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  1. Article: Rhabdomyolysis Associated With Semaglutide Therapy: A Case Report.

    Billings, Sabrina A / Felix, Heidi M / Prier, Cara C / Hedges, Mary S

    Cureus

    2023  Volume 15, Issue 12, Page(s) e50227

    Abstract: This report describes the case of a 47-year-old woman with myalgias, weakness, and elevated creatine kinase associated with semaglutide therapy prescribed for weight loss. Her symptoms and laboratory markers were consistent with rhabdomyolysis and ... ...

    Abstract This report describes the case of a 47-year-old woman with myalgias, weakness, and elevated creatine kinase associated with semaglutide therapy prescribed for weight loss. Her symptoms and laboratory markers were consistent with rhabdomyolysis and resolved after discontinuation of semaglutide. Upon rechallenge at a lower dose, symptoms recurred, and urinalysis was consistent with myoglobinuria. Symptoms again rapidly resolved upon discontinuation of the medication. It is imperative for physicians to recognize semaglutide as a possible cause of myalgias and rhabdomyolysis in clinically suspected patients. To the best of our knowledge, this is the first reported case in the literature and may be specific to semaglutide rather than a class effect of glucagon-like peptide 1 (GLP-1) agonists.
    Language English
    Publishing date 2023-12-09
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.50227
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  2. Article ; Online: Dermatology Residency Applicant Self-Reported Stressors and Coping Mechanisms by Sex, Race, and Geographic Region during the 2020-2021 Application Cycle.

    Tolaymat, Leila M / Walker, Ashley L / Yin, Mingyuan / Gillis, Mindy / Haga, Claire / Heckman, Michael / Dawson, Nancy / Hedges, Mary S

    Southern medical journal

    2023  Volume 116, Issue 3, Page(s) 298–304

    Abstract: Objectives: Our aim was to identify self-reported stressors and coping mechanisms during the 2020-2021 application cycle by dermatology residency applicants. We hypothesized that coronavirus disease 2019 (COVID-19) would be the most reported stressor.!## ...

    Abstract Objectives: Our aim was to identify self-reported stressors and coping mechanisms during the 2020-2021 application cycle by dermatology residency applicants. We hypothesized that coronavirus disease 2019 (COVID-19) would be the most reported stressor.
    Methods: During the 2020-2021 application season, the Mayo Clinic Florida Dermatology residency program sent a supplemental application to each applicant requesting that they describe a challenging life situation and how they handled it. Comparisons of self-reported stressors and self-expressed coping mechanisms according to sex, race, and geographic region were performed.
    Results: The most common stressors reported were academic (18.4%), family crisis (17.7%), and COVID-19 (10.5%). The most frequent coping mechanisms expressed were perseverance (22.3%), seeking community (13.7%), and resilience (11.5%). The coping mechanism of diligence was observed more often in females than in males (2.8% vs 0.0%,
    Conclusions: Stressors reported by dermatology applicants in the 2020-2021 cycle included academic, family crisis, and the COVID-19 pandemic. The type of stressor reported varied by race/ethnicity and geographic location of the applicant.
    MeSH term(s) Female ; Male ; Humans ; Self Report ; COVID-19/epidemiology ; Dermatology ; Internship and Residency ; Pandemics ; Adaptation, Psychological
    Language English
    Publishing date 2023-04-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 185329-6
    ISSN 1541-8243 ; 0038-4348
    ISSN (online) 1541-8243
    ISSN 0038-4348
    DOI 10.14423/SMJ.0000000000001528
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  3. Article: Patient Perception of Physician Attire Before and After the COVID-19 Global Pandemic Began.

    Hedges, Mary S / Tolaymat, Leila M / Haskell, Nicole K / Prier, Cara / Walker, Ashley L / Haga, Claire / Li, Zhuo / Yin, Mingyuan / McManus, Mindy / Dawson, Nancy

    Journal of patient experience

    2023  Volume 10, Page(s) 23743735231203115

    Abstract: Introduction: ...

    Abstract Introduction:
    Language English
    Publishing date 2023-09-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2857285-3
    ISSN 2374-3743 ; 2374-3735
    ISSN (online) 2374-3743
    ISSN 2374-3735
    DOI 10.1177/23743735231203115
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  4. Article ; Online: Determinants of ethnic differences in the uptake of child healthcare services in New Zealand: a decomposition analysis.

