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Spring 2013 – Funding the Future

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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 school enrollment to be felt. The rate of GME must rise. In its present state, GME could sustain reductions as great as 10% of funding without the loss of total residency slots, but any decrease in GME funding will undoubtedly perpetuate the inadequacy of the physician workforce. By 2016, without increased GME funding, there will be a substantial increase in the number of unmatched US seniors and a substantial decrease in the number of foreign medical grads.

 
Published: May 31, 2013
 
 
Senior Editor: N/A
 
Junior Editor: N/A
 
DOI: Pending
 
Citation:
Ortiz DL. Funding the Future. Medical Student Research Journal. 2013;2(Spring):36-39.
 
 
References:
1. National Resident Matching Program. NRMP post-match press release. Washington, DC: National Resident Matching Program; 2013. http://www.nrmp.org/wp-content/uploads/2013/08/pressreleasepostmatch2013.pdf

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9. Center for Workforce Studies. Results of the 2011 Medical School Enrollment Survey. Washington, DC: Association of American Medical Colleges; 2011. https://www.aamc.org/download/281126/data/enrollment2012.pdf.

10. Center for Workforce Studies. 2011 State physician workforce data book. Washington, DC: Association of American Medical Colleges; 2011. https://www.aamc.org/download/263512/data/statedata2011.pdf.

11. National Resident Matching Program. NRMP residency match 2013 results. Washington, DC: National Resident Matching Program; 2013. http://www.nrmp.org/match-data/main-residency-match-data/.

12. Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (2003H.R. 1). GovTrack.us. Available from: http://www.govtrack.us/congress/bills/108/hr1 [cited 15 May 2013].

13. Chen C, Xierali I, Piwnica-Worms K, Phillips R. The redistribution of graduate medical education positions in 2005 failed to boost primary care or rural training. Health Aff. 2013; 32(1):102-10. http://dx.doi.org/10.1377/hlthaff.2012.0032.

14. Local hospital CEOs want private fund for more residencies Jacksonville Business Journal. Available at: http://www.bizjournals.com/jacksonville/print-edition/2011/11/18/local-hospital-ceos-want-private-fund.html?pageall [cited 6 May 2013]

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Spring 2013 – Potential Pathogen Transmission on Medical Student Anatomy Laboratory Clothing

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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. Many of these problems can be avoided by simple hand washing; however, pathogenic microbes can spread through other modes too. In our study, we aim to determine if the setting of an open cadaver laboratory was conducive to the transmission of pathogens such as Staphylococcus aureus, Streptococcus pyogenes, and Enterococcus faecalis. Methods: For this investigation, 67 volunteer medical students had their laboratory coats swabbed and sampled during their time in anatomy laboratory class. Each coat was sampled prior to cadaver contact and at the end of their time in the laboratory, which coincided with the exploration of the gastrointestinal tract. Results: We found that pathogens were present on the laboratory coats of the students. An increase in each of the three microbes for which we tested was detected at the end of the anatomy laboratory course on the garments of the participants. There were six more student laboratory coats with S. aureus in the post-dissection swabbing and there were three more student laboratory coats with S. pyogenesin the post-dissection swabbing than originally documented. E. faecalis was found on four student laboratory coats in the post-dissection swabbing compared to none pre-dissection. Discussion: From these results, we conclude that stronger infection control measures are warranted to prevent the occurrence of unnecessary disease transmission in this setting. Our study provides data that support further investigation of potential pathogen transmission by student laboratory clothing and supports the use of universal infection control procedures to provide safer
environments for medical students and their contacts, including laundering protocols for coats.

 
Published: May 31, 2013
 
 
Senior Editor: Jon Zande
 
Junior Editor: Kailyne Van Stavern
 
DOI: Pending
 
Citation:
Kabadi CJ, Smith III CR, Gomez F. Potential Pathogen Transmission on Medical Student Anatomy Laboratory Clothing. Medical Student Research Journal. 2013;2(Spring):30-35.
 
