Improving Advanced Care Planning Discussions at an Internal Medicine Clinic.

Objective: The project aimed to standardize advanced care planning (ACP) at an internal medicine clinic by initiating physician-patient communication regarding the patient's knowledge, understanding, and openness to pursuing advanced medical directives.

Methods: Data collection was conducted from February 1 to April 1, 2024, with the study concluding on April 24, 2024. ACP was facilitated through an initial standardized six-question pre-intervention survey in both English and Spanish.

Antibiofilm Activity of Epinecidin-1 and Its Variants Against Drug-Resistant and Isolates from Vaginal Candidiasis Patients.

Indwelling intrauterine contraceptive devices (IUDs) have surfaces that facilitate the attachment of spp., creating a suitable environment for biofilm formation. Due to this, vulvovaginal candidiasis (VVC) is frequently linked to IUD usage, necessitating the prompt removal of these devices for effective treatment.

Developing a Bilingual Health Education Program to Identify and Address Healthcare Misinformation in a Border Community.

El Paso Health Education and Awareness Team (EP-HEAT®) is a bilingual program focused on increasing health awareness and dispelling health-related misinformation in the U.S.-Mexico border region.

Evolving Endoscopic Approaches to Pancreatic Pseudocysts and Walled-Off Necrosis: Case Series and Review of Evidence.

Imaging followed by endoscopic ultrasound (EUS)-guided therapy has become the preferred modality for treating pancreatic pseudocysts over surgical or radiological interventions. However, there continues to be a lack of consensus regarding the utility of endoscopic retrograde cholangiopancreatography (ERCP) before and after cyst drainage. We describe 4 cases of large pancreatic pseudocyst causing extrinsic biliary obstruction treated successfully with endoscopic cystogastrostomy decompression using a lumen-apposing self-expandable metal stent (LAMS) without ERCP.

A holistic approach to sustain and support lifelong practices of wellness among healthcare professionals: generating preliminary solid steps towards a culture of wellness.

Background: The COVID-19 pandemic has served as a catalyst for recognizing the challenging environments in which healthcare workers operate, underscoring the urgent need to enhance their wellness to better support themselves and others. The implementation of a culture of wellness within the context of healthcare education, with a particular emphasis on individual-level strategies, allows for the realization of its intrinsic value and significance as a foundation for broader organizational strategies. This approach facilitates the establishment of a sustainable culture of wellness that benefits both current and subsequent generations of healthcare professionals.

Safety of Non-vitamin K Antagonist Oral Anticoagulants on Outcomes After Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis.

The existing evidence on the use of non-vitamin K oral anticoagulants (NOACs) after transcatheter aortic valve replacement (TAVR) surgery is inconclusive and contradictory. Likewise, major society guidelines remain ambivalent about NOAC use around the time of TAVR. The objective of our meta-analysis was to assess the efficacy of NOACs in comparison to vitamin K antagonists (VKAs) in lowering complications following TAVR.

Community-Acquired Methicillin-Resistant Staphylococcus aureus Pneumonia.

Community-acquired pneumonia secondary to methicillin-resistant Staphylococcus aureus (MRSA) is a rare occurrence that is known to occur in young adults with no recent hospitalization. It is known to present with hemoptysis and is usually associated with concomitant influenza infection and is classically diagnosed by sputum culture or broncheoalvolar lavage. Routine treatment of community-acquired pneumonia does not suffice in the event of MRSA growth, and, if left untreated, can develop into serious medical complications of sepsis, multiloculated fluid collections, and multiorgan failure.

Wernicke Encephalopathy Presenting With Hearing Loss and Vision Loss in a Nonalcoholic Patient.

Wernicke encephalopathy is an acute neuropsychiatry syndrome resulting from thiamine deficiency associated with significant morbidity and mortality. We reported a case of a 25-year-old woman with a history of abdomen pain, nausea, vomiting, weight loss, and sore throat who presented with acute neurological symptoms, including binocular diplopia, hearing loss, vision loss, and difficulty ambulating. Examination revealed bilateral vision loss with perception only to light, ophthalmoplegia, hearing loss, gait ataxia, and areflexia.

