Please find below the third article featured in our Winter 2024 Issue, enjoy! http://msrj.chm.msu.edu/wp-content/uploads/2024/04/MSRJ262_final.pdf Background: Those experiencing homelessness face disproportionately large barriers in access to healthcare. Patient Navigation is a service that provides disadvantaged populations with guidance through healthcare systems. Acting as a patient navigator is found to help enhance learning in the pre-clinical years of medical school. Developed by medical students, the Patient Navigator Program (PNP) pairs medical students trained as patient navigators with individuals experiencing homelessness. The uniqueness of this program lies in its fully student-run format, simultaneously providing individuals experiencing homelessness with longitudinal navigation services toward self-defined … Continue reading →

Here’s the second article featured in our Winter 2024 Issue, enjoy! http://msrj.chm.msu.edu/wp-content/uploads/2024/04/MSRJ263_final.pdf Abstract: Dermatofibromas (DF) are small, noncancerous skin lesions typically found in the dermis layer of the skin and are often composed of a variable combination of inflammatory cells, which classically present as a firm, nonpainful, skin-colored nodule on the extremities or trunk. We present a case of a 53-year-old woman with a medical history of psoriasis who had bilateral leg swelling, erythema, and dry skin for which she underwent a punch biopsy of the left thigh. The punch biopsy sample was found to be a dermatofibroma, which was … Continue reading →

We’re back after some technical difficulties! Big thanks to everyone for their patience. Please find below the first addition to our Winter 2024 Issue, enjoy! http://msrj.chm.msu.edu/wp-content/uploads/2024/04/MSRJ257_final.pdf Purpose: Limited institutional resources exist for pregnant and parenting medical students; however, students’ opinions regarding pregnancy in medical school have not been reported. The authors assessed medical students’ perspectives regarding pregnant or parenting peers and underlying bias or resource gaps. Methods: An online, cross-sectional survey was distributed in October 2022 to medical students at Michigan State University College of Human Medicine (n = 806) to explore demographics, bias, family planning, and available resources. Descriptive … Continue reading →

Please enjoy this new addition to our Fall Issue! http://msrj.chm.msu.edu/wp-content/uploads/2023/11/MSRJ254_final.pdf Introduction: Extrapulmonary tuberculosis (EPTB) is an infection by mycobacteria in any part of the body other than the lungs. There is information on tuberculosis infection from more than 3,000 years ago, and despite the knowledge that there is about the disease, nowadays, it is estimated that a quarter of the world population is infected and 15% of the cases are extrapulmonary. Aims: This literature review aims to present the physiopathology of the most common EPTB, update and summarize the current diagnostic and therapeutic advances for the EPTB reviewed, as well … Continue reading →

Please enjoy this new addition to our Fall Issue! http://msrj.chm.msu.edu/wp-content/uploads/2023/11/MSRJ251_final.pdf Objective: The imposter phenomenon (IP) is the belief that one does not deserve success. Medical students, residents, and physicians experience IP at significant rates, often due to the stress of mastering the extensive diagnostic information and treatment modalities as well as the competitive nature of medicine. We aimed to identify the main factors of IP in medical students, residents, and physicians in the available literature to increase awareness of IP in medical education. Methods: In this scoping review, PubMed, PsycINFO, Cochrane Library, Embase, Scopus, Web of Science, Google Scholar, Northern … Continue reading →

Please enjoy this new addition to our Fall Issue! http://msrj.chm.msu.edu/wp-content/uploads/2023/11/MSRJ247_final.pdf Background: The COVID-19 pandemic caused rapid uptake of telemedicine in primary care settings affecting cancer screening. Objective: This study aimed to understand provider perception of future cancer incidence and telehealth feasibility in cancer screening. Methods: Data were gathered and analyzed as part of the 2020 Council of Academic Family Medicine’s (CAFM) Educational Research Alliance (CERA) survey for primary analysis. The 2020 General Member COVID Survey examined demographics, the impact of faculty isolation, E-learning experience, cancer screening during COVID-19, and outpatient prenatal care. Survey participants were practicing family medicine physicians who … Continue reading →

Please enjoy this new addition to our Fall Issue! http://msrj.chm.msu.edu/wp-content/uploads/2023/11/MSRJ242_final.pdf Background: Increased availability and use of cannabis in Michigan have led to a marked increase in emergency department (ED) visits associated with the drug’s adverse cardiopulmonary effects. However, few people are aware of these potential cardiopulmonary side effects. Recognition of these presenting symptoms is critical for emergency clinicians to provide timely and effective care, make accurate diagnoses, and safeguard the health of patients who may be experiencing toxic effects from cannabis use. Study objective: To describe the prevalence, clinical features, and disposition of cannabis cardiopulmonary toxicity in a community- based … Continue reading →

The final article to be included in our Spring 2023 issue is linked below. Enjoy! https://msrj.chm.msu.edu/wp-content/uploads/2023/04/236-ePub-final.pdf Introduction: While some studies suggest probiotic supplements may prevent Gestational Diabetes Mellitus (GDM), it is unclear if probiotics effectively prevent GDM among overweight and obese patients. This systematic review synthesizes recommendations for clinical practice and future research by evaluating the quality of evidence regarding Lactobacillus and Bifidobacterium containing probiotics to prevent GDM among obese and overweight patients.  Methods: PubMed, Embase, CINAHL, and Web of Science were searched using appropriate MeSH terms. Results were limited to randomized controlled trials published between 2011-2021. Titles and abstracts were screened for relevance after duplicates were removed. Included … Continue reading →

We are pleased to share another manuscript that will be included in our Spring 2023 issue. https://msrj.chm.msu.edu/wp-content/uploads/2023/04/231-ePub-final.pdf Background: The medical literature on vulvovaginal lacerations following consensual versus nonconsensual sexual intercourse is sparse and conflicting. Objectives: To compare the predisposing factors, injury location and severity, as well as treatment of vulvovaginal lacerations sustained during consensual versus nonconsensual sexual intercourse, in adult women within a community-based cohort. Methods: This is a retrospective comparative analysis of adult women presenting to the emergency departments of five hospitals and a free-standing nurse examiner clinic during a seven-year study period. All patients had documented vulvovaginal lacerations and reported … Continue reading →

We are pleased to share our latest manuscript for our Spring 2023 issue. https://msrj.chm.msu.edu/wp-content/uploads/2023/03/234-ePub-final.pdf Abstract Diffusion-tensor imaging has become common practice in radiology and imaging research due to its many applications in brain connectivity and neurodevelopment as well as for pathologies including tumors, ischemia, trauma, and neurodegeneration. However, its novelty compared to other neuroimaging techniques has meant that graduate programs, particularly medical schools, have not included opportunities to learn how diffusion tensor imaging can visualize the brain and interpretation of the data clinically and in research. Diffusion tensor imaging can be a challenging utility to understand for newcomers and is … Continue reading →

Check out our latest article below. https://msrj.chm.msu.edu/wp-content/uploads/2023/04/237-ePub-final.pdf Background: Incoming emergency medicine residents may feel unsure of their ability to handle common emergency department scenarios, even if they are well educated on the proper steps to take in those scenarios. This may not stem from a lack of skill so much as a lack of confidence in their ability to perform with skills they have.  Objective: We look to establish a link between completion of simulation- based training in common emergency medicine scenarios and learner self-reported confidence in their ability to perform competently in those scenarios.  Methods: Fourth-year medical students who matched … Continue reading →

https://msrj.chm.msu.edu/wp-content/uploads/2023/04/239-ePub-final.pdf Purpose: Patient positioning plays a crucial role in the field of radiology. Lateral knee x-rays are a type of image that often has incorrect positioning of the angle of knee flexion. The ideal range is between 20-30 degrees. The goal of this study was to assess the angle of knee flexion at two different locations in a single hospital system while determining if several variables influence the angle. Methods: This study is a retrospective chart review that assessed the angle of knee flexion in patients 18 years or older that underwent a lateral-mediolateral knee x-ray taken at an urgent … Continue reading →

