Lynne J. Goebel

Marshall University

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Maurice A. Mufson

Marshall University

Shirley M. Neitch

Marshall University

George M. Yousef

Ochsner Health System

Milliejoan Mongalo

nView Medical (United States)

Mumtaz Rashid

James Paget University Hospital

Paulette Wehner

Marshall University

M. Seifu

Marshall University

Todd Gress

Hershel Woody Williams VA Medical Center

Sirisha Devabhaktuni

West Virginia University

Raj Singh

Virginia Commonwealth University

Cooperative Institutions

Marshall University

Indiana University School of Medicine

West Virginia University

The Ohio State University

Northwestern Medicine

Northwestern Memorial Hospital

Northwestern University

Health Net

Community Health Network

Universidad Autónoma de Guadalajara

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An Intervention to Improve the Evaluation of Clerkship Students

Marshall Journal of Medicine (2020)

Landon Thompson Marc Hettlinger Lynne J. Goebel

Background: Effective feedback is an important part of formative evaluation of clerkship students, improving student performance by increasing awareness to weaknesses and strengths.

10.33470/2379-9536.1240

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Acute Marjolin Ulcer From A Dog Bite

Marshall Journal of Medicine (2020)

Brandon S Henderson Katalin Kovács Lynne J. Goebel

Marjolin ulcers are cancers, usually of squamous cell carcinoma pathology, that occur in scars or wounds. They are classically described in burn victims but can occur with other types of trauma and are rarely seen in association with bite wounds. Marjolin ulcers typically have a latent period of many years post-injury until the development of malignancy, but there are a few case reports of an exceedingly rare acute form. We present a case of a 78-year-old female who developed a Marjolin ulcer one month after sustaining a dog bite to the left index finger.

10.33470/2379-9536.1289

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E-cigarettes: an up to date review and discussion of the controversy.

PubMed (2014)

Zachary Sanford Lynne J. Goebel

Electronic cigarettes (e-cigarettes) present a novel method for nicotine delivery that is reportedly advantageous when compared to traditional cigarette usage. Manufacturers and consumers claim reduced chemical exposure, decreased symptom profiles, and efficacy in smoking reduction and cessation greater than conventional nicotine replacement therapies (NRT). However these products present new challenges and concerns to legislators, clinicians, and public health advocates. Questions of authority in state and federal legislation, establishing product quality control, assessing long-term studies on e-cigarettes and quantifying usefulness in harm reduction represent only a portion of the many unanswered topics being discussed. The purpose of this article is to assess the literature on e-cigarettes and establish perceptions and attitudes on this controversial subject.

harm reduction

Nicotine replacement therapy

Electronic cigarette

Tobacco product

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Chronic paracetamol treatment influences indices of reactive oxygen species accumulation in the aging Fischer 344 X Brown Norway rat aorta.

PubMed (2012)

Kevin M. Rice Sarath Meduru Sunil K. Kakarla Anjaiah Katta Sriram P. Mupparaju

Previous reports have demonstrated that increased levels of reactive oxygen species (ROS) and alterations in cell signaling characterize aging in the Fischer 344 X Brown Norway (FBN) rat aorta. Other work has suggested that increases in ROS may be related to vascular wall thickening and the development of hypertension. Paracetamol (acetaminophen) is a potent antioxidant that has been found to diminish free radicals in ischemia-reperfusion studies. However, it remains unclear whether chronic paracetamol administration influences signaling or ROS accumulation in the aging aorta. FBN rats (27 months old; n=8) were subjected to 6 months of treatment with a therapeutic dose of paracetamol (30 mg/kg/day) and compared to age-matched untreated FBN rat controls (n=8). Compared to measurements in the aortae of 6-month old animals, tunica media thickness, tissue superoxide levels, and protein oxidation levels were 38 ± 7%, 92 ± 31%, and 7 ± 2% higher in the aortae of 33-month control animals (p ≤0.05). Chronic paracetamol treatment decreased tunica media thickness and the amount of oxidized protein by 13 ± 4% and 30 ± 1%, respectively (p ≤0.05). This finding of diminished aortic thickening was associated with increased phosphorylation (activation) of the mitogen activated protein kinases and diminished levels of the anti-apoptotic protein Bcl-2. Taken together, these data suggest that chronic paracetamol treatment may decrease the deleterious effects of aging in the FBN rat aorta.

Tunica media

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Sclerosing Mesenteritis: A Rare Cause of Abdominal Pain

Cureus (2022)

