Tag Archives: MSRJ Winter 2013

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:
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].

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.
 
 
References:
Can donepezil hydrochloride reduce the role of
neuroleptic drugs in delirium? A case report

1. Fields SD. Delirium predicts 12-month mortality independent of dementia status. ACP J Club. 2003; 139(3):80. http://www.ncbi.nlm.nih.gov/pubmed/14594431.

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3. Cerejeira J, Taylor JP. Diagnosing, treating and preventing delirium. Geriatr Med. 2011; 41(2):81-5. http://www.gmjournal.co.uk/uploadedfiles/redbox/pavilion_content/our_content/social_care_and_health/gm_archive/2011/february/feb2011p81.pdf

4. Curran S, Wattis J. Delirium and the elderly patient. Geriatr Med. 2007; 37(11):35-40. https://www.gmjournal.co.uk/uploadedFiles/Redbox/Pavilion_Content/Our_Content/Social_Care_and_Health/GM_Archive/2007/November/Nov07p35.pdf

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6. Boorsma M, Joling KJ, Frijters DH, Ribbe ME, Nijpels G, van Hout JP. The prevalence, incidence and risk factors for delirium in Dutch nursing homes and residential care homes. Int J Geriatr Psychiatry. 2011; 26(7):711-22. http://dx.doi.org/10.1002/gps.2770.

7. Hughes LD, Witham MD, MacLullich A. Delirium in older patients: important determinant of hospital outcome. J Indian Acad Geriatr. 2012; 8(2):92-4. http://sumj.dundee.ac.uk/data/uploads/delirium-jiag.pdf

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10. Tune LE, Egeli S. Acetylcholine and delirium. Dement Geriatr Cogn Disord. 1999; 10(5):342-4. http://dx.doi.org/10.1159/000017167.

11. Hughes LD, Mthembu M, Adams L. Diagnostic work-up and treatment of Dementia. Geriatr Med. 2011; 41(11):595-600. http://sumj.dundee.ac.uk/data/uploads/dementia.pdf

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15. National Institute for Health and Clinical Excellence (2010). Delirium: diagnosis, prevention and cure. London: National Institute for Health and Clinical Excellence. Available From http://www.nice.org.uk/

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17. Posner JD. Particular problems of antibiotic use in the elderly. Geriatrics. 1982; 37(8):49-54. http://www.ncbi.nlm.nih.gov/pubmed/7095428

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19. Hughes LD, Hanslip J, Witham MD. Centrally active prescribing for nursing home residents how are we doing? Eur Geriatric Med. 2012; 3(5):304-7. http://dx.doi.org/10.1016/j.eurger.2012.04.008.

20. Banerjee S. Report for the minister of state for care services: the use of antipsychotic medication for people with dementia; 2009. Available from: http://www.nhs.uk/news/2009/10October/Pages/Antipsychotic-use-in-dementia.aspx
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21. MacLullich AM, Beaglehole A, Hall RJ, Meagher DJ. Delirium and long-term cognitive impairment. Int Rev Psychiatry. 2009; 21(1):30-42. http://dx.doi.org/10.1080/09540260802675031.

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24. Francis PT, Palmerb AM, Snapeb M, Wilcock GK. The cholinergic hypothesis of Alzheimer’s disease: a review of progress. J Neurol Neurosurg Psychiatry. 1999; 66:137-47. http://dx.doi.org/10.1136/jnnp.66.2.137.

25. Birks J. Cholinesterase inhibitors for Alzheimer’s disease. Cochrane Database Syst Rev. 2006; 25(1):CD005593. http://dx.doi.org/10.1002/14651858.CD005593.

