Invited Commentary

Commentary on “Characterization of Sleep Patterns and Problems in Healthcare Workers in a Tertiary Care Hospital”

Although there is no unifying theory that explains the physiological effects of sleep, it is generally agreed upon that sleep is indispensable to human survival. The optimal amount of sleep (duration and quality) for a given individual is that which meets his or her biological needs, thus allowing the person…

Review Article

Negative Predictive Value of Cardiac Troponin for Predicting Adverse Cardiac Events Following Blunt Chest Trauma

Cardiac-specific troponins (Tns) are sensitive and specific markers of myocardial injury that have been shown to be predictive of outcomes in many cardiac and noncardiac conditions. We sought to determine whether normal cardiac Tn concentrations obtained during the first 24 hours following blunt chest trauma would predict good cardiac outcomes….

Original Article

Diabetic Ketoalkalosis in Children and Adults

Objectives Diabetic ketoacidosis (DKA) with metabolic alkalosis (diabetic ketoalkalosis [DKALK]) in adults has been described in the literature, but not in the pediatric population. The discordance in the change in the anion gap (AG) and the bicarbonate is depicted by an elevated delta ratio (DR; rise in AG/drop in bicarbonate),…

Editor's Response

Editor’s Response

I appreciate the letter from Roffey and colleagues regarding their recommendations for minimizing the demoralization syndrome, which is not uncommon in patients who are cared for in the intensive care unit setting. In particular, their experience with this syndrome in patients with cancer points out to clinicians that we must…

Original Article

No Difference in Emergency Department Length of Stay for Patients with Limited Proficiency in English

Objectives The population of the United States continues to diversify, with an increasing percentage of individuals who have limited English proficiency (LEP). A major concern facing emergency departments (EDs) around the country is increasing length of stay (LOS). Although multiple studies have shown racial and ethnic disparities in waiting time…

Invited Commentary

Commentary on “Gynecomastia: Etiologies, Clinical Presentations, Diagnosis, and Management”

In this issue of the Southern Medical Journal, Ladizinski and colleagues present an insightful review of gynecomastia.1 Helpful information on etiologies, diagnosis, and management was reviewed, but one of the more surprising finds was the fact that gynecomastia is found in up to 57% of men.1

Original Article

Characterization of Sleep Patterns and Problems in Healthcare Workers in a Tertiary Care Hospital

Objectives Restrictions in sleep can have important adverse effects on health and job performance. We collected information about sleep from US healthcare workers to determine whether they had sleep difficulties. Methods We used an Internet-based survey to collect information on sleep patterns and sleep quality in healthcare workers at a…

Review Article

Gynecomastia: Etiologies, Clinical Presentations, Diagnosis, and Management

Gynecomastia is a common finding that is present in up to 57% of men. It is caused by proliferation of the mammary glands, which leads to the development of dense subareolar tissue. The condition results from both physiologic (eg, hypogonadism, altered estrogen-to-androgen ratio) and nonphysiologic (eg, drugs, herbal products) causes….

Letter to the Editor

Total Care (Spirituality, Positive Psychology, and Surgical Home) to Minimize Demoralization Syndrome in Intensive Care Unit Setting

To the Editor Demoralization syndrome is a condition of existential distress that occurs in patients with serious and advanced diseases. It was described more than a decade ago in the palliative care setting by Kissane and colleagues, who distinguished it from depression and other psychological illnesses.1 The core features of…

Original Article

Sex-Specific Substance Abuse Treatment for Female Healthcare Professionals: Implications

Objectives Gender plays a significant role in the development and treatment of substance abuse disorders. Sex-specific treatment for girls and women has recurrently proven more effective, with better outcomes than traditional treatment. Research on impaired healthcare professionals (HCPs) has largely focused on men, garnering little attention for women and sex…

Invited Commentary

Commentary on “Evaluation of a Points-Based Scholarly Activity Policy in Internal Medicine”

The importance of research training in internal medicine residency programs has long been recognized. In 1994, the Accreditation Council for Graduate Medical Education (ACGME) implemented a scholarly activity requirement.1 Since that time, residency programs have worked to find a formula for success in resident research training. To accomplish this, programs…

Original Article

Evaluation of a Points-Based Scholarly Activity Policy in Internal Medicine

Objectives The Accreditation Council for Graduate Medical Education requires that scholarly activity be carried out in residency programs without numerical guidelines for publication of papers by residents. Until now, publication-to-resident ratios (PTRR) have not been reported in internal medicine (IM) programs. This article describes the 5-year resident publication record of…

Review Article

Graves Orbitopathy: Update on Diagnosis and Therapy

Graves orbitopathy (GO) is an autoimmune disorder representing the most frequent extrathyroidal manifestation of Graves disease. It is rare, with an age-adjusted incidence of approximately 16.0 cases per 100,000 population per year in women and 2.9 cases per 100,000 population per year in men. GO is an inflammatory process characterized…

Letter to the Editor

Spot Clinical Diagnosis (Revisited)

To the EditorIn recent decades, emphasis has been increasingly placed on laboratory and radiologic results for diagnosis. Moreover, experienced clinicians knowledgeable in clinical diagnosis are becoming scarce, and thus, “passing the torch,” regarding the finer points of clinical diagnosis, has been more of a challenge. In the spirit of reengaging…

Announcement

Announcement

CME Instructions

Original Article

All-Cancers Mortality Rates Approaching Diseases of the Heart Mortality Rates as Leading Cause of Death in Texas

Objectives Diseases of the heart and malignant neoplasms (all-cancers) are the leading causes of death in the United States. The gap between the two has been closing in recent years. To assess the gap status in Texas and to establish a baseline to support evaluation efforts for the Cancer Prevention…

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