J Natl Med Assoc
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There is increasing evidence that testosterone deficiency has key associations with insulin sensitivity and glycemic control. Its presence may therefore contribute to and/or exacerbate clinical disease in men with type 2 diabetes mellitus (T2DM). This study sought to determine the frequency of low free testosterone and explore its relationship with, insulin sensitivity and glycemic control among Nigerian men with T2DM. ⋯ We conclude that low serum testosterone is common among men with T2DM and has a significant association with glycemic control (HbA1c) and insulin sensitivity.
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In the United States, it is estimated that 2.4 million people are currently infected with the hepatitis C virus (HCV). In order to address HCV infection management in the U.S., several government entities collaborated to develop and release a multistep plan for the prevention, care, and treatment of viral hepatitis. Optimal health outcomes from the plan are contingent upon addressing each of the several steps in the HCV care cascade. Among the critical challenging steps is linkage to care and access to treatment. Of the nearly three million people in the U.S. infected with HCV, only 43% have been linked to care, 16% have received treatment, and 9% have had their infection resolved. ⋯ HCV infections remain a major public health concern among patients in the District of Columbia. This study identified fibrosis stage and prior insurance denial as primary barriers to access of HCV treatment. While there are many points in the hepatitis cascade of care in which patients can lose access to or fail treatment completion, the primary point of intervention in our patient population appears to be during the initiation of treatment and insurance prior authorization process.
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Current projections anticipate a dramatic shift from historical population demographics in the United States. Racial and ethnic minorities are expected to constitute the majority of the population by 2050. However, racial minorities continue to be underrepresented in medical school admissions and the physician workforce. Creating a medical student and physician workforce that reflects population demographics of their patients will be an important determinant in promoting public health and health equity. ⋯ The authors call on medical students across the country to join in pursuit of health equity and a diverse physician workforce that reflects the evolving demographics of the United States. Medical students can impact the health of local communities through implementation of educational outreach programming to facilitate access to medical education for middle and high school students.