 
References:
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4. Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 1997; 10(3):505-20. http://cmr.asm.org/content/10/3/505.short.

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7. Nurkin S, Urban, C, Mangini, E, Mariano, N. Is the clinician’s necktie a potential fomite for hospital acquired infections [abstract]. 104th General Meeting of the American Society for Microbiology. 2004. http://www.asm.org/index.php/component/content/article/114-unknown/unknown/5498-is-the-clinicians-necktie-a-potential-fomite-for-hospital-acquired-infections.

8. National Health Service Department of Health. Uniforms and workwear: an evidence base for developing local policy. National Health Service Department of Health; 2007. Available from: http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/publicationsandstatistics/publications/publicationspolicyandguidance/dh_078433.

9. O’Sullivan E, Mitchell B. An improved composition for embalming fluid to preserve cadavers for anatomy teaching in the UK. J Anat. 1993; 182(Pt. 2):295-7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1259842/.http://dx.doi.org/10.1002/ca.20567.

11. Demiryurek D, Bayramoglu A, Ustacelebi S. Infective agents in fixed human cadavers: a brief review and suggested guidelines. Anat Rec. 2002; 269(4):194-7. http://dx.doi.org/ 10.1002/ar.10143.

12. Watson, R. General & medical microbiology: summary of biochemical tests. University of Wyoming; 2013. Available from: http://www.uwyo.edu/molb2210_lab/info/biochemical_tests.htm.

Spring 2013 – A Comprehensive Stroke Center Patient Registry: Advantages, Limitations, and Lessons Learned

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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 of Psychiatry, University of Iowa, Iowa City, IA, USA
7Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), University of Alabama at Birmingham, Birmingham, AL, USA
8Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED), Minority Health & Health Disparities Research Center (MHRC), University of Alabama at Birmingham, Birmingham, AL, USA

 
$James E. Siegler and Amelia K. Boehme contributed equally to the production of this manuscript.

 

[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Spring-2013-A-comprehensive-stroke-center-patient-registry-advantages-limitations-and-lessons-learned.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]
 
*Corresponding Author: Sheryl Martin-Schild; smartin2[at]tulane.edu
 
Key Words: Stroke; Registries; Methodology; Epidemiological Methods; Common Data Elements; Source Data Verification.
 
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 Heart, we must be careful how our experiences affect us.

 
Published: May 31, 2013
 
 
Senior Editor: Kevin C. Patterson
 
Junior Editor: Jessica L. Wummel
 
DOI: Pending
 
Citation:
Siegler JE, Boehme AK, Dorsey AM, Monlezun DJ, George AJ, Shaban A, Bockckholt HJ, Albright KC, Martin-Schild S. A Comprehensive Stroke Center Patient Registry: Advantages, Limitations, and Lessons Learned. Medical Student Research Journal. 2013;2(Spring):21-29.
 
 
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9. Jakobsen E, Palshof T, Osterlind K, Pilegaard H. Data from a national lung cancer registry contributes to improve outcome and quality of surgery: Danish results. Eur J Cardiothorac Surg. 2009; 35(2):348-52. http://dx.doi.org/10.1016/j.ejcts.2008.09.026.

10. Larsson S, Lawyer P, Garellick G, Lindahl B, Lundstrom M. Use of 13 disease registries in 5 countries demonstrates the potential to use outcome data to improve health care’s value. Health Aff. 2012; 31(1):220-7. http://dx.doi.org/10.1377/hlthaff.2011.0762.

11. Maas AI. Traumatic brain injury: simple data collection will improve the outcome. Wien Klin Wochenschr. 2007; 119(1-2):20-2. http://dx.doi.org/10.1007/s00508-006-0759-y.

12. Xian Y, Fonarow GC, Reeves MJ, et al. Data quality in the American Heart Association get with the guidelines-stroke (gwtg-stroke): results from a national data validation audit. Am Heart J. 2012; 163(3): 392-8,e1. http://dx.doi.org/10.1016/j.ahj.2011.12.012.

