Category Archives: Articles

Individual Articles in MSRJ

Fall 2013 – Public Stroke Knowledge – Those Most at Risk, Least Able to Identify Symptoms

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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 in seeking medical treatment. Lack of symptom recognition may contribute to low treatment rates and is an important focus of public health education. The purpose of this study was to determine if an individual’s cumulative number of stroke risk factors correlated with their ability to identify stroke symptoms. Methods: We surveyed adults about their stroke risk factors and knowledge of stroke symptoms at grocery stores and malls in a medium-sized university town in the Midwestern US. Results: In total, 245 adults completed surveys. Self-reported risk factors included high blood pressure (25%), high cholesterol (22%), diabetes (12%), tobacco use (11%), alcohol use (7%), heart disease (7%), and prior stroke (3%). Cumulatively, 56% of respondents had no risk factors, 41% had 13 risk factors, and 4% had 4risk factors. When administered a six-point stroke symptom knowledge test, respondents with 4 risk factors were significantly less knowledgeable, receiving a mean score of 3.2, compared to those with 13 risk factors, who scored a mean of 4.6. Those with four or more years of college were significantly more knowledgeable than those with only a high-school education, receiving mean scores of 4.6 and 3.9, respectively. There was no association between stroke knowledge and use of a primary care physician. Conclusions: Although it is known that individuals with more risk factors are more likely to have a stroke, in our study these respondents were less able to recognize stroke symptoms compared to respondents with fewer risk factors. Future public stroke awareness campaigns should be targeted toward those most at risk so they learn to recognize stroke symptoms and thus seek treatment in a timely manner.
 
Published: September 30, 2013
 
Senior Editor: Jack Mettler
 
Junior Editor: Tim Smith
 
DOI: Pending
 
Citation:
Jarou Z, Harris N, Gill L, Azizi M, Gabasha S, LaBril R. Public Stroke Knowledge – Those Most at Risk, Least Able to Identify Symptoms. Medical Student Research Journal. 2013;3(Fall):3-8.
 
 
References:
1. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics-2011 update a report from the American Heart Association. Circulation. 2011; 123:e18-e209. http://dx.doi.org/10.1161/CIR.0b013e3182009701.

2. Wechsler LR. Intravenous thrombolytic therapy for acute ischemic stroke. N Engl J Med. 2011; 364:2138-46. http://dx.doi.org/10.1056/NEJMct1007370.

3. Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008; 359:1317-29. http://dx.doi.org/10.1056/NEJMoa0804656.

4. California Acute Stroke Pilot Registry (CASPR) Investigators. Prioritizing interventions to improve rates of thrombolysis for ischemic stroke. Neurology 2005; 64(4):654-9. http://dx.doi.org/10.1212/01.WNL.0000151850.39648.51.

5. Barber PAM, Zhang J, Demchuk AM, Hill MD, Buchan AM. Why are stroke patients excluded from TPA therapy? An analysis of patient eligibility. Neurology. 2001; 56(8):1015-20. http://dx.doi.org/10.1212/WNL.56.8.1015.

6. Katzan IL, Hammer MD, Hixson ED, et al. Utilization of intravenous tissue plasminogen activator for acute ischemic stroke. Arch Neurol. 2004; 61(3):346-50. http://dx.doi.org/10.1001/archneur.61.3.346.

7. Kleindorfer D, Khoury J, Broderick JP, et al. Temporal trends in public awareness of stroke warning signs, risk factors, and treatment. Stroke. 2009; 40:2502-6. http://dx.doi.org/10.1161/STROKEAHA.109.551861.

8. Reeves MJ, Rafferty AP, Aranha AAR, Theisen V. Changes in knowledge of stroke risk factors and warning signs among Michigan adults. Cerebrovasc Dis. 2008; 25:385-91. http://dx.doi.org/10.1159/000121338.

9. Kothari R, Sauerbeck L, Jauch E, et al. Patients’ awareness of stroke signs, symptoms, and risk factors. Stroke. 1997; 28:1871-5. http://dx.doi.org/10.1161/01.STR.28.10.1871.
10. American Stroke Association. Stroke warning signs and symptoms. 2013. Available from: http://strokeassociation.org [cited 10 August 2013].

11. Centers for Disease Control and Prevention. 2011 behavioral risk factor surveillance system questionnaire. 2011. Available from: http://www.cdc.gov/brfss/questionnaires.htm [cited 10 August 2013].

