Southern medical journal
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Southern medical journal · Feb 2025
Maternal and Infant Outcomes in a Subset of Patients with Sickle Cell Disease in South Carolina.
Sickle cell disease (SCD), which disproportionately affects minorities, increases complications during pregnancy. Severe maternal mortality is increased in women with SCD, including morbidity related to the disease and other nondisease-related complications. It also can have devastating complications for fetuses, with increases in premature birth and low birth weight. This study aimed to describe the characteristics of women with SCD in South Carolina, with a specific focus on fetal and maternal outcomes and complications. The secondary aim of this study was to identify the effect of maternal characteristics on birth outcomes, including social determinants of health. ⋯ High rates of complications to both mother and infant were found in the women with SCD. Although few statistically significant predictors were found, by identifying and addressing specific needs of pregnant women with SCD, we can work toward reducing fetal and maternal mortality in an already vulnerable population.
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Southern medical journal · Feb 2025
ReviewMedications That May be Contributing to Your Patient's Weight Gain.
Nearly 42% of adults in the United States are considered obese. Although there are a number of contributing factors to obesity, one sometimes overlooked contributor to weight gain is medications. ⋯ Although factors such as efficacy, cost, interactions, and adverse effects play a role in selecting a medication, the effects on weight also should be considered in those who are overweight or obese. This article reviews some of the classes of medications used in the outpatient setting that may affect weight to provide a guide to clinicians.
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Southern medical journal · Feb 2025
ReviewAlpelisib-Induced Hyperglycemia in PIK3CA+ Breast Cancer Patients.
Alpelisib is a phosphatidylinositol 3-kinase inhibitor approved by the US Food and Drug Administration for the treatment of hormone receptor-positive metastatic breast cancer with PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit α) mutation. In recent years a number of adverse effects have been observed to be associated with this therapy, the most notable of which is hyperglycemia. A literature search was conducted to include case studies, case series, systematic reviews, and meta-analyses within the last 10 years that evaluated patients with PIK3CA-mutated hormone receptor-positive, human epidermal growth factor receptor 2 negative metastatic breast cancer. ⋯ Hyperglycemia was manageable with antihyperglycemic agents and dose modification/discontinuation of alpelisib with no severe progression. Other notable adverse effects were rash, stomatitis, diarrhea, pneumonitis, reduced appetite, elevated liver enzymes, nausea, fatigue, and rare reports of diabetic ketoacidosis. This literature review aims to highlight the incidence and risk factors of alpelisib-induced hyperglycemia in greater depth.
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Southern medical journal · Feb 2025
ICU-Broncho-Aspiration Protocols Monitoring at an Academic Health Network System.
The objectives were to determine intensive care unit (ICU) incidence of broncho-aspiration (BA) and the effect of monitoring BA prevention protocols. ⋯ Implementation and monitoring of a BA prevention protocol significantly reduced the rate of BA in the SICU.
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Southern medical journal · Feb 2025
What Physicians Should Consider When Moving Academic Institutions.
There is limited information and guidance for physicians transitioning from one academic institution to another. The following recommendations serve as a resource for academic faculty interested in moving to a different academic institution. The advice falls into three categories of preparation: self-reflection and discernment to determine personal preferences and professional priorities; considerations when preparing for an academic faculty interview; and aspects of the offer, opportunity, and negotiables to discern whether it is right. We acknowledge that the process is nuanced without one strategy that applies to all physicians.