Research Spotlight

Perrotte, J.K., Piña-Watson, B., Baumann, M.R., Weston, R., Morissette, S.B., Gulliver, S.B., Grigsby, T.J. and Garza, R.T. (2021). “Domains matter: A prospective investigation of traditional feminine gender roles and alcohol use among Latinas.” J Ethn Subst Abuse Dec 14. [Epub ahead of print]. 1-21.

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Scholars suggest traditional feminine gender roles (TFGRs) influence alcohol use among U.S. Latinas, but relevant literature is limited. This two-wave study examined how multi-dimensional internal (i.e., beliefs) and external (i.e., practices) TFGR processes related to drinking among college-bound Latina emerging adults across time. TFGRs characterized by virtue predicted less alcohol engagement, while some TFGR dimensions (e.g., subordinate) predicted more. TFGR practices more strongly predicted cross-sectional alcohol outcomes than TFGR beliefs, although some TFGR beliefs predicted later drinking. These findings highlight the utility of assessing multiple TFGR dimensions and domains to better understand the link between TFGRs and drinking among Latinas.

Perrillo, R.P., Burton, J.R., Jr. and Westbrook, L.M. (2022). “Herbal hepatitis due to use of alternative medicines for Lyme disease.” Proc (Bayl Univ Med Cent) 35(1): 104-105.

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Lyme disease often leaves patients with chronic symptoms of fatigue, easy confusion, and even cardiac arrhythmias. We report a case in which Lyme disease was treated with an herbal mixture due to protracted symptoms despite intravenous antibiotics. This mixture was associated with hepatotoxicity. General providers should be aware of the fact that homeopathic remedies may be associated with hepatotoxicity, and herbalists need better understanding of the safety risks of the individual components in remedy mixtures.

Patel, N.H., Rutland, J. and Tecson, K.M. (2022). “Arrhythmias and Intraventricular Conduction Disturbances in Patients Hospitalized With Coronavirus Disease 2019.” Am J Cardiol 162: 111-115.

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Cardiac arrhythmias have been observed in patients hospitalized with coronavirus disease (COVID-19). Most analyses of rhythm disturbances to date include cases of sinus tachycardia, which may not accurately reflect true cardiac dysfunction. Furthermore, limited data exist regarding the development of conduction disturbances in patients hospitalized with COVID-19. Hence, we performed a retrospective review and compared characteristics and outcomes for patients with versus without incident arrhythmia, excluding sinus tachycardia, as well as between those with versus without incident conduction disturbances. There were 27 of 173 patients (16%) hospitalized with COVID-19 who developed a new arrhythmia. Incident arrhythmias were associated with an increased risk of intensive care unit admission (59% vs 31%, p = 0.0045), intubation (56% vs 20%, p <0.0001), and inpatient death (41% vs 10%, p = 0.0002) without an associated increase in risk of decompensated heart failure or other cardiac issues. New conduction disturbances were found in 13 patients (8%). Incident arrhythmias in patients hospitalized with COVID-19 are associated with an increased risk of mortality, likely reflective of underlying COVID-19 disease severity more than intrinsic cardiac dysfunction. Conduction disturbances occurred less commonly and were not associated with adverse patient outcomes.

Pahuja, M., Hernandez-Montfort, J., Whitehead, E.H., Kawabori, M. and Kapur, N.K. (2021). “Device profile of the Impella 5.0 and 5.5 system for mechanical circulatory support for patients with cardiogenic shock: overview of its safety and efficacy.” Expert Rev Med Devices DEc 20. [Epub ahead of print]. 1-10.

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INTRODUCTION: Trans-valvular micro-axial flow pumps such as Impella are increasingly utilized in patients with cardiogenic shock [CS]. A number of different Impella devices are now available providing a wide range of cardiac output. Among these, the Impella 5.0 and recently introduced Impella 5.5 pumps can provides 5.55 L/min of flow, enabling complete left ventricular support with more favorable hemodynamic effects on myocardial oxygen consumption and left ventricular unloading. These devices require placement of a surgical conduit graft for endovascular delivery, but are increasingly being used in patients with CS due to acutely decompensated heart failure [ADHF], acute myocardial infarction [AMI] and after cardiac surgery as a bridge to transplant or durable ventricular assist device surgery or myocardial recovery. AREAS COVERED: This review focuses on the device profile and use of the Impella 5.0 and 5.5 systems in patients with CS. Specifically; we reviewed the published literature for Impella 5.0 device to summarize data regarding safety and efficacy. EXPERT OPINION: The Impella 5.0 and 5.5 are trans-valvular micro-axial flow pumps for which the current data suggest excellent safety and efficacy profiles as approaches to provide circulatory support, myocardial unloading, and axillary placement enabling patient mobilization and rehabilitation. ABBREVIATIONS: pMCS, Percutaneous mechanical circulatory support devices; CS, Cardiogenic shock; ADHF, Acute decompensated heart failure; AMI, Acute myocardial infarction; LVAD, Left ventricular assist deviceI; ABP, Intra-aortic balloon pump; VA-ECLS, Veno-arterial extracorporeal life support.

Nes, E., White, B.A.A., Malek, A.J., Mata, J., Wieters, J.S. and Little, D. (2021). “Building Communication and Conflict Management Awareness in Surgical Education.” J Surg Educ Dec 21;S1931-7204(21)00336-6. [Epub ahead of print].

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OBJECTIVE: A group of surgeons and a medical educator constructed a curriculum to strengthen communication and emotional intelligence skills in the surgical setting. DESIGN: The curriculum consisted of a small group discussion series occurring during medical students’ eight-week surgery clerkship. The curriculum targeted the following objectives: building team rapport, exploring self-management strategies in team communication, recognizing communication styles, diagnosing conflict, identifying opportunities in professional and personal development, and discussing professionalism in medicine. Students completed pre-post Likert style tests about their knowledge and understanding of the above-mentioned topics. SETTING: Texas A&M University College of Medicine, Surgical Clerkship at Baylor Scott and White Medical Center, a level 1 trauma center, in Temple, TX. PARTICIPANTS: Twenty-four students in their third year of medical school completed the communication curriculum. RESULTS: Wilcoxon sign test was used to analyze the non-parametric data and multiple repeat tests required the significance level (p-Value) be adjusted to 0.003. Students showed significant increase in understanding of conflict management, their ability to communicate effectively, and their awareness of communication preferences (p < 0.001). In addition, they recognized better ways to engage with other students, residents, and staff on their rotation (p = 0.002) and felt more confident in their ability to handle feedback (p = 0.001). Open-ended responses on the post-test had overwhelmingly positive feedback with themes of awareness, psychological safety, and team rapport. Finally, students requested that the curriculum be taught longitudinally throughout their third-year clerkships. CONCLUSIONS: Our curriculum enabled students to improve their awareness of communication, conflict management, team dynamics, and professionalism. These important competencies will support students throughout their training and in their practice as future surgeons.