12. National Institute of Neurological Disorders and Stroke (NINDS). Stroke information page. 2013. Available from: http://www.ninds.nih.gov/disorders/stroke/stroke.htm [cited 10 August 2013].
13. Galobardes B, Shaw M, Lawlor DA, Lynch JW, Smith GD. Indicators of socioeconomic position (part 1). J Epidemiol Community Health. 2006; 60:7-12. http://dx.doi.org/10.1136/jech.2004.023531.

14. Schneider AT, Pancioli AM, Khoury JC, et al. Trends in community knowledge of the warning signs and risk factors for stroke. JAMA. 2003; 289(3):343-6. http://dx.doi.org/10.1001/jama.289.3.343.

15. Reeves MJ, Hogan JG, Rafferty AP. Knowledge of stroke risk factors and warning signs among Michigan adults. Neurology. 2002; 59(10):1547-52. http://dx.doi.org/10.1212/01.WNL.0000031796.52748.A5.

16. Yoon SS, Heller RF, Levi C, Wiggers J, Fitzgerald PE. Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke. 2001; 32:1926-30. http://dx.doi.org/10.1161/01.STR.32.8.1926.

17. Greenlund KJ, Neff LJ, Zheng ZJ, et al. Low public recognition of major stroke symptoms. Am J Prev Med. 2003; 25(4):315-19. http://dx.doi.org/10.1016/S0749-3797(03)00206-X.

18. Pancioli AM, Broderick J, Kothari R, et al. Public perception of stroke warning signs and knowledge of potential risk factors. JAMA. 1998; 279(16):1288-92. http://dx.doi.org/10.1001/jama.279.16.1288.

19. Wolf P, D’Agostino R, Belanger A, Kannel W. Probability of stroke: a risk profile from the Framingham study. Stroke. 1991; 22:312-18. http://dx.doi.org/10.1161/01.STR.22.3.312.

Fall 2013 – A Rare Case of Breast Carcinosarcoma with Lymphatic Metastasis

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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 neoplasm that is usually larger in size than epithelial breast cancers and characterized by a rapid increase in size. A 32-year-old woman presented with a palpable lump in the left upper outer breast. Imaging findings and an ultrasound-guided biopsy demonstrated a malignant neoplasm with chondroid differentiation. Interventions and Outcomes: The patient underwent a modified radical left breast mastectomy with sentinel node biopsy. Pathology report from the mastectomy demonstrated an infiltrating metaplastic carcinoma (MPC) with positive lymph nodes. Discussion: The most unusual feature of this case is the lymph node positivity, as lymphatic spread is uncommonly associated with carcinosarcoma or any subtype of metaplastic carcinoma of the breast. This case is important because it illustrates the potential future need for treatment guidelines for this uncommon tumor.
 
Published: September 30, 2013
 
Senior Editor: Skyler Johnson
 
Junior Editor: Alex Golec
 
DOI: Pending
 
Citation:
Hamre MC, Eschbacher JM, Hahn F, Hu T. A Rare Case of Breast Carcinosarcoma with Lymphatic Metastasis. Medical Student Research Journal. 2013;3(Fall):9-12.
 
 
References:
1. Beatty JD, Atwood M, Tickman R, Reiner M. Metaplastic breast cancer: clinical significance. Am J Surg. 2006; 191(5):657-64. http://dx.doi.org/10.1016/j.amjsurg.2006.01.038.

2. Esses KM, Hagmaier RM, Blanchard SA, Lazarchick JJ, Riker AI. Carcinosarcoma of the breast: two case reports and review of the literature. Cases J. 2009; 2:15. http://dx.doi.org/10.1186/1757-1626-2-15.

3. SEER Cancer Statistics Factsheets: Breast Cancer. National Cancer Institute. Bethesda, MD, Available from: http://seer.cancer.gov/statfacts/html/breast.html [cited 8 September 2013].

4. Leddy R, Irshad A, Rumboldt T, Cluver A, Campbell A, Ackerman S. Review of metaplastic carcinoma of the breast: imaging findings and pathologic features. J Clin Imaging Sci. 2012; 2:21. http://dx.doi.org/10.4103/2156-7514.95435.

5. Al Sayed AD, El Weshi AN, Tulbah AM, Rahal MM, Ezzat AA. Metaplastic carcinoma of the breast clinical presenta- tion, treatment results and prognostic factors. Acta Oncol. 2006; 45(2):188-95. http://dx.doi.org/10.1080/02841860500513235.

6. Shin HJ, Kim HH, Kim SM, Kim DB, Kim MJ, Gong G, et al. Imaging features of metaplastic carcinoma with chon- droid differentiation of the breast. AJR Am J Roentgenol. 2007; 188(3):691-6. http://dx.doi.org/10.2214/AJR.05.0831.

