Southern medical journal
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Southern medical journal · Nov 2024
ReviewHealthcare Provider Burnout: Red Flag for a Rising Epidemic.
This article aims to broaden the understanding of burnout in healthcare providers, its causes, and its reduction strategies. The objectives are to raise awareness, facilitate early intervention, and, ultimately, improve the overall well-being of healthcare providers and the quality of patient care. ⋯ Burnout awareness should be a priority from the early stages of healthcare providers' careers because it is crucial for maintaining their well-being, preventing medical errors, and sustaining high-quality patient care. The identification and prevention of burnout are deemed vital not only for the well-being of healthcare providers but also to safeguard against potential harm to patients. This article calls for increased awareness of burnout, its underlying causes, and the implementation of effective reduction strategies in the healthcare profession.
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Southern medical journal · Nov 2024
Multicenter Study Comparative StudyEfficacy and Safety of Direct Oral Anticoagulants Compared to Warfarin in Patients with Cirrhosis and Splanchnic Vein Thrombosis.
The incidence of splanchnic vein thrombosis (SVT) is reported to be <25 times lower than that of deep vein thrombosis and pulmonary emboli, which occur in 70 to 270/100,000 cases in the general population. Current guidelines recommend initial treatment with therapeutic low-molecular-weight heparin followed by a transition to a vitamin K antagonist (VKA) or a direct oral anticoagulant (DOAC) in patients with cirrhosis who develop SVT without severe liver dysfunction. This, however, is based on observational data. This study aimed to evaluate the efficacy and safety of anticoagulant therapy in patients with cirrhosis who present with SVT and receive either a DOAC or a VKA. ⋯ The use of DOACs in patients with cirrhosis who present with SVT may be efficacious and safe compared with warfarin. The findings from our study may inform power analyses for well-conducted randomized trials to confirm these findings.
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Southern medical journal · Nov 2024
Clinical Shift Distribution in Academic Hospital Medicine Fellowship across 10 Years.
As hospital medicine (HM) has grown as a specialty, it has been paralleled by an increase in HM fellowship training programs. Limited data are available surrounding clinical exposure for HM fellows. Using data from a large academic medical center with a long-standing HM fellowship program, we reviewed the types of clinical shifts and distribution of shift data completed by HM fellows from 2013 to 2023. ⋯ HM fellows spend the majority of their clinical time on off-hours shifts, which does not reflect the clinical practice of an academic hospitalist. The least amount of time was spent attending on traditional teaching services. Because HM fellowships are designed to prepare HM fellows for careers as academic hospitalists, more work is necessary to determine how best to optimize and standardize clinical exposure while maintaining adequate time for opportunities to engage in academic development.
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Southern medical journal · Nov 2024
Effect of HIV Status and Charlson Comorbidity Index on COVID-19 Clinical Outcomes in a Case-Control Study.
During the course of the coronavirus disease 2019 (COVID-19) pandemic, numerous comorbidities were identified as risk factors for increased morbidity and mortality. Few studies have examined human immunodeficiency virus (HIV) and COVID-19 co-infection and the impact of HIV on COVID-19 outcomes. In this study, we compared outcomes of people living with HIV with COVID-19 with a control group to examine outcomes. ⋯ We found no difference in outcomes of people living with HIV in comparison to matched controls based on HIV status but found that an increased Charlson Comorbidity Index score led to increased morbidity and mortality regardless of HIV status.
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Southern medical journal · Nov 2024
Neighborhood Ecologies, Cases, and Deaths during the Beginning of the COVID-19 Pandemic: Lessons for Current and Future Epidemics?
The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected Black and Latinx communities. Ecologic analyses have shown that counties with a higher percentage of Latinx and Black people have worse COVID-19 outcome rates. Few ecologic analyses have been published at the neighborhood (census tract) level. We sought to determine whether certain sociodemographic neighborhood ecologies were associated with COVID-19 case and death rates in metropolitan Atlanta, Georgia. ⋯ Neighborhoods were differentially at risk of COVID-19 cases or deaths depending on their sociodemographic ecology at the beginning of the COVID-19 pandemic. Prevention methods and interventions may need to consider different social determinants of health when addressing potential cases and deaths during future emergent epidemics.