Vol. 4: Fall, 2014

MSRJ – Volume 4 – Fall 2014

 

The entire issue can be downloaded as a pdf: here

 

Excerpts from the abstract and links to individual articles are displayed below.

Letter From the Editors. Jessica L. Wummel, Jack Mettler. The editors of MSRJ are excited to announce our Fall 2014 issue, the first issue of the new academic year. We have been overwhelmed with amazing articles from medical students around the world and this has allowed us to publish our largest issue yet! This issue includes stimulating articles written by students from the University of Toronto, Creighton University School of Medicine, Saba University School of Medicine, Michigan State University College of Osteopathic Medicine, and Michigan State University College of Human Medicine. Link here.
Broken. Timothy DeKoninckThere are several elements symbolized in the mosaic that represent a doctor-patient relation- ship. This piece of work strives to piece together and 10 serve as a reminder of the elements that make for a successful and impactful relationship. Link here.
 A Review of the Psychological and Emotional Issues in Men with Prostate Cancer and their Partners. Dane E. Klett. Howard L. Harrod on his struggles with prostate cancer (PCa): ‘Not only had I a sense of having been mutilated, but I had lost the very capacities that were symbolically associated with manhood’.1 Many patients with PCa experience this jolt to their sense of manhood, thus making PCa unique among the various cancer diagnoses and worthy of independent discussion. In addition, PCa remains the most common male cancer and the third leading cause of all male cancer deaths.2 Most physicians are aware of the link between cancer and mental health issues, but many forget or overlook just how important it is to address a patient’s state of mental health. Link here.
 Acute Bronchiolitis – Case Report and Review of Management Guidelines. Neil D. Dattani, Clare M. Hutchinson. Introduction: The treatment of acute bronchiolitis is controversial, despite the fact that several well-designed trials have been conducted on the subject. Patient profile: A 10-month-old boy presented to the emergency department with a 3-day history of upper respiratory tract symptoms and an expiratory wheeze. Chest X-ray showed right upper lobe atelectasis. He was diagnosed with acute bronchiolitis. Interventions: He received nebulized salbutamol (albuterol) and oral dexamethasone in the emergency department. He was admitted to hospital overnight for continued salbutamol treatment via a metered-dose inhaler. Discussion: Five main treatment regimens exist for acute bronchiolitis nebulized epinephrine (adrenaline), other bronchodilators, nebulized hypertonic saline, glucocorticoids, and combinations of these. Nebulized epinephrine decreases the rate of hospitalization, other bronchodilators improve symptoms, and nebulized hypertonic saline reduces the length of hospitalization. There is no strong evidence for glucocorticoids or combinations of these treatments. Combined treatment with epinephrine and dexamethasone reduces rate of hospitalization. Link here.
 Sebaceous Carcinoma of the Abdominal Wall: A Potential Indicator of Muir Torre Syndrome. Stacie L Clark. Introduction: Sebaceous carcinoma is a rare dermatologic tumor affecting the pilosebaceous apparatus of the skin. While the majority of sebaceous carcinomas arise from sebaceous glands in the ocular area, extraocular sebaceous carcinomas, arising from any region populated with sebaceous glands have also been reported. Sebaceous carcinoma can present as a single lesion or in association with secondary malignancies, most commonly with those found in Muir Torre syndrome (MTS), an autosomal dominant condition associated with several types of sebaceous neoplasms as well as a variety of visceral malignancies. The most common form of MTS has been described as a variant of hereditary non polyposis colorectal cancer (Lynch syndrome). Patient profile: Here, we describe the case of a 55-year-old male, with a known history of colorectal cancer, presenting with a rapidly enlarging abdominal wall mass. Interventions and outcomes: Surgical excision of the mass histologically demonstrated sebaceous carcinoma. This diagnosis, the incidental discovery of a papillary thyroid carcinoma and the patient’s history of colorectal cancer, prompted referral for genetic counseling, the results of which are still pending. Discussion: Sebaceous carcinoma is one of several diagnostic criteria of MTS and its presence should prompt a complete evaluation for underlying internal malignancies. Link here.
 A Case of Severe, Refractory Antipsychotic-induced Orthostatic Hypotension. Sahil Gambhir, Nicholas Sandersfeld, DO, Dale D’Mello, MDIntroduction: Antipsychotics have many adverse effects including orthostatic hypotension. Orthostatic hypotension is ideally treated with non-pharmacological strategies; however, these often fail leading to utilization of pharmacological methods. Currently, there is no agreed upon management or protocol for addressing antipsychotic-induced orthostatic hypotension and research in this area is limited. Patient profile: A 60-year-old man with a long history of schizophrenia who was receiving Haldol† Deconoate 200 mg injections every 4 weeks due to previous non-compliance. He was admitted to the inpatient psychiatric service due to worsening psychosis and suicidal behavior. Intervention: Despite use of medications, the patient was switched to risperidone with a goal of transition to an atypical long-acting injectable. The psychosis improved, but the patient developed orthostatic hypotension. After his medications were held, his blood pressure continued to be grossly abnormal. A number of different tests were completed followed by standard non-pharmacological treatment, which proved unsuccessful. Despite receiving intravenous fluid boluses to maintain his blood pressure, the patient required pharmacological treatment. This included midodrine and fludrocortisones, and concluded with Adderall† as his blood pressure stabilized. Conclusion: This case of a 60-year-old man with antipsychotic-induced orthostatic hypotension elucidates the frustration healthcare professionals and patients face with this common treatment-resistant condition. A treatment algorithm for managing drug-induced orthostatic hypotension is proposed and is a nidus for development of future protocols.Link here.
