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Eddie L Hoover

Publications and source records attributed to Eddie L Hoover.

18 recordsLinked to original sources
PubMed2006

Did Flexner's Report condemn black medical schools? Not so, in my opinion.

I invited Kathryn L. Moseley, MD to write the editorial appearing on the pages before this one as to whether she thought that the original Flexner Report was unduly harsh on the existing black medical schools. I invited her to choose whether she wanted to write the "pro" or "con" editorial, and that I would write the opposite piece for the sake of a presentation-although I might not necessarily believe in the position on which I was to write. She elected to write the "yes, it was harmful" piece, and I had to assume the editor's burden. In fact, as I began doing my internal soul searching for answers, I began to believe that the original Flexner Report actually helped preserve two black schools--Howard and Meharry--both of which might well have closed along with the other five schools scattered across the southeast, absent Flexner's direct and tangential support.

Black or African American↗
PubMed2006

Mentoring women in academic surgery: overcoming institutional barriers to success.

Women now comprise 50% of Caucasian matriculants to medical school; 66.6% of African Americans, 48% of Hispanics and 51.3% of Asians beginning medical school are also women. This trend is likely to continue since women now earn 57% of all undergraduate degrees, and they earn more degrees in the health professions and biological sciences than men. Black and Hispanic women now earn 66% and 60% of bachelor's degrees in their respective ethnic groups. Overall, women are concentrated at the lowest faculty ranks at medical schools, with 70% holding the rank of instructor or assistant professor. Women continue to experience difficulty with recruitment, retention, promotion and pay issues compared to men. They also experience additional gender-specific issues, including primary responsibility for rearing families and quality-of-life issues in some specialties, including most of the surgical disciplines. Clearly, there is an evolving population shift at work here; the pool of candidates for medical school faculty positions is likely to be evenly split between men and women for Caucasians, Hispanics and Asians, while the African-American pool is likely heavily weighted in favor of the women. Women are beginning to garner more Latin honors recognition at graduation as well and the definition of the "best and the brightest" is being redefined. Therefore, institutions must continue to identify the barriers that deter women from entering surgery, to develop research tools to understand how to improve the process of developing leadership skills among women and to insure a "buy-in" of their male counterparts when components of the plan are being implemented.

Black or African American↗
PubMed2005

Mentoring surgeons in private and academic practice.

Mentoring is an essential component of a successful career in any profession, and these relationships are beginning to be explored in great detail in academic surgery. However, it is equally important for surgeons in private practice, and this area has not received nearly as much attention in the literature. The goals for both are similar and include providing career advice, guidance, and counseling, with the only regard being the success of the junior associate. In private practice, the mentor can be a senior colleague who may or may not be part of one's group practice. In academia, it may be someone at another university, although proximity is preferable. It may be necessary to repeat the search for a mentor more than once before a successful relationship evolves. This complex process must be mastered if one is to be successful in either academia or private practice.

Faculty, Medical↗
PubMed2005

Postoperative pleural effusion in bronchioloalveolar cancer.

Bronchioloalveolar carcinoma occasionally presents with bronchorrhea and can appear on roentgenogram as cavitary lesions similar to a lung abscess. We present a case of multifocal, cavitary bronchioloalveolar cancer, which was originally treated unsuccessfully as lung abscesses. At surgery, two cavities were identified without evidence of tumor or chronic infection and were left open. The postoperative course was complicated by 5 weeks of massive chest tube drainage, which was finally controlled with radiation and time. This report chronicles our difficulty with diagnosis and management and suggests recommendations for future providers.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed2005

Invited commentary.

Explore the source record for details and available documents.

Cardiac Surgical Procedures↗
PubMed2005

Private volunteer medical organizations: how effective are they?

