Cryptococcal meningitis in a patient with sarcoidosis.
We report a case of cryptococcal meningitis in a 65-year-old man with a new presentation of sarcoidosis who was not receiving immunosuppressive medications. PMID: 27034573 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Adams TN, Gibson M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Thyroid hormone resistance and its management.
Abstract The syndrome of impaired sensitivity to thyroid hormone, also known as syndrome of thyroid hormone resistance, is an inherited condition that occurs in 1 of 40,000 live births characterized by a reduced responsiveness of target tissues to thyroid hormone due to mutations on the thyroid hormone receptor. Patients can present with symptoms of hyperthyroidism or hypothyroidism. They usually have elevated thyroid hormones and a normal or elevated thyroid-stimulating hormone level. Due to their nonspecific symptomatic presentation, these patients can be misdiagnosed if the primary care physician is not familia...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Rivas AM, Lado-Abeal J Tags: Proc (Bayl Univ Med Cent) Source Type: research

The price of a 15-year delay in diagnosis of Sheehan's syndrome.
We describe a case of a 48-year-old woman who presented with a 15-year history of recurrent episodes of hypoglycemia and hyponatremia leading to altered behavior and generalized seizures. She underwent full clinical assessment, endocrine tests, and a pituitary magnetic resonance scan that showed pananterior hypopituitarism secondary to postpartum pituitary necrosis (Sheehan's syndrome). She was commenced on appropriate hormone replacement therapy, which led to significant improvement in lethargy, anorexia, muscle weakness, and episodes of hypoglycemia. In addition to the alleviation of her physical symptoms, she experience...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Parikh R, Buch V, Makwana M, Buch HN Tags: Proc (Bayl Univ Med Cent) Source Type: research

Linezolid-induced serotonin toxicity in a patient not taking monoamine oxidase inhibitors or serotonin receptor antagonists.
We report the case of a 65-year-old woman with signs and symptoms of serotonin toxicity following administration of linezolid for treatment of methicillin-resistant Staphylococcus aureus pneumonia. PMID: 27034576 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Sutton J, Stroup J, Som M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Facts and ideas from anywhere.
PMID: 27034577 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

Meta-analysis of the effect of proton pump inhibitors on obstructive sleep apnea symptoms and indices in patients with gastroesophageal reflux disease.
In conclusion, available studies do not provide enough evidence to make firm conclusions about the effects of PPI treatment on OSA symptoms and indices in patients with concomitant GERD. Controlled clinical trials with larger sample sizes are needed to evaluate these associations. We recommend PPIs in OSA patients with concomitant GERD to treat reflux symptoms. This treatment may improve the quality of sleep without any effect on apnea-hypopnea indices. PMID: 26722154 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Rassameehiran S, Klomjit S, Hosiriluck N, Nugent K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Serum hyperchloremia as a risk factor for acute kidney injury in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.
In conclusion, our study demonstrated no association between baseline serum hyperchloremia and an increased risk of AKI in patients admitted with STEMI treated with PCI. PMID: 26722155 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Patel N, Baker SM, Walters RW, Kaja A, Kandasamy V, Abuzaid A, Modrykamien AM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Frequency of fluid overload and usefulness of bioimpedance in patients requiring intensive care for sepsis syndromes.
Abstract Guideline-directed therapy for sepsis calls for early fluid resuscitation. Often patients receive large volumes of intravenous fluids. Bioimpedance vector analysis (BIVA) is a noninvasive technique useful for measuring total body water. In this prospective observational study, we enrolled 18 patients admitted to the intensive care unit for the treatment of sepsis syndromes. Laboratory data, clinical parameters, and BIVA were recorded daily. All but one patient experienced volume overload during the course of treatment. Two patients had>20 L of excess volume. Volume overload is clinically represented by...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Larsen TR, Singh G, Velocci V, Nasser M, McCullough PA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Surgical management of carotid body tumors: a 15-year single institution experience employing an interdisciplinary approach.
In conclusion, optimal management of cervical paragangliomas should include a thorough preoperative evaluation, accurate definition of the surgical anatomy, and exclusion of synchronous paragangliomas. A combined therapeutic approach by a multidisciplinary team including surgeons and interventional radiologists provides safe and effective management of cervical paragangliomas with very low morbidity and excellent outcomes. PMID: 26722157 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Dixon JL, Atkins MD, Bohannon WT, Buckley CJ, Lairmore TC Tags: Proc (Bayl Univ Med Cent) Source Type: research

