Perspectives

Physician Well-Being and Medical Ethics

Not many people would feel comfortable boarding an airplane knowing that the pilot at the controls had been working for 24 hours straight, without a break. Excessive working hours, sleep deprivation, and the resulting fatigue and exhaustion can increase the potential for human error.1 The link between excessive working hours…

Original Article

Opioid Education in Obstetrics and Gynecology Training Programs

Objective: Our primary objective was to assess the current state of pain and opioid education in obstetrics and gynecology (OBGYN) by performing a detailed review of the national educational curricula guiding OBGYN residency and fellowship training programs in the United States. Methods: From 2019 to 2020 we reviewed seven documents…

Original Article

Does Medical Students’ High Expression of Empathy Correlate with Their Choice of Primary Care Residencies?

Objectives: There are many factors that influence medical students’ (MS) decisions when choosing a career. Some prominent factors include life–work balance, indebtedness, and flexibility of work hours. Whereas the expression of empathy has many positive correlates with a trusting and meaningful physician–patient interaction, only a few studies have analyzed the…

Original Article

Examining Pediatric Residency Voting Practices

Objective: Voting is one of our civic duties, yet many Americans do not vote, and physician voter participation is even lower than that of the general public. We aimed to explore pediatric residents’ attitudes and behaviors in regard to voting and assess the impact of interventions aimed at increasing resident…

Original Article

Using a Hybrid Lecture and Small-Group Standardized Patient Case to Teach the Inclusive Sexual History and Transgender Patient Care

Objectives: Previous negative experiences with the medical community often leave transgender people reluctant to seek medical care. Inadequate teaching and exposure to transgender health during medical training perpetuates the health disparities experienced by this community. Although undergraduate medical education is uniquely positioned to address these disparities, curricular coverage of these…

Original Article

CME Article: Historical Alternans in the Emergency Department (H.A.t.E.D.) for Pain: An Analysis of Patient Pain Descriptors to Attending and Trainee Clinicians

Objectives: The concept of “historical alternans” (HA), a teaching folklore term referring to different descriptions of patient histories to trainees versus attending clinicians, can cause disjointed care and be a source of frustration for the trainee. Increased focus on the proper evaluation and treatment of pain in the emergency department…

Original Article

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Twins Compared with Singletons

Objectives: It is well known that twin pregnancies confer a high degree of adverse perinatal outcomes. Fetal growth restriction, preterm labor/delivery, and hypertensive disorders of pregnancy are among the causal etiologies associated. Hematologic parameters, specifically, the neutrophil:lymphocyte ratio (NLR), the platelet:lymphocyte ratio (PLR), and some of the routine complete blood…

Perspectives

Early Initiation of Combination Feeding among Latina Mothers in the Deep South: Perspectives for Clinicians

Research suggests that exclusive breastfeeding supports optimal infant growth and development,1,2 protects against infections and allergic diseases,2,3 and confers benefits to mothers, including reduced risk of ovarian and breast cancers.1–3 Current infant feeding recommendations from the American Academy of Pediatrics call for exclusive breastfeeding—when an infant is fed only breast…

Original Article

Do Geographic Region, Pathologic Chronicity, and Hospital Affiliation Affect Access to Care Among Medicaid- and Privately Insured Foot and Ankle Surgery Patients?

Objectives: Studies have shown that patients enrolled in Medicaid have difficulty obtaining access to care compared with patients with private insurance. Whether variables such as geographic location, state expansion versus nonexpansion, and private versus academic affiliation affect access to care among foot and ankle surgery patients enrolled in Medicaid has…

Original Article

Patients Desire Personalized, Specific, and Continuous Advice on Weight Management

Objective: To deliver effective care, healthcare systems should understand patients’ preferences for weight management across a spectrum of needs. Our objective was to describe patients’ perceptions of what helps or hinders weight loss and maintenance. Methods: Semistructured interviews were conducted with patients who accessed weight management services at a large…

Original Article

Efficacy and Safety of Nonvitamin K Oral Anticoagulants following Cardiac Valve Replacement

Objective: To compare the efficacy and safety of nonvitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) following bioprosthetic cardiac valve replacement. Methods: This was a retrospective analysis conducted at a community teaching hospital in the southeastern United States between August 2015 and August 2018. Patients 18 years of…

Review Article

Renin-Angiotensin-Aldosterone System (RAAS) Inhibitors and Coronavirus Disease 2019 (COVID-19)

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic. The angiotensin-converting enzyme 2 (ACE2) has been proven to be used by SARS-CoV-2 for host cell entry. Considering that angiotensin receptor blockers and ACE inhibitors (ACEIs) upregulate the expression of ACE2 in animal…

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