    Lewycka, Sonia / Dasgupta, Kabir / Plum, Alexander / Clark, Terryann / Hedges, Mary / Pacheco, Gail

    International journal for equity in health

    2023  Volume 22, Issue 1, Page(s) 13

    Abstract: Background: There are persistent ethnic gaps in uptake of child healthcare services in New Zealand (NZ), despite increasing policy to promote equitable access. We examined ethnic differences in the uptake of immunisation and primary healthcare services ... ...

    Abstract Background: There are persistent ethnic gaps in uptake of child healthcare services in New Zealand (NZ), despite increasing policy to promote equitable access. We examined ethnic differences in the uptake of immunisation and primary healthcare services at different ages and quantified the contribution of relevant explanatory factors, in order to identify potential points of intervention.
    Methods: We used data from the Growing Up in New Zealand birth cohort study, including children born between 2009 and 2010. Econometric approaches were used to explore underlying mechanisms behind ethnic differences in service uptake. Multivariable regression was used to adjust for mother, child, household, socioeconomic, mobility, and social factors. Decomposition analysis was used to assess the proportion of each ethnic gap that could be explained, as well as the main drivers behind the explained component. These analyses were repeated for four data time-points.
    Results: Six thousand eight hundred twenty-two mothers were enrolled during the antenatal survey, and children were followed up at 9-months, 2-years and 4-years. In univariable models, there were ethnic gaps in uptake of immunisation and primary care services. After adjusting for covariates in multivariable models, compared to NZ Europeans, Asian and Pacific children had higher timeliness and completeness of immunisation at all time-points, while indigenous Māori had lower timeliness of first-year vaccines despite high intentions to immunise. Asian and Pacific mothers were less likely to have their first-choice lead maternity caregiver (LMC) than NZ Europeans mothers, and Māori and Asian mothers were less likely to be satisfied with their general practitioner (GP) at 2-years. Healthcare utilisation was strongly influenced by socio-economic, mobility and social factors including ethnic discrimination. In decomposition models comparing Māori to NZ Europeans, the strongest drivers for timely first-year immunisations and GP satisfaction (2-years) were household composition and household income. Gaps between Pacific and NZ Europeans in timely first-year immunisations and choice of maternity carer were largely unexplained by factors included in the models.
    Conclusions: Ethnic gaps in uptake of child healthcare services vary by ethnicity, service, and time-point, and are driven by different factors. Addressing healthcare disparities will require interventions tailored to specific ethnic groups, as well as addressing underlying social determinants and structural racism. Gaps that remain unexplained by our models require further investigation.
    MeSH term(s) Humans ; Female ; Child ; Pregnancy ; New Zealand ; Cohort Studies ; Ethnicity ; Mothers ; Healthcare Disparities
    Language English
    Publishing date 2023-01-16
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2092056-8
    ISSN 1475-9276 ; 1475-9276
    ISSN (online) 1475-9276
    ISSN 1475-9276
    DOI 10.1186/s12939-022-01812-3
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  5. Article: Atraumatic Clostridial Myonecrosis in an Immunocompromised Host.

    Thompson, Kristine M / Kruse, Brian T / Hedges, Mary Ann S

    The Journal of emergency medicine

    2018  Volume 54, Issue 6, Page(s) e121–e123

    Abstract: Background: Necrotizing fasciitis is usually associated with a surgical or traumatic wound. Clostridial myonecrosis is an uncommon but deadly infection that can develop in the absence of a wound and is often associated with occult gastrointestinal ... ...

    Abstract Background: Necrotizing fasciitis is usually associated with a surgical or traumatic wound. Clostridial myonecrosis is an uncommon but deadly infection that can develop in the absence of a wound and is often associated with occult gastrointestinal cancer or immunocompromise, or both.
    Case report: We report a case of catastrophic atraumatic Clostridium septicum infection in an immunocompromised host. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians most commonly associate necrotizing fasciitis with superinfection of an open wound. This case reminds physicians that patients with acquired neutropenia can present with spontaneous gas gangrene due to C. septicum. Providers should consider this diagnosis in immunocompromised patients who present with acute onset of severe atraumatic limb pain.
    MeSH term(s) Clostridium Infections/complications ; Clostridium septicum/pathogenicity ; Emergency Service, Hospital/organization & administration ; Fasciitis, Necrotizing/etiology ; Humans ; Immunocompromised Host ; Male ; Middle Aged ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 2018-03-10
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2018.01.036
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  6. Article ; Online: Skin Cancer in Solid Organ Transplant Recipients: A Review for the Nondermatologist.

