Southern Medical Journal最新文献

{"title":"Relationship between Systolic Ejection Time and Inflammation in End-Stage Heart Failure.","authors":"Joel Gutovitz, Jonathan Kutcher, David Z Cherney, Yael Schiller, Itzhak Gabizon, Eran Keshet, Jordan Rimon, David Koren, Vivek Rao, Liza Grosman-Rimon","doi":"10.14423/SMJ.0000000000001801","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001801","url":null,"abstract":"<p><strong>Objectives: </strong>Systolic ejection time (SET) and systemic inflammation are two essential indicators of heart failure (HF) progression. We aimed to evaluate the associations between SET and inflammatory mediators in end-stage HF.</p><p><strong>Methods: </strong>Participants included 16 patients with end-stage HF recruited from the Heart Failure Clinic at Toronto General Hospital and 16 healthy individuals free of any known cardiovascular disease. SET, end systolic pressure, and levels of inflammatory mediators were documented for each patient, and a Spearman rank correlation coefficient was performed to examine differences between patients with end-stage HF and healthy controls.</p><p><strong>Results: </strong>The mean SET in patients with HF was shorter than in the healthy controls (283.5 ± 34.3 ms vs 330.1 ± 19.0 ms, <i>P</i> < 0.001). C-reactive protein (<i>P</i> = 0.001), macrophage inflammatory protein-1β (<i>P</i> = 0.041), macrophage-derived chemokine (<i>P</i> = 0.007), and cyclic guanosine monophosphate (<i>P</i> < 0.001) levels were negatively correlated with SET. The levels of other inflammatory mediators-granulocyte-stimulating factor, granulocyte-macrophage colony-stimulating factor, interleukin-8, macrophage inflammatory protein-1, macrophage inflammatory protein-1α, and tumor necrosis factor α-were not significantly correlated with SET.</p><p><strong>Conclusions: </strong>We found that SET was significantly lower in patients with end-stage HF compared with healthy controls and that reduced SET correlated with increased levels of several inflammatory mediators in patients with HF. By better understanding the relationship between SET and inflammation in HF, a more thorough evaluation could lead to improved risk stratification among patients with HF. Future work should investigate the roles of SET and inflammation in HF.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"167-170"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543500","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":"Implementation of a Longitudinal Personal Finance Curriculum into Resident Medical Education.","authors":"Arohi Saxena, Rakhee K Bhayani, Fahd A Ahmad","doi":"10.14423/SMJ.0000000000001802","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001802","url":null,"abstract":"<p><strong>Objective: </strong>Residents frequently graduate medical school with a significant amount of debt and low financial literacy. Historically, there has been a lack of standardized, longitudinal financial education curriculum to educate residents about important financial principles. Our objective was to design and implement a longitudinal curriculum to cover a variety of personal and professional finance topics relevant to Pediatrics and Internal Medicine residents.</p><p><strong>Methods: </strong>Beginning in 2016, we integrated four lectures per year on personal and professional finance into the noontime curriculum for Internal Medicine and Pediatrics residents at Washington University School of Medicine with topics repeating over a 3-year cycle. We distributed surveys to residents to evaluate the program during its first 4 years; however, we halted collection in 2020 with the transition to a virtual/hybrid model during the coronavirus disease 2019 pandemic. The knowledge and behavior survey contained both Likert scale questions (1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, 5 = strongly agree) and dichotomous yes/no questions assessing certain behaviors and knowledge.</p><p><strong>Results: </strong>A mean of 80 out of 240 (33%) total residents (standard deviation 17) attended each lecture yearly between 2016 and 2020. The mean postlecture survey response rate was 16% (standard deviation 8.1%). Analysis of first-year survey data showed significant improvements in knowledge domains related to employment contracts, negotiation, and physician practice structures. The qualitative feedback was overall positive, and several trainees commented on the relevancy of the physician-led sessions.</p><p><strong>Conclusions: </strong>We successfully integrated a longitudinal personal finance curriculum into resident medical education to support personal and professional development throughout the stages of their career.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"150-154"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543479","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":"α-Galactose Syndrome Cases within the Prisma Health System, South Carolina.","authors":"Hanna Waltz, Lilianne Kaminski, Kyndall Dye-Braumuller, Matthew Haldeman, Emily Owens Pickle, Melissa S Nolan","doi":"10.14423/SMJ.0000000000001799","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001799","url":null,"abstract":"<p><strong>Objectives: </strong>Humans can develop a vector-associated allergy to galactose-α-1,3-galactose (α-gal) a polysaccharide found in mammalian meats and by-products, resulting in α-gal syndrome (AGS). <i>Amblyomma americanum</i> tick bites have been implicated in AGS development in the United States, but the AGS clinical burden in South Carolina is not well understood. Because <i>A. americanum</i> is the predominant tick species in the state and large AGS cohorts exist in neighboring states, the potential for AGS clinical cases in South Carolina exists. Increased understanding of high-incidence geographical clusters is critical for clinical and public education given the potential for severe anaphylaxis.