Surgeons' perspective of a newly initiated electronic medical record.
Abstract The American Recovery and Reinvestment Act mandates "meaningful use" of an electronic health record (EHR) to receive current financial incentives and to avoid future financial penalties. Surgeons' ongoing adoption of an EHR nationally will be influenced by the early experiences of institutions that have made the transition from paper to electronic records. We conducted a survey to query surgeons at our institution regarding their perception of the EHR 3 months after institutional implementation. A total of 59 surveys were obtained from 24 senior staff and 35 residents. Results showed that surgeo...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Frazee R, Harmon L, Papaconstantinou HT Tags: Proc (Bayl Univ Med Cent) Source Type: research

Invited Commentary.
PMID: 26722159 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Couch C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Abstracts from the 10th annual Baylor Scott & White Department of Surgery Research Day.
Abstracts from the 10th annual Baylor Scott & White Department of Surgery Research Day. Proc (Bayl Univ Med Cent). 2016 Jan;29(1):24-9 Authors: PMID: 26722160 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Tags: Proc (Bayl Univ Med Cent) Source Type: research

Superior mesenteric artery-duodenal fistula secondary to a gunshot wound.
We present a patient who developed a fistula between a middle colic artery pseudoaneurysm, a proximal branch of the superior mesenteric artery (SMA), and the third part of the duodenum 2 weeks after a self-inflicted gunshot wound to the abdomen. The patient's presentation, evaluation, treatment, and prognosis are discussed. All prior published cases of SMA-duodenal fistulas are reviewed. PMID: 26722161 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Fielding CM, Frandah W, Krohmer S, Flomenhoft D Tags: Proc (Bayl Univ Med Cent) Source Type: research

Removal of an embedded crochet needle in the mouth.
Abstract A 3-year-old child presented to the emergency department with a crochet needle lodged in her posterior oral cavity. To localize the needle and significant surrounding anatomic structures, bedside transcavitary ultrasound was employed. After careful localization, the needle was removed using a modified needle cover technique. A review of barbed foreign object removal techniques, including advance-and-cut, retrograde, string-yank, and needle cover techniques, is presented. Important considerations while planning any procedure include risk, benefit, availability of staff, and availability of equipment. Prope...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Klovenski V, Juergens A, Lappo K, Marshall K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Bilateral cavernous sinus and superior ophthalmic vein thrombosis in the setting of facial cellulitis.
We present a case of bilateral cavernous sinus and superior ophthalmic thrombosis secondary to an extreme case of facial cellulitis. PMID: 26722163 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Syed A, Bell B, Hise J, Philip J, Spak C, Opatowsky MJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Coccidioidomycosis with diffuse miliary pneumonia.
Abstract Coccidioidomycosis is a well-known infection in the southwestern United States, and its occurrence is becoming more frequent in endemic areas. This disease can have a significant economic and medical impact; therefore, accurate diagnosis is crucial. In conjunction with patient symptoms, residence in or travel to an endemic area is essential for diagnosis. Diagnosis is usually made with serology, culture, or biopsy and confirmed with DNA probe technology. Pulmonary disease is the most common presentation and is seen in almost 95% of all cases. One-half to two-thirds of all Coccidioides infections are asymp...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Sotello D, Rivas M, Fuller A, Mahmood T, Orellana-Barrios M, Nugent K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Choriocarcinoma presenting with thyrotoxicosis.
We describe a 26-year-old man with metastatic choriocarcinoma who presented with hyperthyroidism associated with elevated β-human chorionic gonadotropin (B-HCG) and respiratory failure secondary to diffuse lung metastasis. After the first cycle of chemotherapy, the concentration of B-HCG dramatically decreased and the patient became euthyroid, allowing us to discontinue antithyroid medications. The patient's hyperthyroidism was caused by stimulation of the thyroid gland by high B-HCG levels, as shown by the marked improvement of the patient's thyroid function panel after chemotherapy. PMID: 26722165 [PubMed] (Sou...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Sotello D, Rivas AM, Test VJ, Lado-Abeal J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Kidney stones and crushed bones secondary to hyperparathyroidism.
Abstract Here we report a 65-year-old woman with multiple brown tumors and renal stones secondary to primary hyperparathyroidism. This case highlights the need for early recognition of parathyroid hyperactivity. PMID: 26722166 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Sreelesh KP, Sreejith GN, Pranab KP Tags: Proc (Bayl Univ Med Cent) Source Type: research

