The Mount Sinai journal of medicine, New York
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Academic hospitalists have grown in number and influence over the past decade. This has fueled concerns about the effect of hospitalists on resident and student education. While the bulk of the literature favors the hospitalist teaching model to a more traditional model concerns remain that hospitalists may negatively impact housestaff autonomy and reduce exposure to subspeciality physicians. This paper will review the literature exploring the effect of the hospitalist teaching model on resident and student education.
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With the advent of continuous subcutaneous insulin infusion therapy and the findings of the Diabetes Control and Complications Trial, the management of type 1 diabetes has changed drastically. Over the past 30 years since its development, the effectiveness of continuous subcutaneous insulin infusion has been assessed in comparison with other modes of intensive treatment. ⋯ Selection criteria of patients for pump use and how to initiate pump therapy are presented. Finally, newer findings on continuous glucose sensors are discussed as the next era of pump therapy continues to focus on the goal of developing an artificial pancreas.
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This article reviews the evidence from randomized, placebo-controlled trials and meta-analyses of pharmacological treatments of the following anxiety disorders: generalized anxiety disorder, panic disorder, social anxiety disorder, and post-traumatic stress disorder. There is evidence from multiple randomized, placebo-controlled trials to support the use of selective serotonin reuptake inhibitors as first-line pharmacotherapy in these disorders, and a number of the selective serotonin reuptake inhibitors have received US Food and Drug Administration approval for these indications. ⋯ Benzodiazepines are also effective treatments for anxiety disorders, and although this medication class has the advantage of a rapid onset of action, their use is limited by their potential for abuse and lack of antidepressant properties. In addition to reviewing the clinical trials that have investigated the anxiolytic effects of these commonly used medications, we review the evidence for novel uses of other agents, including anticonvulsants and atypical antipsychotics, in anxiety disorders.
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New insights into the complex immunopathogenesis of multiple sclerosis have led to a proliferation of promising new therapeutic strategies. While the current armamentarium of immunomodulatory medications has demonstrated beneficial effects on the disease, more effective and tolerable therapies are needed. ⋯ Biomarker profiles may help elucidate disease subtypes as well as therapeutic response in an effort to individualize treatment choice. This review will highlight recent promising therapeutic strategies under investigation in the field of MS.