Click the link below to view the full manuscript. https://msrj.chm.msu.edu/wp-content/uploads/2023/04/230-ePub-final2.pdf Background: Optic neuritis (ON) is inflammation of the optic nerve that can occur in both adults and children. This disease is marked by a heterogeneous presentation in children and has clinical and epidemiologic characteristics that differ greatly from those found in adults. The purpose of this report is to illustrate the clinical features of ON that occur during childhood and to highlight the differences of ON in children versus adults. In doing so, we aim to add to the sparse current literature on this topic and help prevent the future misdiagnosis … Continue reading →

Check out the link below to see an early release from our Spring 2023 issue. https://msrj.chm.msu.edu/wp-content/uploads/2023/02/224-ePub-final.pdf ABSTRACT Introduction: This study aims to assess the impact of various teaching methods including role play, didactic lectures, and case studies on the history taking and communication skills of second year Bachelor of Medicine and Surgery (MBBS) students. The goal is to help students become better doctors by arriving at diagnoses quicker through asking relevant questions in their history taking. A secondary goal is to improve the doctor-patient relationship through better communication skills. Methods: The students were assessed on their history taking and communication … Continue reading →

Check out this interesting article for our upcoming Fall 2022 issue! https://msrj.chm.msu.edu/wp-content/uploads/2022/11/219-ePub-final.pdf Abstract Background: Little is known about the ethical issues confronting medical students during their first exposure to emergency medicine (EM). The aim of this study was to review student narratives to determine the type and frequency of ethical issues that beginning students confront in the ED. Methods: This was a prospective, qualitative observational study of consecutive first- and second-year medical students electing to do a pre-clinical clerkship in Emergency Medicine (EM) at five university- affiliated hospitals. Students were asked to write a short description of three cases that had the … Continue reading →

Check out this early release of the latest article for our Fall 2022 issue! http://msrj.chm.msu.edu/wp-content/uploads/2022/11/222-epub-final.pdf Abstract Quadricuspid aortic valves (QAVs) are a rare congenital anomaly associated with increased risk of aortic insufficiency. This case presents the incidental finding of a quadricuspid aortic valve on intraoperative transesophageal echocardiography after going undetected on transthoracic echocardiography multiple times, suggesting that transesophageal echocardiography may be a superior imaging modality for the identification of this defect. This patient with a history of coronary artery disease presented with sudden onset moderate to severe aortic insufficiency and required subsequent aortic valve replacement (AVR).

Another new and interesting article! Click the link below to view the full case study. https://msrj.chm.msu.edu/wp-content/uploads/2022/11/228-ePub-final.pdf Abstract We aim to add to the literature regarding Petit (inferior lumbar) hernias. The presence and location of lower back masses may have a deeper origin than initially apparent. We urge the surgical community to keep in mind the differential diagnosis of lumbar hernia, although rare, when evaluating subcutaneous masses and lipomata in this region. Simple excision may address the mass but not the cause and will lead to early recurrence of the presenting problem.

Check out the link below to view the full article. http://msrj.chm.msu.edu/wp-content/uploads/2022/11/223-epub-final.pdf Abstract Case: We present a case of acute idiopathic four-compartment syndrome of the leg, treated by four-compartment fasciotomy, and wounds left to heal by secondary intention due to persistent edema following surgery. Conclusion: This case highlights the importance of maintaining a high level of clinical suspicion for idiopathic spontaneous compartment syndrome presentation. This case also illustrates the variability of compartment syndrome treatment and recovery. The standard treatment for compartment syndrome is fasciotomy with delayed primary wound closure, but the patient elected to heal by secondary intention. The patient’s long term follow-up … Continue reading →

Check out the link below to view the full article! https://msrj.chm.msu.edu/wp-content/uploads/2022/11/226-ePub-final.pdf Background: In addition to the purposeful teaching of knowledge and skills to medical students, the “hidden curriculum” refers to the inadvertent – and often unrecognized – transmission of implicit ideas, attitudes, and behaviors. One way to raise student and teacher understanding of the hidden curriculum (HC) is to provide them concrete examples of how and when it occurs during medical school. The goal of this study was to investigate how the HC is depicted popular medical television (TV) shows. Methods: A systematic content analysis of successive episodes of eight prime-time TV … Continue reading →

Author: Haleigh Prather, MHS, Oregon Health & Science University Here’s a reflection from our Fall 2021 journal that most of us could relate to:https://msrj.chm.msu.edu/wp-content/uploads/2022/10/227-ePub.pdf Abstract: This piece is a conversation and reflection of my ongoing relationship with toxic professionalism in medical school. Students are often at the whim of their evaluators to give them outstanding feedback in the name of having a strong residency application, but a great deal of the criteria we are evaluated on is subjective. One piece of feedback I’ve gotten more than once that I take issue with is the idea that being extroverted, enthusiastic, and … Continue reading →

Check out this interesting reflection! https://msrj.chm.msu.edu/wp-content/uploads/2022/10/212-ePub.pdf Author: Hettiarachchige  Diluksha  Prasad  Jayawardana, University of Colombo Abstract: The crooked tree has been adopted as the universal symbol for the field of orthopedics. Each part of this tree has hidden meanings closely related to orthopedic surgery. The purpose of this article is to generate thoughts among medical professionals and stimulate discussion among them on concepts behind the crooked tree and orthopedic surgery.

Another new and interesting article from our Fall 2021 Issue! https://msrj.chm.msu.edu/wp-content/uploads/2022/10/208-ePub.pdf Authors: Luna Kinoshita¹*, Aya Goto, MD, PhD², Makoto Kashimura, PharmD, PhD3, Norihiko Watanabe, BS4, Kenneth E. Nollet, MD, PhD5 1School of Medicine, Fukushima Medical University, Fukushima, Japan. 2Center for Integrated Science and Humanities, Fukushima Medical University, Fukushima, Japan. 3Education Evaluation Division, Fukushima Medical University, Fukushima, Japan. 4Medical Information and Supply Management Division, Fukushima Red Cross Blood Donor Center, Fukushima, Japan. 5Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan. Background: As the number of young people in Japan decreases, the proportion of them who donate blood … Continue reading →

Here is the abstract of our newest accepted publication, Please follow the link below! https://msrj.chm.msu.edu/wp-content/uploads/2022/10/198-ePub.pdf Authors: Mark Sharobim BSc, MSc1*, Peter A. Tsivis, MD, MBA1,2 1Saba University School of Medicine, The Bottom, Saba, The Caribbean Netherlands2Rocky Vista University College of Osteopathic Medicine, Ivins, Utah, USA Introduction:Gliomas are neoplasms of the central nervous system (CNS). Despite aggressive treatment, median survival of malignant tumors remains poor at 12 – 18 months. Newer treatments allow delivery of therapeutic substances across the selectively permeable blood-brain barrier (BBB). This allows for chemotherapeutics to more easily reach their target location in the CNS. Drug eluting wafers … Continue reading →