    Berman, Hannah / Shimshak, Serena / Reimer, Danielle / Brigham, Tara / Hedges, Mary S / Degesys, Catherine / Tolaymat, Leila

    Mayo Clinic proceedings

    2022  Volume 97, Issue 12, Page(s) 2355–2368

    Abstract: Solid organ transplant recipients (SOTRs) are at increased risk for the development of skin cancer compared with the general population, which requires consistent monitoring and management from a multidisciplinary team. The aim of this review is to ... ...

    Abstract Solid organ transplant recipients (SOTRs) are at increased risk for the development of skin cancer compared with the general population, which requires consistent monitoring and management from a multidisciplinary team. The aim of this review is to provide a comprehensive overview for nondermatologist clinicians, outlining skin cancer diagnosis, treatment pearls, and skin cancer prevention strategies as they relate to SOTRs. A comprehensive search of the literature was conducted through the MEDLINE database with search terms including organ transplantation, transplant recipient, skin cancer, cutaneous neoplasms, management, and therapies. The search was limited to the English language and dates ranging from January 1, 2011, to December 28, 2021. All studies were reviewed for inclusion. Skin cancer will develop in more than half of SOTRs at some point in their life, most often nonmelanoma skin cancer such as basal cell carcinoma or squamous cell carcinoma. Melanoma and rarer cutaneous malignant neoplasms, such as Merkel cell carcinoma and Kaposi sarcoma, are also more frequent among SOTRs. A multidisciplinary effort at skin cancer screening and patient education is invaluable to prevent skin cancer-related morbidity and mortality in this population of patients. Reduction in immunosuppressive medications and surgical intervention are effective therapeutic approaches, and more novel systemic therapies including G protein-coupled receptor inhibitors and immune checkpoint inhibitors are possible options when traditional treatment approaches are not feasible. Checkpoint inhibitor therapy, however, comes with the risk of allograft rejection. With a growing and aging SOTR population, it is essential that SOTRs have support from dermatologists and nondermatologists alike in skin cancer prevention and treatment.
    MeSH term(s) Humans ; Transplant Recipients ; Immunosuppressive Agents/therapeutic use ; Skin Neoplasms/diagnosis ; Skin Neoplasms/epidemiology ; Skin Neoplasms/etiology ; Carcinoma, Basal Cell/diagnosis ; Carcinoma, Basal Cell/epidemiology ; Carcinoma, Basal Cell/etiology ; Organ Transplantation/adverse effects
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2022-11-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 124027-4
    ISSN 1942-5546 ; 0025-6196
    ISSN (online) 1942-5546
    ISSN 0025-6196
    DOI 10.1016/j.mayocp.2022.07.004
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  7. Article ; Online: Impact of Menopause Symptoms on Women in the Workplace.

    Faubion, Stephanie S / Enders, Felicity / Hedges, Mary S / Chaudhry, Rajeev / Kling, Juliana M / Shufelt, Chrisandra L / Saadedine, Mariam / Mara, Kristin / Griffin, Joan M / Kapoor, Ekta

    Mayo Clinic proceedings

    2023  Volume 98, Issue 6, Page(s) 833–845

    Abstract: Objective: To evaluate the impact of menopause symptoms on work outcomes and to assess the estimated economic impact.: Patients and methods: Women aged 45 to 60 years receiving primary care at 1 of the 4 Mayo Clinic sites were invited to participate ... ...