Religious and other secular organizations have been involved with medical missionary work in sub-Saharan Africa for centuries, especially in remote provinces and villages. In times past, most of these countries were under the control of foreign powers. Private volunteer organizations operated within a structured environment, which, perhaps, facilitated their mission and their ability to review and evaluate their effectiveness because of the tight control the colonial powers maintained over every facet of native life. However, the transition from colonialism to independence has resulted in a different environment in which healthcare is fragmented and a low priority in most countries because of financial constraints. The lack of standardization, vintage laboratory equipment, a manual medical record system, lack of a subsidized transportation system, infrequent postal service and the absence of phone systems in the remote provinces and villages make treatment and tracking of patients, monitoring therapy and measuring outcomes/results difficult. Therefore, judging the effectiveness of an initiative in remote district hospitals and village clinics can be difficult. This manuscript addresses some of these issues and provides solutions to some that have been effective for one organization.

Africa South of the Sahara↗
PubMed2005

Medical volunteers: guidelines for success and safety.

Many African Americans from a variety of medical specialties are interested in satisfying a life-long dream of visiting Africa by volunteering their services to faith-based and private volunteer organizations doing missionary work on the continent. While this can be an extremely rewarding experience in which measurable good can be accomplished, this path can also be strewn with many obstacles that will affect both the success of the mission and the personal well-being of the volunteer. The American Medical Team for Africa is a nonprofit, tax-exempt, volunteer organization that has been doing medical missionary work in Africa since 1993. This manuscript is a compilation of this 10-year experience that has established some very useful guidelines for insuring a successful and safe mission if you are fortunate enough to have this opportunity.

Africa South of the Sahara↗
PubMed2005

Medical care on the brink: the need for re-engineering healthcare services in sub-Saharan Africa.

The sub-Saharan region of Africa is home to more of the ills of mankind than any other region on earth. Nowhere is the aggregate of disease, political turmoil, inadequate resources and a crumbling infrastructure so completely packaged in a seemingly "escape proof" pod as in sub-Saharan Africa. This continent is a kaleidoscope of people and problems derived from artificial boundaries drawn by European colonial powers, resulting in a litany of problems that have flourished for many decades. In the immediate postcolonial era, there was some oversight by the departed powers, but this has changed recently with decreasing interest in African affairs and only episodic worldwide news coverage because of other world events that overshadow Africa and its problems. The end of the cold war also eliminated the attention Africa received when the superpowers were courting nations. The American Medical Team for Africa has conducted medical missionary work throughout Africa for over a decade and, through its observations, has developed recommendations that are germane to all of sub-Saharan Africa. The organization thinks that this might warrant the attention of governments, international pharmaceutical houses, foundations, the United Nations and all international aid agencies concerned about the plight of healthcare in Africa. These recommendations should enable these countries to re-establish an affordable, efficient and sustainable infrastructure for basic hospital services so that they can diagnosis, monitor, treat and manage disease populations. In some areas, Africa needs to be retrofitted with technology from the past, while in others it needs to be fast-forwarded into the future. The purpose of this manuscript is to try putting the various healthcare challenges into one of these two categories.

Africa South of the Sahara↗
PubMed2005

A century after Flexner: the need for reform in medical education from college and medical school through residency training.

The last major change in medical education occurred almost 100 years ago following an independent investigation conducted by Dr. Abraham Flexner in 1910. Although individual institutions have implemented drastic changes in their own curriculum and the accrediting agencies have mandated other initiatives intended to maintain medical education at the cutting edge of science and technology, many facets of medical education, from the premedical requirements through medical school and residency training, have not changed in nearly half a century. There are areas that are completely lacking in the process of training physicians, and perhaps the assumption was that physicians were intelligent enough to figure this out on their own. While that may have been true in the past when things were less complicated, this approach offers too many opportunities for misadventure, ultimately to the detriment of physicians and patients. Perhaps what is needed is a more rigorous, didactic training program and more thought put into areas where judgment, morality and ethics converge to create potential hazards that can defeat the finest training, equipment and intent. Although American residency programs produce physicians fully capable of independent practice after their prescribed periods of training, there are elements of these training programs that are outdated, costly and perhaps not the best way to get to the desired endpoint. Perhaps these can be revised to more accurately reflect the changing times. This manuscript addresses some of these issues at all levels of training with recommendations for corrective action.