Interested in the gut microbiome?  Read the abstract and click the link below for our newest accepted publication! http://msrj.chm.msu.edu/wp-content/uploads/2022/10/218-ePub.pdf Authors: Divya Lakshmi Yerramsetty, Dipendra R. Pandeya, Ph.D. Medical University of the Americas, Devens, MA, USA Hypothesis: Compared to the flawed antimicrobial interventions, fecal microbiota transplantation (FMT) is more efficacious and safer in offering a significant clinical resolution of recurrent Clostridioides difficile (rCDI) – the world’s leading hospital-acquired infection. Methods: An electronic search using Medscape, PubMed, and Google Scholar databases, limited only to articles published in academic journals with full-text access within the past ten years (2010-2020). Selection criteria consisted of … Continue reading →

Here is the abstract of our newest accepted publication, Please follow the link below! http://msrj.chm.msu.edu/wp-content/uploads/2020/08/MSRJ2019187.pdf Deborah Anuoluwapo Aina, Saba University School of Medicine, Devens, MA, USA, Dutch Caribbean Objective: The aim of this literature review is to evaluate the hormonal relationship between polycystic ovary syndrome and hypothyroidism. Methods: Electronic databases such as Ebscohost and PubMed were searched, using words and phrases specific to the topic. Journal articles were filtered for publications from no earlier than 2008 to ensure accuracy and relevance. Results: Anti-thyroid peroxidase antibodies and thyroid-stimulating hormone were significantly higher in polycystic ovary syndrome patients compared to controls (P<0.05). … Continue reading →

Interested in imaging modalities and their effectiveness in diagnostics?  Read the abstract and click the link below for our newest accepted publication!   Ultrasound vs CT for Diagnosing Acute Appendicitis and Appendicitis Treatment Altering Conditions Christopher Borowy, MS-IV1*, Luke Rond, D.O2, John Ashurst, D.O2, and Stefan Merrill, M.D2 1Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA 2Department of Emergency Medicine, Kingman Regional Medical Center, Kingman, AZ, USA Introduction: Acute appendicitis is the most common cause of atraumatic abdominal pain in children over 1 year of age. Even though diagnostic imaging modalities have evolved over the past 20 years, … Continue reading →

Another new and interesting article from our Fall 2019 Issue!  Read the abstract below and click on the link for the full article. Transfemoral Aortic Valve-in-Valve Replacement in Patient with Aortic Root Pseudoaneurysm (Click link for full PDF)   Authors: Mark A. Nolan, P.E., M.Eng1, Stephane Leung Wai Sang, M.D., MSc2 Background: Transcatheter aortic valve replacement (TAVR) was successfully performed to treat aortic regurgitation (AR) in a patient with a failed aortic valve replacement complicated by aortic root pseudoaneurysm. Case Presentation: A 92-year-old male presented with acute decompensated congestive heart failure secondary to AR of a previously implanted stentless aortic … Continue reading →

New article from the MSRJ 2019 Fall issue is now up on the site! Read the abstract or click on the link below for the full article. Association between Total Knee Arthroplasty and Subtalar Joint Changes: A Cadaver Study (Click link for full PDF article) Authors: Dominick J. Casciato, B.A.1*, Natalie A. Builes, B.A.2, Luis A. Rodriguez Anaya, DPM1, Bibi N. Singh, DPM1 Background: Total knee arthroplasty (TKA) has become the procedure of choice for those suffering from debilitating degenerative joint disease of the knee; however, new research suggests that functional changes in the rearfoot occur following the procedure to … Continue reading →

This case report is about a very rare tumor – a malignant chondroid syringoma. The objective of this piece is to review both the case presented along with the current literature on cutaneous adnexal tumors. Continue reading →

Primary intestinal lymphangiectasia (Waldmann’s disease) is a rare protein-losing enteropathy which is mostly seen in young children. A 22-month-old male baby presented with a 1-week history of abdominal distension, chronic loose stools, recurrent ear infections, and failure to thrive. He had edematous eyelids and non-pitting edema of his hands and feet. The patient was diagnosed via endoscopic visualization and biopsy of the lymphangiectasia in the small bowel. He was managed through dietary restriction with a high-protein, low-fat diet. The patient subsequently had resolution of the diarrhea and an increase in albumin and total protein on labs. We describe a rare case of primary intestinal lymphangiectasia and highlight its clinical presentation, diagnosis, and treatment. Continue reading →

Our allopathic medical school has utilized a peer-tutoring program since inception in 2011, where second-year medical students teach first-year students in 2-h lecture-style review sessions. In 2015, an alternative format was implemented using four, repeating 30-min modules. This study was designed to compare student satisfaction with both approaches. Continue reading →

A disproportionate amount of health care spending in the United States is attributed to a small subset of patients who employ inpatient and emergency department (ED) services. While patients with high ED utilization have previously been well- described, patients seen in an inpatient academic medical setting may differ with regard to demographics, medical conditions, and social factors. Continue reading →

Documented immigrants eligible to stay in Norway for more than 6 months can enroll in the universal healthcare system for full healthcare services, such as acute, chronic, and preventative care.1 All other non-citizens only have access to emergency services. With an increasing influx of immigrants to Norway, it is advantageous to evaluate the Norwegian healthcare system, how documented and undocumented immigrants utilize the system, and any barriers they may face when doing so. The aim of this study is to identify barriers to healthcare for immigrants in Norway in order to better address them in the future. Continue reading →

Opioid overdoses profoundly impact thousands of families across the United States. Behind this issue lies the accessibility of opioid prescriptions right inside our medicine cabinets. Our goal was to educate adolescent students in Kentucky schools about this matter because they comprise a vulnerable population. Continue reading →

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. Continue reading →

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. Continue reading →

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. Continue reading →

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. Continue reading →

Purpose Computed tomography (CT) has emerged as the gold standard test for the evaluation of suspected appendicitis in pediatric patients. It has been shown to have excellent accuracy and to decrease negative appendectomy rates. However, CT scans expose patients to ionizing radiation, which is of especially high concern in children. Magnetic resonance imaging (MRI) is a potential alternative that could be used to evaluate children while eliminating exposure to radiation. This systematic review tests the hypothesis that the sensitivity and specificity of MRI are not inferior to that of CT in the evaluation of suspected appendicitis in children. Methods A search of the Medline database was conducted to identify articles that used MRI to evaluate children with suspected appendicitis. Articles that focused on pediatric subjects and reported sensitivity and specificity of MRI in these subjects were included. Data for the calculation of sensitivity, specificity, and 95% confidence intervals for each were extracted from each study included. Pooled data for sensitivity and specificity of MRI were calculated and tested for significance compared to sensitivity and specificity of CT using Fisher’s exact test. Results Nine studies were found to be relevant to the question posed by this systematic review and met the inclusion criteria. The pooled sensitivity and specificity of MRI for the diagnosis of appendicitis were 0.96 (95% CI: 0.94-0.98) and 0.97 (95% CI: 0.96-0.98) as opposed to values of 0.94 (95% CI: 0.92-0.97) and 0.95 (95% CI: 0.94-0.97) for CT. The difference between MRI and CT was not statistically significant for sensitivity (p=0.11) or specificity (p=0.06) in the evaluation of suspected appendicitis in children. Conclusion In children with suspected appendicitis, the sensitivity and specificity of MRI are comparable to those of CT in terms of sensitivity and specificity. MRI is a viable choice for imaging in these patients and limits exposure to radiation. Continue reading →

