Recent ucsdsom_isp items

Adolescent metabolic syndrome risk is increased with higher infancy weight gain and decreased with longer breast feeding

Thu, 17 Nov 2022 00:00:00 +0000

Adolescent metabolic syndrome risk is increased with higher infancy weight gain and decreased with longer breast feeding

Spot urine sodium measurements do not accurately estimate dietary sodium intake in chronic kidney disease.

Thu, 17 Nov 2022 00:00:00 +0000

Sodium intake influences blood pressure and proteinuria, yet the impact on long-term outcomes is uncertain in chronic kidney disease (CKD). Accurate assessment is essential for clinical and public policy recommendations, but few large-scale studies use 24-h urine collections. Recent studies that used spot urine sodium and associated estimating equations suggest that they may provide a suitable alternative, but their accuracy in patients with CKD is unknown.

We compared the accuracy of 4 equations [the Nerbass, INTERSALT (International Cooperative Study on Salt, Other Factors, and Blood Pressure), Tanaka, and Kawasaki equations] that use spot urine sodium to estimate 24-h sodium excretion in patients with moderate to advanced CKD.

We evaluated the accuracy of spot urine sodium to predict mean 24-h urine sodium excretion over 9 mo in 129 participants with stage 3-4 CKD. Spot morning urine sodium was used in 4 estimating equations. Bias, precision, and accuracy were...

Coronary Artery Aneurysms in Kawasaki Disease: Risk Factors for Progressive Disease and Adverse Cardiac Events in the US Population

Thu, 17 Nov 2022 00:00:00 +0000

Background

The natural history of coronary artery aneurysms (CAA) after intravenous immunoglobulin (IVIG) treatment in the United States is not well described. We describe the natural history of CAA in US Kawasaki disease (KD) patients and identify factors associated with major adverse cardiac events (MACE) and CAA regression.

Methods and Results

We evaluated all KD patients with CAA at 2 centers from 1979 to 2014. Factors associated with CAA regression, maximum CA z‐score over time (zMax), and MACE were analyzed. We performed a matched analysis of treatment effect on likelihood of CAA regression. Of 2860 KD patients, 500 (17%) had CAA, including 90 with CAA z‐score >10. Most (91%) received IVIG within 10 days of illness, 32% received >1 IVIG, and 27% received adjunctive anti‐inflammatory medications. CAA regression occurred in 75%. Lack of CAA regression and higher CAA zMax were associated with earlier era, larger CAA z‐score at diagnosis, and bilateral CAA...

Parental and Youth Understanding of the Informed Consent Process for Pediatric Endoscopy

Thu, 17 Nov 2022 00:00:00 +0000

Parental and Youth Understanding of the Informed Consent Process for Pediatric Endoscopy

Focused clinical multi-disciplinary ISP final project: substance use disorder and PTSD

Thu, 29 Oct 2020 00:00:00 +0000

Multiple theories about the association between Post Traumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) have been proposed, but there is yet to be a common consensus on their exact relationship. Regardless of the etiology of their association, it is reasonable to suggest that the interaction between SUD and comorbid PTSD is complex. The intention of this project was not to dive deeper into the suggested theoretical models, but rather to focus on understanding how these conditions affect patients and on a pragmatic approach to treatment. This was based largely in principle on two observations from prior studies. One of which was the fact that patients with the SUD/PTSD are more likley to struggle with treatment for substance use disorder in regards to retention and periods of abstinence. Second was the realization that patients with comorbid disease have higher rates of homelessness, physical health problems, psychiatric cormorbities, and psychosocial impairment...

Growth chart basics in 3 minutes: A resource for improving parent’s understanding of growth charts

Thu, 29 Oct 2020 00:00:00 +0000

As information technology continues to improve, patients are given access to increasing amounts of their health data. Health applications such as Epic MyChart provide an easily accessible archive of information for both patients and, in the case of pediatrics, parents. With increasing amounts of available information there is a concurrent need to provide education about interpretation. This study aimed to create a short, parent-focused, educational video to convey high-yield information regarding growth chart data. A pre- and post-survey were administered in conjunction with the educational video using QR codes at pediatric offices in La Jolla. We found, in general, parents felt well-equipped to be active participants in their child’s health, but identified some areas for improvement regarding perceptions of health.

Massage therapy in the neurologic intensive care unit

Thu, 29 Oct 2020 00:00:00 +0000

Massage therapy in the NICU appears to be safe, feasible, and improves patient pain self-assessment without vital sign instability.

Reducing opioid doses prescribed from a pediatric emergency department

Thu, 29 Oct 2020 00:00:00 +0000

Background: opioid overdose and abuse have reaches epidemic rates in the United States. Legitimate prescriptions are a large source of opioid misuse in adults and adolescents. The goal of this quality improvement project was to reduce opioid exposure from our pediatric emergency department (ED).

