HCA healthcare journal of medicine最新文献

{"title":"Care Alert Program in Chronic Emergency Department Using Patients: Expanded Study.","authors":"Jonathan Leggett, Kaitlyn Phelps, David Nuñez, Brent Wright, Erica Gibbons, Jonathan Bryan, Brian Griggs","doi":"10.36518/2689-0216.1896","DOIUrl":"10.36518/2689-0216.1896","url":null,"abstract":"<p><strong>Introduction: </strong>The Care Alert Program (CAP) is designed to help navigate encounters with patients who are high utilizers of Emergency Department (ED) resources. The CAP intends to address the needs of this challenging patient population by designing individualized care plans that are approved by a multidisciplinary committee. The patient populations that frequently use ED resources often have chronic medical conditions, a poor understanding of their conditions, unrealistic expectations regarding treatment, a lack of outpatient resources, and present with multiple complaints when using ED resources.</p><p><strong>Methods: </strong>The CAP was adopted by our facility in the spring of 2020. The present study is an expanded version of a previously published pilot project conducted in 2020-2021, in which we demonstrated a decrease in both ED visits and admission rates.</p><p><strong>Results: </strong>In this expanded study, we reviewed 46 CAP cases and determined the mean percentage of patient ED visits decreased by 42.3% in this patient population. Average hospital admission rates decreased by 50.4% during the initial 8 months after enrollment into the CAP.</p><p><strong>Conclusion: </strong>Implementing the CAP is an effective way reduce hospital admission rate and average ED visits amongst high utilizers.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 3","pages":"233-237"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610478","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":"Unraveling the Threads: A Case Report on Confusional Migraine and the Intricate Dance Between Psychiatry and Neurology.","authors":"Mabit C Gonzalez, Manjula Kottapalli","doi":"10.36518/2689-0216.1898","DOIUrl":"10.36518/2689-0216.1898","url":null,"abstract":"<p><strong>Background: </strong>Migraine affects about 1 billion people worldwide and is associated with a significant negative impact on personal and occupational functioning. Migraine accompanied by aura is seen in about 15% of migraineurs. Visual aura is the most common type of aura. Much less common though are auras that involve higher mental function, such as confusional state. The confusional state may manifest with a wide variety of cortical dysfunction, such as speech impairment, increased alertness, agitation, and amnesia, often lasting longer than a typical migraine aura.</p><p><strong>Case presentation: </strong>The authors present the unique case of a 29-year-old patient with episodic and transient bizarre behavioral symptoms in the context of migraine headaches.</p><p><strong>Conclusion: </strong>Our patient's presentation is suggestive of acute confusional migraine, which poses several diagnostic complexities and illustrates the difficulties with symptomatology that might have a medical/organic component versus a psychiatric one. The literature on this topic is lacking, and further research into this condition is warranted to optimize comprehensive patient care.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 3","pages":"279-282"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610503","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":"Automated Dispensing Cabinet Stocking Schedule and Inventory Management Optimization.","authors":"Daniel Elkes, Victoria Timmons","doi":"10.36518/2689-0216.1822","DOIUrl":"10.36518/2689-0216.1822","url":null,"abstract":"<p><strong>Background: </strong>Prior practice in a 523-bed community hospital required automated dispensing cabinets (ADCs) to be replenished daily by early afternoon to ensure accurate drug ordering. Because of the tight time window, technicians frequently refilled ADCs during peak medication administration times. After a positive report from a smaller facility in the health system, the study facility implemented a quality improvement project to optimize the ADCs. This involved new processes of every-other-day ADC replenishment staggered via shift-specific workflows, and a dedicated technician was assigned to optimize ADC inventories.</p><p><strong>Methods: </strong>Monthly reports of ADC refilling and dispensing transactions were compiled from inpatient, nonprocedural units. Data on stock-out transactions, when a nurse attempts to remove a medication from an empty ADC pocket, were obtained from facility reports from the same machines. Based on hospital policy for standard medication administration times, peak times were identified. For these time windows, an overlap ratio was calculated by dividing the relative frequencies of refill and dispense transactions. The average overlap ratios were calculated for the pre- and post-implementation periods. Stock-out transactions were tracked monthly, and a 95% confidence interval was constructed for all months before implementation.</p><p><strong>Results: </strong>Post-implementation, monthly stock-out counts significantly decreased by 38% within 6 months. While there was no change in medication dispensing patterns, there was a major shift in refilling activity patterns. Overlap during morning peak times decreased, but overlap increased during the evening peak times due to the rearrangement of technician shift times and workflows.