Distal radius fractures are one of the most common fractures in the elderly. Falls and motor vehicle collisions lead to increased risk for this type of fracture. A seventy-three year-old female had a previous history of distal radius fracture with repair by open reduction and internal fixation. She was involved in a motor vehicle collision that re- fractured the distal radius. The plate was bent and required removal, which is a very rare but potentially serious complication. Surgery was done to fix the open reduction and internal fixation with volar locking plates while removing damaged hardware. Only a select few cases have reported hardware failure as a cause of complications. Among those cases, high-energy activities and maintained stress on the hardware were likely causes. Distal radius fractures are the most common upper extremity fracture in the elderly. We highlight a unique case of re-fracture in the setting of trauma with prior hardware failure and describe the strategy for hardware repair. Continue reading →

Neonatal meconium periorchitis is a rare condition, with less than 60 cases described in the literature. Of the reported cases, only one describes the complication of a congenital rupture of the scrotum. We present a case of a Hispanic preterm neonate who was diagnosed with cystic fibrosis after scrotal rupture secondary to meconium periorchitis. The neonate was taken to the operating room for exploratory laparotomy and scrotal exploration. No calcification was noted and the patient’s left scrotum was surgically packed as well as creating a colostomy. The surgery proved successful and the patient was discharged home on day of life 79. This case of a neonate presenting with meconium periorchitis and scrotal rupture notes the varying degree of initial presentations for cystic fibrosis in a neonate. Successful outcomes for neonates presenting with a ruptured scrotum depend on early clinical assessment. Continue reading →

Purpose Chiari Malformation Type I (CM I) is characterized by cerebellar tonsil ectopia and has varying symptomatology . Previous research has shown a relationship between tonsillar dominance and related conditions but few examined association with symptomatology. This study attempts to elucidate a relationship between cerebellar tonsil dominance, age, and symptomatology. Methods Data from CM I patients were extracted from the Conquer Chiari Patient Registry. Tonsillar dominance was determined using a ratio of right-to-left herniation length. Pearson’s correlation and one-tailed Student’s T-test were used for analysis. Results Length of tonsillar descent appears to be negatively correlated to age of onset (r = -0.266; p < 0.001; n = 113) and diagnosis (r = -0.323; p < 0.001; n = 113). No correlation was found between tonsillar dominance and symptom location, nor between tonsillar dominance and symptom severity bilaterally (p > 0.05). Symptom location and severity ratios appear to be correlated (r = 0.666; p < 0.001). Tonsillar descent length appears to be strongly correlated bilaterally (r = 0.972; p < 0.001; n = 50). Conclusion Inconsistency between tonsillar dominance as related to symptomatology suggests a multifactorial contribution to clinical presentation. The inverse relationship between tonsillar herniation length and age of symptom onset and diagnosis suggests herniation length may be an important predictor for clinical outcomes. Further research is needed to elucidate additional contributing factors and tonsillar dominance and symptomatology association. Continue reading →

Introduction: Degeneration of the lumbar motion segment is the primary cause of low back pain in many individuals. Therefore, new minimally invasive treatments are being sought. Patient Profile: A 47-year old man presented with severe low back pain and radicular symptoms of several years duration. Lumbar MRI revealed severe desiccation, loss of disc height, and an annular tear with right lateral disc protrusion at L4-5. Interventions/Outcomes: After conservative treatment failed, the patient received a Wallis® interspinous spacer at the affected level. 100% subjective pain relief was obtained at 3 months post-op. Nucleus pulposus rehydration on MRI was observed. Discussion: Controversy exists over whether disc dehydration is a reliable indicator of low back pain; however, interspinous spacers seem to alter abnormal motion segment’s biomechanics in a way that results in alleviation of low back pain and increased range of motion. With the advent of biologic therapy, this may provide an intriguing minimally invasive treatment modality, although further research is needed. Continue reading →

Background: Neurological deterioration (ND) is common, with nearly one-half of ND patients deteriorating within the first 24 to 48 hours of stroke. The timing of ND with respect to ND etiology and reversibility has not been investigated. Methods: At our center, we define ND as an increase of 2 or more points in the National Institutes of Health Stroke Scale (NIHSS) score within 24 hours and categorize etiologies of ND according to clinical reversibility. ND etiologies were considered non-reversible if such causes may have produced or extended any areas of ischemic neurologic injury due to temporary or permanent impairment in cerebral perfusion. Results: Seventy-one of 350 ischemic stroke patients experienced ND. Over half (54.9%) of the patients who experienced ND did so within the 48 hours of last seen normal. The median time to ND for non-reversible causes was 1.5 days (IQR 0.9, 2.4 days) versus 2.6 days for reversible causes (IQR 1.4, 5.5 days, p=0.011). After adjusting for NIHSS and hematocrit on admission, the log-normal survival model demonstrated that for each 1-year increase in a patient’s age, we expect a 3.9% shorter time to ND (p=0.0257). In addition, adjusting for age and hematocrit on admission, we found that that for each 1-point increase in the admission NIHSS, we expect a 3.1% shorter time to ND (p=0.0034). Conclusions: We found that despite having similar stroke severity and age, patients with nonreversible causes of ND had significantly shorter median time to ND when compared to patients with reversible causes of ND. Continue reading →

Introduction: With an aging, urbanizing population, China is home to the world’s largest number of adult diabetics. Although more diabetic patients currently live in cities, the prevalence of pre-diabetes is greater in the rural population due to changing dietary and physical habits, as well as the relative poverty. This demographic is thus an important target for public health intervention. As Traditional Chinese Medicine (TCM) is viewed in China as useful for treating chronic diseases and widely accepted, we sought to explore its use for rural diabetic patients. Methods: The study population included 63 diabetic patients and two village doctors from four rural villages near Changsha, China. An initial survey was orally conducted with all 63 participants to collect demographics, financial situation, health-seeking behaviors, treatment beliefs, and medical expenditure. Three focus groups of six rural patients each were subsequently held at village health centers. For analysis, questionnaire data was summarized using means and standard deviations or medians and quartiles. Focus group sessions were voice-recorded and transcripts were coded for thematic analysis. Results/Conclusions: Questionnaire data revealed that for the majority of participants, seeing a doctor is costly in terms of time and money. Patients often do not have the luxury of choosing their medical provider. Despite the benefits of TCM, its slow speed and cumbersome preparation methods do not fit a need for immediate results. Furthermore, TCM doctors are not as available or accessible as Western medicine doctors. As such, although 20% of rural patients rated higher trust in TCM than WM, no patient solely used TCM for their treatment. Instead, almost 40% of patients try to use both TCM and WM. Village practitioners similarly believed that although diabetes treatment should go towards integrative treatment, TCM’s development is hindered by its slow onset and inconvenience coupled with a more systemic lack of TCM infrastructure and research in China. In summary, the continued trust that rural patients place in TCM supports further research for better understanding the true economic, social, and health benefits of having combined TCM-WM treatment be part of diabetes standard of care. Continue reading →

The expression of humanism in patient encounters is a core component of the medical profession and evolving national medical student curriculum. Growing evidence suggests that empathetic care improves patient outcomes and diagnostic accuracy while decreasing physician stress and rates of litigation. Unfortunately, multiple recent studies using different scales and survey tools have consistently shown empathy to decrease during the third and fourth years of medical school. We developed a replicable, case-based, student and expert-driven, small-group discussion series designed to address this decline. Over two years, the series included four separate discussions over controversial topics seldom addressed by formal courses (Chronic Pain Management vs. Prescription Drug Abuse, Balancing Business and Medicine, and Domestic Violence). We utilized pre- and post-session surveys to qualitatively and quantitatively evaluate the program. Our results demonstrated significant improvement in participants’ comfort with the subject matter and desire to approach faculty and peers regarding humanistic patient care. Future and more frequent interactions, combined with optimization of the format could further uncover the utility of this program. Ultimately, we believe our discussion series could be replicated on other medical campuses. Continue reading →