Successful treatment of pegaspargase-induced acute hepatotoxicity with vitamin B complex and L-carnitine.
We report a patient with ALL who developed pegaspargase-induced severe hepatotoxicity that was rescued by treatment with vitamin B complex and L-carnitine. Our patient had a quicker response than prior reported cases, suggesting this treatment might be a better regimen. PMID: 26722167 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Lu G, Karur V, Herrington JD, Walker MG Tags: Proc (Bayl Univ Med Cent) Source Type: research

Recurrent lumbosacral herpes simplex virus infection.
We present the case of a 54-year-old white woman with episodic lumbosacral lesions that she had been treating as psoriasis. Evaluation revealed classic herpes simplex virus (HSV) infection. The discussion reviews the significance and potential complications of recurrent lumbosacral HSV infection. PMID: 26722168 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Vassantachart JM, Menter A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Disseminated cutaneous histoplasmosis in newly diagnosed HIV.
We present a woman with a widespread severe papulopustular eruption, fever, and fatigue of 5 weeks' duration. HIV infection was diagnosed, with an absolute CD4(+) count of 3 cells/µL. The eruption was consistent with disseminated cutaneous histoplasmosis. The clinical manifestations and management of cutaneous histoplasmosis are reviewed. PMID: 26722169 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Soza GM, Patel M, Readinger A, Ryan C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Disseminated Kaposi sarcoma with osseous metastases in an HIV-positive patient.
We present a 44-year-old African immigrant woman who presented to the emergency department after several months of abdominal pain. She was found to be HIV positive, and computed tomography demonstrated numerous lesions of the lungs, liver, and spleen, gastric wall thickening, and several lytic lesions of the spine. Fluoroscopy-guided biopsy of a lytic lesion of the spine yielded the diagnosis of Kaposi sarcoma. AIDS-related Kaposi sarcoma with osseous involvement is rare, with approximately 30 cases reported in the literature. When osteolytic lesions are encountered in an HIV-positive patient, Kaposi sarcoma should remain ...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Bell BM, Syed A, Carmack SW, Thomas CA, Layton KF Tags: Proc (Bayl Univ Med Cent) Source Type: research

A giant splenic hydatid cyst.
Abstract A 16-year-old girl presented with pain in the left hypochondrium, which had been progressing for 5 months. Examination revealed large splenomegaly, and ultrasonography showed a huge hydatid cyst in the spleen. Preoperative planning and postoperative care lead to successful management of this entity. Radiological investigations also play a major role in diagnosis and decrease morbidity. PMID: 26722171 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Singal R, Sandhu KS, Mittal A, Gupta S, Jindal G Tags: Proc (Bayl Univ Med Cent) Source Type: research

Segmental ischemia in testicular torsion.
We present a case of partial testicular ischemia due to testicular torsion. PMID: 26722172 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Tavaslı B, Köseoğlu H, Çevik H Tags: Proc (Bayl Univ Med Cent) Source Type: research

