West Virginia Medical Journal

Introduction: Social support is key to wellness, especially during times of stress and uncertainty. The working climate, including the multidisciplinary medical community provides opportunities for both positive and negative wellness experiences. The purpose of this study is to explore residents' concepts of wellness and the influence of programs, faculty, peers, and nursing and ancillary staff. Methods: An email with a link to the REDCap survey was sent to each resident (n=450) in the school of medicine at West Virginia University asking them to give examples of ways their wellness has been supported (or not) by faculty members, their program, co-residents, and nursing and ancillary staff...

In most health care fields, outcomes are becoming increasingly scrutinized and may play a role in "pay for performance;" therefore, selecting the most appropriate outcomes measures for the populations being studied or treated has evolved into a key aspect of outcomes monitoring. One way to assess patient goals is to administer a "patient generated index" (PGI). The philosophical underpinning of the PGI is that the person living the life is the best judge of the quality of that life. The PGI has been utilized in low back pain, as well as in adult spinal deformity surgery, however, it has not been previously utilized in an Appalachian population...

Background and Objectives: This study was conducted by the West Virginia Practice-Based Research Network Learning Collaborative to assess research activity, confidence, and attitudes toward residency programs' research and quality improvement requirements and inform the integration of the state-wide practice-based research network (PBRN) as mentors to support practice transformation implementation initiatives across various resident training sites in West Virginia. Methods: This pilot study assessed residents' attitudes regarding (1) research activity, (2) confidence and (3) requirements of their program in research and quality improvement training by using an anonymous survey, administered during regular residency meetings...

OBJECTIVE: We investigate how West Virginia University football games affect transport to Ruby Memorial Hospital, which shares a parking lot with Milan Puskar Football Stadium. METHODS: A retrospective chart review of a trauma registry from a level 1-trauma center was conducted from 2007 to 2011 for all home and away football games. Home games served as time period of interest and away games served as a control time period. Patient charts were collected for a 36-hour time window surrounding the game...

Background: Renal cell carcinoma (RCC) accounts for over 80% of malignant tumors arising from the kidney. However, metastatic RCC to the head and neck is a relatively rare entity. Case Presentation: We describe three patients with metastatic RCC to the head and neck with the involvement of the parapharyngeal space, the level V region of the neck, and the maxillary sinus. Conclusion: Metastatic RCC in the head and neck is uncommon; however, it must be taken into consideration given a patient with a history of RCC...

Purpose: Research has shown that Appalachia has a higher traffic fatality rate than the non-Appalachian United States. This study compared traffic fatality rates in West Virginia to the rest of the United States. Methods: Fatality Analysis Reporting System and Census data from 2008-2012 were used to calculate traffic fatality rates. Poisson regression was used to model rate ratios stratified by age, sex, rurality, and transportation type, as well as rate ratios per licensed driver, vehicles registered and miles travelled...

Focused Observartion (FO) is associated with assessing complex skills and differs from generalized observations and evaluations. We've developed a FO assessing clinical procedural skills using Hubert Dreyfus Stages of Skill Acquisition as descriptive anchors. This study sought to analyze the effectiveness of this measure of skill progression. During week 1 and week 4 of training, FO was performed repetitively on 6 residents during endotracheal intubation. Skill stage ratings were converted to numerical scores...

Objectives: Management of patients with primary spontaneous pneumothorax is controversial. We sought to review our experience in the treatment of primary spontaneous pneumothorax (PSP) by comparing outcomes from video-assisted thoracoscopic surgery (VATS) with thoracotomy. A retrospective review of electronic and paper medical charts identified 104 consecutive operations performed at University of Kentucky Chandler Medical Center for spontaneous pneumothorax management between the dates of January 2000 and January 2013...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

We report a case of acquired anterior thoracic lung herniation in a 63-yeal-old female. This painful herniation developed four years after uncomplicated video-assisted thoracic surgery for lung cancer resection and adjuvant radiation for concomitant breast cancer. The herniation site was remote from all prior incisions, and demonstrated intercostal muscle denervation and radiation fibrosis. The 8 cm x 10 cm chest wall defect was reconstructed with inlay PROCEED mesh and reinforced with a pedicled latissimus dorsi flap...

Progressive Supranuclear Palsy (PSP) is a rare geriatric pathology, from the abnormal deposition of the tau protein, combining the motor tremor and bradykinesia of Parkinson's disease with the cognitive defects of Alzheimer's disease. As physical and mental debilities progressively manifest in PSP, the physician, family, and patient face decisions on how to manage this terminal neurodegenerative disease. Physicians note the outcomes of decisions and often express, either to peers or internally to oneself, how they would handle a similar situation affecting their own family...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Isolated splenic metasisis is a rare finding in colorectal carcinoma. We report a case of metastatic cecal adenocarcinoma to the spleen. In spring 2011, a 53-yearold woman underwent en bloc right hemicolectomy with partial omentectomy. The tumor was Stage III pT3 pN2a M0. She received four months of modified FOLFOX6 chemotherapy and one month of capecitabine. In spring 2012, a PET/CT revealed a low attenuation focus in the spleen consistent with metastatic adenocarcinoma, so she underwent splenectomy. Additional imaging has revealed no disease recurrence...

Backgfound: Cellular angiofibroma is a rare benign mesenchymal tumor that occurs in the inguinal and vulvovaginal region. We report a case of the tumor occurring in the right inguinal region of a 64 old male and a review of the current literature. Case: A 64 year old male veteran was referred to our general surgery service with an incidentally discovered right inguinal mass on a computerized tomography scan. The scan was performed to follow a history of prostate cancer that had been treated with brachytherapy...

Potassium balance is maintained in the body by balancing the intake with the excretion and the transcellular shifts of potassium. Excretion of potassium is mainly renal as the contribution of the colon to the net potassium secretion of the colon to the net potassium secretion is trivial in patients with normal renal function. As the majority of potassium excretion is renal, it is not surprising to note that patients with end stage renal disease (ESRD) are at an increased risk of developing hyperkalemia in ESRD patients has been estimated to be 3-5%...

We report a case of exposure to raccoon feces found to be contaminated with baylisascaris procyonis. The exposure was recognized early enough by the family to allow prophylaxis with albendazole. Because of the potential fatal or neurologically catastrophic effects of this disease immediate treatment is indicated. This is started in advance of environmental studies that are done to determine if the feces is indeed contaminated.