J Natl Med Assoc
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Despite recent attention to social justice, diversity, equity, and inclusion within medical education, little is currently known about whether and to what extent that attention has translated into the language of formal documents articulating organization purpose: medical school mission statements. Mission statements are the marquee declaration of a medical school's identity and purpose, and a recommended tool for applicants to determine "fit" when applying. This study examines whether and to what extent social justice, diversity, equity, and inclusion have made it into the formal public statements of organizational purpose and identity over the last several years. ⋯ Overall, mission statement change was quite common with most medical schools making changes across the 14 years covered in this study. And despite a doubling of the number of medical schools MSs mentioning diversity over a 10-year period, that increase seemed to slow in recent years even among schools who had a chance to change their MS. As of mid-2021, two in five US medical schools still have no mention of diversity related language in their most formal, said articulation of organizational purpose.
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Review Case Reports
Intrahepatic cholestasis in sickle cell disease: A review of diagnostic criteria, treatments, and case reports.
Objective To delineate the etiology, symptomatology, and treatment of sickle cell intrahepatic cholestasis (SCIC). Sickle cell disease (SCD) is the most frequently inherited hematologic disease, and SCIC is one rare and often fatal complication and comorbid disease. The literature contains only a small number of case reports involving SCIC and hence limited guidance can be obtained. ⋯ We reported consistencies in clinical presentation and treatment outcomes among cases as well as serological and hematological finding. Conclusions While there is some consistency in the symptom presentation of individuals with SCIC, reliable evaluation and clinical procedures were not demonstrated in what we reviewed. Further research is needed to delineate the attributes of this complicated disease that occurs within SCD.
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Breast cancer is the most lethal malignancy for women worldwide. Developed countries, such as Portugal, Spain, and the United States, have declining mortality rates due to breast cancer; however, in developing countries, the epidemiological reports are scarce. In this context, the aims of this study are to describe and discuss the female breast cancer profile of hospitalization and mortality according to age and geographic region in Brazil from 2008 to 2019. ⋯ We have shown an increase in morbidity and mortality over time, which is dependent on patients' age and region. The results presented here may contribute to the ongoing discussion about the role and future perspectives of the Brazilian health care system, especially regarding to the strategies for the prevention, control, and treatment of breast cancer.
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Colorectal cancer screening has been shown effective at reducing stage at presentation, but there is differential uptake of screening based on insurance status. We sought to determine the population-level effect of Medicare and screening guidelines on colorectal screening by race and region. ⋯ Our data highlight the significant impact that near-universal insurance has on reducing colorectal cancer stage at presentation in areas with poor baseline insurance coverage, particularly for Black patients. To reduce disparities in advanced stage at presentation for colorectal cancer, state-level insurance coverage should be addressed.