Warfarin-induced skin necrosis following heparin-induced thrombocytopenia.
Abstract Anticoagulants, such as heparin and warfarin, are commonly used in the treatment and prevention of thromboembolic events. The risk of developing warfarin-induced skin necrosis (WISN) with warfarin is reported to be
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Fawaz B, Candelario NM, Rochet N, Tran C, Brau C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Metastatic thymoma involving the bone marrow.
Abstract Although relatively rare, thymomas can be involved in a considerable variety of clinical presentations. Clinicians should be mindful of the breadth of associations with other diseases, including autoimmune disorders and many secondary nonthymic malignancies. For the pathologist, knowledge of the extremely varied histopathologic presentation of thymoma is vital to formulate a proper differential, workup, and diagnosis. The presented case illustrates the finding of very rare metastatic thymoma involvement of bone marrow, identified during evaluation for pancytopenia. The history of prior prostate cancer and...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Dekmezian M, Wenceslao S, Krause JR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Mullerian adenosarcoma of the cervix with heterologous elements and sarcomatous overgrowth.
We report a case of adenosarcoma of the cervix with heterologous elements and sarcomatous overgrowth in a 38-year-old woman. PMID: 26722175 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Podduturi V, Pinto KR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Neuroendocrine carcinoma of the prostate gland.
Abstract Small cell prostate carcinoma (SCPC) has a clinical course and prognosis that is markedly different from that of common adenocarcinoma of the prostate. The patient in this case presented with fever of unknown origin, dyspnea, and near spinal cord compression. He was subsequently found to have widely metastatic high-grade neuroendocrine carcinoma of prostatic origin. This case emphasizes that despite the commonality of prostate cancer, there are rare presentations of this common disease. PMID: 26722176 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Hoof P, Tsai-Nguyen G, Paulson S, Syed A, Mora A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Seronegative neuromyelitis optica after cardiac transplantation.
We report a case of a 42-year-old man who presented with progressive weakness and blindness over the course of several months and met criteria for seronegative neuromyelitis optica. This presentation was in the setting of immunosuppression following cardiac transplant. No infectious causes were found within the neuroaxis, and he ultimately died with complete blindness, quadriplegia, and respiratory failure attributed to panmyelitis and brain stem inflammation despite aggressive therapies. PMID: 26722177 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Kim E, Van Vrancken M, Shaji M, Mir O, Spak CW, Gupta M, Shamim SA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Successful heart transplantation using a donor heart afflicted by takotsubo cardiomyopathy.
Abstract Takotsubo cardiomyopathy, also known as apical ballooning syndrome, stress cardiomyopathy, or broken heart syndrome, is a disease characterized by transient ventricular dysfunction in the absence of obstructive coronary artery disease. Herein, we present a case in which a heart with mild takotsubo cardiomyopathy was utilized as the donor organ for an orthotopic heart transplant. PMID: 26722178 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Ravi Y, Campagna R, Rosas PC, Essa E, Hasan AK, Higgins RS, Emani S, Sai-Sudhakar CB Tags: Proc (Bayl Univ Med Cent) Source Type: research

Invited Commentary: Using "broken hearts" for cardiac transplantation: a risky venture or fruitful endeavor?
Invited Commentary: Using "broken hearts" for cardiac transplantation: a risky venture or fruitful endeavor? Proc (Bayl Univ Med Cent). 2016 Jan;29(1):74-5 Authors: Lima B PMID: 26722179 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Lima B Tags: Proc (Bayl Univ Med Cent) Source Type: research

Utility of indium-111 octreotide to identify a cardiac metastasis of a carcinoid neoplasm.
We present a case in which an indium-111 octreotide scan revealed uptake in three distinct masses in the colon, liver, and right ventricle. The results of the scan were contradictory to the biopsy results, which were diagnostic for hepatic carcinoid and cardiac myxoma. PMID: 26722180 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Farooqui M, Rathore S, Ball T Tags: Proc (Bayl Univ Med Cent) Source Type: research

Angiosarcoma of the right atrium presenting as hemoptysis.
Abstract This case report describes a previously healthy 32-year-old man who presented with several weeks of hemoptysis. Initially he was treated with antibiotics with a preliminary diagnosis of pneumonia. With increasing hemoptysis and additional symptoms, he was referred to our institution. Cardiac magnetic resonance imaging suggested a diagnosis of right atrial angiosarcoma with extensive pulmonary metastases. His extensive pulmonary tumor burden caused the hemoptysis. Pulmonary biopsy was well tolerated, and he was referred to medical oncology for adjuvant therapy. Following the first cycle of chemotherapy, hi...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Choi CH, Konda S, Shake JG Tags: Proc (Bayl Univ Med Cent) Source Type: research

Rupture of a left internal mammary artery during cardiopulmonary resuscitation.
We present a rare case of a left internal mammary artery rupture during cardiopulmonary resuscitation (CPR). This case demonstrates that intrinsic cardiac/vascular injuries can occur even with manual CPR, and each patient should be monitored closely, considering the very subtle signs that can clue the physicians into the diagnosis. PMID: 26722182 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Patel C, Metting A, Curtis B, Mixon T Tags: Proc (Bayl Univ Med Cent) Source Type: research