Introduction: Humanism is a necessary component of patient care. Medical schools are implementing strategies to educate students about humanism in medicine. The University of Louisville School of Medicine (ULSOM) encourages such practices through collaboration with Medals4Mettle (M4M), a non-profit organization that gives marathon medals to patients battling debilitating illnesses. The ULSOM’s chapter matches students participating in the Kentucky Derby Half/Full Marathon with pediatric patients, allowing students to establish a relationship with their “running buddies” prior to gifting their medals on race day as an act of support and acknowledgement of their struggle. The goal of this study was to evaluate the ULSOM chapter and to create a replicable model for other institutions to employ. Methods: We conducted a survey for current and previous student and patient/parent participants. Participants were asked to complete six 5-point Likert scaled questions anchored with “Strongly Disagree” to “Strongly Agree” and three open-ended questions. The surveys were analyzed using the Mann-Whitney U test for quantitative analysis and Pandit’s variation of Glaser and Straus’ constant comparison for qualitative analysis. Results: Data was collected from 62 medical students and 21 patients or parents (49% and 33% response rate, respectively). Five of the scaled questions had mean scores above 4.0, revealing that the majority of participants would recommend the M4M program to others and that M4M helped students relate to their patient on a personal level. The qualitative analysis identified four themes among participants: M4M is a wonderful program, it provides a patient benefit, people want to re-participate, and it allows you to connect with others. Discussion: Findings from the survey suggest the implementation of programs like M4M will promote the integration of humanistic practices into medical school curricula. In the future, we plan to pair medical students with the patients earlier to create a longer-lasting, more meaningful relationship prior to the race. Continue reading →

Care for Laotian Ethnic Minorities: A Cross-National Study of Medical Students in Laos and California Author: Katherine Crabtree1,Oanh L. Meyer2, Tonya L. Fancher3 Author Affiliations: 1UC Davis College of Medicine, Sacramento, CA, USA 2UC Davis School of Medicine, Alzheimer’s Disease Center, Department of Neurology, Sacramento, CA, USA 3UC Davis School of Medicine, Division of General Internal Medicine, Sacramento, CA, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2015/04/Winter-2015-Care-for-Laotian-Minorities.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button] Corresponding Author: Katherine Crabtree, katcrabtree[at]gmail.com Key Words: Hmong; Mien; Laos, refugees; cross-cultural healthcare; medical education. Abstract: Background: In both the United States and Laos, Lao ethnic minority patients face cultural and linguistic challenges to adequate … Continue reading →

Sticking to the Plan: Patient Preferences for Epidural Use During Labor Author: Lauren Ann Gamble1, Ashley Hesson1, Tiffany Burns2. Author Affiliations: 1College of Human Medicine, Michigan State University, East Lansing, MI, USA 2Department of Family Medicine, Michigan State University, East Lansing, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2015/04/Winter-2015-Sticking-to-the-Plan.pdf” type=”big” color=”orange” newwindow=”yes”] Full Text Article PDF[/button] Corresponding Author: Lauren Ann Gamble, gambleL2[at]msu.edu Key Words: epidural; birth plan; labor analgesia; patient preference, decision making. Abstract: Background: Women have been shown to value control in the labor experience, a desire that is often formalized into an explicit birth plan. Epidural preferences are a primary component of this plan. Despite … Continue reading →

In Situ Thrombosis of the Pulmonary Arteries: An Emerging New Perspective on Pulmonary Embolism Author: Virginia Corbett1, Houria Hassouna2, Reda Girgis3 Author Affiliations: 1College of Human Medicine, Michigan State University, East Lansing, MI, USA 2Division of Thrombosis, Department of Internal Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA 3Department of Pulmonary Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2015/04/Winter-2015-In-Situ-Thrombosis.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button] Corresponding Author: Virginia Corbett, corbettv[at]msu.edu Key Words: pulmonary embolism; in situ pulmonary artery thrombosis; deep vein thrombosis (DVT); pulmonary circulation; Virchow’s triad Abstract: The annual incidence of … Continue reading →

White Coat Sparty. Author:  Carter Anderson Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2015/04/Winter-2015-Cover-Art-Reflection.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button] Corresponding author: Carter Anderson; carterbanderson[at]yahoo.com Key Words: N/A Abstract: Professional responsibility, compassion, honesty, respect for others, competence, and social responsibility are the characteristics that the Michigan State University College of Human Medicine strives to instill in every student. Published on date: January 1, 2015 Senior Editor: N/A Junior Editor: N/A DOI: pending Citation: Anderson C. White Coat Sparty. Medical Student Research Journal. 2015;4(Winter):52-53. References: N/A   [facebook][retweet]

Letter From the Editors. Author: Jessica L Wummel1, Jack C Mettler2 Author Affiliations: 1College of Human Medicine, Michigan State University, East Lansing, MI, USA, 2College of Human Medicine, Michigan State University, Flint, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2015/04/Winter-2015-Letter-from-the-editors.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button] Corresponding Author: Jessica L Wummel; Jessica[at]msrj.org, Jack C Mettler; Jack[at]msrj.org Key Words: N/A Abstract: The editors of MSRJ are excited to announce our Winter 2015 issue. As always, we were incredibly impressed by the caliber of submissions. This issue includes interesting articles written by medical students from UC Davis College of Medicine and Michigan State University College of Human Medicine. … Continue reading →

The Growth of Medical Student Opportunities in Global Health. Author: Johnathan Kao, MPH Author Affiliations: College of Human Medicine, Michigan State University, Flint, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/12/Fall-2014-Editorial-Global-Health.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Johnathan Kao; johnathan.kao[at]msrj.org Key Words: sexual health; relationships; intimacy; radiotherapy; psycho-supportive treatment; hormone therapy. Abstract: 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 … Continue reading →

Comparing Current Screening Modalities for Colorectal Cancer and Precancerous Lesions: Is Colonoscopy the Method of Choice? Author: Puneet K. Singh Author Affiliations: Saba University School of Medicine, Saba, Dutch Caribbean [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/12/Fall-2014-CRC-Screening.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Puneet K. Singh; pun33t.singh[at]gmail.com Key Words: Colonoscopy; colorectal neoplasms; sigmoidoscopy; CT colonography; mass screening. Abstract: 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 … Continue reading →

Alzheimer’s Disease: A Clinical and Basic Science Review.  Author: Igor O. Korolev Author Affiliations: College of Osteopathic Medicine and Neuroscience Program, Michigan State University, East Lansing, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/12/Fall-2014-Alzheimers-Disease.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Igor O. Korolev; korolevi[at]msu.edu Key Words: Alzheimer’s disease; mild cognitive impairment; dementia; neurodegeneration; neuroimaging; biomarkers. Abstract: 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 … Continue reading →

A Medical Student Elective Course in Business and Finance: A Needs Analysis and Pilot. Author: Joseph B. Meleca1, Maria Tecos1, Abigail L. Wenzlick1, Rebecca Henry2, Patricia A. Brewer3. Author Affiliations: 1College of Human Medicine, Michigan State University, East Lansing, MI, US 2Office of Medical Education, Research and Development, College of Human Medicine, Mighigan State University, East Lansing, MI, USA 3Office of Preclinical Curriculum, College of Human Medicine, Michigan State University, East Lansing, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/12/Fall-2014-Business-Elective.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Joseph B. Meleca; melecajo[at]msu.edu Key Words: curriculum reform; medical business; medical finance; student-led; course; elective; module; student … Continue reading →