Bioethics↗
PubMed2003

Unusual complications of long-term percutaneous gastrostomy tubes.

Percutaneous endoscopic gastrostomy (PEG) has been popular since it was introduced in 1980. Gastrostomy tubes left in place for long periods often result in unusual complications. Complications may also result from simply replacing a long-term indwelling tube. Five patients who had gastrostomy tubes in place for as long as 4 years are presented and their complications reviewed. Various methods used in treating these complications are discussed, and suggestions for their prevention are given. Gastrointestinal erosion and jejunal perforation following migration of the gastrostomy tube, persistent abdominal wall sinus tracts, and separation of the flange head with small bowel obstruction were encountered. Reinsertion of a gastrostomy tube through a tract prior to adequate maturation was also noted to lead to complications. Complications may result from gastrostomy tubes left in place for extended periods of time and during replacement procedures. Awareness of such complications along with education of caregivers and timely intervention by the endoscopist may prevent such occurrences. In some cases one can only hope to minimize morbidity.

Adolescent↗
PubMed2003

Minimally invasive mitral valve surgery: from Port Access to fully robotic-assisted surgery.

Currently, there is a growing interest in minimally invasive cardiac surgery, and despite early criticisms, it has become the preferred method of mitral valve repair and replacement in many institutions worldwide with excellent results. The interest in performing cardiac valve operations through minimal incisions was stimulated by Port Access technology and has evolved to include robotically assisted video-enhanced valve surgery. Robotic assistance has led to shorter operating times and represents an ideal tool to prepare for fully robotic-assisted cardiac procedures. This report will highlight minimally invasive mitral valve surgery with its evolution from Port Access techniques to fully robotic-assisted surgery. The nuances, strengths, and shortcomings, as well as the potential to enhance the valvular procedure, the promise to reduce hospital stay, earlier return to normal activity, less pain, better cosmesis, and the rethinking of surgical dogma that wide surgical exposure is essential for such complex intracardiac surgery are discussed.

Cardiac Catheterization↗
PubMed2003

Bouveret's syndrome: revisiting gallstone obstruction of the duodenum.

Bouveret's Syndrome is obstruction of the duodenum secondary to an impacted gallstone, usually without the presence of pneumobilia. With the steadily increasing life expectancy, greater numbers of these cases are being seen. Gallstones enter the gastrointestinal tract following fistula formation between the gallbladder and an adjacent hollow viscus and may cause obstruction at any point along the intestinal tract. Duodenal obstruction is the least common and represents only a very small percentage of cases. The presenting signs of nausea vomiting, abdominal cramping, and the absence of abdominal distension should alert the clinician to pathology in the proximal small bowel. The purpose of this report is to heighten the awareness of the primary care physicians, emergency room doctors, and surgeons to this diagnosis in elderly patients so that it can be included in the differential with the usual causes of gastric outlet obstruction--including ulcer disease; neoplasm; gastric volvulus; and other enteroliths, such as bezoars. Early diagnosis is critical, as these cases require urgent surgical intervention. Early resuscitation, diagnosis, and treatment are essential for a successful outcome.

Aged↗
PubMedDate not supplied

The hybrid approach to coronary artery revascularization: minimally invasive direct coronary artery bypass with percutaneous coronary intervention.

In the past decade, new developments in cardiology and cardiac surgery have begun to offer patients a variety of new, less invasive options for the treatment of coronary artery disease. One such option is the hybrid approach to coronary artery revascularization. This combines minimally invasive direct coronary artery bypass surgery (MIDCAB) of the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) of the remaining diseased coronary arteries. This approach, as an alternative to conventional coronary artery bypass surgery, retains the benefit of internal mammary artery bypass to the LAD, accomplished with a minimally invasive technique, substitutes PCI for saphenous vein grafts as treatment for low-grade lesions of other coronary arteries, and may provide a maximally beneficial outcome for many patients. Preliminary outcomes of patients receiving the hybrid approach have been strikingly positive. This report highlights the rationale for the development of this procedure, patient selection, results, and future applications of this emerging method of treating coronary artery disease.

Coronary Artery Bypass↗