Said Sharawi Vincent Graffeo Lynne J. Goebel

Sclerosing mesenteritis (SM) is a rare inflammatory fibrotic disease of the small intestine mesenteric fat often discovered incidentally on a CT scan. Clinical manifestations depend on the mass effect on the viscera and vessels. The most common symptoms are abdominal pain, bloating, and nausea. SM occurs predominantly in Caucasian men, during the fifth to seventh decades of life. We present a 69-year-old woman with SM whose symptoms were thought to be from irritable bowel syndrome. A 69-year-old female with a history of fibromyalgia presented with recurrent bouts of abdominal pain across her mid-abdomen lasting 30 minutes to an hour associated with nausea, alternating constipation and diarrhea with occasional mucus, and bloating. She used bismuth subsalicylate and ondansetron with temporary relief. Upper endoscopy and colonoscopy were unrevealing. Initially, she was felt to have irritable bowel. Later she presented with nausea and right upper quadrant pain and underwent cholecystectomy. When her pain recurred, the patient had a CT abdomen and pelvis which showed multiple sub-centimeter mesenteric lymph nodes with surrounding haziness and stranding in the root of the mesentery consistent with SM. The patient had a pannus biopsy showing fat necrosis that confirmed the diagnosis. She continued to have waxing and waning symptoms over several years and in the interim was diagnosed with melanoma limited to the skin. The patient had a particularly severe episode of abdominal pain prompting a repeat CT scan with a subsequent biopsy of an enlarged left para-aortic lymph node that revealed lymphoma. Our patient's diagnosis of SM was delayed as her symptoms were mistaken for irritable bowel syndrome. Worsening symptoms should alert clinicians to an alternate diagnosis such as SM. There are characteristic radiographic findings on CT scans and biopsy of the lesions. SM's association with neoplastic diseases such as lymphoma, melanoma, colorectal, and prostate cancer is controversial, however, practitioners should be aware of this possibility and consider biopsy for any suspicious lesions.

Bloating

10.7759/cureus.28573

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A Case Control Study of Nutrient Intake Deficiencies in Patients Taking Warfarin

Marshall Journal of Medicine (2015)

Philip Riley Kim Lucas Day George M. Yousef Sirisha Devabhaktuni Ashley N. Gaing

We previously published the case of a woman taking warfarin who was found to have scurvy, a disease caused by a deficiency of vitamin C. This led us to hypothesize that patients taking warfarin who consume a diet limited in vitamin K rich foods may be at risk for other nutrient deficiencies. To test our hypothesis, we studied dietary nutrient intake in patients taking warfarin compared to patients with heart disease not taking warfarin.

Scurvy

10.18590/mjm.2015.vol1.iss1.2

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Update on adolescent tobacco cessation.

PubMed (2014)

M Keyser Lynne J. Goebel

Adolescent tobacco use is decreasing in West Virginia, a state which features the Not on Tobacco (NOT) and RAZE programs. This manuscript gives an overview of recent studies in adolescent tobacco cessation, what works and what doesn't. More research is needed to improve cessation rates in adolescents.

West virginia

Smoking prevention

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STANDING ORDERS IN AN AMBULATORY SETTING INCREASES INFLUENZA VACCINE USAGE.

Journal of Investigative Medicine (2004)

Lynne J. Goebel Shirley M. Neitch Maurice A. Mufson

10.1097/00042871-200401001-00861

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A Randomized Open-Label Study of Two Methods of Proton Pump Inhibitors Discontinuation

Cureus (2021)

Emily Hendricks Aman N Ajmeri Monider M Singh Milliejoan Mongalo Lynne J. Goebel

Background Proton pump inhibitors (PPIs) are effective in treating gastroesophageal reflux disease (GERD). Unfortunately, they are often inappropriately prescribed and long-term use has potential adverse effects. A single best method for discontinuation of PPIs does not currently exist. The objective of this study was to determine if there is a significant difference in successfully discontinuing PPI use at 12 months between patients discontinuing abruptly or tapering first. Methodology We conducted a randomized trial with 38 patients diagnosed with GERD. We collected six weekly and then monthly surveys of symptoms based on the Dyspepsia Symptom Severity Index. Chart review at 12 months determined whether the patient was able to discontinue PPI. Results A Kaplan-Meier survival analysis at 12 months did not show a statistically significant difference between the abrupt and taper groups for discontinuation of PPI medication (p = 0.75). Cox regression analysis showed no association of alcohol use, smoking, or caffeine use with failure to discontinue PPI, but H2 blocker use was associated with a 79% reduction in risk of failure to discontinue PPI (p = 0.004). The taper group had significantly less symptoms 14, 18, 22, and 30 weeks after discontinuation. Conclusions Our study suggests that there is no difference in successful discontinuation of PPIs between abrupt and taper methods at 12 months; however, there are less symptoms in the taper method, and H2 blocker use is associated with success. Further study is needed with larger numbers of participants and randomization of H2 blocker use.

Discontinuation

10.7759/cureus.15022

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Rectal Neuroendocrine Tumor in a Patient with CHEK2 Mutation

Marshall Journal of Medicine (2020)

Shefali Khanna Deena Dahshan Erin Fankhanel Doreen Griswold Lynne J. Goebel

We provide new information about CHEK2 mutation in association with a rectal neuroendocrine tumor (NET). A 67-year-old Caucasian woman diagnosed with estrogen receptor positive ductal carcinoma in situ breast cancer underwent genetic testing, revealing a CHEK2 mutation that prompted her to have a colonoscopy. This revealed a polyp with immunohistochemical staining positive for markers classically associated with NETs. Six-month follow up surveillance colonoscopy after initial polyp removal found no evidence of recurrence. While the CHEK2 mutation is known to be associated with adenocarcinomas, there is only one other reported case of its association with NETs.

CHEK2

MEN1

10.33470/2379-9536.1247

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Citations (1)