A Medical Student Elective Course in Business and Finance: A Needs Analysis and Pilot. Joseph B. Meleca, Maria Tecos, Abigail L. Wenzlick, Rebecca Henry, Patricia A. Brewer. Background:  As the knowledge needed by physicians expands past basic science and patient care, students are calling for their medical school education to do the same. At Michigan State University College of Human Medicine, students addressed this concern by developing a pilot elective, Medical Business and Finance (MBF). The goal of this student-led elective was to provide a basic understanding of personal finance, student debt handling, business management, and insurance reimbursement issues. Methods:  A preliminary needs assessment was conducted to discern if students wanted medical business and finance supplementation to the medical school curriculum.  Ninety percent of students reported interest in a business and finance elective. Once the course was instated, student satisfaction and knowledge-base in medical business and finance was analyzed through pre-elective, pre-session and post-elective survey. Results:  Results were analyzed on forty-eight students’ pre-survey and post-survey responses.  After the course, self-assessed student knowledge regarding finance and business nearly doubled.  The average pre-elective self-assessed knowledge of finance was 3.02 on a ten-point scale and knowledge of business was 2.61. This was compared to an average post-elective self-assessed knowledge of 5.75 and 5.44, respectively. Satisfaction in MSU CHM business and finance resources also slightly increased at the completion of the course.  Nearly 85% of students felt they benefited from participating in the elective.  Similarly, 85% felt that incoming students would also benefit from taking the course. Almost 30% of students believed the material covered in the MBF Elective should be in the required medical school curriculum. Conclusion:  A student led elective can be an effective way to introduce students to an array of topics related to medical business and finance. Students felt that their knowledge of these topics increased and they valued the addition of medical business and finance education to their curriculum. A student-led elective is one potential way for others to successfully incorporate these topics into medical school curricula across the country. Link here. 
Alzheimer’s Disease: A Clinical and Basic Science Review. Igor O. Korolev. Alzheimer’s disease (AD) is the most common cause of dementia in older adults and an important public health problem. The purpose of this review article is to provide a brief introduction to AD and the related concept of mild cognitive impairment (MCI). The article emphasizes clinical and neurobiological aspects of AD and MCI that medical students should be familiar with. In addition, the article describes advances in the use of biomarkers for diagnosis of AD and highlights ongoing efforts to develop novel therapies. Link here
 Comparing Current Screening Modalities for Colorectal Cancer and Precancerous Lesions: Is Colonoscopy the Method of Choice? Puneet K. Singh. Colorectal cancer (CRC) is the third most common form of cancer and the second leading cause of cancer death in the Western world. Presently, screening tools such as colonoscopy, sigmoidoscopy, fecal occult blood test (FOBT) and computed tomographic colonography (CTC) are available for CRC screening. The debate over which screening tool is most effective in detecting CRC and precancerous lesions is ongoing. Many recent studies have identified colonoscopy as the most sensitive and specific screening modality for CRC. However, a number of factors have prevented colonoscopy from being widely accepted. Less invasive techniques such as sigmoidoscopy and CTC are growing in popularity among physicians and patients who are apprehensive about colonoscopy screening; although many still are yet to experience the procedure first-hand. This literature review will attempt to validate the growing theory that colonoscopy is superior to other modalities for the diagnosis and screening of CRC and reduces the risk of CRC mortality. In order to do so, the paper will compare the risks and benefits of colonoscopy to sigmoidoscopy and CTC. It will further look at the different aspects that encompass a patient’s decision to partake in screening, such as basic knowledge about CRC, history of CRC in the family, advice from physicians and individual beliefs about what screening entails. Finally, this paper will propose ways in which colonoscopy screening can be improved and thus surpass other screening modalities to universally become the first choice for CRC screening. Link here
The Growth of Medical Student Opportunities in Global Health. Johnathan Kao. Since the establishment of the World Health Organization on April 7, 1948,1 global health has grown in prominence and popularity among health care workers at all levels of training. International clinical rotation electives have been available to students for over half a century2 and interest in these programs has risen steadily over the decades. During this period, many organizations established programs for students and faculty interested in global health research and service. In 2006, these organizations united under the WHO’s Global Health Workforce Alliance to assist students and faculty in becoming more involved in global health activities.3 Despite these Changes, in 2007, Drain et al. recognized a lack of global health education in medical schools and growing student interest, calling for more opportunities to fill the gap.4 Link here. 