A Case of Severe, Refractory Antipsychotic-induced Orthostatic Hypotension. Author: 1Sahil Gambhir, 2Nicholas Sandersfeld, DO, 2Dale D’Mello, MD Author Affiliations: 1College of Human Medicine, Michigan State  University, East Lansing, MI, USA; 2Department of Psychiatry, College of Human  Medicine, Michigan State University, East Lansing, MI [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/12/Fall-2014-Antipsychotic-Hypotension.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Sahil Gambhir, Gambhir1[at]msu.edu Key Words: Orthostatic hypotension; antipsychotics; refractory; side effects; schizophrenia; management guidelines. Abstract: Introduction: 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 … Continue reading →

Sebaceous Carcinoma of the Abdominal Wall: A Potential Indicator of Muir Torre Syndrome Author: Stacie L. Clark Author Affiliations: College of Human Medicine, Michigan State University, Grand Rapids, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/12/Fall-2014-Sebaceous-Carcinoma.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Stacie L. Clark, clarkst[at]msu.edu Key Words: sebaceous gland; sebaceous carcinoma; abdominal wall; Muir-Torre syndrome; colorectal cancer; HNPCC. Abstract: 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 … Continue reading →

Acute Bronchiolitis – Case Report and Review of Management Guidelines. Author: Neil D. Dattani, Clare M. Hutchinson Author Affiliations: Norwich Medical School, Faculty of Medicine and health Sciences, University of East Anglia, Norwich, United Kingdom [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/12/Fall-2014-Acute-Bronchiolitis.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Clare M. Hutchinson, claremhutchinson[at]gmail.com Key Words: Bronchiolitis; Case reports; Pediatrics; Practice guidelines; Therapeutics. Abstract: 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 … Continue reading →

A Review of the Psychological and Emotional Issues in Men with Prostate Cancer and their Partners. Author: Dane E. Klett Author Affiliations: School of Medicine, Creighton University, Phoenix, AZ, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/12/Fall-2014-Prostate-Cancer.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Dane E. Klett Key Words: sexual health; relationships; intimacy; radiotherapy; psycho-supportive treatment; hormone therapy. Abstract: 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 … Continue reading →

Broken. Author:  Timothy DeKoninck Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/11/MSRJ-Fall-2014-Broken.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding author: Timothy DeKoninck; dekonin4[at]msu.edu Key Words: N/A Abstract: There are several elements symbolized in the mosaic that represent a doctor-patient relation- ship. This piece of work strives to piece together and serve as a reminder of the elements that make for a successful and impactful relationship. Published on date: September 31, 2014 Senior Editor: N/A Junior Editor: N/A DOI: pending Citation: DeKoninck T. Broken. Medical Student Research Journal. 2014;4(Fall):2-3. References: N/A

Letter From the Editors. Author: Jessica L Wummel1, Jack C Mettler2 Author Affiliations: 1College of Human Medicine, Michigan State University, East Lansing, MI, USA, 2College of Human Medicine, Michigan State University, Flint, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/11/MSRJ-Fall-2014-Letter-from-the-Editors.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Jessica L Wummel; Jessica[at]msrj.org, Jack C Mettler; Jack[at]msrj.org Key Words: N/A Abstract: 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 … Continue reading →

Isolated Orbital Mucormycosis in an Immunocompetent Adolescent. Author: Jolie Krystle H. Guevara Author Affiliations: University of the East Ramon Magsaysay Memorial Medical Center, Manila, Philippines [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/07/MSRJ-Spring-2014-Isolated-Orbital-Mucormycosis.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Jolie Krystle H. Guevara; Jolieg800[at]gmail.com Key Words: rhinocerebral; zygomycosis; pediatric; amphotericin B; corticosteroids; exenteration. Abstract: Introduction and patient profile: Mucormycosis is a life-threatening disease that usually affects patients with diabetes and other immunocompromised states. However, recent literature has shown an emergence of this disease in immunocompetent individuals. Here we are presenting a rare case of a healthy 13-year-old adolescent diagnosed to have isolated orbital mucormycosis, previously treated with … Continue reading →

Leiomyosarcoma of Small Bowel Discovered by Double Balloon Enteroscopy: a Case Report Authors: Malika Gill*, Shabana F. Pasha, Matthew A, Zarka Author Affiliations: Royal College of Surgeons Ireland, Dublin, Ireland Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, AZ, USA Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, AZ, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/07/MSRJ-Spring-2014-Leiomyosarcoma-of-Small-Bowel.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Malika Gill; malikagill[at]rcsi.ie Key Words: leiomyosarcoma; double balloon eneroscopy; small bowel tumors; balloon-assisted enteroscopy; deep enteroscopy; capsule endoscopy. Abstract: Introduction and Patient Profile: Introduction of deep enteroscopy (capsule endoscopy (CE), balloon-assisted enteroscopy, and spiral enteroscopy) has led to a significant … Continue reading →

Future Medical Practice and Genetics. Author: Alec J. Beaney Author Affiliations: Norwich Medical School, Faculty of Medicine and health Sciences, University of East Anglia, Norwich, United Kingdom [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/07/MSRJ-Spring-2014-Future-Medical-Practice-and-Genetics.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Alec J. Beaney; A.Beaney[at]uea.ac.uk Key Words: medical student; breast cancer; single nucleotide polymorphisms; genome-wide association studies. Abstract: Significant progress has been made in the rapidly evolving sub specialty of medical genetics. In this article, breast cancer has been used as an example to highlight recent developments in this field of medicine, with a discussion on the implications this has on medical practice and policy. The … Continue reading →

The Anatomy of a Patient. Author: Scott C. Mauch Author Affiliations: College of Human Medicine, Michigan State University, Grand Rapids, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/07/MSRJ-Spring-2014-The-Anatomy-of-a-Patient.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding author: Scott C. Mauch; scott.mauch[at]gmail.com Key Words: N/A Abstract: My grandfather passed away the day after Christmas in 2012. He was a brilliant man who practiced medicine for several decades. During that time, he delivered thousands of babies, and even performed the amniocentesis on my mother when I was a fetus. Yet, in his last months, his failing health did not convey this brilliance. Parkinson’s disease and other neurological issues prevented my grandfather from speaking quickly or coherently. … Continue reading →

Letter From the Editors. Author: Kevin C Patterson. Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/07/MSRJ-Spring-2014-Letter-from-the-Editors.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button] Corresponding Author: Kevin C. Patterson; patte297[at]gmail.com Key Words: N/A Abstract: With the wrap-up of the 2013-2014 academic year, we are proud of the strides that Medical Student Research Journal (MSRJ) has made. The journal has grown in the number of issues as well as in the number of articles published per issue. In addition, the breadth of article types and topics has greatly increased. This spring issue includes works from the Royal College of Surgeons in Ireland, University … Continue reading →

Vemurafenib: Background, Patterns of Resistance, and Strategies to Combat Resistance in Melanoma.   Arjun Dupati* and Liza Gill   Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA     [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Winter-2014-Vemurafenib-Background-Patterns-of-Resistance-and-Strategies-to-Combat-Resistance-in-Melanoma.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]     *Corresponding author: Arjun Dupati; dupatiar[at]gmail.com Arjun Dupati and Liza Gill contributed equally to the production of this manuscript.   Key Words: Vemurafenib; Molecular Targeted Therapy; Melanoma Drug Resistance; Metastatic Melanoma; Tyrosine Kinase Inhibitor; Melanoma Treatment.   Abstract: Introduction: Finding an effective treatment for metastatic melanoma has posed a series of challenges. Vemurafenib, a B-RAF … Continue reading →

