Baylor University Medical Center Proceedings最新文献

{"title":"Adherence to guideline-recommended management in acute severe ulcerative colitis: a retrospective audit.","authors":"David Alvarez, Dhanushya Battepati, Christopher Johnson","doi":"10.1080/08998280.2026.2698321","DOIUrl":"10.1080/08998280.2026.2698321","url":null,"abstract":"<p><strong>Background: </strong>Acute severe ulcerative colitis (ASUC) is a life-threatening complication of ulcerative colitis that requires hospitalization and prompt guideline-directed management. We evaluated adherence to recommended inpatient management in hospitalized patients with ASUC.</p><p><strong>Methods: </strong>We conducted a single-center retrospective audit of patients hospitalized with ASUC at a tertiary care center from 2014 to 2024. ASUC was defined using Truelove and Witts' criteria. Patients <18 years were excluded. The primary outcome was venous thromboembolism (VTE) prophylaxis. Secondary outcomes included <i>Clostridioides difficile</i> and cytomegalovirus (CMV) testing, specialist consultation, intravenous steroid failure, colectomy, 30-day readmission, and mortality. Adherence was also compared between preguideline (2014-2018) and postguideline (2019-2024) time periods.</p><p><strong>Results: </strong>Among 530 encounters reviewed, 35 patients met inclusion criteria, accounting for 56 admissions. VTE prophylaxis was administered in 43% of admissions, CMV testing in 30%, and <i>C. difficile</i> testing in 82%. Gastroenterology consultation occurred in 98% of admissions, whereas colorectal surgery consultation occurred in 30%. Intravenous steroid failure occurred in 18%, colectomy in 16%, and 30-day readmission in 23%. No in-hospital deaths occurred. Following guideline publication, VTE prophylaxis increased from 25% to 75% (<i>P</i> = 0.001) and CMV screening from 14% to 60% (<i>P</i> = 0.001).</p><p><strong>Conclusions: </strong>Adherence to guideline-recommended ASUC management was variable, particularly for VTE prophylaxis and CMV testing, both of which improved significantly following the 2019 ACG guideline publication, underscoring the impact of guideline dissemination and highlighting remaining targets for quality improvement.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1022-1028"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418330","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":"Clinical progression of a smallpox postvaccination response.","authors":"Maggie H Zhou, Shari R Lipner, Stephen K Tyring","doi":"10.1080/08998280.2026.2661295","DOIUrl":"10.1080/08998280.2026.2661295","url":null,"abstract":"<p><p>We present the case of a 20-year-old man with a non-necrotic, shallow, well-circumscribed ulcer on the shoulder. The patient had no significant medical history, although he noted that he was joining the military and received a smallpox vaccine injection at the same site several weeks earlier. While the differential diagnosis also included pyoderma gangrenosum, brown recluse bite, and Buruli ulcer, the patient's presentation is characteristic of a typical postvaccination progression, which is self-limited. It is important for dermatologists for be aware of this postvaccination response to avoid misdiagnosis and unnecessary workup, given that the smallpox vaccine is still administered in healthcare workers and military recruits.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1138-1140"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534921","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":"Enhancing objective structured clinical examination performance through an artificial intelligence virtual patient: a proof-of-concept study.","authors":"Betty S Chan, Jack Marjot, Timothy Dodds, Lucy S R Jo, Hyun Yang, Jen Xiang, Paul Dyer, Bhavani Kannan, Graham Hannah, Adrienne Torda","doi":"10.1080/08998280.2026.2699604","DOIUrl":"10.1080/08998280.2026.2699604","url":null,"abstract":"<p><strong>Background: </strong>The application of artificial intelligence (AI) in simulating detailed patient-doctor interactions for objective structured clinical examinations (OSCEs) remains emerging. This study aimed to evaluate an AI virtual patient (AIVP) innovation designed to support medical education through interactive patient simulations and feedback.</p><p><strong>Method: </strong>This prospective mixed-methods pilot recruited final-year medical students during their critical care term. Two cohorts were examined: a volunteer AIVP group (n = 43) and an educational-support medical education enhancement training (MEET) group (n = 8). Participants completed pre- and postintervention OSCEs scored across communication, history and examination, management, and overall outcome domains. Students accessed nine emergency medicine scenarios featuring AI-driven dialogue, speech recognition, avatar interaction, and immediate feedback. Quantitative outcomes were analyzed using the Wilcoxon signed-rank test. Postintervention surveys (Likert scale) and focus groups provided qualitative data, which were analyzed thematically.</p><p><strong>Results: </strong>In the AIVP cohort, descriptive improvements were observed across domains; however, Wilcoxon testing identified no statistically significant changes. MEET students demonstrated significant improvement in overall OSCE outcomes (median 37 [IQR: 30-67] vs 67 [IQR: 47-75]; <i>P</i> = 0.03), with positive trends in all domains. Survey responses (n = 25) showed high agreement that AIVP enhanced confidence in history-taking (83%), differential diagnosis (78%), and management planning (78%). Thematic analysis from 10 students demonstrated that AIVP was experienced as a structured, exam-focused, and confidence-building learning tool that addresses gaps in workplace-based learning.</p><p><strong>Conclusion: </strong>AIVP was feasible and well received, providing practice aligned with university OSCE standards. While the volunteer cohort showed modest gains, the MEET group demonstrated significant improvement, suggesting benefit for students needing structured support. Tailored feedback and alignment with OSCE standards highlight AIVP as a promising adjunct for training.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1092-1095"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547658","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":"Does digital clinical decision support, known as computerized assistance, have the potential to lessen the burden of practicing physicians and improve clinical outcomes?","authors":"F David Winter","doi":"10.1080/08998280.2026.2724670","DOIUrl":"10.1080/08998280.2026.2724670","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1107-1108"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872791","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":"Association of patient characteristics with preterm birth among patients with a history of preterm birth: a single-center retrospective study.","authors":"Marissa N Rosa, Diana Villazana-Kretzer, Michael P Hofkamp","doi":"10.1080/08998280.2026.2697683","DOIUrl":"10.1080/08998280.2026.2697683","url":null,"abstract":"<p><strong>Background: </strong>We hypothesized that receiving cervical length screening (CLS) would be associated with a lower incidence of preterm birth (PTB) among patients with a history of PTB.