J Natl Med Assoc
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Minority physicians have been persistently underrepresented in medicine (URiM) when compared with their representation in the general U.S. ⋯ This review summarizes and updates the literature on programs to improve the diversity of faculty at AMCs. It includes specific recommendations for components that can provide a foundation for programs to improve faculty diversity. Future research should use high quality methods to compare different interventions to improve the diversity of faculty in AMCs.
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Patients with chronic kidney disease (CKD) are susceptible to infectious organisms in part due to the many facets of uremia-associated immune deficiency. Vaccination plays a crucial role in curbing vaccine preventable infection in patients with CKD and Kidney transplant recipients. Vaccination should be done early in the course of CKD or prior to kidney transplantation when possible. It is incumbent upon all healthcare providers to not only stay abreast of the rapidly evolving evidence and recommendations regarding this area but to also continue to update clinical practice regarding vaccines for long-recognized infectious threats, such as pneumococcal disease and chronic hepatitis B infection, to mitigate the burden of infectious diseases on this particularly vulnerable patient population.
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A need exists to examine racial disparities in the healthcare arena and the impact on patients with cancer. Despite ongoing efforts to increase equity in primary healthcare access, racial and socioeconomic disparities persist, thus contributing to disproportionate treatment outcomes and survivorship among minority and low-income patients. Such disparities have been revealed in treatment cohorts of patients with multiple forms of cancer, including breast, cervical, ovarian, endometrial, prostate, lung, colorectal, gastrointestinal, and hepatocellular, and have been attributed to a range of co-occurring behavioral, social determinants of health, underlying genetic factors, as well as access to educational opportunities that limit the quality of informed healthcare. ⋯ This requires developing a system of justice and trust based on specific, solution-oriented grassroots community efforts working in tandem with medical and pharmaceutical leaders. By fully exploring and pinpointing the underlying causes of healthcare disparities, it should be possible to define strategies and interventions most likely to transform cancer care. The ultimate goal is understanding individual, cultural, and biological vulnerabilities, including environmental and epigenetic liabilities, to optimize cancer prevention, diagnosis, and treatment.
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Of the four subtypes of cutaneous melanoma, acral lentiginous melanoma (ALM) is atypical in its presentation. ALM is a rare melanoma subtype that presents on the volar surfaces of the hand and foot. The difficulty of making an early diagnosis of ALM is highlighted by the case seen in our institution. ⋯ The original lesion was considered to be an ulcerating left great toe lesion with signs typical of osteomyelitis. These clinical findings were corroborated by radiological x-ray evidence. Upon amputation and biopsy for suspected worsening osteomyelitis five years later, the pathological diagnosis of melanoma was finally made.
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Despite multiple efforts, African American women continue to be inadequately represented in clinical research while being overrepresented in disease, producing research results with limited generalizability to this specific population. Our understanding of the barriers to participation in clinical trials among racial/ethnic minority patients in general has evolved, but few studies have examined the reasoning behind African American women's decision to not participate in clinical trials. ⋯ A targeted and comprehensive understanding of the barriers impacting African American women's decision to participate in clinical research informs population-specific recruitment and research strategies for future studies. Additional studies assessing barriers to clinical trial research participation that intentionally report on disaggregated data by not only race/ethnicity but also sex are essential to improving the risk/benefit profile for a wide range of prevention and treatment efforts. This improved understanding of the differences between subgroups within minority populations has implications for bolstering culturally sensitive messages to enhance the engagement of minority communities in clinical trial research.