Postgraduate medicine
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Health care has become increasingly fragmented, partly due to advancing medical technology. Patients are often managed by various specialty teams when presenting with symptoms that could be manifestations of different diseases. Approximately one third of them are referred to specialists, at over half for outpatient appointments. ⋯ Communication between doctors could improve continuity. There are many differences and similarities in the pathophysiology, symptomatology, diagnosis, and treatment of fibromyalgia, Sjogren's syndrome, and depression. Understanding the associations between fibromyalgia, Sjogren's syndrome and depression should improve clinical outcome via a common holistic approach.
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Postgraduate medicine · Sep 2020
Assessment of Adequacy of Respiratory Infection Prevention in Hospitals of Inner Mongolia, China: A Cross-sectional Study using Unannounced Standardized Patients.
Recent respiratory infectious disease (RID) outbreaks of influenza and the novel coronavirus have resulted in global pandemics. RIDs can trigger nosocomial infections if not adequately prevented. ⋯ There is a need to improve respiratory infectious disease procedures in our study hospitals, especially in outpatient and emergency departments.
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Objectives: Atopic dermatitis, or eczema, is an inflammatory illness that impacts individuals of all ages. The cost of treating AD and the impact on the quality of life have not been well documented in the state of Nevada. This study seeks to fill this gap by identifying factors that impact the cost of AD in the state utilizing clinical and patient demographics. ⋯ In the outpatient setting, physician type, region, and African American race remained significant (p < 0.05). Conclusions: Data from this study indicate that the AD cost burden is dependent on both demographic and clinical factors in the state of Nevada. These differences suggest that patients with AD may encounter higher costs depending on age, race, and clinical factors.
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Postgraduate medicine · Sep 2020
Psychiatry teaching amongst medical undergraduates: stories that matter and mediators of better learning outcome.
Psychotic disorders can exact a toll on both patients and caregivers. Whilst the desired teaching goals include gaining an understanding of the manifestations, neurobiology and treatment of these conditions, such concepts may appear abstract to medical undergraduates new to psychiatry before their clinical rotation. This study aimed to examine the use of patient narratives in teaching. Based on self-determination and Kolb's learning theories, it was hypothesized that intermediate processes (such as engagement, motivation, reflection) mediate narratives' effectiveness as a pedagogical tool. ⋯ Consistent with adult learning theories, the use of narratives can improve appreciation of psychotic spectrum disorders via better engagement, motivation, and reflection within learners. Appropriate narratives can be incorporated into other topics to enhance undergraduate psychiatry education.
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Postgraduate medicine · Sep 2020
Case ReportsPrimary retroperitoneal paraganglioma mimicking a ureteral tumor: A case report and literature review.
Paragangliomas (PGLs) arise from chromaffin cells of the extra-adrenal sites along the sympathetic and/or the parasympathetic chain. Majority of the PGLs occur in the abdomen. When retroperitoneal PGLs produce symptoms of compression or invasion of adjacent organs, they could be misdiagnosed as a tumor of adjacent organs. ⋯ A histopathological examination of the tumor confirmed retroperitoneal PGL partly infiltrating the ureter. The patient's blood pressure returned to the normal range postoperatively. Our case demonstrates the importance of considering extra-adrenal PGL in the differential diagnosis of retroperitoneal tumors.