It Takes a Village: An Interdisciplinary Approach to Preparing Internal Medicine Residents to Care for Patients at the Intersection of Women's Health, Gender-Affirming Care, and Health Disparities

Journal of Women s Health · 2024 · 2 citations

• Sociology
• Medical education
• Medicine

Our interdisciplinary curriculum was feasible, valued by trainees, and increased resident learning. The curriculum provides a template to address equity issues across a spectrum of women's and gender-affirming care conditions that can be used by other institutions in implementing similar curricula.

A Dubious Discharge

Annals of Internal Medicine · 2022

• Medicine
• Classics
• Linguistics

On Being a DoctorNovember 2022A Dubious DischargePaul L. Bernstein, MDPaul L. Bernstein, MDYale University, New Haven, ConnecticutSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-2108 Audio Reading - “A Dubious Discharge” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “A Dubious Discharge” by Paul L. Bernstein Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “We want to talk to you about next steps,” the anxious intern explained as the team formed a semicircle around Mr. Chubb on morning rounds. The patient was seated. The intern was not. The intern's rumpled scrubs pulled in all the wrong places. Mr. Chubb, hands folded in his lap, unclasped and opened them, thumbs out in a sign of acceptance. A slow nod of his head invited the intern to continue.While we listened, I replayed the days of his admission. He was admitted through the ICU and step-down unit; his alcohol binge in the midst of winter had ... Author, Article, and Disclosure InformationAuthors: Paul L. Bernstein, MDAffiliations: Yale University, New Haven, ConnecticutCorresponding Author: Paul L. Bernstein, MD; e-mail, paul.[email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “A Dubious Discharge” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “A Dubious Discharge” by Paul L. Bernstein Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics November 2022Volume 175, Issue 11Page: 1614 ePublished: 15 November 2022 Issue Published: November 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Real-Time Four-Dimensional Echocardiography in the Diagnosis and Management of Cor Triatriatum

CASE · 2017-06-16

•Echocardiography is fundamental in the clinical management of cor triatriatum.•The clinical presentation is mimicked by other abnormalities in the left atrium.•Real-time 4D echocardiography can help characterize the level of obstruction.

Treatment of hyperkalemia: something old, something new

Kidney International · 2016-02-02 · 139 citations

Hypocalcemic hypercalciuria? A conundrum

2014-11-17

PERCUTANEOUS CORONARY INTERVENTION OF A NONINFARCT ARTERY IN SELECTED PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION MAINTAINS EXCELLENT CLINICAL OUTCOMES AND ACHIEVES SUBSTANTIAL COST SAVINGS COMPARED TO STAGED SECOND-VESSEL INTERVENTION

Journal of the American College of Cardiology · 2012-03-01 · 1 citations

Diuretics and Salt Transport Along the Nephron

Seminars in Nephrology · 2011-11-01 · 13 citations

Ion-Exchange Resins for the Treatment of Hyperkalemia

Journal of the American Society of Nephrology · 2010-02-19 · 300 citations

Sodium polystyrene sulfonate (SPS), an ion-exchange resin designed to bind potassium in the colon, was approved in 1958 as a treatment for hyperkalemia by the US Food and Drug Administration, 4 years before drug manufacturers were required to prove the effectiveness and safety of their drugs. In September 2009, citing reports of colonic necrosis, the Food and Drug Administration issued a warning advising against concomitant administration of sorbitol, an osmotic cathartic used to prevent SPS-induced fecal impaction and to speed delivery of resin to the colon, with the powdered resin; however, a premixed suspension of SPS in sorbitol, the only preparation stocked by many hospital pharmacies, is prescribed routinely for treatment of hyperkalemia. We can find no convincing evidence that SPS increases fecal potassium losses in experimental animals or humans and no evidence that adding sorbitol to the resin increases its effectiveness as a treatment for hyperkalemia. There is growing concern, however, that suspensions of SPS in sorbitol can be harmful. It would be wise to exhaust other alternatives for managing hyperkalemia before turning to these largely unproven and potentially harmful therapies.

The utility of thrombo-elastography in the monitoring of aspirin therapy.

PubMed · 2007-12-01 · 1 citations

To assess the utility of the thrombo-elastogram in monitoring of aspirin therapy 25 healthy volunteers were selected and given low-dose aspirin therapy. Thrombo-elastography and platelet aggregometry were conducted at baseline and 1 week later. After 1 week of aspirin therapy, thrombo-elastogram data failed to demonstrate a significant change in the clotting profile. Platelet aggregometry identified significant changes in the clotting profile in response to stimulation with arachidonic acid, adrenaline and ADP. We conclude that thrombo-elastography may not have utility in monitoring of response to aspirin.

Erythrocyte sedimentation rate as a marker of inflammation and ongoing coagulation in stroke and transient ischaemic attack.

PubMed · 2005-08-01 · 11 citations

OBJECTIVE: Systemic infection and inflammation have been implicated in the aetiology of thrombotic cerebral events, particularly in younger patients. We decided to determine whether those patients with raised D-dimer levels, indicating continuing thrombosis and fibrinolysis, had evidence of concurrent infection or inflammation as manifested by a raised erythrocyte sedimentation rate (ESR) measured after an ischaemic stroke/transient ischaemic attack (TIA). METHODS: One hundred and forty-eight patients who had suffered either single or recurrent cerebrovascular episodes were analysed. The patients were referred to the thrombosis and haemostasis unit at Johannesburg Hospital for evaluation of their thrombotic profiles, including D-dimer levels. Concurrent infection was assessed by measurement of white cell count (WCC) and ESR. The variable time interval between the date of the most recent cerebrovascular event and the date of venesection was determined. A history was taken, a physical and neurological examination was performed, and a cardiology assessment and neuroimaging studies were done. RESULTS: Raised D-dimer levels correlated significantly with ESR levels (p = 0.0094) in all patients. This was particularly evident when comparing the 70 younger patients (aged less than 45 years) with the 78 older patients (> 45 years) with raised D-dimers (p = 0.0070). When analysing other markers of inflammation/infection in association with raised D-dimer levels and ESR, mean fibrinogen levels were significantly raised at 6.56 g/l (p = 0.0122). An elevated WCC, as a categorical variable, was significantly associated with an elevated ESR (p = 0.0092). CONCLUSION: There is a significant correlation between elevated D-dimer levels (indicating abnormalities of coagulation and fibrinolysis) and markers of inflammatory and/or infective processes. This is particularly evident in black patients below the age of 45 years. These patients are believed to be at decreased risk for generalised atheromatous disease compared with older white patients. The ramifications of these findings are potentially important with regard to thrombotic cerebrovascular disease aetiology, investigation, management and prevention.