Substance Use Among Physicians and Medical Students.   Catalina I. Dumitrascu1*, Philip Z. Mannes2, Lena J. Gamble3, Jeffrey A. Selzer4   Author Affiliations: 1Creighton University School of Medicine, Omaha, NE, USA. 2Dartmouth College, Hanover, NH, USA. 3National Institutes of Health, Department of Perioperative Medicine, Bethesda, MD, USA. 4Committee for Physician Health, Albany, NY, USA.     [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Winter-2014-Substance-Use-Among-Physicians-and-Medical-Students.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding author: Catalina I. Dumitrascu, BS, MS; catalinadumitrascu[at]creighton.edu   Key Words: Substance-related disorders; Alcohol abuse; Physician Health Programs.   Abstract: Background: Physicians and medical students whose substance use causes impairment pose a risk … Continue reading →

Morphine-Induced Myoclonus in a Patient with End-Stage Renal Disease.   Victoria L. Stahl1*, Hassan I. Ahmad2, and James E. Novak3   Author Affiliations: 1School of Medicine, Wayne State University, Detroit, MI, USA. 2Department of Medicine, Henry Ford Hospital, Detroit, MI, USA. 3Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI, USA.     [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Winter-2014-Morphine-induced-Myoclonus-in-a-Patient-with-End-stage-Renal-Disease.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   *Corresponding author: Victoria Stahl, BS; vstahl[at]med.wayne.edu   Key Words: End-Stage Renal Disease; Dialysis; Myoclonus; Morphine; Opioid Rotation.   Abstract: Introduction and Patient Profile: Pain is a common complaint, and pain control is frequently challenging. End-stage … Continue reading →

Declaration of Helsinki: What Does the Future Hold?   Margaret D. Chi* and Michelle A. Dwyer   Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA     Corresponding author: Margaret D. Chi MPH; chimarga[at]msu.edu   Key Words: Research Ethics; Medicine; Human Research Subject Protection; Informed Consent; Helsinki Declaration; Bioethics   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Winter-2014-Declaration-of-Helsinki-What-Does-the-Future-Hold.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding author: Margaret D. Chi MPH; chimarga[at]msu.edu   Key Words: Research Ethics; Medicine; Human Research Subject Protection; Informed Consent; Helsinki Declaration; Bioethics   Abstract: Within the world of medical research, the Declaration of Helsinki … Continue reading →

Spirit Queen.   Masaki Nagamine   Author Affiliations: College of Human Medicine, Michigan State University, Grand Rapids, MI, USA     [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Winter-2014-Spirit-Queen.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding Author: Masaki Nagamine; masakinagamine[at]gmail.com   Key Words: N/A   Abstract: Preface: In my childhood, I lived with a family member suffering from paranoid schizophrenia. The painting is my interpretation of the inner turmoil that this family member faces regularly. It is my hope that the viewers of this painting can gain some insight into the difficulties involved in living with a chronic mental illness that cannot be … Continue reading →

Letter From the Editors.   Kevin C. Patterson and Jessica L. Wummel   Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Winter-2014-Letter-From-The-Editors.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding Author: Kevin C. Patterson; patte297[at]gmail.com   Key Words: N/A   Abstract: The editors of MSRJ would like to extend our warm wishes in the winter season and hope that it has been filled with joy, family, and good fortune. We are very excited to introduce the first issue of 2014, as well as the second issue of the 20132014 academic year. … Continue reading →

Direct Access to Physical Therapy in Michigan is Overdue.   Kevin C. Patterson1*, Rachel A. Patterson2   1College of Human Medicine, Michigan State University, Grand Rapids, MI, USA 2College of Health Professions, Grand Valley State University, Grand Rapids, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Fall-2013-Direct-Access-to-Physical-Therapy-in-Michigan-is-Overdue.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   *Corresponding Author: Kevin C. Patterson; patte297[at]gmail.com   Key Words: Direct Access; Physical Therapy; Primary Care; Healthcare; Utilization   Abstract: Direct access to physical therapists (PTs), the ability for a patient to seek care from a PT without physician referral, has been contested for many years. The traditional gatekeeper … Continue reading →

Public Stroke Knowledge – Those Most at Risk, Least Able to Identify Symptoms.   Zachary Jarou*, Nathaniel Harris, Liza Gill, Meena Azizi, Shayef Gabasha, Robert LaBril.   College of Human Medicine, Michigan State University, East Lansing, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Fall-2013-Public-Stroke-Knowledge-Those-Most-at-Risk-Least-Able-to-Identify-Symptoms.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   *Corresponding author: Zachary Jarou; zachjarou[at]gmail.com   Key Words: Stroke; CVA; Risk Factors; Warning Signs; Patient Education; Public Health.   Abstract: Background and purpose: Fewer than 1 in 20 patients with acute ischemic stroke are treated with thrombolytic drugs, with three quarters of otherwise eligible patients being excluded secondary to delay … Continue reading →

A Rare Case of Breast Carcinosarcoma with Lymphatic Metastasis.   Megan C. Hamre1*, Jennifer M. Eschbacher2, Frances Hahn2, Tilina Hu2   1School of Medicine, Creighton University, Omaha, NE, USA 2St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Fall-2013-A-Rare-Case-of-Breast-Carcinosarcoma-with-Lymphatic-Metastasis.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   *Corresponding Author: Megan C. Hamre; Meganhamre1[at]creighton.edu   Key Words: Breast Cancer; Carcinosarcoma; Clinical Protocols; Treatment Protocols; Lymphatic Metastasis.   Abstract: Introduction and Patient Profile: Carcinosarcoma of the breast is a rare malignancy composed of two cell lines described as a ductal-type carcinoma with a sarcoma-like component. It is an aggressive … Continue reading →

Incomplete Storytelling.   Alexander S. Golec.   College of Human Medicine, Michigan State University, East Lansing, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Fall-2013-Incomplete-Storytelling.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding Author: Alexander S. Golec; golec@msu.edu   Key Words: N/A   Abstract: Our interviews, physical exams, and laboratory tests only uncover select words of a patient’s story. Some days we may be lucky enough to stumble upon a phrase or complete sentence in their life’s tome. We base our diagnoses on these incomplete discoveries and hope for the best. Some of us may act like we have the Rosetta Stone … Continue reading →

Letter From the Editors.   Kevin C. Patterson, Jessica L. Wummel.   College of Human Medicine, Michigan State University, Grand Rapids, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Fall-2013-Letter-from-the-Editors.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding Author: Kevin C. Patterson; patte297[at]gmail.com   Key Words: N/A   Abstract: In the third MSRJ issue of 2013 and the first of the 2013-2014 academic year, we are very excited to present enlightening and thought-provoking articles. We are publishing the work of students from Michigan State University’s College of Human Medicine and Creighton University School of Medicine. This journal has seen large growth since … Continue reading →

Funding the Future.   David L. Ortiz.   Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Spring-2013-Funding-the-Future.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding author: David Ortiz; ortizdav[at]msu.edu   Key Words: N/A   Abstract: The problems facing healthcare training today are not simple. Predictions about future demand for physicians have a poor track record, as the GMENAC studies of the 1980s showed. Even if one could predict perfectly the demand for physicians in the future, history has shown that it takes 10-40 years for the full effects of increased medical … Continue reading →

