The American journal of the medical sciences
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Training young physicians to perform research is challenging on many levels. Thus, many internal medicine training programs, including both core and subspecialty programs, struggle with providing a rigorous and successful research experience for their trainees. Here, the authors report on the rationale, design, practical implementation and outcome of a new program that was developed at the University Gastroenterology Fellowship Training Program. ⋯ Additionally, the proportion of trainees remaining in academic medicine increased from 14% before implementation of the program to 51% after it began. Several elements were viewed to be critically important for the program including the following: communication of expectations and development of a robust program structure, dedicated protected time, a dedicated research curriculum, programmatic support, mentorship and oversight as well as accountability/tracking of accomplishments. The authors conclude that institutions able to adopt these or similar approaches will reap the many rewards of discovery research performed by trainees.
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Multicenter Study
CUR-65 Score for Community-Acquired Pneumonia Predicted Mortality Better Than CURB-65 Score in Low-Mortality Rate Settings.
It is not clear whether low-blood pressure criterion could be removed from CURB-65 (confusion, urea >7 mmol/L, respiratory rate ≥30/min, low blood pressure and age ≥65 years) score to orchestrate an improvement in identifying patients with community-acquired pneumonia (CAP) in low-mortality rate settings. ⋯ CURB-65 score could be simplified by removing low blood pressure to orchestrate an improvement in predicting mortality in CAP patients who have a low risk of death. A CUR-65 score of ≥2 might be a more valuable cutoff value for severe CAP.
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Intra-abdominal hypertension is identified as an independent risk factor for death. However, this pathophysiological state is not always considered in patients in medical intensive care units and is frequently underdiagnosed. ⋯ Bladder pressure measurements provide an easy method to estimate intra-abdominal pressures and provide an additional tool for the physiologic assessment of critically ill patients.