13. Yoon SS, George MG, Myers S, et al. Analysis of data-collection methods for an acute stroke care registry. Am J Prev Med. 2006; 31(6):S196-201. http://dx.doi.org/10.1016/j.amepre.2006.08.010.

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16. Siegler JE, Martin-Schild S. Early neurological deterioration (end) after stroke: the end depends on the definition. Int J Stroke. 2011; 6(3):211-2. http://dx.doi.org/10.1111/j.1747-4949.2011.00596.x.

17. Albright KC, Martin-Schild S, Bockholt HJ, et al. No consensus on definition criteria for stroke registry common data elements. Cerebrovasc Dis Extra. 2011; 1(1):84-92. http://dx.doi.org/10.1159/000334146.

18. Davis FG, Bruner JM, Surawicz TS. The rationale for standardized registration and reporting of brain and central nervous system tumors in population-based cancer registries. Neuroepidemiology. 1997; 16(6):308-16. http://dx.doi.org/10.1159/000109703.

19. Leung LY, Albright KC, Boehme AK, et al. Short-term bleeding events observed with clopidogrel loading in acute ischemic stroke patients. J Stroke Cerebrovasc Dis. 2013; 22(7):1184-9. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2013.03.001.

20. Siegler JE, Boehme AK, Albright KC, Martin-Schild S. Ethnic disparities trump other risk factors in determining delay to emergency department arrival in acute ischemic stroke. Ethn Dis. 2013; 23(1):29-34. http://www.ncbi.nlm.nih.gov/pubmed/23495619.

21.Siegler JE, Boehme AK, Kumar AD, et al. Identification of modifiable and nonmodifiable risk factors for neurologic deterioration after acute ischemic stroke. J Stroke Cerebrovasc Dis. 2012; 22(7):e207-13. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2012.11.006.

22. Kumar AD, Boehme AK, Siegler JE, Gillette M, Albright KC, Martin-Schild S. Leukocytosis in patients with neurologic deterioration after acute ischemic stroke is
associated with poor outcomes. J Stroke Cerebrovasc Dis. 2012; 22(7):e111-7. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2012.08.008.

23. Saver JL, Warach S, Janis S, et al. Standardizing the structure of stoke clinical and epidemiological research data: the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Common Data Element (CDE) project. Stroke. 2012; 43:967-73. http://dx.doi.org/10.1161/STROKEAHA.111.634352.

24. van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19:604-7. http://dx.doi.org/10.1161/01.STR.19.5.604.

25. Drolet BC, Johnson KB. Categorizing the world of registries. J Biomed Inform. 2008; 41(6):1009-20. http://dx.doi.org/10.1016/j.jbi.2008.01.009.

26. Bufalino VJ, Masoudi FA, Stranne SK, et al. The American Heart Association’s recommendations for expanding the applications of existing and future clinical registries: a policy statement from the American Heart Association. Circulation. 2011; 123:2167-79. http://dx.doi.org/10.1161/CIR.0b013e3182181529.

27. Jones EM, Albright KC, Fossati-Bellani M, Siegler JE, Martin-Schild S. Emergency department shift change is associated with pneumonia in patients with acute ischemic stroke. Stroke. 2011; 42:3226-30. http://dx.doi.org/10.1161/STROKEAHA.110.613026.

28. Johnson CM, Nahm M, Shaw RJ, et al. Can prospective usability evaluation predict data errors? AMIA Annu Symp Proc. 2010; 2010:346-50. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041437/?report=classic.

29. Reeves MJ, Mullard AJ, Wehner S. Inter-rater reliability of data elements from a prototype of the paul coverdell national acute stroke registry. BMC Neurol. 2008; 8:19. http://dx.doi.org/10.1186/1471-2377-8-19.

30. Paulsen A, Overgaard S, Lauritsen JM. Quality of Data Entry Using Single Entry, Double Entry and Automated Forms Processing–An Example Based on a Study of Patient-Reported Outcomes. PloS One. 2012; 7(4):e35087. http://dx.doi.org/10.1371/journal.pone.0035087.

