Postgraduate medicine
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Postgraduate medicine · May 2021
EditorialThe necessary evolution of diabetes fellowships in the united states.
The number of Americans affected by diabetes continues to increase but the number of endocrinologists with specialty training to treat this population has not kept up with demand. Primary care outpatient visits can also not meet the projected diabetes population demands or the needs for other complex diabetes management issues. ⋯ This can fill some of the gaps left by a lack of resources in the U. S. healthcare system.
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Postgraduate medicine · May 2021
Are residents receiving the training needed within their residency programs to optimally manage patients with diabetes?
Objective: Diabetes is a prevalent and growing problem in the United States (U. S.); primary care physicians need to be prepared to initiate and progressively advance treatment. The objective of this study was to understand how diabetes management is taught in U. ⋯ A variety of training materials and resources could help overcome some of the current barriers to curriculum expansion of other important components of diabetes care that may help future physicians successfully manage diabetes with newer generation insulin and glucose monitoring technologies. Abbreviations: U. S: United States; PCP: Primary Care Physician; FM: Family Medicine; IM: Internal Medicine; CGM: Continuous Glucose Monitor; AAFP: American Academy of Family Physicians; ACGME: Accreditation Council for Graduate Medical Education; U/mL: units per milliliter; CME: Continuing Medical Education.
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Postgraduate medicine · May 2021
Serum electrolyte/metabolite abnormalities among patients with acute myocardial infarction: comparison between patients with and without diabetes mellitus.
Background: Diabetes mellitus (DM) in a setting of acute myocardial infarction (AMI) is associated with significant metabolic changes and worse outcomes. Objective: To evaluate the prevalence and the prognostic significance of electrolyte/metabolite disturbances among AMI patients with vs. without DM. Methods: Patients admitted to a tertiary medical center with AMI throughout 2002-2012 were screened. ⋯ The prognostic significance of the different categories of the investigated variables is very similar among diabetics and nondiabetics, except increased and decreased uric acid levels [<4.5 (men); <4.0 (women) and ≥9.0 (men); ≥9.4 (women)] which are associated with worse outcomes among diabetics while hyperglycemia (Glucose ≥213 mg/dL) and increased Potassium levels (Potassium ≥4.4mEq/L) which comprise significantly worse prognosis among nondiabetics. Conclusions: Patients with DM admitted with AMI are at greater risk for electrolyte/metabolite abnormalities which are associated with increased risk for in-hospital mortality. The latter association is similar among patients with and without DM except for hyperglycemia and increased potassium levels (stronger among nondiabetics).
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Postgraduate medicine · May 2021
Case ReportsComplications after tibial tubercle traction and femoral neck fractures in children: A case report.
Background: Genu recurvatum and femoral neck fracture in children are very rare, and relevant literaturewas reported. However, there were no reports on avascular necrosisafter internal fixation of femoral neck fractures in children, and genu recurvatum and tibial dysplasia after tibial tubercle traction. Case presentation: In this case, a 32-year-old female patient suffered from a femoral neck fracture at the age of 10. The tibial tubercle traction was applied in the conservative treatment, and closed reduction and internal fixationwere adopted after the failure of the conservative treatment. When the patient came to our hospital for the treatment of hip and knee joint pain for 20 years, the doctor discovered that the patient had severe genu recurvatum and avascular necrosis. ⋯ Meanwhile, tibial traction should be avoided for children with lower extremity fractures, because it may damage the tibial growth plate, thus leading to the early closure of the metaphyseal region in children, and genu recurvatum. The modified surgery for the treatment of genu recurvatum is simple to operate and can avoid patella Baja, so it has a strong healing ability in the osteotomy area. The results of the surgery technique were ideal in this case. P.
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Postgraduate medicine · May 2021
Improving the online presence of residency programs to ameliorate COVID-19's impact on residency applications.
Objectives: The coronavirus disease 2019 (COVID-19) pandemic has created several challenges for residency programs and prospective interns alike during the upcoming application cycle, including the cancellation of away sub-internships and in-person interviews. Given prior research documenting that applicants' application and ranking decisions are significantly influenced by residency webpages, a potential solution to the loss of in-person experiences during the pandemic is the expansion of residency programs' online presence through their program websites, provision of virtual grand rounds and pseudo-away rotations, and enhancement of virtual interviews. This study seeks to summarize the existing literature on these areas and provide concrete suggestions for improving programs' virtual presence. ⋯ Program websites were also limited by underrepresentation of content most valued by applicants as well as potential areas of inaccurate or outdated information. Conclusions: There are several interventions programs can undertake to address existing gaps in online presence. During an application cycle facing unprecedented resource strain, bolstering the online presence of programs may facilitate an improved fit between programs and future residents.