Potential Pathogen Transmission on Medical Student Anatomy Laboratory Clothing.   Chandan J. Kabadi1, Carroll R. Smith III1, Fernando Gomez2*   Author Affiliations: 1American University of the Caribbean School of Medicine, Cupecoy, St. Maarten 2Department of Pathology, American University of the Caribbean School of Medicine, Cupecoy, St. Maarten   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Spring-2013-Potential-pathogen-transmission-on-medical-student-anatomy-laboratory-clothing.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   *Corresponding author: Fernando Gomez MD; fgomez[at]aucmed.edu   Key Words: Pathogen Transmission; Infectious Precautions; White Coat; Medical Students; Contamination; Cadaver.   Abstract: Introduction: Despite great advances in the fields of medicine and sanitation, nosocomial infections remain a very common and serious issue. … Continue reading →

A Comprehensive Stroke Center Patient Registry: Advantages, Limitations, and Lessons Learned.   James E. Siegler1$, Amelia K. Boehme2,3$, Adrianne M. Dorsey1, Dominique J. Monlezun1, Alex J. George1, Amir Shaban4, H. Jeremy Bockholt5,6, Karen C. Albright2,3,7,8, Sheryl Martin-Schild4*.   Author Affiliations: 1Tulane University School of Medicine, New Orleans, LA, USA 2Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA 3Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA 4Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA, USA 5Advanced Biomedical Informatics Group, LLC, Iowa City, IA, USA 6Department … Continue reading →

All Heart.   Brittney M. Benjamin.   Author Affiliations: College of Human Medicine, Michigan State University, Grand Rapids, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Spring-2013-All-Heart.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding author: Brittney M. Benjamin; brittneymichellebenjamin[at]gmail.com   Key Words: N/A   Abstract: There has been a trend to portray doctors as “all” - all knowing, all thinking, all seeing, all doing. We’re all brains, learning and memorizing, and all hands, cutting and suturing. Doctors can be any or none of these things, but sometimes we miss our greatest strength: we can be all Heart. And by being all … Continue reading →

Letter From the Editors.   Chad Klochko.   Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Spring-2013-Letter-from-the-Editors.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding Author: Chad Klochko; Chad[at]msrj.chm.msu.edu   Key Words: N/A   Abstract: It has been a pleasure to work as an editor over the past year. I believe that this can be a significant outlet for medical students to publish their research work, enabling them to receive credit for publishing, but even more importantly, contributing to the general body of medical knowledge and teaching valuable academic skills.   … Continue reading →

Too Small to Fail.   Chad Klochko.   Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Winter-2013-Too-Small-to-Fail.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding Author: Chad Klochko; chad[at]msrj.chm.msu.edu   Key Words: N/A   Abstract: On December 7, 2012, Nicholas Kristof, two-time Pulitzer Prize winning journalist, wrote a compelling article about people in poverty in the United States. The article, which appeared in the New York Times, describes the plight of young children who are failing in school and who are not acquiring the skills needed to move forward in their … Continue reading →

Can Donepezil Hydrochloride Reduce the Role of Neuroleptic Drugs in Delirium? A Case Report.   Lloyd D Hughes*, Emily McKay.   Author Affiliations: Medical School, Liverpool University, Liverpool, England   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Winter-2013-Can-Donepezil-Hydrochloride-Reduce-the-Role-of-Neuroleptic-Drugs-in-Delirium-A-Case-Report.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   *Corresponding author: Lloyd D. Hughes; L.D.Hughes[at]dundee.ac.uk   Key Words: geriatrics; delirium; psychiatry; acetylcholinesterase inhibitors.   Abstract: Background: Recent evidence shows that a confirmed diagnosis of delirium increases both patient morbidity and mortality. Importantly, these increases are independent of patient age, and presence of co-morbid disease. In the last few years, there has been evidence that acetylcholinesterase inhibitors may have … Continue reading →

The Role of Ultrasound Screening in Reducing AAA Mortality: A Review.   Kashif Imran Ahmad.   Author Affiliations: Medical School, Liverpool University, Liverpool, England   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Winter-2013-The-Role-of-Ultrasound-Screening-in-Reducing-AAA-Mortality-a-Review.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding author: Kashif Imran Ahmad; K.Ahmad[at]Lancaster.ac.uk   Key Words: population; screening; ultrasonography; abdominal aortic aneurysms; mortality; systematic review.   Abstract: Men aged 65-79 are at the highest risk of having an abdominal aortic aneurysm (AAA) as well as a high incidence of rupture; this is treated as a surgical emergency, which has a total mortality of 75-90%. The diameter of an AAA proves to … Continue reading →

The Color of Medicine.   Diana Salinas.   Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Winter-2013-The-Color-of-Medicine.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding Author: Diana Salinas; email not available.   Key Words: N/A   Abstract: ’I will not permit considerations of religion, nationality, race, gender, politics, socioeconomic standing, or sexual orientation to intervene between my duty and my patient.’ This bullet point from the physician’s oath is engraved around the margins to remind us that as physicians we should treat and care for each patient equally and in an … Continue reading →

Letter From the Editors.   Chad Klochko, David Ortiz.   Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA   [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Winter-2013-Letter-from-the-Editors.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]   Corresponding Author: Chad Klochko; Chad[at]msrj.chm.msu.edu   Key Words: N/A   Abstract: The year 2013 is going to be a very exciting year for the Medical Student Research Journal (MSRJ). MSRJ has made great strides in the past 12 months and can look forward to a bright furture in the year ahead. We have more than tripled our editoral staff, which now consists of 12 second … Continue reading →

10 Minutes with Paul Hebert, Editor-in-Chief of the Canadian Medical Association Journal. Pamela Verma, Diane Wu. Author Affiliations: University of British Columbia, Vancouver, BC, Canada [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Spring-2011-10-minutes-with-Paul-Hebert-Editor-in-Chief-of-the-Canadian-Medical-Association-Journal.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button] *Corresponding Author: Pamela Verma; pamverma[at]interchange.ubc.ca Key Words: N/A Abstract: Background: Most medical students, at some point in their career, aspire to publish a research paper of enough significance to join the pages of the major international medical journals. At the helm of these journals are physicians renowned for their academic and research acumen; in Canada, one of these physicians is Dr. Paul Hebert. We sat … Continue reading →

Pregnant Patient Presenting with Syncope and a Medulloblastoma: A Case Report. Mark Ishak. Author Affiliations: New York College of Osteopathic Medicine of NYIT, Old Westbury, NY, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Spring-2011-Pregnant-patient-presenting-with-syncope-and-a-medulloblastoma-a-case-report.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button] *Corresponding Author: Mark Ishak, mishak[at]nyit.edu Key Words: Adult medulloblastoma; pregnant; syncope. Abstract: Medulloblastoma is a primary cerebellar tumor seen most commonly in the pediatric population. In adults, it represents about 1% of cancer found in the central nervous system. In adult medulloblastoma, only one third of cases occur in women and even less in pregnant women. This case describes a 34-year-old pregnant woman … Continue reading →

Retention of Cardiopulmonary Resuscitation Skills in Medical Students Utilizing a High-Fidelity Patient Simulator. Travis Behrend*, John Heineman, Lei Wu, Chad Burk, Ngoc-Truc Duong, Mark Munoz, Dawn Pruett, Michael Seropian, Dawn Dillman. Author Affiliations: Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University (OHSU), Portland, OR, USA [button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Spring-2011-Retention-of-cardiopulmonary-resuscitation-skills-in-medical-students-utilizing-a-high-fidelity-patient-simulator.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button] *Corresponding author: Travis Behrend; behrendt[at]ohsu.edu Key Words: CPR; simulation; medical education; medical students; skills retention. Abstract: Objective: To evaluate the difference in retention of cardiopulmonary resuscitation (CPR) skills between first and second year medical students in accordance with American Heart Association (AHA) … Continue reading →