Implementing bilingual labor & delivery education modules for the centering pregnancy curriculum at Chula Vista Medical Plaza

Thu, 29 Oct 2020 00:00:00 +0000

The aim of this project was to create supplemental education modules to assist in the labor and delivery sessions, Sessions 5 and 6, of the CenteringPregnancy curriculum hosted at Chula Vista Medical Plaza in order to allow participants that are monolingual in Spanish to better understand the processes of labor and delivery. The activities already in place from the curriculum made assumptions about patient understandings of their own anatomy, what uterine contractions are, and stages of labor. By designing education tools that were more visual, barriers in language that prevent understanding of educational content could be overcome. Most importantly, participants could feel empowered in their pregnancies by understanding the physiological changes their bodies would experience during labor and delivery.

Patient attitudes regarding online sources of health information

Thu, 29 Oct 2020 00:00:00 +0000

Health literacy, generally defined as an individual's skill in obtaining and understanding information related to their health, has been shown to have significant impact on patient outcomes. Low health literacy is associated with higher rates of hospitalization and health care resource utilization, higher prevalence and severity of chronic disease, and worsened global measures of health including mortality. Poor health literacy is prevalent in the United States; as many as 36 percent of the population demonstrates limited health literacy. Rates are higher in certain subgroups such as the elderly, minorities, and those of low education or socioeconomic status. Given the wide prevalence and far-ranging effects on long-term health outcomes, efforts to improve health literacy nationally clearly offer significant benefits across the population. This study surveyed ambulatory patients at four clinic sites within the UCSD health care system. Patients were offered participation in the...

Development of an organotypic slice culture protocol and proof of cultured sample viability

Thu, 29 Oct 2020 00:00:00 +0000

Ischemia reperfusion injury is a major cause of morbidity and mortality worldwide. A better understanding of the cardioprotective effects of anesthetics is needed to open up opportunities for research in a variety of medical fields such as internal medicine, geriatrics, cardiology, surgery and anesthesiology. Furthermore, a better understanding of the mechanism of pre- and post- conditioning of anesthetics may lead to the development of novel cardioprotective therapeutics for older patients who are in need of cardiac surgery. This project takes a novel approach towards the study of cardiac tissue in vivo. Previously, human samples were obtained from patient surgeries. This approach presented the scientific community with several problems. First, the samples were scarce and difficult to obtain. Second, the experiments and the time available was very limited due to the viability of the tissue. New approaches include the culturing of cardiac myocytes. However, the lack of the microenvironment...

Food insecurity and food pantry utilization at the UCSD Student-Run Free Clinics

Thu, 29 Oct 2020 00:00:00 +0000

In a recent study, 74% of 430 UCSD Student-Run Free Clinic (UCSDSRFC) patients were food insecure using the 6-item USDA food insecurity screening questionnaire. 30% of the 430 had "very low food security". Since the pubilcation of this study, a robust Food Rx program has been instituted. All patients now receive a "food prescription" consisting of two 5-10 lb bags of healthy food at clinic. Additionally, food insecure patients at UCSDSRFC are often referred to food pantries. At most clinics where a Food Rx program has not or cannot be implemented, referrals to food pantries are one of few interventions available for food insecure patients. However, there is little research that addresses who is most interested in going to a food pantry and if referred patients actually go. This survey study includes 292 patients surveyed during a 3-month period. This survey included the 6-item USDA food insecurity-screening questionnaire and additional questions about food pantry utilization....

Fertility preservation and decisional regret in young breast cancer survivors: a longitudinal analysis

Thu, 29 Oct 2020 00:00:00 +0000

Fertility is important to young breast cancer survivors (YBCS). Treatment for breast cancer increases the risk of infertility. Fertility preservation prior to breast cancer treatment aims to improve options for fertility post-treatment. Fertility preservation decisions are challenging for YBCS. In retrospective cohort studies, YBCS that underwent fertility preservation experienced less decisional regret after primary cancer treatment. Objectives and hypotheses: to assess longitudinal changes in decisional regret on fertility preservation following breast cancer diagnosis; to determine if fertility concerns and fertility preservation treatment decisions are related to decisional regret.

A clinical survey evaluating the most common factors influencing a parental decision of vaccine refusal, and whether a correlation exists between vaccine refusal and the degree of trust in pediatricians

Thu, 29 Oct 2020 00:00:00 +0000

The practice of vaccine delay and refusal has recently held the attention of the medical community, most notably due to outbreaks of vaccine preventable diseases. It is a loaded subject both for parents/guardians and pediatricians; to the point of pediatricians being more likely to dismiss families who refuse vaccinations for their children. Within the field of pediatrics, this is a topic that poses a threat to the physician-patient relationshp. Studies have shown an increase in vaccine refusals in the last decade; therefore, further examination of the reasons behind this decision remains key in better understanding what drives this decision when made by some parents and guardians. This survey will attempt to cite the most common reasons for this decision directly from parents/guardians, as well as to examine if there is any significant difference between the degree of trust in pediatricians amonst parents/guardians who refuse or delay vaccines when compared to non-refusing parents/guardians....

