Winter 2015 – In Situ Thrombosis of the Pulmonary Arteries: An Emerging New Perspective on Pulmonary Embolism

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

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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 pulmonary embolism(PE) in the United States is reported to be 0.69 per1,000 persons with mortality of up to 30% depending upon the size of the emboli.1 PE and deep venous thrombosis (DVT) are both considered manifestations ofthe same disease of venous thromboembolism. Virchowpostulated that dysfunction of vessel walls, alternationsin blood flow and hypercoagulability of theblood triggered inappropriate thrombus formation.2 DVT most commonly occurs as local clot formation in the deep calf veins. PE arises when clots break off from a peripheral DVT and become lodged within the pulmonary arterial vasculature. PE is routinely diagnosed when filling defects are found in the pulmonary arteries on computed tomography angiogram (CTA). Among the general population of patients presenting to emergency rooms, absence of DVT may occur in up to 57% of those diagnosed with PE.3 A high prevalence of isolated PE may suggest localized thrombus formation in the pulmonary arteries instead of embolization from peripheral clots.

Published on date: January 1, 2015

Senior Editor: Kailyne Van Stavern

Junior Editor: Garrett Roe

DOI: Pending

Citation: Corbett V. Hassouna H. Girgis R. In Situ Thrombosis of the Pulmonary Arteries: An Emerging New Perspective on Pulmonary Embolism . Medical Student Research Journal. 2015;4(Winter):54-8.

References:

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  29. Van langevelde K, Sra´mek A, Vincken PW, Van rooden JK, Rosendaal FR, Cannegieter SC. Finding the origin of pulmonary emboli with a total-body magnetic resonance direct thrombus imaging technique. Haematologica 2013; 98(2):309_15. doi: 10.3324/haematol.2012.069195
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  32. Korkmaz A, Ozlu T, Ozsu S, Kazaz Z, Bulbul Y. Long-term outcomes in acute pulmonary thromboembolism: the incidence of chronic thromboembolic pulmonary hypertension and associated risk factors. Clin Appl Thromb Hemost 2012;18(3): 281_8. doi: 10.1177/1076029611431956

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Winter 2015 – White Coat Sparty

White Coat Sparty.

Author:  Carter Anderson

Author Affiliations: College of Human Medicine, Michigan State University, East Lansing, MI, USA

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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

 

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Winter 2015 – Letter from the Editors

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

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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.

Published on date: January 1, 2015

Senior Editor: N/A

Junior Editor: N/A

DOI: Pending

Citation: Wummel JL, Mettler JC. Letter From the Editors. Medical Student Research Journal. 2015;4(Winter):51.

References: N/A

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Fall 2014 – The Growth of Medical Student Opportunities in Global Health

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

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Corresponding Author: Johnathan Kao; johnathan.kao[at]msrj.org

Key Words: sexual health; relationships; intimacy; radiotherapy; psycho-supportive treatment; hormone therapy.

AbstractSince the establishment of the World Health Organization on April 7, 1948,1 global health has grown in prominence and popularity among health care workers at all levels of training. International clinical rotation electives have been available to students for over half a century2 and interest in these programs has risen steadily over the decades. During this period, many organizations established programs for students and faculty interested in global health research and service. In 2006, these organizations united under the WHO’s Global Health Workforce Alliance to assist students and faculty in becoming more involved in global health activities.3 Despite these Changes, in 2007, Drain et al recognized a lack of global health education in medical schools and growing student interest, calling for more opportunities to fill the gap.4

Published on date: September 31, 2014

Senior Editor: N/A

Junior Editor: N/A

DOI: Pending

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

References:

