Spartan medical research journal最新文献

{"title":"Disordered Eating and Eating Disorders in Adolescent Athletes","authors":"Ryley Mancine, S. Kennedy, P. Stephan, A. Ley","doi":"10.51894/001c.11595","DOIUrl":"https://doi.org/10.51894/001c.11595","url":null,"abstract":"CONTEXT To summarize available literature to date and discuss the importance of Disordered Eating (DE) in adolescent athletes, with special attention to the female athlete triad. In this paper, the authors will review the literature regarding adolescent athletes who intentionally engage in abnormal eating behaviors and focus on adolescent athletes of all training levels who may be affected by both DE and eating disorders (ED). METHODS In 2019, the authors completed a systematic literature search on PubMed using the search term variations of “Feeding and Eating Disorders” and “athletes” with “high school.” RESULTS A total of 20 pertinent articles were identified concerning DE in adolescent athletes. ED have been shown to impose higher rates of comorbidity than other psychological disorders and only a small number of individuals with ED seek treatment. ED tend to be more prevalent in adolescent elite athletes than non-athletes of both genders in all sports and levels of competition. CONCLUSIONS More rigorous tools for family practice physicians, nurses, and coaches to use when working with at-risk adolescent athletes are needed to identify DE behaviors. Healthcare and school professionals need to be educated and trained to detect DE and the components of the female athlete triad. Additional research with adolescent males or those associating with alternative gender roles is also required to help them prevent physical and mental health consequences associated with DE.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44300861","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":"Disordered Eating and Eating Disorders in Adolescent Athletes.","authors":"Ryley Mancine, Samantha Kennedy, Peter Stephan, Alyse Ley","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>To summarize available literature to date and discuss the importance of Disordered Eating (DE) in adolescent athletes, with special attention to the female athlete triad. In this paper, the authors will review the literature regarding adolescent athletes who intentionally engage in abnormal eating behaviors and focus on adolescent athletes of all training levels who may be affected by both DE and eating disorders (ED).</p><p><strong>Methods: </strong>In 2019, the authors completed a systematic literature search on PubMed using the search term variations of \"Feeding and Eating Disorders\" and \"athletes\" with \"high school.\"</p><p><strong>Results: </strong>A total of 20 pertinent articles were identified concerning DE in adolescent athletes. ED have been shown to impose higher rates of comorbidity than other psychological disorders and only a small number of individuals with ED seek treatment. ED tend to be more prevalent in adolescent elite athletes than non-athletes of both genders in all sports and levels of competition.</p><p><strong>Conclusions: </strong>More rigorous tools for family practice physicians, nurses, and coaches to use when working with at-risk adolescent athletes are needed to identify DE behaviors. Healthcare and school professionals need to be educated and trained to detect DE and the components of the female athlete triad. Additional research with adolescent males or those associating with alternative gender roles is also required to help them prevent physical and mental health consequences associated with DE.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11595"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25425071","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 Novel 'Train the Trainer' Emergency Medicine Resident Point-of-Care Ultrasound Course: A Feasibility Study.","authors":"Nikolai Butki, Jereme Long, Andrew Butki, William Corser","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>A novel multi-site 'train the trainer' point-of-care ultrasound (POCUS) training course was designed to better meet the graduate medical education learning needs of a geographically dispersed consortium of 16 community-based Michigan emergency medicine (EM) residency programs. The specific aim of this study was to explore the feasibility of using volunteer EM physicians who were novices with ultrasound techniques as instructors for a POCUS course. Additionally, the authors evaluated the effectiveness and consistency of a POCUS course delivered over multiple sites to enhance EM residents' ultrasound knowledge and skill acquisition.</p><p><strong>Methods: </strong>For the initial session, the lead instructor conducted a focused two-hour course with the novice instructors. A subsequent four-hour session was then repeated for EM residents whereby the aforementioned novice instructors provided the hands-on instruction. The residents were given 10-item pre- and 20-item post-course knowledge tests to gauge the effectiveness of the instruction model. After the course, a satisfaction survey was administered to the resident participants and a qualitative open-ended survey to the volunteer EM physicians who served as instructors.</p><p><strong>Results: </strong>Forty-two EM residents from 11 different residency programs attended at one of the three courses that were offered. After adjustments for size differences in the pre- and post-training tests, 35 (87.5%) of total sample resident learners' scores proportionately increased from pre- to post-test scores, with five (11.9%) other residents maintaining their pre-course score levels and only two (4.8%) residents experienced a post-score decline. In addition, resident participants responded favorably to a post-course summary evaluation with an average response of 4.8 (0-5 Likert scale) demonstrating overall satisfaction with the course. In the separate qualitative survey given to instructors, comments consistently conveyed a perceived benefit for the volunteer EM physicians.