Southern medical journal
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Southern medical journal · Apr 2022
Case ReportsWhen Statins Get Physical: A Curious Cause of Statin Myopathy.
We present the case of a 61-year-old male with hyperlipidemia and lumbar radiculopathy admitted to our hospital with rhabdomyolysis attributed to the recent initiation of statin therapy. Despite aggressive fluid resuscitation and an initial declination in his creatine phosphokinase (CPK) levels, he had persistent myalgias with progressive weakness. Rheumatologic and neurologic evaluation for other causes of myopathy were negative. ⋯ He improved with the initiation of immunosuppressive therapy. Statin-induced necrotizing autoimmune myopathy is an underdiagnosed cause of myalgias, proximal muscle weakness, and significant CPK elevation that fails to respond to statin discontinuation and fluid resuscitation. Given the prevalence of statin use, internists need to have a high index of suspicion for this diagnosis in patients presenting with CPK elevations and muscle weakness who take statin therapy.
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Southern medical journal · Apr 2022
Receiving Medical Care for Chronic Migraines: A Phenomenological Study.
Treating chronic migraine (CM) effectively is one of the greatest challenges a primary care provider (PCP) may encounter. Many patients with CM report dissatisfaction and minimal gains from treatment, despite using the best medical interventions available. For this study, patients with CM and their partners provided insight into how PCPs could improve CM treatment. ⋯ PCPs could be trained to encourage patients with CM to shift toward accepting and managing migraines rather than endlessly hoping for a cure. Patients could be taught to manage CM using a holistic, biopsychosocial approach.
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Southern medical journal · Apr 2022
Do Interviews Really Matter in Generating Programs and Applicants' Rank Lists for the Match?
A paucity of data exists on the role of the interview day in programs and applicants' final rank list. The objective of our study was to investigate the impact interview day has on our programs and our interviewees' final rank list. ⋯ The programs rank list correlated more with the candidates' written application than their interview day performance; however, interview experience greatly influenced the applicants' rank lists. In the coronavirus disease 2019 pandemic, in which all interviews are virtual, programs should make diligent efforts to construct virtual interview days, given their importance to applicants in generating their final rank list for the match.
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Southern medical journal · Apr 2022
Randomized Controlled TrialCOVID-19 Trials: Who Participates and Who Benefits?
The coronavirus disease 2019 (COVID-19) pandemic has disproportionately afflicted vulnerable populations. Older adults, particularly residents of nursing facilities, represent a small percentage of the population but account for 40% of mortality from COVID-19 in the United States. Racial and ethnic minority individuals, particularly Black, Hispanic, and Indigenous Americans have experienced higher rates of infection and death than the White population. Although there has been an unprecedented explosion of clinical trials to examine potential therapies, participation by members of these vulnerable communities is crucial to obtaining data generalizable to those communities. ⋯ The high rate of nonparticipation in our trial of nursing facility residents and Black people emphasizes the concern that clinical trials for therapeutics may not target key populations with high mortality rates.