7. Smith TB, Gilcrease MZ, Santiago L, Hunt KK, Yang WT. Imaging features of primary breast sarcoma. AJR Am J Roentgenol. 2012; 198(4):W386-93. http://dx.doi.org/10.2214/AJR.11.7341.

Fall 2013 – Incomplete Storytelling

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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 in our pocket, granting us the ability to translate everything into our noble medical language. Others may focus too much time on the details of the letters and completely miss the story behind them. Deciphering the story of each patient requires not only a stellar medical acumen but also an ability to comprehend stories in languages that may seem foreign to us.

 
Published: September 30, 2013
 
Senior Editor: N/A
 
Junior Editor: N/A
 
DOI: Pending
 
Citation:
Golec AS. Incomplete Storytelling. Medical Student Research Journal. 2013;3(Fall):2.
 
 
References:
N/A

Fall 2013 – Letter From the Editors

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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 the Spring 2013 issue, and we have bigger plans for the future.

 
Published: September 30, 2013
 
Senior Editor: N/A
 
Junior Editor: N/A
 
DOI: Pending
 
Citation:
Patterson KC, Wummel JL. Letter from the Editors. Medical Student Research Journal. 2013;2(Fall):1.
 
 
References:
N/A

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.
 
 
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6. Nicholson S. Will the United States have a shortage of physicians in 10 years? 2009. Available from: http://hdl.handle.net/1813/15101. Accessed May 1, 2013.

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8. Reinhardt UE. Analyzing cause and effect in the U.S. physician workforce. Health Aff. 2002; 21(1):165-6. http://dx.doi.org/10.1377/hlthaff.21.1.165.

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]

15. Porter S. Federal dollars launch National Family Medicine Residency Program. AAFP. Available at: http://www.aafp.org/online/en/home/ publications/news/news-now/education-professional-development/20130307ntlfmresidency.html. Accessed May 6, 2013.

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19. Kirch DG, Henderson MK, Dill MJ. Physician workforce projections in an era of health care reform. Annu Rev Med. 2012; 63(1):435-45. http://dx.doi.org/10.1146/annurev-med-050310-134634.

20. Association of American Medical Colleges. AAMC physician workforce policy recommendations. Washington, DC: Association of American Medical Colleges; 2012. https://www.aamc.org/download/304026/data/2012aamcworkforcepolicyrecommendations.pdf

21. Rye B. 2012. Assessing the impact of potential cuts in medicare doctor-training subsidies. Washington, DC: Bloomberg Government. http://about.bgov.com/content/uploads/sites/2/2012/03/ryestudy.pdf

22. Office of Management and Budget. Fiscal year 2014 budget of the U.S. Government. Washington, DC: U.S. Government Printing Office; 2013. http://www.whitehouse.gov/sites/default/files/omb/budget/fy2014/assets/budget.pdf

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25.Association of American Medical Colleges. House bill would increase residency positions, ease doctor shortage. Available from: https://www.aamc.org/newsroom/newsreleases/330948/031413.html. [cited 15 May 2013].

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28. Nasca TJ, Miller RS, Holt KD. The potential impact of reduction in federal GME funding in the United States: a study of the estimates of designated institutional officials. J Grad Med Educ. 2011; 3(4):585-90. http://dx.doi.org/10.4300/JGME-03-04-33.

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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:
1. Boyce JM, Pittet D. Guideline for hand hygiene in health care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR. 2002; 51(RR-16). http://www.cdc.gov/mmwr/pdf/rr/rr5116.pdf.

2. Siegel JD, Rhinehard E, Jackson M, Chiarello L, the HICPAC. Management of multidrug-resistant organisms in healthcare settings. AJIC. 2006; 35(10):S165-93. http://dx.doi.org/10.1016/j.ajic.2007.10.006.

3. Siegel JD, Rhinehart E, Jackson M, Chiarello L, the HICPAC. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. AJIC. 2007; 35(10):S65-164. http://dx.doi.org/10.1016/j.ajic.2007.10.007.

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.

5. Sevillano D, Aguilar L, Alou L, et al. b-Lactam effects on mixed cultures of common respiratory isolates as an approach to treatment effects on nasopharyngeal bacterial population dynamics. PloS One. 2008; 3(12):e3846. http://dx.doi.org/10.1371/journal.pone.0003846.

6. Noble CJ. Carriage of group D streptococci in the human bowel. J Clin Pathol. 1978; 31:1182-6. http://dx.doi.org/10.1136/jcp.31.12.1182.

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.
 
 
References:
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6. Schwamm LH, Fonarow GC, Reeves MJ, et al. Get with the guidelines-stroke is associated with sustained improvement in care for patients hospitalized with acute stroke or transient ischemic attack. Circulation. 2009; 119:107-15. http://dx.doi.org/10.1161/CIRCULATIONAHA.108.783688.