</p><p><strong>Conclusions: </strong>The evaluation of this novel model supports the feasibility of the 'train the trainer' program. It provides a proof of principle that train the trainer model can be implemented for POCUS training courses. Despite the small sample size, our results show an increase in the pre- to post-test scores among most participating residents. This model provides an additional option for EM residency program educators to consider when developing their POCUS training courses across multiple GME settings.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11650"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25425076","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 Evaluation of a Community Hospital’s Emergency Department Ultrasonography Processes for the Diagnosis of Acute Pediatric Appendicitis","authors":"T. Davis, Samuel J Wisniewski, Heidi Suidinski, J. Betcher","doi":"10.51894/001c.11639","DOIUrl":"https://doi.org/10.51894/001c.11639","url":null,"abstract":"CONTEXT Since the 1980s, the use of ultrasonography for suspected acute pediatric appendicitis has become increasingly common. Multiple studies have suggested that ultrasound of the appendix has consistently high sensitivity and specificity when the appendix can be clearly visualized. The authors’ primary objective for this study was to retrospectively evaluate their community-based healthcare system’s processes for detecting acute pediatric appendicitis using ultrasonography. METHODS This was a retrospective medical chart review study of data over a five-year 2014-2018 period at Mercy Health Muskegon in Muskegon, Michigan. All patients aged 3-18 years who had received an appendix ultrasound during this period were identified using the McKesson Radiology (MS) PACS-Lite computer program. Pediatric appendix ultrasound cases were collected and analyzed for sensitivity, specificity, positive predictive value, negative predictive value with 95% confidence intervals. Acute appendicitis cases had been confirmed based on pathology reports. Secondary measures including white blood cell, body mass index, and body temperature were also included in analyses. RESULTS In this sample, the overall sensitivity at detecting acute pediatric appendicitis using ultrasonography was relatively low at approximately 42% (95% CI: 21.1 - 66.0%). On the other hand, sample specificity was quite high at 97% (95% CI: 89.9 – 99.5%). The overall positive predictive value (PPV) was 80% (95% CI: 44.2-96.5%) and the negative predictive Value (NPV) was 86% (95% CI: 75.7-92.4%). The occurrence for false positives was 20% (95% CI: 3.5-55.8%). False negatives were 14% (95% CI: 7.6-24.3%). CONCLUSIONS The use of ultrasonography at the authors’ institution less often accurately identified cases of later-confirmed pediatric appendicitis compared to some earlier published studies. The authors concluded that this could be due to seeing a lower number of more complex/ambiguous cases of pediatric appendicitis or lack of hospital personnel’s pediatric-specific training and/or experience compared to specialty children’s hospitals. It is possible that imaging improvements could be achieved by either or a combination of: offering training sessions for general ultrasound technicians, offering training session for radiologists, and visiting pediatric physicians and ultrasound technicians. A valuable follow-up study would be to track anticipated improvements and lead to formulation of an acute pediatric appendicitis care protocol within the authors’ healthcare system.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42221661","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":"Osteopathic Orthopaedic Residency Selection Criteria: Program Directors' Survey and Analysis.","authors":"Michael McDonald,&nbsp;Saad Khan,&nbsp;Clarence Cabatu,&nbsp;Fremont Scott","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>Orthopaedic Surgery has become one of the most competitive specialties. Each year the number of applicants is far greater than the number of available Orthopaedic residency training spots [1,2,3]. With medical schools expanding their class sizes and new medical schools opening out of proportion to the number of residency spots, the competition is becoming even more fierce [12]. There are several published articles on resident selection in allopathic orthopaedic programs [5-7]. However, there are currently no such published studies on osteopathic orthopaedic programs to our knowledge. With the AOA and ACGME merger, this topic is critical to both allopathic and osteopathic applicants alike. The goal of our study was to evaluate the resident selection criteria for osteopathic orthopaedic residency programs.</p><p><strong>Methods: </strong>A twenty-five-question survey was sent to all of the osteopathic orthopaedic programs in December of 2017. The most important selection factors were then calculated as a mean of all the responses and were ranked accordingly.</p><p><strong>Results: </strong>The survey was completed by 29 out of 41 program directors (71%). The most important factors in resident selection were performance during the student's rotation at the program, formality/politeness and performance in the interview, and medical school board exam scores.