    Abstract Objective: To evaluate the impact of menopause symptoms on work outcomes and to assess the estimated economic impact.
    Patients and methods: Women aged 45 to 60 years receiving primary care at 1 of the 4 Mayo Clinic sites were invited to participate in a survey study (Hormones and ExpeRiences of Aging) from March 1 through June 30, 2021. A total of 32,469 surveys were sent, with 5219 responses (16.1% response rate). Of the 5219 respondents, 4440 (85.1%) reported current employment information and were included in the study. The primary outcome was self-reported adverse work outcomes related to menopause symptoms assessed by the Menopause Rating Scale (MRS).
    Results: The mean age of the 4440 participants was 53.9±4.5 years, with the majority being White (4127 [93.0%]), married (3398 [76.5%]), and educated (2632 [59.3%] college graduate or higher); the mean total MRS score was 12.1, signifying moderate menopause symptom burden. Overall, 597 women (13.4%) reported at least one adverse work outcome due to menopause symptoms; 480 women (10.8%) reported missing work in the preceding 12 months (median, 3 days missed). The odds of reporting an adverse work outcome increased with increasing menopause symptom severity; women in the highest quartile of total MRS scores were 15.6 (95% CI, 10.7 to 22.7; P<.001) times more likely to have an adverse work outcome vs those in the first quartile. Based on workdays missed due to menopause symptoms, we estimate an annual loss of $1.8 billion in the United States.
    Conclusion: This large cross-sectional study identified a major negative impact of menopause symptoms on work outcomes and the need to improve medical treatment for these women and make the workplace environment more supportive. Additional studies are needed to confirm these findings in larger and more diverse groups of women.
    MeSH term(s) Humans ; Female ; Middle Aged ; Cross-Sectional Studies ; Menopause/physiology ; Aging ; Surveys and Questionnaires ; Workplace
    Language English
    Publishing date 2023-04-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 124027-4
    ISSN 1942-5546 ; 0025-6196
    ISSN (online) 1942-5546
    ISSN 0025-6196
    DOI 10.1016/j.mayocp.2023.02.025
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  8. Article: New-onset delirium during hospitalization in older adults: incidence and risk factors.

    Lami Pereira, Rodrigo / Bojanini Molina, Leyla / Wilger, Kaeli / Hedges, Mary S / Tolaymat, Leila / Haga, Clare / Walker, Ashley / Gillis, Melinda / Yin, Mingyuan / Dawson, Nancy L

    Hospital practice (1995)

    2023  Volume 51, Issue 4, Page(s) 219–222

    Abstract: Objective: Delirium is a clinical diagnosis that can occur frequently in hospitalized patients. A retrospective study was completed to identify the incidence of patients aged greater than 65 developing delirium during hospitalization.: Methods: This ... ...

    Abstract Objective: Delirium is a clinical diagnosis that can occur frequently in hospitalized patients. A retrospective study was completed to identify the incidence of patients aged greater than 65 developing delirium during hospitalization.
    Methods: This study was conducted at a single tertiary care teaching hospital. Charts of discharged patients from November to December 2018 were evaluated and patients less than age 65 or with delirium present on admission were excluded. The search terms altered, delirium, encephalopathy, and confusion were used to identify patients who developed delirium during the hospitalization. Characteristics of the patients with delirium were also collected.
    Results: The incidence of new-onset delirium in patients over age 65 during hospitalization was 10%. Patients who developed delirium during their hospital stay were found to have a higher risk of mortality (
    Conclusion: The strong correlation between a longer LOS and a higher incidence of delirium should guide the development of new innovative strategies to shorten the LOS and thus reduce the risk of delirium, in high-risk older hospitalized patients.
    MeSH term(s) Humans ; Aged ; Incidence ; Retrospective Studies ; Delirium/epidemiology ; Delirium/diagnosis ; Hospitalization ; Length of Stay ; Risk Factors
    Language English
    Publishing date 2023-11-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2570453-9
    ISSN 2377-1003 ; 2154-8331 ; 8750-2836
    ISSN (online) 2377-1003
    ISSN 2154-8331 ; 8750-2836
    DOI 10.1080/21548331.2023.2267983
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  9. Article: Virtual Academic Asynchronous Mentoring (VAAM) for Faculty Physicians: An Innovative Mentorship.