  1. World Health Organization. History of WHO. 2014. Accessed from: http://www.who.int/about/history/en/ [cited 21 June 2014].
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  3. World Health Organization. Global Health Education Consortium. 2014. Accessed from: http://www.who.int/workforcealliance/members_partners/member_list /ghec/en/ [cited 21 June 2014].
  4. Drain PK, Primack A, Hunt DD, Fawzi WW, Holmes KK, Gardner P. Global Health in Medical Education: A Call for More Training and Opportunities. Acad Med 2007; 82(3):226-30. doi: 10.1097/ACM.0b013e3180305cf9
  5. Hag C, Rothenberg D, Gjerde C, Bobula J, Wilson C, Bickley L, Cardelle A, Joseph A. New World Views: Preparing Physicians in Training for Global Health Work. Fam Med 2000; 32(8):566-72.
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  7. Imperato PJ. A Third World International Health Elective for U.S. Medical Students: The 25-year Experience of the State University of New York, Downstate Medical Center. J Community Health 2004; 29(5):337-73. doi:10.1023/b:johe.0000038652.65641.0d
  8. Pust RE, Moher SP. A Core Curriculum for International Health: Evaluating Ten Years’ Experience at the University of Arizona. Acad Med 1992; 67(2):90-4. doi:10.1097/00001888-199202000-00007
  9. Haq C, Rothenberg D, Gjerde C, Bobula J, Wilson C, Bickley L, Cardelle A, Joseph A. New World Views: Preparing Physicians in Training for Global Health Work. Fam Med 2000; 32(8):566-72.
  10. Suchdev P, Ahrens K, Click E, Macklin L, Evangelista D, Graham E. A Model for Sustainable Short-Term International Medical Trips. Ambul Pediatr 2007; 7(4):317-20. doi: 10.1016/j.ambp.2007.04.003
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  13. AAMC GSA Steering Committee. Guidelines for Premedical and Medical Students Providing Patient Care During Clinical Experiences. AAMC 2011. Accessed from: https://www.aamc.org/download/181690/data/guidelinesforstudentsprovidingpatientcare.pdf [cited 21 June 2014].
  14. DeCamp M, Enumah S, O’Neill D, Sugarman J. Perceptions of a Short-Term Medical Programme in the Dominican Republic: Voices of Care Recipients. Glob Public Health 2014; 9(4):411-25. doi: 10.1080/17441692.2014.893368
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  16. Thompson MJ, Huntington MK, Hunt DD, Pinsky LE, Brodie JJ. Educational Effects of International Health Electives on U.S. and Canadian Medical Students and Residents: A Literature Review. Acad Med 2007; 82(3):226-30. doi: 10.1097/00001888-200303000-00023

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Fall 2014 – Comparing Current Screening Modalities for Colorectal Cancer and Precancerous Lesions: Is Colonoscopy the Method of Choice?

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 is most effective in detecting CRC and precancerous lesions is ongoing. Many recent studies have identified colonoscopy as the most sensitive and specific screening modality for CRC. However, a number of factors have prevented colonoscopy from being widely accepted. Less invasive techniques such as sigmoidoscopy and CTC are growing in popularity among physicians and patients who are apprehensive about colonoscopy screening; although many still are yet to experience the procedure first-hand. This literature review will attempt to validate the growing theory that colonoscopy is superior to other modalities for the diagnosis and screening of CRC and reduces the risk of CRC mortality. In order to do so, the paper will compare the risks and benefits of colonoscopy to sigmoidoscopy and CTC. It will further look at the different aspects that encompass a patient’s decision to partake in screening, such as basic knowledge about CRC, history of CRC in the family, advice from physicians and individual beliefs about what screening entails. Finally, this paper will propose ways in which colonoscopy screening can be improved and thus surpass other screening modalities to universally become the first choice for CRC screening.

Published on date: September 31, 2014

Senior Editor: Jack Mettler

Junior Editor: David Carr

DOI: Pending

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

References:

