The American journal of the medical sciences
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Asymptomatic cardiac involvement in systemic sclerosis (SSc) has been reported. Long-term follow-up might elucidate the clinical implications of these abnormalities. The aim was to identify the clinical outcomes of asymptomatic cardiac involvement in SSc patients after 2 years of follow-up. ⋯ Cardiac involvement in SSc can progress slowly or even be reversed. Based on a previous test, the incidence of symptomatic cardiac involvement after 2 years was low despite its being a persistent involvement. If symptomatic cardiac involvement develops, PAH is the most prevalent symptom.
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The therapeutic benefits and rationale for treating fevers with external cooling methods remain unclear. We aimed to describe the clinical settings in which cooling blankets (CBs) are used. ⋯ Documentation of CB use including temperature set points, time of discontinuation and duration in EMRs was poor. We could not establish benefits of CB use in this study but observed that almost a third of patients developed adverse effects in the form of shivering. Thus, adverse effects of CB use may outweigh potential benefits. Their use should be reevaluated and institutional protocols developed for their use.
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Heart transplantation represents one of the last treatment options for advanced heart failure. Little is known about the factors associated with return to work in patients after heart transplantation. The aim of this study was to identify those factors. ⋯ Return to work after heart transplantation is variable, with a tendency to be low, and is lower in patients near to retirement age. Protective factors were related to the social, physical and mental environment.
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Dysregulation of the circadian rhythm is linked to immune response deficiencies. Diurnal temperature variation-a surrogate for the circadian rhythm, exists in humans, yet its preservation during illness is not well understood. ⋯ Hospitalization is associated with disruption in the circadian rhythm as reflected by patients' body temperature. Since abnormality in body temperature is known to affect patient outcomes, an understanding of the diurnal cycle during hospitalization is the first step towards devising approaches to re-establish the circadian rhythm.
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Clinician-educator tracks improve teaching behaviors in trainees. However, detailed curriculum descriptions to fully understand, compare, and reproduce them are often lacking. We aimed to describe and evaluate a medical education curriculum for senior residents. ⋯ We describe a one-month medical education curriculum with a strong foundation in learning theory. The curriculum is feasible and presented in sufficient detail to allow reproduction. Our findings suggest that it increases participants' self-perceptions of teaching knowledge, confidence, and skills.