26. National Institute for Health and Clinical Excellence (2011). Dementia supporting people with dementia and their careers in health and social care’ [incorporating NICE technology appraisal of drugs for Alzheimer’s disease]. London: National Institute for Health and Clinical Excellence. Available from http://www.scie.org.uk/publications/misc/dementia/dementia-guideline.pdf

27. Moretti R, Torre P, Antonello RM, Cattaruzza T, Cazzato G. Cholinesterase inhibition as a possible therapy for delirium in vascular dementia: a controlled, open 24-month study of 246 patients. Am J Alzheimers Dis Other Demen. 2004; 19(6):333-9. http://dx.doi.org/10.1177/153331750401900607.

28. Oldenbeuving AW, de Kort PL, Jansen BP, Kappelle LJ, Roks G. A pilot study of rivastigmine in the treatment of delirium after stroke: a safe alternative. BMC Neurol. 2008; 8:34. http://dx.doi.org/10.1186/1471-2377-8-34.

29. Gamberini M, Bolliger D, Lurati B, et al. Rivastigmine for the prevention of postoperative delirium in elderly patients undergoing elective cardiac surgery – a randomized controlled trial. Crit Care Med. 2009; 37:1762-8. http://dx.doi.org/10.1097/CCM.0b013e31819da780.

30. Cerejeira J, Batista P, Nogueira V. Low preoperative plasma cholinesterase activity as a risk marker of post-operative delirium in elderly patients. Age Ageing. 2011; 40(5): 621-6. http://dx.doi/org/10.1093/ageing/afr053.

31. van Eijk MMJ, Roes KCB, Honing MLH, et al. Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomized trial. Lancet. 2010; 376:1829-37. http://dx.doi.org/10.1016/S0140-6736(10)61855-7.

32. de Pont AC, van Geer MA, Schultz MJ. Cholinesterase inhibitor treatment in patients with delirium. Lancet. 2011; 377(9769):899. http://dx.doi.org/10.1016/S0140-6736(11)60342-5.

33. Frölich L, Forstl H. Cholinesterase inhibitor treatment in patients with delirium. Lancet. 2011; 377(9769):899. http://dx.doi.org/10.1016/S0140-6736(11)60341-3.

34. MacLullich AM, Hall RJ. Who understands delirium? Age Ageing. 2011; 40(4):412-4. http://dx.doi.org/10.1093/ageing/afr062.

35. MacLeod AD. Delirium: the clinical concept. Palliat Support Care. 2006; 4(3):305-12. http://dx.doi.org/10.1017/S147895150606038X.

36. British Geriatric Society. Guidelines for the prevention, diagnosis and management of delirium in older people in hospital; 2006. Available from: http://www.bgs.org.uk [cited 28 October 2012].

37. Mason N, Fletcher P. Assessment of a confused patient. Geriatr Med. 2012; 42(10):41-5. http://www.gmjournal.co.uk/uploadedfiles/redbox/pavilion_content/our_content/social_care_and_health/gm_archive/2012/october/gmoct2012p41.pdf

38. Maclullich AM, Ferguson KJ, Miller T, de Rooij SE, Cunningham C. Unravelling the pathophysiology of delirium: a focus on the role of aberrant stress responses. J Psychosom Res. 2008; 65(3):229-38. http://dx.doi.org/10.1016/j.jpsychores.2008.05.019.

39. Van der Mast RC, Fekkes D. Serotonin and amino acids: partners in delirium pathophysiology? Semin Clin Neuropsychiatry. 2000; 5(2):125-31. http://www.ncbi.nlm.nih.gov/pubmed/10837101

40. Pandharipande PP, Morandi A, Adams JR, et al. Plasma tryptophan and tyrosine levels are independent risk factors for delirium in critically ill patients. Intensive Care Med. 2009; 35(11):1886-92. http://dx.doi.org/10.1007/s00134-009-1573-6.

41. Shahid A, Milapkumar P, Shagufta J, et al. Insight into delirium. Innov Clin Neurosci. 2011; 8(10):25-34. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225129/

Winter 2013 – The Role of Ultrasound Screening in Reducing AAA Mortality: A Review

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The Role of Ultrasound Screening in Reducing AAA Mortality: A Review.
 
