Brainstem and Cerebellar Involvement in Ramsay Hunt Syndrome.

We present a case of a 62-year-old Caucasian male with laryngeal cancer and Ramsay Hunt Syndrome otherwise known as herpes zoster oticus due to reactivation of the varicella zoster virus. Classic findings include the triad of ipsilateral facial paralysis, otic pain, and herpetic lesions in the sensory supply of the facial nerve. The common pathogenesis is associated with anterograde axonal reactivation of the varicella zoster virus in the geniculate ganglion.

Identifying Predictors of Primary Adherence to Second Generation Long-Acting Injectable Antipsychotics Following Discharge from an Acute Inpatient Psychiatry Unit.

Objectives: Describe primary adherence and medication persistence to second generation long-acting injectable (LAI) antipsychotics following an inpatient psychiatry hospitalization, compare rates of psychiatric-related hospital readmissions and emergency visits within 6 months of discharge between patients who were adherent versus nonadherent, and explore predictors of primary adherence to second generation LAI antipsychotics following hospitalization.

Experimental Design: This retrospective chart review included patients who received at least 1 dose of a second-generation LAI antipsychotic while hospitalized in an acute care psychiatry unit between April 1, 2016 and July 31, 2017, had active Missouri Medicaid, and continued on the second-generation LAI antipsychotic upon discharge. Patients were excluded if they were discharged to a care setting where medication was administered.

Multilevel Factors Predicting Cardiac Rehabilitation Attendance and Adherence in Underserved Patients at a Safety-Net Hospital.

Purpose: This study examined multilevel factors as predictors of cardiac rehabilitation (CR) attendance and adherence among underserved patients at a safety-net hospital (SNH).

Methods: Participants were recruited during hospitalization for a cardiac procedure or event. Participants responded to a questionnaire, and outcome data (including CR attendance and adherence) were extracted from medical records at baseline and 6 mo post-discharge.

Adverse Effects of Smoking on Musculoskeletal Health.

Smoking remains a prevalent part of present day society, with over 42 million Americans who continue to use cigarettes. Smoking is strongly associated with a variety of conditions that result in increased morbidity and mortality. Research also indicates that smoking has an adverse effect on surgical outcomes.

Primary Care Physician Supply for Missouri.

Primary Care Supply is not at a level to support needs for the U.S. public now or in the future.

A Triad of Dermatologic Dilemmas.

The U.S. health care system relies on primary care physicians to provide the majority of the dermatologic care-dermatologists see an estimated 30-40% of patients with dermatologic issues.

The "Magic Triangle" Foundation to Effective Use of Information Technology in the Exam Room.

The computer has become an integral part of the exam room and plays an important role in provider-patient interaction. The special arrangement of the provider-patient and computer as well as the provider's computer skills and hardware knowledge play a pivotal role in patient satisfaction, engagement and productivity. Patient satisfaction and engagement play an ever increasing role as medicine migrates to value-based reimbursement.

Electrocardiograhic findings resulting in inappropriate cardiac catheterization laboratory activation for ST-segment elevation myocardial infarction.

Background: Prompt reperfusion has been shown to improve outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) with a goal of culprit vessel patency in <90 minutes. This requires a coordinated approach between the emergency medical services (EMS), emergency department (ED) and interventional cardiology. The urgency of this process can contribute to inappropriate cardiac catheterization laboratory (CCL) activations.

Giant atypical carcinoid of the liver with vascular metastases and local sinusoidal invasion: a case report.

We present the case of a 46 year old woman with a giant, 23-centimeter, atypical carcinoid of the liver. A primary site for this neoplasm could not be identified despite multiple radiographic imaging studies, including a somatostatin scan, and a thorough inspection of the bowel during surgical resection of the lesion. Histologically, the tumor displayed mild cytologic atypia, abundant necrosis, and intravascular metastases, the last feature of which was identified by immunohistochemical markers for chromogranin and synaptophysin.

Kicking butts: smoking cessation update.

Tobacco is one of the most commonly abused drugs in the history of mankind. Smoking cessation has occupied a significant amount of research to help smokers quit to avoid the health risks. In this paper, we will discuss the methods available for smoking cessation.

An overview of alpha-1 antitrypsin deficiency.

Alpha-1 Antitrypsin Deficiency is a common hereditary disorder that results from abnormal Alpha Antitrypsin production. This predisposes patients to early onset emphysema especially when exposed to tobacco smoke. Early recognition is important.

Pulmonary complications of sickle cell disease in adults.

Acute and chronic pulmonary complications are a very important cause of morbidity and mortality in sickle cell disease. The Acute Chest Syndrome (ACS) is the most common form of acute pulmonary disease and will be reviewed in this article. Early recognition and aggressive treatment of ACS are important for successful management.

Diagnosis of acute pulmonary embolism.

Acute pulmonary embolism (PE) is a common, serious and potentially fatal event. Due to the serious nature of this ailment and since therapy is usually with long-term anticoagulation, it is important for the clinician to be able to diagnose or exclude acute PE. Several diagnostic options are available to the clinician, and below is a review of the more common modalities.

Community acquired pneumonia.

Community acquired pneumonia is a leading cause of morbidity and mortality worldwide. The American Thoracic Society, Infectious Disease Society of America and the British Thoracic Society have furnished very comprehensive guidelines for the evaluation and management of this disease. This article reviews and summarizes the important issues in the etiology, diagnosis and community acquired pneumonia.