</p><p><strong>Methods: </strong>We conducted a 5-year retrospective chart abstraction of AGS patient cases serologically confirmed within the state's largest healthcare system to characterize this condition in South Carolina's Upstate and Midlands regions.</p><p><strong>Results: </strong>From October 2017 to February 2023, 50 patients were serologically diagnosed as having AGS within the Prisma Health system. Cohort demographics were mostly older, White males, and Black patients were significantly underrepresented in the AGS caseload (<i>P</i> = 0.0004). Immunosuppressing comorbidities and cooccurring allergies were common.</p><p><strong>Conclusions: </strong>This article presents the first clinical AGS case series in South Carolina, warranting further clinical and public education and a need for continued clinical research on this emerging tick-associated condition.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"161-166"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543538","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":"Exploration of the Intersection between Infant Feeding and Postpartum Contraception in Western North Carolina: Perspectives of Postpartum Individuals and Providers.","authors":"Liane M Ventura, Melissa White, Rebecca Strasser, Kate E Beatty","doi":"10.14423/SMJ.0000000000001798","DOIUrl":"10.14423/SMJ.0000000000001798","url":null,"abstract":"<p><strong>Objectives: </strong>Short interpregnancy intervals are associated with preterm births. Increasing access to postpartum contraception is a preventive intervention. Best practice recommendations suggest that postpartum individuals exclusively breastfeed for up to 6 months. Conversations about these two topics tend to occur simultaneously throughout the perinatal period. This study explores the intersection between infant feeding and postpartum contraception.</p><p><strong>Methods: </strong>Semistructured key informant interviews were conducted with postpartum individuals and providers from throughout western North Carolina. Interviews were audio recorded and transcribed. The \"Sort and Sift, Think and Shift\" method was applied. Emergent themes were identified by systematically generating summaries, memoranda, and quotation diagrams independently by two coders.</p><p><strong>Results: </strong>Key themes included the need to prioritize individual decision-making autonomy and to provide prenatal patient education about infant feeding and postpartum contraception. Participants also discussed the types of social support needed for successful breastfeeding efforts and the impact of infant feeding on mental health. Contextual factors related to infant feeding and postpartum contraceptive decision-making encompassed cultural influences (eg, the historical context of reproductive rights and breastfeeding in public), the inherent challenges of rurality (eg, lack of transportation and the closure of labor and delivery units), and family leave and workplace policies.</p><p><strong>Conclusions: </strong>Infant feeding method and postpartum contraception are highly individualized decisions, which are supported through patient education and shared decision making, particularly during the prenatal period. Findings suggest the importance of incorporating infant feeding within the sexual and reproductive health literature.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"189-195"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Chat Generative Pre-Trained Transformer on Personal Review of Learning in Obstetrics and Gynecology.","authors":"Adam Cohen, Jersey Burns, Martina Gabra, Alex Gordon, Nicholas Deebel, Ryan Terlecki, Katherine L Woodburn","doi":"10.14423/SMJ.0000000000001783","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001783","url":null,"abstract":"<p><strong>Objectives: </strong>Chat Generative Pre-Trained Transformer (ChatGPT) is a popular natural-language processor that is able to analyze and respond to a variety of prompts, providing eloquent answers based on a collection of Internet data. ChatGPT has been considered an avenue for the education of resident physicians in the form of board preparation in the contemporary literature, where it has been applied against board study material across multiple medical specialties. The purpose of our study was to evaluate the performance of ChatGPT on the Personal Review of Learning in Obstetrics and Gynecology (PROLOG) assessments and gauge its specialty specific knowledge for educational applications.</p><p><strong>Methods: </strong>PROLOG assessments were administered to ChatGPT version 3.5, and the percentage of correct responses was recorded. Questions were categorized by question stem order and used to measure ChatGPT performance. Performance was compared using descriptive statistics.</p><p><strong>Results: </strong>There were 848 questions without visual components; ChatGPT answered 57.8% correct (N = 490). ChatGPT performed worse on higher-order questions compared with first-order questions, 56.8% vs 60.5%, respectively. There were 65 questions containing visual data, and ChatGPT answered 16.9% correctly.</p><p><strong>Conclusions: </strong>The passing score for the PROLOG assessments is 80%; therefore ChatGPT 3.5 did not perform satisfactorily. Given this, it is unlikely that the tested version of ChatGPT has sufficient specialty-specific knowledge or logical capability to serve as a reliable tool for trainee education.