J Natl Med Assoc
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Kikuchi-Fujimoto (KF) disease, also known as necrotizing histiocytic lymphadenitis, is a rare cause of fever of unknown origin. Most commonly seen in Japanese populations, it presents with fever and diffuse lymphadenopathy. KF can present a diagnostic challenge as its presentation can mimic sepsis, autoimmune disease, and/or malignancy. We present a case of KF disease presenting with innumerable pulmonary nodules and suspected sepsis. ⋯ Patients with innumerable pulmonary nodules and fever of unknown origin should be evaluated early in their hospital course for KF as early diagnosis can reduce excessive testing and shorten hospital stay.
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The goal of this study was to identify factors that influence the selection of Neurology as a career choice for Black medical students. ⋯ Neurological disorders are important contributors to morbidity and mortality. It is imperative that the field attract medical students toward careers in Neurology, particularly those students from traditionally and persistently underrepresented backgrounds. Our findings suggest that Black medical students consider Neurology as a specialty choice less frequently than their counterparts do, and this decision may be made prior to training. We conclude that a multifaceted approach is best to improve the racial/ethnic diversity within the neurological workforce, which should include targeted interventions prior to and after matriculation to medical school.
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Despite advances in healthcare and improved chemotherapy, disparities in breast cancer outcomes continue to persist. Our aim was to evaluate socioeconomic factors that may impact timing of treatment for patients receiving chemotherapy in underserved communities. ⋯ Older age and non-English language were associated with prolonged time from surgery to adjuvant chemotherapy. Targeted interventions directed at patient education and decreasing language barriers especially post-operatively may decrease delays in treatment and subsequently reduce disparities seen in the breast cancer population.
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Accreditation standards in medical education require curricular elements dedicated to understanding diversity and addressing inequities in health care. The development and implementation of culturally effective care curricula are crucial to improving health care outcomes, yet these curricular elements are currently limited in residency training. ⋯ The implementation of a comprehensive resident EDI curriculum was feasible earning positive evaluations in its first year, with requests for additional content. It has also spurred multiple institution-wide ripple effects. Suggestions for improvement included more case-based learning, skills practice, and simulation. Future steps include expansion of this EDI curriculum to faculty and examining its impact in resident of color affinity groups. Given ACGME requirements to improve training addressing equity and social determinants of health, this curriculum development process serves as a possible template for other training programs.
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Racial health disparities persist despite increased public awareness of systemic racism. Due to the inherent subjectivity of pain perception, assessment and management, physician-patient bias in pain medicine remains widespread. It is broadly accepted that increasing racial diversity in the field of medicine is a critical step towards addressing persistent inequities in patient care. ⋯ Of the total eligible resident pool for pain fellowships (n = 30,415) drawn from core specialties, 44% were non-Hispanic White, 4.9% non-Hispanic Black and 5.1% Hispanic. Similar proportions were observed for pain medicine and regional anesthesia fellows. We briefly discuss the implications of the shortage of non-Hispanic Black and Hispanic representation in pain medicine as it relates to the COVID-19 pandemic and suggest approaches to improving these disparities.