Respect your elders- age disparities in intracranial pressure monitor use in traumatic brain injury

Thu, 29 Oct 2020 00:00:00 +0000

The Brain Trauma Foundation recommends intracranial pressure (ICP) monitor placement for patients with severe traumatic brain injury (TBI). Adherence with these guidelines in elderly patients is unknown. We hypothesized that disparities in ICP monitor placement would exist based on patient age.

Trends in emergency physician opioid prescribing practices during the United States opioid crisis

Thu, 29 Oct 2020 00:00:00 +0000

Background: prescription opioid related deaths have increased dramatically over the past 17 years. Although emergency physicians (EPs) have not been the primary force behind this rise, previous literature has suggested that EPs could improve their opioid prescribing practices. We designed this study to evaluate the trend in emergency department (ED) opioid prescriptions over time during the US opioid epidemic. Methods: we conducted a retrospective cohort study from July 1, 2012 to June 30, 2018, evaluating all adult patients who presented to two study EDs for a pain-related complaint and received an analgesic prescription upon ED discharge. We compared these data to trends in lay media and medical literature regarding the opioid epidemic. We also evaluated the incidence of repeat ED visits based on the type of analgesic prescriptions provided. Results: opioid prescriptions decreased from 37.76% to 13.29% over the six year study period. This coupled with an increase in non-opioid...

Defining the three-dimensional deformity in slipped capital femoral epiphysis

Thu, 29 Oct 2020 00:00:00 +0000

The purpose of this study was to define a novel angle measure (theta) characterizing true slipped capital femoral epiphysis (SCFE) deformity; use theta to differentiate between SCFE hips, contralateral unaffected hips, and normal hips; and to compare theta to the Southwick slip angle (SSA). 3DCT reconstructions of the pelvis and femurs were obtained and pelvic position was standardized. The center point and direction vector of the femoral epiphysis was determined. The femoral neck axis was defined. The angle between the femoral neck axis and epiphysis vector defined the 3D angle of deformity (theta). The 3D translation of the femoral epiphysis, measured as a percentage of femoral neck diameter, was measured in three planes. The average theta angle was significantly greater in SCFE hips (44.9±22.5°) compared to control (14.5±8.8°) or normal (14.0±6.5°) hips (p<0.001). There was no significant difference in theta angle between control and normal hips (p=0.83). Theta angle correlated...

Determine the feasibility of a customizable Ultrasound gel phantom for production and distribution to the masses: A cheaper, realistic gel phantom will allow more accessibility and improved training for practitioners

Thu, 29 Oct 2020 00:00:00 +0000

Simulation has become an integral part of learning new procedures and staying adept at skills already learned. Ultrasound (US) guided peripheral IV (PIV) needle insertion is a skill necessary for EM, Anesthesia, and general practice nurses and physicians. Medical schools, teaching hospitals, and community hospitals universally use simulation amongst their practitioners. Ultrasound POC use is increasing in Emergency Department (ED) and other hospital areas. Most institutions have formalized training to teach residents and nurses proper techniques for POC US use. Training models can vary from commercially available ones costing thousands of dollars to home-made ones that have a short life-span and suboptimal viewing characteristics. 1 Patient safety has been a driving force in changing medical training. "To Err is Human", a landmark study published in 1999 estimated 3% of injuries to hospital patients are caused by medical errors, resulting in between 44,000-98,000 deaths per year....

Patients who leave the emergency department without being seen and their follow-up behavior: a retrospective descriptive analysis

Thu, 29 Oct 2020 00:00:00 +0000

Past studies suggest that patients who leave without being seen by a physician (LWBS) from a hospital’s emergency department (ED) represent a quality and safety concern, and thus LWBS rates have often been used as an ED performance metric. There are few recent studies, however, that have examined the characteristics of the LWBS population at hospitals in the United States.

Web-based pharmacology cases for Cardiovascular System 1 and Renal System 1

Thu, 29 Oct 2020 00:00:00 +0000

Undergraduate medical education is constantly evolving to develop new, effective, engaging teaching methods. An integrated medical school curriculum correlates the basic and clinical sciences beginning in the first year in order to engage students, develop clinical reasoning skills, and prepare them for their clinical experiences. Contextualization, in which clinical case examples are used to illustrate basic science principles, is one strategy used to achieve this goal. In addition to changes in the structure of medical school curricula, the platforms by which educational material is delivered are also rapidly changing. Web-based applications, including podcasts and virtual interactive cases, provide endless opportunities to present information in efficient and interesting formats and encourage self-directed learning by students. Pharmacology is an area of preclerkship education that is particularly challenging to medical students. One reason for this is the fact that students...