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"102-105"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068043","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":"Firearm Shootings: A Serious Public Health Issue.","authors":"Steven Lippmann","doi":"10.14423/SMJ.0000000000001781","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001781","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"140"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068038","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":"Increasing Communication about Fall Risk and Prevention between Internal Medicine Residents and Older Adults.","authors":"Mary L Thomas, Yulu Pan, Christopher D Jackson","doi":"10.14423/SMJ.0000000000001786","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001786","url":null,"abstract":"<p><strong>Objectives: </strong>More than one in four older adults fall yearly, but fewer than half inform their doctors. As such, medical trainees must gain experience assessing fall risk in older adults. Studies exploring how often residents initiate these assessments and which interventions effectively increase this frequency are needed. The objective of our study was to determine whether a reminder survey increases the frequency and proportion of resident-initiated fall risk and prevention discussions between Internal Medicine residents and older adults.</p><p><strong>Methods: </strong>This quantitative pre- and postintervention study used an anonymous survey distributed to residents within one urban Internal Medicine resident clinic. For 1 week, residents were exposed to Stopping Elderly Accidents, Deaths, and Injuries fall risk assessments completed by patients 65 years and older to stimulate fall risk and prevention discussions. Residents completed the same survey 3 months after intervention withdrawal.</p><p><strong>Results: </strong>Postintervention, there was a statistically significant increase in the proportion of resident-initiated fall risk and prevention discussions (43% vs 81%, <i>P</i> = 0.03). Although not statistically significant, residents reported initiating fall risk (14% vs 19%, <i>P</i> = 1) and fall prevention (3.6% vs 19%, <i>P</i> = 0.25) discussions more frequently, and fewer residents reported forgetfulness as a barrier to having these discussions (57% vs 44%, <i>P</i> = 0.59).</p><p><strong>Conclusions: </strong>Exposure to the Stopping Elderly Accidents, Deaths, and Injuries fall risk tool is a promising reminder intervention to increase the frequency and proportion of resident-initiated fall risk and prevention discussions; however, larger multisite studies are needed to assess the statistical significance of these findings.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"114-117"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068040","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":"Enhancing Medical Education for the Care of Patients with Intellectual and Developmental Disabilities: The Role of Specialized Training and Early Exposure.","authors":"Alice Hamilton, Caroline Sachse, Elisa Sottile, Rafik Jacob","doi":"10.14423/SMJ.0000000000001782","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001782","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"111-113"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068036","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":"Alpelisib-Induced Hyperglycemia in <i>PIK3CA</i>⁺ Breast Cancer Patients.","authors":"Anika Annoor, Mariya Rahman Marzan, Raisa Binte Iqbal, Aysha Ferdausi, Arowa Yasmeen, Parisa Tarannum, Preethi John","doi":"10.14423/SMJ.0000000000001791","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001791","url":null,"abstract":"<p><p>Alpelisib is a phosphatidylinositol 3-kinase inhibitor approved by the US Food and Drug Administration for the treatment of hormone receptor-positive metastatic breast cancer with <i>PIK3CA</i> (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit α) mutation. In recent years a number of adverse effects have been observed to be associated with this therapy, the most notable of which is hyperglycemia. A literature search was conducted to include case studies, case series, systematic reviews, and meta-analyses within the last 10 years that evaluated patients with <i>PIK3CA-</i>mutated hormone receptor-positive, human epidermal growth factor receptor 2 negative metastatic breast cancer. Hyperglycemia was a notable adverse effect that was found in the majority of patients without preexisting diabetes mellitus. Patients with hyperglycemia were in the high-risk groups of advanced age, prediabetes mellitus or history of insulin resistance, increased body mass index, increased blood monocyte count, and increased hemoglobin A1c (glycated hemoglobin). Hyperglycemia was manageable with antihyperglycemic agents and dose modification/discontinuation of alpelisib with no severe progression. Other notable adverse effects were rash, stomatitis, diarrhea, pneumonitis, reduced appetite, elevated liver enzymes, nausea, fatigue, and rare reports of diabetic ketoacidosis. This literature review aims to highlight the incidence and risk factors of alpelisib-induced hyperglycemia in greater depth.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"97-101"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068034","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":"Medications That May be Contributing to Your Patient's Weight Gain.","authors":"Jason Powell, James Taylor","doi":"10.14423/SMJ.0000000000001792","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001792","url":null,"abstract":"<p><p>Nearly 42% of adults in the United States are considered obese. Although there are a number of contributing factors to obesity, one sometimes overlooked contributor to weight gain is medications. Within many classes of medications that may affect weight, the degree of weight gain varies. Although factors such as efficacy, cost, interactions, and adverse effects play a role in selecting a medication, the effects on weight also should be considered in those who are overweight or obese. This article reviews some of the classes of medications used in the outpatient setting that may affect weight to provide a guide to clinicians.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"122-127"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068042","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}