    Yin, Mingyuan / McManus, Mindy / Dawson, Nancy / Tolaymat, Leila / Prier, Cara C / Tan, Winston / Pritchard, Ingrid / Hill, Ebone / Haga, Claire / Hedges, Mary S

    Cureus

    2023  Volume 15, Issue 12, Page(s) e51289

    Abstract: Introduction: Successful mentorship programs in academic medicine correlate with increased achievement in scholarly activities, leadership, and academic advancement for faculty members, as well as reduced burnout. Despite these benefits, the traditional ...

    Abstract Introduction: Successful mentorship programs in academic medicine correlate with increased achievement in scholarly activities, leadership, and academic advancement for faculty members, as well as reduced burnout. Despite these benefits, the traditional mentorship model may be underutilized due to challenges of time constraints and alignment in goals. Furthermore, women and underrepresented in medicine (UriM) physicians are less likely to have mentorship, perpetuating the gap in the diversity of academic faculty in leadership and career advancement. To address this, we created an innovative mentorship model for busy academic faculty physicians using a virtual academic asynchronous mentoring video platform.  Methods: A series of videos were created by interviewing 10 identified mentors (four male, six female) from various medical specialties at a national academic institution. The mentors included nine physician faculty with the academic rank of Associate Professor or full Professor and one Research Administrator. Key learning points shared by mentors included topics on academic advancement, mentorship development, leadership development, and research resources.
    Results: Between March 2020 and September 2023, the Virtual Academic Asynchronous Mentoring (VAAM) Video Series garnered 182 unique viewers, received 2,107 visits, and accumulated 1,871 total minutes of viewing time. All viewers were surveyed, with an 11% survey response rate received. Fifty-two percent of survey respondents reported that the video content was excellent and 43% reported very good. Seventy-six percent of respondents thought the video series had the potential to enhance their professional development and academic productivity.
    Conclusion: The VAAM Video Platform offers a novel approach to academic mentoring for faculty physicians which eliminates limitations of traditional mentorship models in a convenient and cost-effective way. VAAM offers an egalitarian starting point for all junior faculty who have not yet established a mentoring relationship to seek information and resources on academic advancement and career development.
    Language English
    Publishing date 2023-12-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.51289
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  10. Article ; Online: Delayed COVID respiratory failure: what every front line healthcare worker needs to know.

    Hedges, Mary S / Jackson, Kensler D / Matcha, Gautam V / Ramakrishna, Jahanavi M / Libertin, Claudia R

    Romanian journal of internal medicine = Revue roumaine de medecine interne

    2020  Volume 58, Issue 4, Page(s) 259–263

    Abstract: The pandemic of COVID-19 has presented several diagnostic challenges in both recognition of acute disease and also the temporal presentation of disease convalescence with return to normal activity. We present a case of delayed clinical progression of ... ...

    Abstract The pandemic of COVID-19 has presented several diagnostic challenges in both recognition of acute disease and also the temporal presentation of disease convalescence with return to normal activity. We present a case of delayed clinical progression of COVID-19 associated respiratory failure on day 25 after initial symptom onset and, notably, after initial full resolution of symptoms and negative RT-PCR nasopharyngeal testing. The patient's delayed presentation of exertional dyspnea and the utilization of specific characteristics of chest radiography in confirmation with laboratory cytokine measurement allowed for clinical re-categorization of the patient's status to active COVID-19 clinical disease and changed acute management. COVID-19 positive patients should be advised to continue to monitor for respiratory deterioration for a greatly extended period of time, even if RT-PCR testing is negative and initial clinical symptoms have resolved. Frontline healthcare workers, including first responders and primary care providers, also need to be aware to monitor for and recognize this delayed presentation.
    MeSH term(s) COVID-19/complications ; COVID-19/diagnostic imaging ; COVID-19/immunology ; Cytokines/blood ; Disease Progression ; Dyspnea/virology ; Humans ; Radiography ; Respiratory Insufficiency/diagnostic imaging ; Respiratory Insufficiency/immunology ; Respiratory Insufficiency/virology ; SARS-CoV-2 ; Time Factors
    Chemical Substances Cytokines
    Keywords covid19
    Language English
    Publishing date 2020-12-17
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 2015966-3
    ISSN 2501-062X ; 0035-3973 ; 1582-3296
    ISSN (online) 2501-062X
    ISSN 0035-3973 ; 1582-3296
    DOI 10.2478/rjim-2020-0022
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