Kashif Imran Ahmad.
 
Author Affiliations:
Medical School, Liverpool University, Liverpool, England

 
[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Winter-2013-The-Role-of-Ultrasound-Screening-in-Reducing-AAA-Mortality-a-Review.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]

 
Corresponding author: Kashif Imran Ahmad; K.Ahmad[at]Lancaster.ac.uk
 
Key Words: population; screening; ultrasonography; abdominal aortic aneurysms; mortality; systematic review.
 
Abstract:
Men aged 65-79 are at the highest risk of having an abdominal aortic aneurysm (AAA) as well as a high incidence of rupture; this is treated as a surgical emergency, which has a total mortality of 75-90%. The diameter of an AAA proves to be the most useful risk factor in predicting mortality rates.

 
Published: February 27, 2013
 
Senior Editor: Emina Bajrovic
 
Junior Editor: Bobby Gambhir
 
DOI: Pending
 
Citation:
Ahmad KI. The Role of Ultrasound Screening in Reducing AAA Mortality: A Review. Medical Student Research Journal. 2013;2(Winter):3-10.
 
 
References:
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2. Scott R, Vardulaki K, Walker N, Day N, Duffy S, Ashton H. The long-term benefits of a single scan for abdominal aortic aneurysm (AAA) at age 65. Eur J Vasc Endovasc. 2001; 21:535-40. http://dx.doi.org/10.1053/ejvs.2001.1368.

3. Scott R, Bridgewater S, Ashton H. Randomized clinical trial of screening for abdominal aortic aneurysm in women. Brit J Surg. 2002; 89:283-5. http://dx.doi.org/10.1046/j.0007-1323.2001.02014.x.

4. Heronm M, Hoyert D, Murphy S, Xu J, Kochanek K,Tejada-Vera B. Deaths: final data for 2006. Natl Vital Stat Rep. 2009; 57(14):34-86. http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf

5. Bown M, Sutton A, Bell P, Sayers R. A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair. Brit J Surg. 2002; 89:714-30. http://dx.doi.org/10.1046/j.1365-2168.2002.02122.x.

6. UK Small Aneurysm Trial Participants. Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms. NEJM. 2002; 346(19):1445-52. http://dx.doi.org/10.1056/NEJMoa013527.

7. Lederle F, Wilson S, Johnson G, et al. Immediate repair compared with surveillance of small abdominal aortic aneurysms. NEJM. 2002; 346(19):1437-44. http://dx.doi.org/10.1056/NEJMoa012573.

8. NHS (2011). NHS evidence screening. Available from: http://www.library.nhs.uk/screening/SearchResults.aspx?catID=15441&tabID=289&pgIndex0& [cited 15 April 2011].

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10. Lederle F, Johnson G, Wilson S, et al. The aneurysm detection and management study screening program: validation cohort and final results. Aneurysm detection and management veterans affairs cooperative study investigators. Arch Intern Med. 2000; 160:1425-30. http://dx.doi.org/10.1001/archinte.160.10.1425.

11. Lederle F, Johnson G, Wilson S. Abdominal aortic aneurysm in women. J Vasc Surg. 2001; 34:122-6. http://dx.doi.org/10.1067/mva.2001.115275.

12. Lindholt J, Henneberg E, Fasting H, Juul S. Hospital based screening of 65-73 year old men for abdominal aortic aneurysms in the county of Viborg, Denmark. J Med Screen. 1996; 3:43-6. http://dx.doi.org/10.1177/096914139600300111.

13. Vardulaki K, Pervost T, Walker N, et al. Incidence among men of asymptomatic abdominal aortic aneurysms: estimates from 500 screen detected cases. J Medl Screen. 1999; 6(1):50-4. http://dx.doi.org/10.1136/jms.6.1.50.

