MSRJ 2019 Cover Art Competition

MSRJ 2019 Cover Art Competition

The Medical Student Research Journal is hosting its first cover art competition! This is a competition to have your art featured in the Fall 2019 edition of the Medical Student Research Journal. This is a great opportunity to showcase humanism in medicine and earn a CITATION that you can add to your curriculum vitae! Details: • Competition Dates?  June 1 to August 31, 2019 • Theme?  Medicine • Who is eligible?  All MSU graduate and undergraduate students, KCAD students. • How to compete? Please submit artwork in PDF or JPEG format by 11:59pm, August 31 2019. Please send submissions to: jacob.purcell@msrj.chm.msu.edu Check out the official flyer and last years cover art below: Fall 2018 publication...

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MSRJ 2018-2019 Editorial Staff

MSRJ 2018-2019 Editorial Staff

Meet Our 2018-2019 MSRJ Editorial Staff

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Advance Directive Status in >65yo ED Population

Advance directives are an important aspect of medical care for the elderly given the uncertainty of health and longevity. In their absence, family and physicians are often left with questions regarding what patient’s wishes would entail if they become incapacitated. Individuals >65 years presenting to the ED were surveyed during the months of June-September 2015 by study investigators regarding their knowledge and utilization of advance directives. 168 patient surveys were completed with a mean age of 77.2 (SD ±7.45 years; range 65-97). Of those, 91% were either ―very familiar‖ or ―somewhat familiar‖ with Advance Directives with 76.1% having some form of documented advance directives in place. Of those who felt family were aware of their wishes, 84.9% had assigned a Medical Durable Power of Attorney. Only a small minority had developed advance directives with their physician’s assistance (6.8%). The majority of patients stated that they had prepared their end of life documents with a Lawyer (72%). Only 35.8% of patients sampled had even mentioned the topic or their specific wishes with their primary care or ED physician. Overall rates of formalized advance directives would appear to be highly utilized in this patient population with little variation based upon respondents’ self-assessment of physical health. A surprising finding was how minor of a role physicians appear to play in the development of ADs. This provides an opportunity to enhance the physician-patient relationship and improve patient education regarding end of care discussions. Physicians should take initiative and begin having these conversations, in order to ensure that patients are making educated decisions and that proper documentation is occurring.

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Case Report of Glanzmann Thrombasthenia

Background

Glanzmann Thrombasthenia (GT) is a rare inherited genetic platelet disorder characterized by a qualitative, or quantitative mutation in GPIIb/IIIa receptor; which results in defective platelet aggregation and diminished clot retraction.

Case

A 19-year-old Arab descent female presented to emergency department with severe menorrhagia. On examination an ill looking pale patient in addition to generalized fatigue of one-week duration.

Conclusion

Acquired platelet disorders are more frequently encountered in practice than inherited ones, usually due to medical therapy or an underlying medical condition. GT, was previously known as hereditary hemorrhagic thrombasthenia, is an autosomal recessive disorder that is often disregarded as it has many clinical and laboratory findings similar to some acquired platelet disorders.

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Three Wishes Survey

Purpose

In this study we assessed the underlying values and goals of current medical students by examining personal wishes. The authors also aimed to determine the impact of the increased financial burden of medical training on students‟ motivations by comparing current wishes to those of students from 1999. We also examined the relationships between types of wishes, choice of future medical specialty, and demographic characteristics.

Methods

An anonymous survey with the question: “If you had three wishes, what would you wish for?”, and items pertaining to specialization choice and demographics was completed by 418 medical students. Wishes were coded into seventeen categories. Results were compared to a previous survey conducted in 1999.

Results

The largest category of wishes was altruism (40% of students) followed by achievement (36%), and money (34%). Significantly more medical students in 2015 had altruistic and achievement wishes compared to 1999. However, there was no significant increase in money-related wishes in the 2015 cohort compared to students from 1999. Final year students were more likely to report power-related wishes and male medical students had significantly more wishes related to power, money, and self-esteem. Students who aspired to be surgeons had more affiliation wishes and fewer knowledge-related aspirations. Conversely, medical students planning to enter internal medicine training were more likely to have wishes related to power and self-esteem. Achievement wishes were more common among individuals wanting to enter family medicine.

Conclusion

There was no evidence that medical students are becoming less altruistic and more money-orientated. Further, individuals did not appear to become less altruistic or increasingly financially driven as they progressed through the medical course.

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Aerococcus Viridans

In this case report we discuss splenic infarction as a presentation for infectious endocarditis. While not unheard of, splenic infarctions are usually incidental findings and are not usually used to diagnose infectious endocarditis. Since our patient was on hemodialysis, had AIDS and blood cultures tested positive for Aerococcus viridans and Streptococcus parasanguis, we propose that atypical presentations of IE should be considered in immunocompromised patients.

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