High-intensity cardiac rehabilitation training of a commercial pilot who, after percutaneous coronary intervention, wanted to continue participating in a rigorous strength and conditioning program.
Abstract After undergoing elective percutaneous coronary intervention, a 64-year-old commercial pilot was referred to cardiac rehabilitation. His stated goals were to continue participating in a rigorous strength and conditioning program at a community workout facility and to resume working as a pilot. To help him meet those goals, we designed and implemented a regimen of high-intensity exercises, with quick transitions between a variety of tasks that are not typically included in cardiac rehabilitation programs (e.g., medicine ball throws, push-ups, dead lifts, squats, military presses, sprints, and lunges). The ...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Shrestha S, Adams J, Lawrence A, Schussler JM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Electrocardiogram read by the computer as arm-lead reversal.
PMID: 26722184 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Glancy DL, Quintal RE, McShurley TD Tags: Proc (Bayl Univ Med Cent) Source Type: research

John M. T. Finney: distinguished surgeon and Oslerphile.
Abstract John Finney (1863-1942) was born near Natchez, Mississippi. After receiving his medical degree from Harvard, he interned at Massachusetts General Hospital and then went to Baltimore to become one of the first interns at the new Johns Hopkins Hospital. He met William Osler the day the hospital opened and became a lifelong admirer of "the Chief." Finney specialized in gastrointestinal surgery and was recognized for his expertise in the field. Osler recommended Finney to a physician colleague, writing, "You could not be in better hands…. Finney has been most successful and his judgment ...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Stone MJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Reflections of Churchill's personal cardiologist.
PMID: 26722186 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Cantwell JD, Wilson C Tags: Proc (Bayl Univ Med Cent) Source Type: research

An alternative approach to prescribing sternal precautions after median sternotomy, "Keep Your Move in the Tube".
An alternative approach to prescribing sternal precautions after median sternotomy, "Keep Your Move in the Tube". Proc (Bayl Univ Med Cent). 2016 Jan;29(1):97-100 Authors: Adams J, Lotshaw A, Exum E, Campbell M, Spranger CB, Beveridge J, Baker S, McCray S, Bilbrey T, Shock T, Lawrence A, Hamman BL, Schussler JM Abstract Traditional sternal precautions, given to sternotomy patients as part of their discharge education, are intended to help prevent sternal wound complications. They vary widely but generally include arbitrary load and time restrictions (lifting no more than a specified weight f...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Adams J, Lotshaw A, Exum E, Campbell M, Spranger CB, Beveridge J, Baker S, McCray S, Bilbrey T, Shock T, Lawrence A, Hamman BL, Schussler JM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Delivering bad news to patients.
Abstract When physicians lack proper training, breaking bad news can lead to negative consequences for patients, families, and physicians. A questionnaire was used to determine whether a didactic program on delivering bad news was needed at our institution. Results revealed that 91% of respondents perceived delivering bad news as a very important skill, but only 40% felt they had the training to effectively deliver such news. We provide a brief review of different approaches to delivering bad news and advocate for training physicians in a comprehensive, structured model. PMID: 26722188 [PubMed] (Source: Baylo...
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Monden KR, Gentry L, Cox TR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Cool it.
PMID: 26722189 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Weisse AB Tags: Proc (Bayl Univ Med Cent) Source Type: research

Facts and ideas from anywhere.
PMID: 26722190 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2016 Category: Universities & Medical Training Authors: Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

Hepatitis prevention project in the Korean American community in Killeen, Texas.
Abstract Educational efforts related to viral hepatitis have the potential to increase awareness and identify chronically infected individuals and can lead to successful vaccination strategies. However, in underserved semirural communities, such as the Korean American community in Killeen, Texas, these outreach activities are lacking. The GanYum ("hepatitis" in Korean) Prevention Project aimed to evaluate thoughts/behaviors, assess vulnerability, and educate Korean Americans on hepatitis B and C. Two outreach events were held at a Korean church and a Korean market (O'Mart) to provide education, screening...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Hasan SS, Ma J, Kang F, Song J, Fang-Hollingsworth Y, Sears D Tags: Proc (Bayl Univ Med Cent) Source Type: research

