HCA healthcare journal of medicine最新文献

{"title":"An Examination of Health Coaching as a Developing Profession.","authors":"Katie Suleta, Jonathan M Davis","doi":"10.36518/2689-0216.1919","DOIUrl":"10.36518/2689-0216.1919","url":null,"abstract":"<p><strong>Background: </strong>Health coaching is a field that is growing in popularity. Health coaching is not regulated and there is no standard for background, education, or training for those acting as health coaches. The purpose of this study was to investigate the burgeoning field of health coaching: who is performing it and common practices.</p><p><strong>Methods: </strong>A total of 560 health coaching websites were reviewed to record educational backgrounds, recommendations for supplements, and the sale of supplements and/or other wellness products. Multivariable logistic regression was used to test associations between characteristics of health coaches and whether they recommend supplements, sell supplements, or sell other wellness products.</p><p><strong>Results: </strong>The sample was mostly female without an applicable associate or bachelor's degree listed practicing without national board certification. Twenty-nine percent recommended supplements, approximately 17% sold supplements, and 17% sold other wellness products. Of those without national board certification, nearly a quarter sold supplements. Multivariable logistic regression was used to identify associations between characteristics and supplement recommendations or selling supplements or other wellness products.</p><p><strong>Conclusion: </strong>As health coaching develops, it is important to understand who is practicing as a health coach and common health coaching practices in the field.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"147-150"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rooster.","authors":"Taylor J Templeton-Jager","doi":"10.36518/2689-0216.2172","DOIUrl":"10.36518/2689-0216.2172","url":null,"abstract":"<p><p>Description I painted this rooster during my first semester of graduate school while relaxing after a long day of research. It was my first time using oil paint and a palette knife. I kept it because it brings me joy and reminds me to try new things.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"207-208"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guillain-Barré Syndrome Following Moderna Spikevax Messenger RNA COVID-19 Vaccine: A Case Analysis.","authors":"Jamie Lee Aldakkour, Alvin Boyd Newman-Caro, Usama Bardan, Hector Gonzalez-Montalvo, Guruswamy Ramamurthy","doi":"10.36518/2689-0216.1512","DOIUrl":"10.36518/2689-0216.1512","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barré Syndrome (GBS) is an acute autoimmune polyneuropathy. Cases of GBS have been reported following administration of the vaccines for swine influenza, seasonal influenza, hemagglutinin type 1 and neuraminidase type 1, and meningococcal disease. Despite these links, a causal relationship has not been confirmed.</p><p><strong>Case presentation: </strong>We present a case of a 70-year-old woman who presented with progressive bilateral ascending weakness and numbness and reported receiving the first dose of the Moderna COVID-19 vaccine 2 weeks prior to presentation.</p><p><strong>Conclusion: </strong>At the time of writing, this is the first reported case of GBS following the Moderna Spikevax COVID-19 vaccine. While a temporal link does not confirm causation, vigilance for GBS symptoms in recently vaccinated patients is crucial. Early recognition enables timely treatment, preventing severe complications like respiratory failure. However, the public health benefits of vaccination far outweigh the risks, as it remains the most effective tool in preventing severe disease.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"163-166"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Write a Successful Research Manuscript: Back to Basics.","authors":"Nayda Parisio Poldiak, Nancy Crossley","doi":"10.36518/2689-0216.1715","DOIUrl":"10.36518/2689-0216.1715","url":null,"abstract":"<p><p>Description Writing a research manuscript is a meticulous process necessary for effective communication of scientific findings. In this article, we cover the key concepts and steps involved in crafting a well-structured manuscript. Research manuscripts use a formal structure with discrete sections that facilitate data review and interpretation. The opening section is a structured abstract, which summarizes the entire manuscript in about 300 words and highlights the research problem, using the headings Background, Methods, Results, and Conclusion. The