</p><p><strong>Conclusion: </strong>After implementation of the new process and ADC inventory optimization, refill habits significantly changed, leading to reduced technician-nurse overlap during the morning medication pass, likely due to the spread out replenishment schedule. Dispensing habits did not change during the study period, and while there was a significant decrease in stock-outs post-implementation, there was insufficient data to assess effects of the new refilling processes.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 3","pages":"225-232"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610475","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":"Efficacy and Safety of Lotilaner Ophthalmic Solution 0.25% in Demodex Blepharitis: A Systematic Review.","authors":"Stephanie P Fabara, Thalia Fabara, Akankcha Alok, Nausheen Khuddus","doi":"10.36518/2689-0216.1985","DOIUrl":"10.36518/2689-0216.1985","url":null,"abstract":"<p><p>Description <i>Demodex</i> blepharitis is a chronic eyelid inflammation caused by <i>Demodex</i> mites, which are ubiquitous skin parasites. Lotilaner, a newly United States Food and Drug Administration (FDA)-approved drug, is an antiparasitic agent that selectively inhibits parasite-specific γ-aminobutyric acid chloride channels, inducing spastic paralysis and death of <i>Demodex</i> mites. It is applied as an ophthalmic solution, 0.25%, twice a day for 6 weeks, and it has a long half-life and high lipophilicity, facilitating the penetration of the drug into the eyelash follicles and meibomian glands where the mites reside. This study systematically reviewed 6 clinical trials that compared lotilaner with placebo for <i>Demodex</i> blepharitis. The primary efficacy endpoint was complete collarette cure, defined as collarette grade 0 on the upper lid of the analysis eye. The secondary efficacy endpoint was decreased mite density with mite eradication, defined as 0 mites per lash on the analysis eye at day 42. The results showed that lotilaner treatment was significantly more effective than the control in achieving both endpoints, with a maximum reduction of 94.7% in mite density at day 43. The treatment effect persisted for at least 2 months after the end of treatment. Lotilaner was also safe and well tolerated, with no serious adverse events reported. For primary care providers, this study underscores the importance of recognizing collarettes as a key diagnostic marker for <i>Demodex</i> blepharitis during routine examinations. Lotilaner ophthalmic solution, 0.25%, offers a novel, effective therapy for this condition, enabling earlier intervention and improved outcomes for patients. Further investigation in larger trials is warranted to confirm these findings and refine their clinical application.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 3","pages":"213-223"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610482","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":"COVID-19 Vaccine-Induced Rhabdomyolysis in a 53-Year-Old Woman.","authors":"Akash Hazari, Jack Chien, Daniel Nunez","doi":"10.36518/2689-0216.1463","DOIUrl":"10.36518/2689-0216.1463","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19-induced rhabdomyolysis is a common complication in COVID-19 infection. However, only a handful of cases have been reported showing links between COVID-19 vaccine and rhabdomyolysis.</p><p><strong>Case presentation: </strong>We present the case of a 53-year-old woman, who recently received COVID-19 vaccine and presented to the hospital with progressive extremity weakness. Common reasons for rhabdomyolysis were ruled out as possibility and the patient was found to have rhabdomyolysis induced from COVID-19 vaccine.</p><p><strong>Conclusion: </strong>Even though COVID-19 vaccine-induced rhabdomyolysis is rare, it should be considered in the differential diagnosis with patients presenting with neuromuscular complaints and a recent COVID-19 vaccine.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 3","pages":"259-262"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610481","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":"Little Changes.","authors":"Jessica Wolfe","doi":"10.36518/2689-0216.2178","DOIUrl":"https://doi.org/10.36518/2689-0216.2178","url":null,"abstract":"<p><p>Description This collage is made of hundreds of small pieces of paper cut from old magazines and junk mail. As I worked on it, I thought about how each tiny piece of paper alters the canvas in a nearly imperceptible way, but the shapes and colors could shift completely in the course of an hour. This concept of making small changes is something I think a lot about in my work as a psychiatric nurse as well. Even though it doesn't always feel like it, we become wiser each day. By looking for these small opportunities to evolve, we can build resilience and live happier, healthier lives.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 3","pages":"297-298"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610483","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":"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}