 

Cover Page: Download here
Credits and Acknowledgements: Download here
Table of Contents: Download here
Citations for the articles:

Wummel JL, Mettler JC. Letter From the Editors. Medical Student Research Journal. 2014;4(Fall):1.

DeKoninck T. Broken. Medical Student Research Journal. 2014;4(Fall):2-3.

Klett DE. A Review of the Psychological and Emotional Issues in Men with Prostate Cancer and their Partners. Medical Student Research Journal. 2014;4(Fall):4-7.

Dattani ND, Hutchinson CM. Acute Bronchiolitis – Case Report and Review of Management Guidelines. Medical Student Research Journal. 2014;4(Fall):8-11.

Clark SL. Sebaceous Carcinoma of the Abdominal Wall: A Potential Indicator of Muir-Torre Syndrome. Medical Student Research Journal. 2014;4(Fall): 12-4.

Gambhir S, Sandersfeld N, D’Mello D. A Case of Severe, Refractory Antipsychotic-Induced Orthostatic Hypotension. Medical Student Research Journal. 2014;4(Fall): 15-7.

Meleca JB, Tecos M, Wenzlick AL, Henry R, Brewer PA. A Medical Student Elective Course in Business and Finance: A Needs Analysis and Pilot. Medical Student Research Journal. 2014;4(Fall):18-23.

Korolev IO. Alzheimer’s Disease: A Clinical and Basic Science Review.  Medical Student Research Journal. 2014;4(Fall):24-33.

Singh PK. Comparing Current Screening Modalities for Colorectal Cancer and Precancerous Lesions: Is Colonoscopy the Method of Choice? Medical Student Research Journal. 2014;4(Fall):34-47.

Kao J. The Growth of Medical Student Opportunities in Global Health. Medical Student Research Journal. 2014;4(Fall):48-50.

 

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Jessica Wummel

Executive Editor
Jessica Wummel is a third year medical student at Michigan State University’s College of Human Medicine. She received her B.S. in Human Biology with a specialization in Bioethics, Humanities, and Society also from Michigan State University in 2011 from the Lyman Briggs College. She is interested in pursuing a career in Med/Peds and would eventually like to be involved in academic medicine later in her career.