Screening for hepatitis B in patients with lymphoma.
Abstract Chronic hepatitis B virus (HBV) infection can be reactivated during lymphoma chemotherapy, specifically with rituximab. In 2008, the Centers for Disease Control and Prevention and, in 2010, the American Society of Clinical Oncology made recommendations that anyone who received cytotoxic or immunosuppressive therapy should be tested for serologic markers of HBV infection. In our study, we wanted to determine the screening rates for HBV infection at our institution and if simply adding a checkbox onto the rituximab order would improve HBV screening. We performed a retrospective chart review of two cohorts o...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Ramirez J, Duddempudi AT, Sana MM, Hasan SS, de Los Santos M, Song J, Fang-Hollingsworth Y, Gupta SS, Sears DM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Invited Commentary: Screening for hepatitis B in the immigrant population and individuals who are in need of immunosuppressive drug therapy.
Abstract Chronic hepatitis B (CHB) afflicts approximately 300 million people in the world. Hepatitis B virus (HBV) is a known carcinogenic virus and continues to be the leading cause of hepatocellular carcinoma (HCC) (1). Approximately 70% of hepatitis B surface antigen (HBsAg) carriers reside in intermediate (>2% prevalence) to high-risk (>8% prevalence) areas such as Asia, the Pacific Islands, Africa, India, and parts of Southern Europe (1). There is a common misperception that this disorder is not very common in the United States. However, 63% of the nearly 28 million immigrants who entered the US between...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Perrillo R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Dual antiplatelet compared to triple antithrombotic therapy in anterior wall acute myocardial infarction complicated by depressed left ventricular ejection fraction.
Abstract Current guidelines recommend triple antithrombotic therapy (TT) consisting of warfarin, aspirin, and a P2Y12 inhibitor following an anterior ST elevation myocardial infarction (STEMI) complicated by extensive wall motion abnormalities. This recommendation, however, is based on data collected before percutaneous coronary intervention (PCI) became the standard of care for the treatment of STEMI. We designed a retrospective study of patients who received PCI for anterior STEMI over an 8-year period to compare rates of thromboembolic and bleeding events between patients receiving dual antiplatelet therapy (DA...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Oyetayo OO, Slicker K, De La Rosa L, Lane W, Langsjoen D, Patel C, Brough K, Michel J, Chiles C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Improving compliance with cervical cancer screening guidelines.
In conclusion, transition to Epic and a training session had minimal impact on compliance with ordering HPV cotesting at the time of a Pap smear except among family practice physicians, who did significantly improve their compliance rate. Gynecologists and mid-level providers were more compliant with ordering HPV cotesting throughout, but did not significantly improve after the interventions. PMID: 26424938 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Langsjoen J, Goodell C, Castro E, Thomas J, Kuehl TJ, Wehbe-Janek H, Hinskey M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Replacement of the aortic valve with a bioprosthesis at the time of continuous flow ventricular assist device implantation for preexisting aortic valve dysfunction.
Abstract Left ventricular assist device (LVAD) implantation has become a mainstay of therapy for advanced heart failure patients who are either ineligible for, or awaiting, cardiac transplantation. Controversy remains over the optimal therapeutic strategy for preexisting aortic valvular dysfunction in these patients at the time of LVAD implant. In patients with moderate to severe aortic regurgitation, surgical approaches are center specific and range from variable leaflet closure techniques to concomitant aortic valve replacement (AVR) with a bioprosthesis. In the present study, we retrospectively analyzed our out...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Lima B, Chamogeorgakis T, Mountis M, Gonzalez-Stawinski GV Tags: Proc (Bayl Univ Med Cent) Source Type: research

The gender of authors in the Baylor Proceedings: a reflection of both current staff composition and lesser number of publications by female physicians.
Abstract Gender parity has been achieved in entrance to medical school, but women still constitute only 32% of the physicians licensed to practice in the state of Texas. Similarly, female physicians lag behind in scholarly publications. This gender imbalance appears to be improving, although parity has yet to be achieved in many journals. We could reliably obtain the gender of both the physician staff of the North Division of Baylor Scott & White Health and of the authors in Baylor University Medical Center Proceedings. Of the Baylor authors, 19% were female physicians, while 65% were male physicians (others w...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Stefanos S, Paul A, Thakur R, Bass K, East C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Acral vesicles and bullae in a patient with severe rheumatoid arthritis.
We present the case of a 56-year-old black woman with rheumatoid arthritis who developed worsening fatigue, fever, weight loss, and a vesiculobullous skin eruption while being treated with certolizumab pegol for her arthritis. Microscopic findings confirmed the diagnosis of a neutrophilic dermatosis. PMID: 26424941 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Soza GM, Griffin JR Tags: Proc (Bayl Univ Med Cent) Source Type: research