Southern medical journal
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Common variable immunodeficiency (CVID) is one of the most common primary immunodeficiencies encountered by physicians, yet it is still poorly described and vastly underdiagnosed and underreported. It is characterized by low levels of immunoglobulins IgG, IgM, and IgA, recurrent infections, and an increased incidence of autoimmune conditions and malignancies. Diverse clinical presentation, poor understanding of its true prevalence, and the daunting, rarely ordered, diagnostic testing make this disease incredibly difficult to diagnose in a primary care setting. Our objectives in this study were to establish a simple marker that can be used in a primary care setting to raise suspicion of CVID and prompt further diagnostic testing and to demonstrate that the true prevalence of CVID is much higher than previously reported. ⋯ Patients with Ig deficiencies tend to have a higher number of office visits related to infectious processes. This difference, however, was not statistically significant in our study, likely because of the small number of participants. Our study also demonstrated that the prevalence of CVID is likely much higher than currently reported, and it highlights the difficulties related to the convoluted diagnostic process of this disease.
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Southern medical journal · Aug 2022
Implementation of a Night-Float Curriculum: Impact on Intern Confidence over Time.
Formal nighttime education is becoming increasingly necessary as more internal medicine (IM) residency programs adopt night-float rotations (NFRs); however, the efficacy of an NFR curriculum throughout an academic year and which topics in an NFR curriculum increase trainee confidence are unknown. We implemented a 12-module, self-paced NFR curriculum for 76 postgraduate year-1 residents at an academic IM residency program. We evaluated the impact of this curriculum on postgraduate year-1 residents' clinical confidence, as well as longitudinal efficacy of the curriculum. ⋯ It may be especially important to emphasize an NFR curriculum at the beginning of the academic year. IM residency programs also may wish to carefully consider that certain topics may maintain their efficacy throughout the year, whereas other topics should potentially be replaced with more complex modules as the academic year progresses.
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Southern medical journal · Aug 2022
Eligible Prescriber Experiences with Substance Use Disorder Treatment and Perceptions of Pharmacy Barriers to Buprenorphine.
The primary aim of this study was to better understand North Carolina providers' specific substance use disorder (SUD) and opioid use disorder treatment practices and buprenorphine prescribing. Furthermore, this study aimed to provide novel information regarding US South and rural providers' opioid use disorder treatment behaviors and perceptions of patient experience at community pharmacies. ⋯ Early detection of SUDs can help prevent negative health outcomes for patients. Regardless of patient rurality, providers should screen for SUDs and familiarize themselves with the patient's experience when filling a buprenorphine prescription, along with possible barriers. Furthermore, providers should incorporate questions about their patient's ability to receive buprenorphine to help ensure that patients are receiving proper and necessary treatment.
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Southern medical journal · Aug 2022
Prevalence of Fatty Liver among Children under Multiple Machine Learning Models.
To analyze the possible factors causing fatty liver in children based on ultrasound data of children in south Texas, and to establish machine learning models of fatty liver in children to provide ideas for the prevention and treatment of fatty liver in children. ⋯ Based on the analysis of the results of the two prediction models established by logistic regression and CatBoost, we determined that the mean probability of fatty liver in severely obese children was between 74.47% and 92.22%, 73.45% and 85.41% in obese children, and slightly higher in boys than in girls, with a mean difference of 3.00% to 3.95%.