </strong>Sexual and gender minority (SGM) communities at increased risk of human immunodeficiency virus (HIV) may be underprescribed preexposure prophylaxis (PrEP), but PrEP research on SGM communities other than transgender women and cisgender men who have sex with men is limited. We sought to better understand SGM individuals' vulnerability to HIV acquisition and awareness and perceptions of PrEP in North Carolina, with a focus on SGM groups less often included in research.</p><p><strong>Methods: </strong>We administered a 37-item online survey to adult SGM participants, examining differences in perceived and behavioral HIV risk based on self-reported behaviors. We also compared PrEP awareness, prescriptions, and stigma between SGM identities and used logistic regression to examine associations between HIV risk and PrEP use.</p><p><strong>Results: </strong>In total, 372 participants completed the survey. Although 30.9% reported behaviors that increase the likelihood of HIV acquisition, only 9.5% perceived their risk as elevated. Most (78.5%) were aware of PrEP, but only 15.1% had been prescribed PrEP. PrEP stigma was most pervasive among cisgender women. Nonbinary and queer participants were more likely to have experienced mistreatment by a provider (20.3%, <i>P</i> < 0.0001; 19.2%, <i>P</i> < 0.01) and avoid care fearing mistreatment (31.9%, <i>P</i> < 0.001; 27.7%; <i>P</i> < 0.001) compared with the entire sample.</p><p><strong>Conclusions: </strong>PrEP is prescribed at low rates across many SGM communities, with misperception of HIV risk, PrEP stigma, and mistreatment in health care identified as important barriers. Healthcare providers should take steps to create a safe environment for SGM patients and ask all patients about HIV risk factors and provide information about PrEP regardless of sexual orientation or gender identity.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"357-364"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SMA's 5th Annual Physicians-in-Training Leadership Conference Abstract Presentations.","authors":"None Available","doi":"10.14423/SMJ.0000000000001842","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001842","url":null,"abstract":"<p><p>These abstracts were accepted and presented during Southern Medical Association's 5th Annual Physicians-in-Training Leadership Conference that took place February 7-9, 2025, at the University of Alabama at Birmingham Heersink College of Medicine. For space consideration, abstracts have been formatted in the Editorial office. Abstract content is published as submitted. These abstracts may also be found in the PIT 2025 Playlist on SMA's YouTube Channel.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"408-516"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Know Your Guidelines: <i>American Journal of Gastroenterology</i> Clinical Guidelines on Acute Liver Failure.","authors":"Chloe N Hundman, James Grant Pearson, Grace Ann Thomas, Christopher D Jackson, Desirée C Burroughs-Ray","doi":"10.14423/SMJ.0000000000001844","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001844","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 7","pages":"387-388"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}