introduction provides context, states the research question and justifies its significance. The methods section details the study design, data collection, and analysis procedures. The results section presents findings objectively, using tables, figures, and text, while also emphasizing key results and trends. In the discussion section, the authors interpret their results and relate them to the research question and findings from similar studies-some of which should be covered in the introduction-consider implications, address limitations, and suggest future research directions. The conclusion provides a summary of the main findings and their significance. Lastly, the reference section presents citations of all sources used in the article, formatted according to the chosen journal's citation style.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"193-203"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Instance of <i>Streptococcus agalactiae</i> Pyomyoma in a Postmenopausal Patient: A Case Report.","authors":"Mariah Piazza, Sai V Nagula, Madeleine Salzberg, Darren Preuninger","doi":"10.36518/2689-0216.1489","DOIUrl":"10.36518/2689-0216.1489","url":null,"abstract":"<p><strong>Background: </strong>Pyomyoma is a rare, but potentially fatal, complication of uterine leiomyoma. Most cases occur in postpartum or postmenopausal patients with vascular disease and arise due to infarction and infection of existing fibroids. The proposed diagnostic triad for pyomyoma includes 1) sepsis or bacteremia; 2) uterine leiomyomata; and 3) no other apparent source of infection. We present a case of a postmenopausal patient who presented with the aforementioned triad and was found to have a pyomyoma, positive for <i>Streptococcus agalactiae</i>.</p><p><strong>Case presentation: </strong>A 67-year-old woman with no known past medical history presented to the emergency department for altered mental status. Although afebrile, she was tachycardic and hypertensive, with severe hyperglycemia and leukocytosis on initial assessment. Multiple embolic cerebral infarcts were noted on imaging, but workup was negative for a cardiac or vascular source. Her infectious workup was ultimately notable for <i>S agalactiae</i> bacteremia and a fibroid uterus with a rim enhancing fluid collection seen on a computed tomography (CT) abdomen and pelvis scan. Broad spectrum antibiotics were initiated, and she underwent CT-guided drainage of the abscess, which was also positive for <i>S agalactiae</i>. Given continued fevers and elevated white blood cell counts, the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic washout. Intraoperative findings were notable for a pedunculated, necrotic uterine fibroid with purulent material within, and no other apparent gastrointestinal source. The final pathology was benign, and the patient was ultimately discharged to an inpatient rehabilitation facility.</p><p><strong>Conclusion: </strong>While rare, pyomyoma should be considered for any postpartum or postmenopausal patient with risk factors for, or known, vascular disease, presenting with the triad noted above. The high mortality rate associated with pyomyoma is often due to patients succumbing to overwhelming sepsis, likely related to delays in diagnosis. As such, pyomyoma should be considered in the appropriate context and warrants prompt diagnosis and treatment.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"151-155"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portable Head Computed Tomography Protocol for Trauma.","authors":"Christian Quinones, Alexander Bolufer, Cory Hewitt, Sagun Tuli","doi":"10.36518/2689-0216.1858","DOIUrl":"10.36518/2689-0216.1858","url":null,"abstract":"<p><p>Description The use of portable computed tomography (CT) scanners has been shown to reduce risks associated with intrahospital transport and to expedite imaging in critically ill patients. While their use is established in intensive care units, their utility on intraoperative trauma patients remains underexplored. This paper reviews existing literature on portable CT use, defines appropriate clinical indications, outlines contraindications, and identifies quality metrics and implementation challenges. It also presents a proposed protocol for integrating portable head CT imaging into trauma workflows, focusing on early identification of intracranial or spinal injuries in the operating room. The development and analysis of standardized protocols may guide future adoption of portable CT technology in trauma settings.