31. Day S, Fayers P, Harvey D. Double data entry: what value, what price? Control Clin Trials. 1998; 19(1):15-24. http://dx.doi.org/10.1016/S0197-2456(97)00096-2.

32. Howard G. Why do we have a stroke belt in the southeastern united states? A review of unlikely and uninvestigated potential causes. Am J Med Sci. 1999; 317(3):160-7. http://journals.lww.com/amjmedsci/pages/articleviewer.aspx?year=1999&issue=03000&article=00005&type=abstract.

33. Lyden P, Raman R, Liu L, et al. NIHSS training and certification using a new digital video disk is reliable. Stroke. 2005; 36:2446-9. http://dx.doi.org/10.1161/01.STR.0000185725.42768.92.

34. Towfighi A, Saver JL. Stroke declines from third to fourth leading cause of death in the United States: historical perspective and challenges ahead. Stroke. 2012; 42:2351-5. http://dx.doi.org/10.1161/STROKEAHA.111.621904.

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Spring 2013 – All Heart

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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 Heart, we must be careful how our experiences affect us.

 
Published: May 31, 2013
 
 
Senior Editor: N/A
 
Junior Editor: N/A
 
DOI: Pending
 
Citation:
Benjamin BM. All Heart. Medical Student Research Journal. 2013;2(Spring):20.
 
 
References:
N/A

Spring 2013 – Letter From the Editors

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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.

 
Published: May 31, 2013
 
Senior Editor: N/A
 
Junior Editor: N/A
 
DOI: Pending
 
Citation:
Klochko C. Letter From the Editors. Medical Student Research Journal. 2013;2(Spring):19.
 
 
References:
N/A

Editorial Staff 2013-2014

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Introducing the 2013 – 2014 editorial staff for the MSRJ. This is an exciting time for our staff as another year passes and they gain more experience in the medical journal field. We’re enthusiastic about the new directions the journal is taking, the fantastic submissions we get each month, and the opportunity to help out other medical students across the world!

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Winter 2013 – Too Small to Fail

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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 education, and tragically, in some cases, parents are allowing them to fail.

 
Published: February 27, 2013
 
Senior Editor: N/A
 
Junior Editor: N/A
 
DOI: Pending
 
Citation:
Klochko C. Too Small to Fail. Medical Student Research Journal. 2013;2(Winter):17-18.
 
 
References:
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Winter 2013 – Can Donepezil Hydrochloride Reduce the Role of Neuroleptic Drugs in Delirium? A Case Report

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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 a limited role in managing episodes of mild/moderate delirium. Methods: This case study reports a patient whose behavioral disturbances caused by delirium, responded well to donepezil hydrochloride in a nursing home in Dundee, United Kingdom. Results:Our clinical case focuses on a patient who was diagnosed with a mixed picture delirium after developing PUO. This case report notes that Mr A, a patient already prescribed donepezil hydrochloride, saw an improvement in his behavioral symptoms after an increase in his dose. This enabled the patient to avoid receiving neuroleptic or benzodiazepine medication, known to be particularly problematic in older patients.
Conclusion: The authors tentatively propose that patients in community care already prescribed acetylcholinesterase inhibitors, may benefit from an increased dose in cases of mild delirium (where there is no clear cause or requirement for hospital admission). In line with the significant impact that delirium has upon older patients in community care, we would call for further studies looking at the influence that these medications may have on the sequelae of delirium in patients in the community.

 
Published: February 27, 2013
 
Senior Editor: Skyler Johnson
 
Junior Editor: Bobby Gambhir
 
DOI: Pending
 

Citation:
Hughes LD, McKay E. Can Donepezil Hydrochloride Reduce the Role of Neuroleptic Drugs in Delirium? A Case Report. Medical Student Research Journal. 2013;2(Winter):11-16.
 
 
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Can donepezil hydrochloride reduce the role of
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