</p><p><strong>Conclusions: </strong>This study is the most comprehensive study to date on the osteopathic orthopaedic resident selection process. The results from this study will help future applicants, both MD and DO, to focus on the factors in resident selection. The results may also help programs evaluate their own selection process and make improvements.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11598"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25425073","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":"Provider Driven Follow-Up in a Chest Pain Accelerated Diagnostic Protocol: Round Two of the PDSA Cycle in a Multidisciplinary Quality Improvement Patient Safety Project","authors":"Isaac Troiano, Mary Mitchell, M. Schury, Nikolai Butki","doi":"10.51894/001c.11727","DOIUrl":"https://doi.org/10.51894/001c.11727","url":null,"abstract":"CONTEXT In 2016, the McLaren Oakland Department of Emergency Medicine developed and implemented a Chest Pain Accelerated Diagnostic Protocol (CP-ADP) to identify patients presenting to the emergency department (ED) with chest pain who were at low risk for acute coronary syndrome (ACS) and appropriate for outpatient follow-up. The evaluation of the QI/PS project demonstrated that only 47% of the patients discharged from the ED under the CP-ADP received outpatient follow-up. In response, a second round of the PDSA cycle modified the CP-ADP to add a multidisciplinary provider driven follow-up. METHODS After ED discharge, patients in the CP-ADP with provider driven follow-up were contacted by a primary care physician to schedule a follow-up appointment. The premise was that this provider driven follow-up would alleviate navigation of the health care system as a barrier to follow-up. RESULTS The evaluation of the modified CP-ADP with provider driven follow-up demonstrated that 9 of the 30 patients discharged from the ED were able to be contacted. 21 of the patients were unable to be reached by the phone number they provided. Only 3 patients discharged with provider driven follow-up showed up to follow up appointments. CONCLUSIONS There were some internal process failures identified that contributed to the low numbers of patients that were successfully contacted. External factors such as patient access to phones and means of communication were also discussed as factors that were originally not considered.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43224394","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":"The Efficacy of Subchondroplasty for the Treatment of Knee Pain Associated with Bone Marrow Lesions","authors":"Nathan M. Krebs, James L. Kehoe, Michael J. Van Wagner, C. Ríos-Bedoya","doi":"10.51894/001c.11767","DOIUrl":"https://doi.org/10.51894/001c.11767","url":null,"abstract":"CONTEXT Symptomatic bone marrow lesions on MRI in patients with knee osteoarthritis are strongly associated with progressive deterioration of the joint and an increased risk of progression requiring joint replacement surgery. This study evaluates the efficacy of knee arthroscopy with adjunctive subchondroplasty (i.e. cartilage stabilization) to improve self-rated visual analog scale (VAS) pain scores, rate of conversion to arthroplasty, and patient satisfaction levels. METHODS A retrospective chart review and phone survey was performed on 12 patients who had undergone knee arthroscopy with adjunctive subchondroplasty for knee pain associated with chronic subchondral bone marrow lesions on MRI. Follow-up for the 12 patients was 36 months on average (range of 12 to 51 months), self-reported paired preoperative and postoperative VAS scores were analyzed in addition to rate of conversion to arthroplasty and patient satisfaction. RESULTS The results demonstrated statistically significant reductions in mean preoperative VAS scores versus six-week postoperative VAS scores from 7.58 to 1.83 (p < 0.001) in addition to significant reductions in mean preoperative VAS scores to final postoperative VAS scores from 7.58 to 1.60 (p < 0.001). There was no statistically significant association (p > 0.05) with patients’ demographic and clinical data (e.g., age, height, weight, BMI, length of symptoms) and rate of revision to total arthroplasty after receiving the arthroscopic subchondroplasty procedure. Out of the 12 patients, two (16.7%) patients went on to conversion to total knee arthroplasty. CONCLUSIONS In this series, knee arthroscopy with adjunctive subchondroplasty for the treatment of osteoarthritis with symptomatic bone marrow lesions was associated with clinically significant improvements in VAS pain scores. Furthermore, patients who underwent subchondroplasty had a low rate (16.7%) of conversion to total knee arthroplasty at 36-month follow-up.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48523205","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":"An Evaluation of a Community Hospital's Emergency Department Ultrasonography Processes for the Diagnosis of Acute Pediatric Appendicitis.","authors":"Tanner Davis, Samuel J Wisniewski, Heidi Suidinski, Joe Betcher","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>Since the 1980s, the use of ultrasonography for suspected acute pediatric appendicitis has become increasingly common. Multiple studies have suggested that ultrasound of the appendix has consistently high sensitivity and specificity when the appendix can be clearly visualized. The authors' primary objective for this study was to retrospectively evaluate their community-based healthcare system's processes for detecting acute pediatric appendicitis using ultrasonography.