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  9. Rabeneck L, Paszat LF, Saskin R, Stukel TA. Association between colonoscopy rates and colorectal cancer mortality. Am J Gastroenterol. 2010;105:1627-1632. doi: 10.1038/ajg.2010.83
  10. Manser CN, Bachmann LM, Brunner J, Hunold F, Bauerfeind P, Marbet UA. Colonoscopy screening markedly reduces the occurrence of colon carcinomas and carcinoma-related death: a closed cohort study. Gastrointest Endosc. 2012;76:110-117. doi: 10.1016/j.gie.2012.02.040
  11. Singh H, Nugent Z, Demers AA, Kliewer EV, Mahmud SM, Bernstein CN. The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer. Gastroenterology. 2010;139:1128-1137. doi: 10.1053/j.gastro.2010.06.052
  12. Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L. Association of colonoscopy and death from colorectal cancer. Ann Intern Med. 2009;150:1-8.
  13. Bretagne JF, Hamonic S, Piette C, et al. Variations between endoscopists in rates of detection of colorectal neoplasia and their impact on a regional screening program based on colonoscopy after fecal occult blood testing. Gastrointest Endosc. 2010;71:335-341. doi: 10.1016/j.gie.2009.08.032
  14. Adler A, Wegscheider K, Lieberman D, et al. Factors determining the quality of screening colonoscopy: a prospective study on adenoma detection rates, from 12,134 examinations (Berlin colonoscopy project 3, BECOP-3). Gut. 2013;62:236-241. doi: 10.1136/gutjnl-2011-300167
  15. Baxter NN, Warren JL, Barrett MJ, Stukel TA, Doria-Rose VP. Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopist specialty. J Clin Oncol. 2012;30:2664-2669. doi: 10.1200/JCO.2011.40.4772
  16. Ko CW, Dominitz JA, Green P, Kreuter W, Baldwin LM. Specialty differences in polyp detection, removal, and biopsy during colonoscopy. Am J Med. 2010;123:528-535. doi: 10.1016/j.amjmed.2010.01.016
  17. Graser A, Stieber P, Nagel D, et al. Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut. 2009;58:241-248. doi: 10.1136/gut.2008.156448
  18. Schoen RE, Pinsky PF, Weissfeld JL, et al. Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med. 2012;366:2345-2357. doi: 10.1056/NEJMoa1114635
  19. Hoff G, Grotmol T, Skovlund E, Bretthauer M, Norwegian Colorectal Cancer Prevention Study G. Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomised controlled trial. BMJ. 2009;338:b1846. doi: 10.1136/bmj.b1846
  20. Johnson CD, Chen MH, Toledano AY, et al. Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med. 18 2008;359:1207-1217. doi: 10.1056/NEJMoa0800996
  21. Zalis ME, Blake MA, Cai W, et al. Diagnostic accuracy of laxative-free computed tomographic colonography for detection of adenomatous polyps in asymptomatic adults: a prospective evaluation. Ann Intern Med. 2012;156:692-702. doi: 10.7326/0003-4819-156-10-201205150-00005
  22. Atkin W, Dadswell E, Wooldrage K, et al. Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial. Lancet. 2013;381:1194-1202. doi: 10.1016/S0140-6736(12)62186-2
  23. von Wagner C, Ghanouni A, Halligan S, et al. Patient acceptability and psychologic consequences of CT colonography compared with those of colonoscopy: results from a multicenter randomized controlled trial of symptomatic patients. Radiology. 2012;263:723-731. doi: 10.1148/radiol.12111523
  24. de Wijkerslooth TR, de Haan MC, Stoop EM, et al. Reasons for participation and nonparticipation in colorectal cancer screening: a randomized trial of colonoscopy and CT colonography. Am J Gastroenterol. 2012;107:1777-1783. doi:  10.1038/ajg.2012
  25. de Wijkerslooth TR, de Haan MC, Stoop EM, et al. Burden of colonoscopy compared to non-cathartic CT-colonography in a colorectal cancer screening programme: randomised controlled trial. Gut.2012;61:1552-1559. doi:  10.1038/ajg.2012
  26. Courtney RJ, Paul CL, Sanson-Fisher RW, et al. Individual- and provider-level factors associated with colorectal cancer screening in accordance with guideline recommendation: a community-level perspective across varying levels of risk. BMC Public Health. 2013;13:248. doi: 10.1186/1471-2458-13-248
  27. Fenton JJ, Jerant AF, von Friederichs-Fitzwater MM, Tancredi DJ, Franks P. Physician counseling for colorectal cancer screening: impact on patient attitudes, beliefs, and behavior. J Am Board Fam Med. 2011;24:673-681. doi: 10.3122/jabfm.2011.06.110001

Fall 2014 – Alzheimer’s Disease: A Clinical and Basic Science Review

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

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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 that medical students should be familiar with. In addition, the article describes advances in the use of biomarkers for diagnosis of AD and highlights ongoing efforts to develop novel therapies.

