Southern medical journal
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Southern medical journal · Feb 2023
ReviewHypertension in Chronic Kidney Disease: An Update on Diagnosis and Management.
Hypertension (HTN) and chronic kidney disease (CKD) are pathophysiologic states that are intimately related, such that long-term HTN can lead to poor kidney function, and renal function decline can lead to worsening blood pressure (BP) control. HTN in CKD is caused by an interplay of factors, including salt and water retention, with extracellular volume expansion, sympathetic nervous system overactivity, renin-angiotensin-aldosterone system activation, and endothelial dysfunction. ⋯ With accumulating evidence, the diagnosis as well as management of HTN in CKD has been evolving in the last decade. In this comprehensive review based on current evidence and recommendations, we summarize the basics of pathophysiology, BP variability, diagnosis, and management of HTN in CKD with an emphasis on special populations with CKD.
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Southern medical journal · Feb 2023
ReviewReducing Infection Rates with Enhanced Preoperative Diabetes Mellitus Diagnosis and Optimization Processes.
Hyperglycemia and increased preoperative hemoglobin A1c (HbA1c) are associated with perioperative morbidity and death. For nonurgent operations, adequate glycemic control before surgery is recommended. Our surgical practice needed a process for preoperative diabetes mellitus (DM) diagnosis and glycemic optimization. ⋯ The implemented process benefited patients scheduled for nonurgent procedures by optimizing glucose control and lowering infection rates through earlier preoperative DM diagnosis, glycemic management, and standardized patient medication instruction.
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Southern medical journal · Feb 2023
Women's Health Provider Perspectives on Reproductive Services Provision in the Veterans Health Administration.
Women veterans are a fast-growing population in the Veterans Health Administration (VHA), and ensuring reproductive service availability is a VHA priority. As such, we sought to explore barriers and facilitators to VHA reproductive service provision across a catchment area from women's health providers' perspectives. ⋯ Addressing barriers to VHA reproductive healthcare provision may overcome reproductive service variations related to clinic location and improve reproductive health outcomes for women veterans.
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Southern medical journal · Feb 2023
Retaining Faculty from Underrepresented Groups in Academic Medicine: Results from a Needs Assessment.
Academic medical centers can improve the quality of care and address health inequities by recruiting and retaining faculty from underrepresented in medicine (URiM) groups; however, the retention of URiM faculty is a barrier to reaching equity-related goals because URiM faculty are less likely to remain in academia and be promoted compared with their peers. As such, the objective of this study was to determine factors that influence the retention of URiM faculty at large academic centers. ⋯ This study underscored the importance of supportive leadership, URiM-specific faculty development programs, networking opportunities, and the recognition of achievements as factors that influence the retention of faculty at a large academic medical center. In addition, participants highlighted the need for strong mentor networks and emphasizing sponsorship.
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Southern medical journal · Feb 2023
Retrospective Study of Psychiatric Hospitalizations in a West Texas Mental Health Treatment Facility during the COVID-19 Pandemic.
The association between the coronavirus disease (COVID-19) pandemic and adverse mental health outcomes has been well documented; however, little is known about its impact in rural areas of the United States. This study aims to characterize and compare inpatient psychiatric admissions in West Texas before and during the initial months of the COVID-19 pandemic. ⋯ Rural communities in West Texas experienced a decrease in psychiatric hospitalizations during the beginning of the COVID-19 pandemic, followed by an increase as lockdown restrictions began to lift; this warrants further investigation into healthcare service utilization during the pandemic.