Postgraduate medicine
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Postgraduate medicine · Aug 2023
ReviewNew innovations and educational process in undergraduate neurology education in blended learning.
Many undergraduate students suffer from 'neurophobia,' which refers to a lack of knowledge or confidence in neurology, and this can influence their career choices. Various measures have been taken to address this issue, including the implementation of new technologies and methodologies. ⋯ The purpose of this review is to provide a summary of the current understanding of blended learning as well as innovative methods, technologies, and assessments of undergraduate neurology education. It aims to highlight opportunities for implementing a novel, comprehensive learning model with a suitable blended learning method within a framework of customized technology-assessment processes for future neurology classes, encompassing both theoretical and clinical training.
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Postgraduate medicine · Aug 2023
Exploring a case for education about sexual and gender minorities in postgraduate emergency medicine training: forming recommendations for change.
Social medicine and health advocacy curricula are known to be uncommon in postgraduate medical education. As justice movements work to unveil the systemic barriers experienced by sexual and gender minority (SGM) populations, it is imperative that the emergency medicine (EM) community progress in its efforts to provide equitable, accessible, and competent care for these vulnerable groups. Given the paucity of literature on this subject in the context of EM in Canada, this commentary borrows evidence from other specialties across North America. ⋯ The scarcity of SGM curricula can be attributed to the universal absence of formal acknowledgment of SGM health as a required competency by accreditation boards and professional membership associations. This commentary synthesizes hand-picked literature in an attempt to inform healthcare professionals on their journey toward developing culturally competent postgraduate medical education. By thematically organizing evidence into a stepwise approach, the goal of this article is to borrow ideas across medical and surgical specialties to inform the creation of recommendations and make a case for an SGM curriculum for EM programs in Canada.
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Postgraduate medicine · Aug 2023
Exertional leg pain represents a severe disease phenotype in childhood familial Mediterranean fever.
Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease. Recurrent fever, serositis, and arthritis are common findings of the disease. In addition, musculoskeletal complaints such as exertional leg pain can be overlooked, although they are common and affect patients' quality of life. The aim of this study was to evaluate the frequency of exertional leg pain in pediatric FMF patients and to analyze the association of this finding with other characteristics of FMF. ⋯ Exertional leg pain in pediatric FMF patients is the component of moderate-to-severe disease course, and this may be considerably associated with the presence of M694V mutation.
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Postgraduate medicine · Aug 2023
Central sensitization syndrome in patients with rotator cuff tear: prevalence and associated factors.
A significant number of rotator cuff tear (RCT) patients developed chronic shoulder pain that did not correspond to physiological changes. Central sensitization syndrome (CSS) is a neurophysiological adaptation process that can result in hypersensitivity to peripheral stimuli. Although there is evidence of an association between CSS and musculoskeletal problems, no studies have focused on the association between CSS and RCT. The primary purpose of this study was to examine the prevalence of CSS in patients with RCT. The secondary purpose was to document the associated conditions and comorbidity that were associated with the CSS. ⋯ The prevalence of CSS in patients with RCT was relatively high at 39.4%. The CSS was associated with higher age, female gender, and clinical findings of symptoms lasting over six months, nonphysical laborers, abnormal LHB, concurrent shoulder stiffness, anxiety, and depression.
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Postgraduate medicine · Jun 2023
ReviewConsiderations when selecting an antidepressant: a narrative review for primary care providers treating adults with depression.
Major depressive disorder (MDD) is a debilitating mental disorder that can be treated with a number of different antidepressant therapies, each with its own unique prescribing considerations. Complicating the selection of an appropriate antidepressant for adults with MDD is the heterogeneity of clinical profiles and depression subtypes. Additionally, patient comorbidities, preferences, and likelihood of adhering to treatment must all be considered when selecting an appropriate therapy. ⋯ In this narrative review, we propose that careful selection of the most appropriate antidepressant for adult patients with MDD based on their clinical profile and comorbidities is vital for initial treatment selection. Strategies must be considered for addressing partial and inadequate responses as well to help patients achieve full remission and sustained functional recovery. This review also highlights data for MDD clinical outcomes for which gaps in the literature have been identified, including the effects of antidepressants on functional outcomes, sleep disturbances, emotional and cognitive blunting, anxiety, and residual symptoms of depression.