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"113-118"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of a Massive Right Atrial Thrombus Removal Under Transesophageal Echocardiographic Guidance.","authors":"Justin Phillips, Max Kabolowsky, Alex M Hendon, Samantha Arzillo","doi":"10.36518/2689-0216.1857","DOIUrl":"10.36518/2689-0216.1857","url":null,"abstract":"<p><strong>Background: </strong>With the advent of catheter guided interventions, practitioners have added another tool alongside chemical lysis and surgical removal to reduce the clot burden of patients with large emboli and thrombi. Due to comorbid conditions, many patients are poor candidates for surgical or chemical clot treatment but may present optimally for catheter-based thromboembolectomy. In this case, we highlight the benefits of mechanical thrombectomy with transesophageal echocardiographic guidance to reduce the clot burden of a patient who would otherwise be considered a poor candidate for surgical or chemical treatment.</p><p><strong>Case presentation: </strong>This case follows a 78-year-old man with a past medical history significant for persistent atrial fibrillation, type 2 diabetes, hypertension, hyperlipidemia, coronary artery disease, cardiomyopathy status post biventricular implantable cardioverter-defibrillator, left atrial appendage exclusion device, and a recent deep vein thrombosis. The patient was taking apixaban and was found to have a large, mobile, right atrial thrombus on a transthoracic echocardiograpic evaluation for a routine sepsis workup. The patient underwent an emergency thrombectomy due to the high risk of thrombus embolization. Due to the large size of the thrombus and complexity of the case, an intra-operative inferior vena cava filter was placed to prevent shower embolization of the thrombus during evacuation. Under guidance from the transesophageal echocardiography, the thrombus was successfully removed using a mechanical thrombectomy device.</p><p><strong>Conclusion: </strong>In an aging population with significant cardiac or hematological comorbidities, some patients who develop right atrial thrombi may be considered poor candidates for an open thrombectomy or chemical thrombolysis. With the development of catheter based mechanical thrombectomy interventions, patients with relative contraindications to traditional methods may benefit from newer technology, especially if the technique allows for accurate visualization of the thrombus via transesophageal echocardiography.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"177-181"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Point-of-Care Ultrasound for the Medical Management of Marathoners and Spectators: A Case Series.","authors":"Jacob D Pope, Casey Wilson, Kelsey Daller, Jonathan Hardin, Steven Rickett","doi":"10.36518/2689-0216.1863","DOIUrl":"10.36518/2689-0216.1863","url":null,"abstract":"<p><strong>Background: </strong>Temporary field hospitals play a crucial role in providing medical care to individuals who experience illnesses and injuries during mass gathering events. Handheld point-of-care ultrasound (POCUS) devices offer an affordable and portable adjunct for emergency care. We present multiple patients from a field hospital during a marathon event in which handheld POCUS devices changed clinical management.</p><p><strong>Case presentation: </strong>A 75-year-old man who had fallen was able to be discharged after a lung exam confirmed no rib fractures or pneumothorax. A hypotensive and hypoglycemic 21-year-old man had an echocardiogram confirming volume depletion. He received treatment, and a repeat exam demonstrated improvement, which facilitated discharge. Finally, an ultrasound-guided intravenous catheter was placed in a 27-year-old woman with difficult vascular access.</p><p><strong>Conclusion: </strong>Point-of-care ultrasound facilitated the triage and evaluation of conditions such as fractures, pneumothorax, altered mental status, chest pain, and dehydration in a field hospital. The portability, availability, and affordability of handheld POCUS devices allowed for quick and convenient access to real-time imaging of marathon runners and event spectators. By leveraging these advantages, field hospitals can enhance their capability to deliver efficient and comprehensive medical care to patients during mass gathering events.