</p><p><strong>Methods: </strong>This was a retrospective medical chart review study of data over a five-year 2014-2018 period at Mercy Health Muskegon in Muskegon, Michigan. All patients aged 3-18 years who had received an appendix ultrasound during this period were identified using the McKesson Radiology (MS) PACS-Lite computer program. Pediatric appendix ultrasound cases were collected and analyzed for sensitivity, specificity, positive predictive value, negative predictive value with 95% confidence intervals. Acute appendicitis cases had been confirmed based on pathology reports. Secondary measures including white blood cell, body mass index, and body temperature were also included in analyses.</p><p><strong>Results: </strong>In this sample, the overall sensitivity at detecting acute pediatric appendicitis using ultrasonography was relatively low at approximately 42% (95% CI: 21.1 - 66.0%). On the other hand, sample specificity was quite high at 97% (95% CI: 89.9 - 99.5%). The overall positive predictive value (PPV) was 80% (95% CI: 44.2-96.5%) and the negative predictive Value (NPV) was 86% (95% CI: 75.7-92.4%). The occurrence for false positives was 20% (95% CI: 3.5-55.8%). False negatives were 14% (95% CI: 7.6-24.3%).</p><p><strong>Conclusions: </strong>The use of ultrasonography at the authors' institution less often accurately identified cases of later-confirmed pediatric appendicitis compared to some earlier published studies. The authors concluded that this could be due to seeing a lower number of more complex/ambiguous cases of pediatric appendicitis or lack of hospital personnel's pediatric-specific training and/or experience compared to specialty children's hospitals. It is possible that imaging improvements could be achieved by either or a combination of: offering training sessions for general ultrasound technicians, offering training session for radiologists, and visiting pediatric physicians and ultrasound technicians. A valuable follow-up study would be to track anticipated improvements and lead to formulation of an acute pediatric appendicitis care protocol within the authors' healthcare system.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11639"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184454","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":"The Rules of Four: A Systematic Approach to Diagnosing Common Musculoskeletal Conditions of the Knee.","authors":"Shawn Lerew, Steven Stoker, Shivajee Nallamothu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Musculoskeletal symptoms are consistently one of the most commonly cited reasons for visits to ambulatory care centers every year, with knee pain accounting for approximately one-third of the reported complaints. Previous studies have demonstrated that many non-orthopedic physicians report a lack of confidence in performing clinical musculoskeletal knee examinations. \"The Rules of Four\" approach presented in this paper is designed to present a systematic and concise method to musculoskeletal examination of the knee within a memorable format. The approach allows for the timely diagnosis of common musculoskeletal injuries while aiding in directing further treatment and diagnostic testing. This method will ideally allow medical students and non-orthopedic physicians alike to confidently and effectively evaluate patients with complaints of knee pain in ambulatory care settings.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11765"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25424501","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":"Consultation Intervention Rates for the Otolaryngology Service: A Large Metropolitan Hospital Experience.","authors":"Matt Mors, Colin Bohr, Michael Fozo, Carl Shermetaro","doi":"10.51894/001c.11596","DOIUrl":"10.51894/001c.11596","url":null,"abstract":"<p><strong>Context: </strong>The purpose of this study was to evaluate the types of consultations received by an otolaryngology service at a 772-bed large metropolitan, MI-based hospital.</p><p><strong>Methods: </strong>The authors performed a retrospective review of the specific types of consultations received during calendar year 2016.</p><p><strong>Results: </strong>A total of 518 consultations were reviewed and analyzed by the first and second authors (MM, CB). Consultations with low intervention rates included dysphagia (difficulty swallowing) (32.3%), dysphonia (difficulty speaking) (16%), otalgia (earache) (20.8%), hearing loss (13.3%), rule out vocal cord dysfunction (0%), and vertigo/dizziness (0%). Epistaxis (nosebleed) was the most frequent reason for consultations, and angioedema (lip or airway swelling) was the most common airway-related consultation. Notably, emergent or urgent surgery was only performed on 4.6% of sample patients. Several common consultation reasons (e.g., longer-term hearing loss evaluation and cerumen (\"earwax\") removal) could have been deferred for clinic-based evaluation where audiograms and microscopes are more readily available.</p><p><strong>Conclusions: </strong>These findings suggest areas for continuing education for primary care provider and resident education to place more appropriate hospital consultations. Annual resident lectures to prepare junior residents for the most common call scenarios (i.e., control epistaxis and incision and drainage of peritonsillar abscesses) could be helpful in this area. In addition, didactic lectures for primary care physicians on how to evaluate patients with dysphagia may be of value as this was a common consult for otolaryngologist referrals.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 2","pages":"11596"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25425072","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}