Need for Structured Pain Management Curriculum and Competency-Based Evaluation in GME: An Observational Study in One Internal Medicine Residency Program.

Objectives: One of the major contributing factors to the opioid crisis, marked by a surge in opioid prescriptions, includes inadequate adherence to guideline-based pain management practices, highlighting the need for a comprehensive curriculum during residency training. In this study, we aim to assess opioid exposure prevalence among hospitalized patients and examine potential associations between disease conditions, patient demographics, and opioid prescriptions during their hospital stay.

Methods: In this retrospective cohort study at a southern California county teaching hospital, we analyzed the medical records of 2272 patients admitted to the IM resident inpatient teaching service for 1 year, from September 2017 through September 2018.

Dollars and Disparities: Unraveling Executive Compensation Patterns in American Non-Profit Healthcare.

Introduction: This study examines trends in executive compensation at non-profit hospitals across the United States from 2018 to 2022. The research aims to address gaps in the current literature by providing an up-to-date analysis of compensation practices and their relationship to hospital financial metrics.

Methods: A descriptive longitudinal study was conducted using data from Form 990 filings of 20 randomly selected non-profit hospitals across four U.

Injuries from border wall falls after 2018 are more severe: a retrospective cohort study.

Background: The U.S.-Mexico "border wall" between El Paso, Texas and Ciudad Juárez, Mexico was raised and extended beginning in 2018 in accordance with Presidential Executive Order 13,767.

Pregabalin for the Treatment of Neuropathic Pain: A Systematic Review of Patient-Reported Outcomes.

Neuropathic pain (NeP) arises from pathologies of the nervous system, significantly impacting patient functionality and quality of life. Pregabalin is a first-line treatment for NeP, but there has been limited focus on patient-reported outcomes (PROs). This systematic review synthesizes PROs from clinical studies assessing pregabalin's efficacy in treating NeP, with a focus on sleep disturbance, mental health, and health-related quality of life (HRQOL).

Color perception and its relation to dental anxiety in children.

Background: One of the major causes of dental anxiety in children is their first impression of the dental environment. Even minor details, such as the choice of color in a dental setting and the color of dental equipment, can positively influence a child's behavior.

Objectives: The aim of the study was to assess the relationship between the emotions in children and color combinations in a pediatric setting.

Use of Cell-Free DNA Testing to Diagnose Infective Endocarditis in a Patient With Negative Blood Cultures.

Infective endocarditis (IE) is associated with significant morbidity and mortality. Its diagnosis can be especially challenging, as can the identification of a causative pathogen, which, in turn, is crucial for appropriate management. Here, we present a rare case of Streptococcus intermedius endocarditis complicated by lung and cerebral abscess in which clinicians employed cell-free deoxyribonucleic acid (cfDNA) testing to confirm the diagnosis, establish a causative pathogen, and determine appropriate antibiotic therapy.

Association of exposure to nonpersistent endocrine disruptors with sex hormones and metabolic health in US females.

Endocrine disruptive chemicals (EDCs) are considered as the potential attributes for the increasing trend in obesity and metabolic syndrome (MS) through disruption of sex hormones, particularly in women. We evaluated the association of understudied EDC compounds with total testosterone (TT), sex hormone-binding globulin (SHBG), obesity, and MS. A population-based cross-sectional study was conducted using the National Health and Nutrition Examination Survey datasets collected during the years 2013-2016.

Ewing Sarcoma in the Pediatric Population: Predictors of Survival Within the United States.

Introduction: Bone and joint tumors are the third most common cause of pediatric cancer-related deaths in the United States. Although there have been improvements in survival rates among pediatric cancer patients over the past few decades, bone and joint cancers remain the exception. Considering current clinical trials involving novel targeted therapies, the establishment of updated mortality rates and predictors of survival for this cancer would be prudent.

Emergency department management of patients with low back pain: a review of current evidence.

Low back pain is a common presentation in the emergency department, and determining whether the cause is benign or life-threatening can be challenging. A systematic strategy for the history and physical examination can help reduce unnecessary imaging, and an evidence-based approach will inform safe and effective pain management recommendations. This issue reviews the evidence on red flag signs and symptoms for low back pain, current diagnostic studies recommendations, and best-practice treatment and disposition strategies.