Published on date: September 31, 2014

Senior Editor: Liza Gill

Junior Editor: Timothy Smith

DOI: Pending

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

References:

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  2. Alzheimer A. About a Peculiar Disease of the Cerebral Cortex. Alzheimer Dis Assoc Disord. 1987; 1: 3-8.
  3. Maurer K, Volk S, Gerbaldo H. Auguste D and Alzheimer’s Disease. Lancet. May 1997; 349(9064): 1546-1549. doi: 10.1016/S0140-6736(96)10203-8
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Fall 2014 – A Medical Student Elective Course in Business and Finance: A Needs Analysis and Pilot

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 debt.

Abstract: Background:  As the knowledge needed by physicians expands past basic science and patient care, students are calling for their medical school education to do the same. At Michigan State University College of Human Medicine, students addressed this concern by developing a pilot elective, Medical Business and Finance (MBF). The goal of this student-led elective was to provide a basic understanding of personal finance, student debt handling, business management, and insurance reimbursement issues. Methods:  A preliminary needs assessment was conducted to discern if students wanted medical business and finance supplementation to the medical school curriculum.  Ninety percent of students reported interest in a business and finance elective. Once the course was instated, student satisfaction and knowledge-base in medical business and finance was analyzed through pre-elective, pre-session and post-elective survey. Results:  Results were analyzed on forty-eight students’ pre-survey and post-survey responses.  After the course, self-assessed student knowledge regarding finance and business nearly doubled.  The average pre-elective self-assessed knowledge of finance was 3.02 on a ten-point scale and knowledge of business was 2.61. This was compared to an average post-elective self-assessed knowledge of 5.75 and 5.44, respectively. Satisfaction in MSU CHM business and finance resources also slightly increased at the completion of the course.  Nearly 85% of students felt they benefited from participating in the elective.  Similarly, 85% felt that incoming students would also benefit from taking the course. Almost 30% of students believed the material covered in the MBF Elective should be in the required medical school curriculum. Conclusion:  A student led elective can be an effective way to introduce students to an array of topics related to medical business and finance. Students felt that their knowledge of these topics increased and they valued the addition of medical business and finance education to their curriculum. A student-led elective is one potential way for others to successfully incorporate these topics into medical school curricula across the country.

Published on date: September 31, 2014

Senior Editor: Jon Zande

Junior Editor: Ghadear Shukr

DOI: Pending

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

References:

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  16. Lazarus A. Physicians with MBA Degrees: Change agents for healthcare improvement. J Med Pract Manage. 2010; 26(3): 188-90.
  17. Hornick P, Hornick C, Taylor K, Ratnatunga C. Should business management training be part of medical education? Ann R Coll Surg Engl. 1997; 79(5 Suppl): 200-1.
  18. Dhaliwal, G. Chou, C. L. A. Brief educational intervention in personal finance for medical residents. J Gen Intern Med. 2007; 22(3): 374-7. doi: 10.1007/s11606-006-0078-z
  19. Patel AT, Bohmer RMJ, Barbour JR, Fried MP. National assessment of business-of-medicine training and its implications for the development of a business-of-medicine curriculum. Laryngoscope. 2005; 115(1): 51-5. doi: 10.1097/01.mlg.0000150677.75978.75
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Fall 2014 – A Case of Severe, Refractory Antipsychotic-induced Orthostatic Hypotension

A Case of Severe, Refractory Antipsychotic-induced Orthostatic Hypotension.

Author1Sahil Gambhir, 2Nicholas Sandersfeld, DO, 2Dale D’Mello, MD

Author Affiliations1College 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 orthostatic hypotension and research in this area is limited. Patient profile: A 60-year-old man with a long history of schizophrenia who was receiving Haldol† Deconoate 200 mg injections every 4 weeks due to previous non-compliance. He was admitted to the inpatient psychiatric service due to worsening psychosis and suicidal behavior. Intervention: Despite use of medications, the patient was switched to risperidone with a goal of transition to an atypical long-acting injectable. The psychosis improved, but the patient developed orthostatic hypotension. After his medications were held, his blood pressure continued to be grossly abnormal. A number of different tests were completed followed by standard non-pharmacological treatment, which proved unsuccessful. Despite receiving intravenous fluid boluses to maintain his blood pressure, the patient required pharmacological treatment. This included midodrine and fludrocortisones, and concluded with Adderall† as his blood pressure stabilized. Conclusion: This case of a 60-year-old man with antipsychotic-induced orthostatic hypotension elucidates the frustration healthcare professionals and patients face with this common treatment-resistant condition. A treatment algorithm for managing drug-induced orthostatic hypotension is proposed and is a nidus for development of future protocols.