</p><p><strong>Methods: </strong>Patients who delivered live and stillborn infants at Baylor Scott & White Medical Center - Temple from January 1, 2023, to December 31, 2023 and had a medical history of PTB were included in the analysis. We performed a bivariate analysis between patients who did and did not have PTB. We then performed a multivariate logistic regression to determine which variables were independently associated with PTB.</p><p><strong>Results: </strong>There were 2756 births during the study period, and 185 patients met inclusion criteria. Tricare versus commercial insurance (adjusted odds ratio [aOR] 3.39; 95% confidence interval [CI] 1.17-9.80; <i>P</i> = 0.02) and receiving CLS (aOR 2.82; 95% CI 1.37-5.81; <i>P</i> = 0.005) were independently associated with PTB. The c-statistic of this multivariate model was 0.68.</p><p><strong>Discussion: </strong>Tricare versus commercial insurance and receiving CLS were associated with a 239% and 182% increase, respectively, in the chance of PTB. It is possible that unmeasured variables among patients who had CLS were associated with PTB.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1070-1074"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403473","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":"Acute generalized exanthematous pustulosis sine pustules.","authors":"Justin Raman, Riley Shin, Mary Fitzgibbon, Alba Posligua, Michelle Tarbox","doi":"10.1080/08998280.2026.2667079","DOIUrl":"10.1080/08998280.2026.2667079","url":null,"abstract":"<p><p>Acute generalized exanthematous pustulosis (AGEP) is a type of severe cutaneous adverse reaction, typically presenting with sterile pustules in predominantly flexural areas. However, AGEP may present without clinically evident pustules, making histopathologic investigation particularly important in instances of complex or unclear medication administration history.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1154-1156"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534980","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 structured histotechnology curriculum for Mohs micrographic surgery trainees.","authors":"George M Jeha, Anna Catinis, Umer Nadir, Barbara Ponath, Stanislav N Tolkachjov","doi":"10.1080/08998280.2026.2703437","DOIUrl":"10.1080/08998280.2026.2703437","url":null,"abstract":"<p><strong>Background: </strong>Mohs micrographic surgery achieves high cure rates for skin cancer through immediate histopathologic evaluation of frozen sections, yet histotechnology training for Mohs fellows varies widely across programs and is often learned informally during routine clinical care. This article describes the development and implementation of a structured, competency-based histotechnology curriculum for Mohs surgery trainees.</p><p><strong>Methods: </strong>We developed a modular laboratory training curriculum incorporating focused didactic instruction, supervised hands-on laboratory experience, and checklist-based competency assessment. In our program, training occurs during two dedicated 8-hour sessions early in fellowship under direct supervision of a senior histotechnologist. The curriculum addresses three domains: laboratory operations and regulatory requirements, tissue processing and cryostat sectioning techniques, and staining with quality assurance. Competency is assessed using a standardized checklist aligned with expectations for trainees directing Mohs laboratories.</p><p><strong>Results: </strong>The curriculum was implemented as a structured training module providing supervised laboratory instruction for Mohs trainees during the fellowship year. Trainees completed competency assessments across checklist domains and demonstrated proficiency in key tasks required for laboratory oversight. The training sessions were completed without disruption of routine clinical workflow.</p><p><strong>Conclusion: </strong>A structured, competency-based histotechnology curriculum may provide a practical framework for standardized laboratory training in Mohs fellowship programs.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1161-1164"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468626","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 clinic on the mountain.","authors":"Leonard Kuan-Pei Wang, Christopher William Pearce, Jackie Stewart","doi":"10.1080/08998280.2026.2715952","DOIUrl":"10.1080/08998280.2026.2715952","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1165-1166"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720638","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":"Defining the patient-physician relationship versus a customer-physician relationship.","authors":"Chad D Housewright, Donn Matthew LaTour","doi":"10.1080/08998280.2026.2748177","DOIUrl":"https://doi.org/10.1080/08998280.2026.2748177","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285029","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":"History of anesthesia: examining 19th century religious objections to obstetric anesthesia and James Young Simpson's rebuttal.","authors":"Nathaniel B Hunter, Russell K McAllister","doi":"10.1080/08998280.2026.2747572","DOIUrl":"https://doi.org/10.1080/08998280.2026.2747572","url":null,"abstract":"<p><p>James Young Simpson's 1847 introduction of chloroform to obstetric practice is popularly remembered as a battle between science and religion, with Simpson portrayed as valiantly confronting a hostile clergy over the \"curse of Eve.\" A closer examination of contemporaneous sources reveals limited clerical opposition, with the most explicit theological objections coming from physicians rather than the pulpit, and prominent religious leaders of the day either in agreement with Simpson or remaining silent on the matter. Not until nearly 50 years later, with Andrew Dickson White's popular polemic, did the science-versus-religion narrative become dominant. A closer reading of Simpson's own 1847 pamphlet, meanwhile, reveals the sophistication of his theological arguments, which draw on extensive biblical exegesis and Hebrew philology to demonstrate that obstetric anesthesia did not violate divine command. Recovering the true history of this episode restores Simpson's identity as a genuine polymath of his age and cautions against the temptation to let convenient myths stand in for the historical record.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285003","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}