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"183-187"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution of Patient's Anaphylaxis to the Moderna COVID-19 Vaccine by Desensitization.","authors":"Stefan M Pienkowski, Marek M Pienkowski","doi":"10.36518/2689-0216.1792","DOIUrl":"10.36518/2689-0216.1792","url":null,"abstract":"<p><strong>Introduction: </strong>Management of patients with rare anaphylaxis to COVID-19 vaccines creates a challenge. Desensitization to medications and vaccines has proven to be effective in managing anaphylactic reactions in selected individuals with a high benefit-to-risk ratio. A previous report described the successful administration of the Moderna modified messenger RNA (MmRNA) COVID-19 vaccine via a graded dose protocol to a patient with previous anaphylaxis to the MmRNA vaccine. Our report describes successful desensitization to the MmRNA vaccine followed by administration of the full dose MmRNA vaccine.</p><p><strong>Case presentation: </strong>A patient with a history of chronic allergies and anaphylaxis due to insect sting venom reported anaphylaxis after her first dose of the MmRNA vaccine, for which she was premedicated. She was subsequently clinically diagnosed with anaphylaxis to skin testing of the MmRNA vaccine-meeting Brighton's criteria for level 1 certainty of diagnosis-and underwent a desensitization protocol to the vaccine. After the desensitization protocol, the patient was administered the full second dose of the MmRNA vaccine via intramuscular injection, without systemic allergic reactions, and with elicitation of an immunological response.</p><p><strong>Conclusion: </strong>This severely allergic patient developed 2 separate anaphylactic reactions to the MmRNA vaccine despite being treated with omalizumab. The patient was then desensitized to the MmRNA vaccine and was subsequently administered the full second dose of MmRNA vaccine via intramuscular injection without systemic allergic reactions and with elicitation of an immunological response. Our patient's case illustrates the ability to desensitize patients who desire administration of the MmRNA vaccine, but are unlikely to prevent anaphylaxis with premedication.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"167-170"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Incorporating Radiological Findings of Right Heart Strain in Patients With Acute Pulmonary Embolism for Risk Stratification of Adverse Outcomes: A Retrospective Analysis.","authors":"Joshua Amaya, Sameer Allahabadi, Daniel L Habenicht, John Hunton, Amal M Khan, Subhash Venigalla, Curran Reddy, Jeremy V Doan, Grace Wang, Daniel R Eickenhorst, Shovendra Gautam","doi":"10.36518/2689-0216.1889","DOIUrl":"10.36518/2689-0216.1889","url":null,"abstract":"<p><strong>Background: </strong>Right heart (RH) strain in the setting of pulmonary embolisms can significantly increase the risk of mortality. Thus, screening for risk of complications in these patients is crucial. The goal of our study was to assess the strength of specific diagnostic findings of RH strain for predicting adverse outcomes including mortality, hospital length of stay, and the requirement of advanced interventions.</p><p><strong>Methods: </strong>A single-center, retrospective cohort study of 81 patients diagnosed with acute pulmonary embolism with RH strain on computed tomography pulmonary angiogram (CTPA) from September 12, 2019, to August 30, 2023. Data were collected on patient computed tomography findings, transthoracic echocardiogram (TTE) findings, electrocardiogram findings, troponin I, and B-type natriuretic peptide values. Adverse outcomes were recorded including 30-day mortality, increased hospital length of stay, and utilization of advanced therapy (systemic fibrinolysis, catheter-directed therapy, or pulmonary embolectomy). Stepwise regression analysis was performed to model predictors of adverse outcomes in RH strain patients.</p><p><strong>Results: </strong>Right ventricle (RV) dilation on TTE was significantly associated with 30-day mortality (<i>P</i> = .005). Tricuspid annular plane systolic excursion (TAPSE) of less than 16 mm on TTE was significantly associated with the use of advanced therapy (<i>P</i> = .001). An increased length of hospital stay was significantly associated with right ventricular dilation on TTE (<i>P</i> < .001), renal insufficiency (<i>P</i> = .012), and surgery within 90 days (<i>P</i> = .003). A finding of McConnell's sign on TTE (<i>P</i> = .044) was significantly associated with a higher pulmonary embolism severity index.</p><p><strong>Conclusion: </strong>Advanced interventions should strongly be considered in patients with a CTPA diagnosis of RH strain who have TTE findings of RV dysfunction including RV dilation, TAPSE less than 16 mm, and McConnell's sign due to the high risk of mortality and morbidity.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"139-146"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}