Published on date: September 31, 2014

Senior Editor: Kaitlyn Vitale

Junior Editor:Mike Klinger

DOI: Pending

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

References:

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  3. Effect of midodrine on chlorpromazine-induced orthostatic hypotension in rabbits: comparison with amezinium, etilefrine, and droxidopa. Kurihara, J; Takata, Y; Suzuki, S; Okubo, Y; Kato, H. Biological Pharmacology Bulletin, 2000 Dec; 23(12):1445-9.
  4. Evaluation and Management of Orthostatic Hypotension. Lanier, Jeff; Mole, Matt; Clay, Emily. American Family Physicians, 2011 Sept 1; 84(5): 527-536.
  5. Antipsychotic pharmacotherapy and orthostatic hypotension: identification and management. Gugger, JJ. CNS Drugs, 2011 Aug; 25(8): 659-71
  6. Freeman R. Chapter 20. Syncope. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison’s Principles of Internal Medicine, 18e. New York: McGraw-Hill; 2012.
  7. Crawford MH. Chapter 16. Syncope. In: Crawford MH. eds. Current Diagnosis & Treatment: Cardiology, 4e. New York: McGraw-Hill; 2014.

Fall 2014 – Sebaceous Carcinoma of the Abdominal Wall: A Potential Indicator of Muir Torre Syndrome

Sebaceous Carcinoma of the Abdominal Wall: A Potential Indicator of Muir Torre Syndrome

AuthorStacie 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 a single lesion or in association with secondary malignancies, most commonly with those found in Muir Torre syndrome (MTS), an autosomal dominant condition associated with several types of sebaceous neoplasms as well as a variety of visceral malignancies. The most common form of MTS has been described as a variant of hereditary non polyposis colorectal cancer (Lynch syndrome). Patient profile: Here, we describe the case of a 55-year-old male, with a known history of colorectal cancer, presenting with a rapidly enlarging abdominal wall mass. Interventions and outcomes: Surgical excision of the mass histologically demonstrated sebaceous carcinoma. This diagnosis, the incidental discovery of a papillary thyroid carcinoma and the patient’s history of colorectal cancer, prompted referral for genetic counseling, the results of which are still pending. Discussion: Sebaceous carcinoma is one of several diagnostic criteria of MTS and its presence should prompt a complete evaluation for underlying internal malignancies.

Published on date: September 31, 2014

Senior Editor: Timothy Smith

Junior Editor: Joginder Singh

DOI: Pending

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

References:

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Fall 2014 – Acute Bronchiolitis – Case Report and Review of Management Guidelines

Acute Bronchiolitis – Case Report and Review of Management Guidelines.

AuthorNeil 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 right upper lobe atelectasis. He was diagnosed with acute bronchiolitis. Interventions: He received nebulized salbutamol (albuterol) and oral dexamethasone in the emergency department. He was admitted to hospital overnight for continued salbutamol treatment via a metered-dose inhaler. Discussion: Five main treatment regimens exist for acute bronchiolitis nebulized epinephrine (adrenaline), other bronchodilators, nebulized hypertonic saline, glucocorticoids, and combinations of these. Nebulized epinephrine decreases the rate of hospitalization, other bronchodilators improve symptoms, and nebulized hypertonic saline reduces the length of hospitalization. There is no strong evidence for glucocorticoids or combinations of these treatments. Combined treatment with epinephrine and dexamethasone reduces rate of hospitalization.

Published on date: September 31, 2014

Senior Editor: Kevin Patterson

Junior Editor: Patrick Roach

DOI: Pending

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

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