14. Earnshaw J, Shaw E, Whyman M, Poskitt K, Heather B. Screening for abdominal aortic aneurysms in men. Brit Med J. 2004; 328(7448):1122-4. http://dx.doi.org/10.1136/bmj.328.7448.1122.

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29. Leger A, Spencely M, McCollum C, Mossa M. Screening for abdominal aortic aneurysms: a computer assisted cost-utility analysis. Eur J Vasc Endovasc. 1996; 11:183-90. http://www.ejves.com/article/S1078-5884%2896%2980049-9/abstract

30. Wilmink A, Forshaw M, Quick C, Hubbard C, Day N. Accuracy of serial screening for abdominal aortic aneurysms by ultrasound. J Med Screen. 2002; 9:125-7. http://dx.doi.org/10.1136/jms.9.3.125.

31. Lindholt J, Vammen S, Juul S, Henneberg E, Fasting H. The validity of ultrasonographic scanning as screening method for abdominal aortic aneurysm. Eur J Vasc Endovasc. 1999; 17(6):472-5. http://dx.doi.org/10.1053/ejvs.1999.0835.

32. Greenhalgh T. How to read a paper – the basics of evidence-based medicine. 4th ed. BMJ Books. London: Wiley-Blackwell; 2010.

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36. Ashton H, Buxton M, Day N, et al. The multicentre aneurysm screening study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet. 2002; 360(9345):1531-39. http://dx.doi.org/10.1016/S0140-6736(02)11522-4.

37. Norman P, Jamrozik K, Lawrence-Brown M, et al. Population based randomised controlled trial on impact of screening on mortality from abdominal aortic aneurysm. Brit Med J. 2004; 329:1259-62. http://dx.doi.org/10.1136/bmj.330.7491.596.

38. Lindholt J, Juul S, Fasting H, Henneberg E. Hospital costs and benefits of screening for abdominal aortic aneurysms. Results from a randomised population screening trial. Eur J Vasc Endovasc. 2002; 23(1):55-60. http://dx.doi.org/10.1053/ejvs.2001.1534.

Winter 2013 – The Color of Medicine

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The Color of Medicine.
 
Diana Salinas.
 
Author Affiliations:
College of Human Medicine, Michigan State University, East Lansing, MI, USA

 
[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Winter-2013-The-Color-of-Medicine.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]
 
Corresponding Author: Diana Salinas; email not available.
 
Key Words: N/A
 
Abstract:
’I will not permit considerations of religion, nationality, race, gender, politics, socioeconomic standing, or sexual orientation to intervene between my duty and my patient.’ This bullet point from the physician’s oath is engraved around the margins to remind us that as physicians we should treat and care for each patient equally and in an unbiased manner, but at the same time understand that a universal treatment plan will not apply to all patients.

 
Published: February 27, 2013
 
Senior Editor: N/A
 
Junior Editor: N/A
 
DOI: Pending
 
Citation:
Salinas D. The Color of Medicine. Medical Student Research Journal. 2013;2(Winter):2.
 
 
References:
N/A

Winter 2013 – Letter From the Editors

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Letter From the Editors.
 
Chad Klochko, David Ortiz.
 
Author Affiliations:
College of Human Medicine, Michigan State University, East Lansing, MI, USA

 
[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/05/MSRJ-Winter-2013-Letter-from-the-Editors.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF [/button]
 
Corresponding Author: Chad Klochko; Chad[at]msrj.chm.msu.edu
 
Key Words: N/A

 
Abstract:
The year 2013 is going to be a very exciting year for the Medical Student Research Journal (MSRJ). MSRJ has made great strides in the past 12 months and can look forward to a bright furture in the year ahead. We have more than tripled our editoral staff, which now consists of 12 second – through fourth – year medical students.

 
Published: February 27, 2013
 
Senior Editor: N/A
 
Junior Editor: N/A
 
DOI: Pending
 
Citation:
Klochko C, Ortiz D. Letter From the Editors. Medical Student Research Journal. 2013;2(Winter):1.
 
 
References:
N/A