Journal of general internal medicine
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Infertility care is provided to Veterans through the Veterans Health Administration (VHA) medical benefits package and includes infertility evaluation and many infertility treatments. ⋯ In comparison to a recent study of active duty servicemembers, we found a lower rate of infertility among Veteran men and a higher rate among Veteran women. Further work is needed to investigate military exposures and circumstances that may lead to infertility. Given the rates of infertility among Veterans and active duty servicemembers, enhancing communications between Department of Defense and VHA systems regarding sources of and treatment for infertility is essential to help more men and women benefit from infertility care during military service or as Veterans.
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Editorial
Rural Internal Medicine Residencies: Models, Facilitators, Barriers, and Equity Considerations.
Rural communities in the USA on average experience higher mortality rates and greater physician shortages than urban communities, especially rural communities that are historically Black, American Indian, and Alaska Native. Graduate medical education resources in the USA are concentrated within teaching hospitals in non-rural settings. The federal government has recently established several pathways to expand rural graduate medical education. ⋯ Rural internal medicine residency training models include Rural Track Programs (RTPs), in which training is split between urban and rural training sites. RTPs, though the cornerstone of rural residency expansion in family medicine, raise complex issues in internal medicine. We review the structure of RTPs, alternate rural residency training pathways, and the facilitators and challenges of each pathway with respect to internal medicine training.
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Antipsychotic medications do not alter the incidence or duration of delirium, but these medications are frequently prescribed and continued at transitions of care in critically ill patients when they may no longer be necessary or appropriate. ⋯ Critical care and ward healthcare professionals report several factors influencing established antipsychotic medication prescribing practices. These factors aim to maintain patient and staff safety to facilitate the provision of care to patients with delirium and agitation limiting adherence to current guideline recommendations.
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Women's health care has evolved significantly since it was first acknowledged as an integral part of internal medicine training more than two decades ago. To update and clarify core competencies in sex- and gender-based women's health for general internists, the Society of General Internal Medicine (SGIM) Women and Medicine Commission prepared the following Position Paper, approved by the SGIM council in 2023. ⋯ These competencies are relevant to the care of patients who identify as women, as well as gender-diverse individuals to whom these principles apply. They align with pivotal advances in women's health and acknowledge the changing context of patients' lives, reaffirming the role of general internal medicine physicians in providing comprehensive care to women.
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Habitually skipping breakfast may promote the initiation and progression of gastrointestinal (GI) cancers, which have never been systematically explored in large-scale prospective studies. ⋯ Habitually skipping breakfast was associated with a greater risk of GI cancers including esophageal, gastric, colorectal, liver, gallbladder, and extrahepatic bile duct cancer.