7. LaBresh KA. Quality of acute stroke care improvement framework for the paul coverdell national acute stroke registry: facilitating policy and system change at the hospital level. Am J Prev Med. 2006; 31(6):S246-50. http://dx.doi.org/10.1016/j.amepre.2006.08.012.

8. George MG, Tong X, McGruder H, et al. Paul coverdell national acute stroke registry surveillance – four states. 2005-2007. MMWR Surveill Summ. 2009; 58(SS07):1-23. http://origin.glb.cdc.gov/mmwr/preview/mmwrhtml/ss5807a1.htm.

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.

14. Braunschweig CA. Creating a clinical nutrition registry: prospects, problems, and preliminary results. J Am Diet Assoc. 1999; 99(4):467-70. http://dx.doi.org/10.1016/S0002-8223(99)00115-7.

15. Arts DG, De Keizer NF, Scheffer GJ. Defining and improving data quality in medical registries: a literature review, case study, and generic framework. J Am Med Inform Assoc. 2002; 9(6):600-11. http://dx.doi.org/10.1197/jamia.M1087.

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.

35. Hsieh FI, Lien LM, Chen ST, et al. Get with the guidelines-stroke performance indicators: surveillance of stroke care in the Taiwan stroke registry: get with the guidelines-stroke in Taiwan. Circulation. 2010; 122:1116-23. http://dx.doi.org/10.1161/CIRCULATIONAHA.110.936526.

36. California Acute Stroke Pilot Registry Investigators. The impact of standardized stroke orders on adherence to best practices. Neurology. 2005; 65(3):360-5. http://dx.doi.org/10.1212/01.wnl.0000171706.68756.b7.

37. Centers for Disease Control and Prevention (CDC). Use of a registry to improve acute stroke care-seven states, 2005-2009. MMWR. 2011; 60(07):206-10. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6007a2.htm.

Spring 2013 – All Heart

Posted on by

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

Posted on by

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

Winter 2013 – Too Small to Fail

Posted on by

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:
1. Kristof N. Profiting from a child’s illiteracy. The New York Times, 7 December 2012. Available from: http://www.nytimes.com/2012/12/09/opinion/sunday/kristof-profiting-from-a-childs-illiteracy.html?pagewanted=all&_r=0 [cited 23 January 2013].

2. Kathy R, Pavetti L. SSI and children with disabilities: just the facts. Center on Budget and Policy Priorities. Available from: http://www.cbpp.org/cms/index.cfm?fa=view&id=3875 [cited 23 January 2013].

3. U.S. House. Committee on ways and means. Supplemental security income for children hearing, 17, October 2011. Available from: http://waysandmeans.house.gov/news/documentsingle.aspx?DocumentID=270423 [cited 19 January 2013].

4. Social security administration. Annual statistical supplement report, 2012 (Table 7.e4). Available from: http://www.ssa.gov/policy/docs/statcomps/ssi_asr/2010/sect10.html#table69 [cited 17 January 2013].

5. Hemmeter J, Kauff J, Wittenburg D. Changing circumstances: experiences of child SSI recipients before and after their age-18 redetermination for adult benefits. J Vocat Rehabil. 2009; 30:201-21. http://dx.doi.org/10.3233/JVR-2009-0462.

6. DeCesaro A, Hemmeter J. Unmet health care needs and medical out-of-pocket expenses of SSI children. J Vocat Rehabil. 2009; 30:3. http://dx.doi.org/10.3233/JVR-2009-0461.

7. About Us. Save the Children. (2012, December). Available from: http://www.savethechildren.org/site/c.8rKLIXMGIpI4E/b.6146405/k.C7E9/About_Us.htm [cited 23 January 2013].

8. The Power and Promise of Education. Save the Children. (n.d.). Available from: http://www.savethechildren.org/site/c.8rKLIXMGIpI4E/b.6153015/k.E633/Education.htm [cited 23 January 2013].

9. What is Health Literacy? National Institutes of Health. (2012, March 5). Available from: http://www.nih.gov/clearcommunication/healthliteracy.htm [cited 23 January 2013].

10. Weir E. Illiteracy as a public health issue. CMAJ. 2001; 164:1486. http://www.cmaj.ca/content/164/10/1486.full.pdf+html

11. Kutner M, Greenberg E, Jin Y, Paulsen C. The health literacy of America’s adults: results from the 2003 National Assessment of Adult Literacy. National Center for Education Statistics. Available from: http://nces.ed.gov/pubs2006/2006483.pdf [cited 23 January 2013].