Implementation of an educational exercise to enhance clinical reasoning in third year medical students

Thu, 29 Oct 2020 00:00:00 +0000

Clinical reasoning (CR) is essential to a physician's practice of medicine. Although there have clear efforts to incorporate CR into the pre-clinical curriculum at UCSD-SOM, there is a lack of formal CR education during rotations. Thus, the Clinical Reasoning Exercise (CRE) was designed for third year medical students on the inpatient internal medicine service. The CRE is an educational exercise that provides step-by-step guidance through the diagnostic process by utilizing three principles--problem representation, diagnostic schema, and illness scrips. Supplementary materials include narrated PowerPoint/YouTube tutorials (for both students and faculty) as well as an example completed CRE for student reference. The CRE was piloted with six students rotating the Veteran's Association (VA) in February 2019. Students were met in small groups (2-3) to review general aspects and logistics. After the one-month long inpatient rotation, students were sent the link to an anonymous survey....

Intervertebral disc kinematics in active duty marines with and without lumbar spine pathology

Thu, 29 Oct 2020 00:00:00 +0000

Military members are required to carry heavy loads frequently during training and active duty combat. We investigated if operationally relevant axial loads affect lumbar disc kinematics in forty-one male active duty Marines with no previous clinically diagnosed pathology. Marines were imaged standing upright with and without load. From T2-weighted magnetic resonance images, IVD health and kinematic changes between loading conditions and across lumbar levels were evaluated using two-way repeated measures analysis of variance tests. IVD kinematics with loading were compared between individuals with and without signs of degeneration on imaging. Linear regression analyses were performed to determine associations between IVD position and kinematic changes with loading. Fifty-eight percent (118/205) of IVDs showed evidence of degeneration and 3% (7/205) demonstrated a disc bulge. IVD degeneration was not related to posterior annular position (p>0.205). Changes in sagittal intervertebral...

Using high-fidelity simulation to teach neurological emergency and neurocritical care skills: A systematic review of the literature

Thu, 29 Oct 2020 00:00:00 +0000

This article analyzes the current available literature on high-fidelity simulation as an educational tool in teaching acute neurology and neurocritical care skills to trainees. Twenty-five studies were found to be published in peer-reviewed journals. While every study had a common target of educating learners on appropriate acute neurology evaluation, diagnosis, and management, there exists significant heterogeneity in the chosen topics, implemented procedures, and assessments of learner outcomes. Overall findings suggest that there is considerably significant evidence for the effectiveness and utility of simulation-based education when it comes to the teaching of acute and critical neurological emergencies to trainees and even practicing providers. Existing literature is summarized, current trends are discussed, and recommendations for areas of future research are included.

Parental polst preferences for pediatric patients enrolled in palliative home care

Thu, 29 Oct 2020 00:00:00 +0000

Palliative care and advanced health directives, particularly the Physician’s Orders for Life Sustaining Treatment (POLST), play significant roles in the management of seriously ill children and those with chronic medical conditions. Multiple studies have demonstrated improved patient quality of life and family sense of autonomy and control when advance health directives are implemented, yet little is known about actual end‐of-life‐care choices parents make. The goal of this project was to examine parental preferences for end‐of‐life care among patients enrolled in a pediatric palliative home care program (PPHCP) or hospice who have completed a POLST. .

Investigation of enrichment programs at juvenile detention facilities in San Diego County

Thu, 29 Oct 2020 00:00:00 +0000

Enrichment activities are known to enhance youth development, and are especially beneficial for at-risk youth who have not consistently had the social capital to receive such enrichment throughout the critical periods of their development. The National Institute of Justice has published many studies demonstrating the benefit of enrichment activities for disadvantaged youth. Enrichment activities promote self-esteem and sense of discipline and well-being, which impacts mental health and risk taking behaviors such as substance abuse. With the goal of achieving the aforementioned impact, juvenile detention centers offer enrichment programs as part of the rehabilitation process. My goal for this project was to further investigate the availability, equity and impact of such programs on mental health outcomes for at risk youth, I completed a needs assessment. The following needs assessment report summarizes my findings.

Patient-derived organoid systems for the study of castrate-resistant metastatic prostate cancer

Thu, 29 Oct 2020 00:00:00 +0000

Bone metastases of prostate cancer continue to elude effective clinical management world-wide. A newly developed xenograft model, PCSD1, is a pre-clinical therapeutic development and testing platform to understand the mechanisms of resistance to androgen deprivation therapy of bone metastatic prostate cancer. Prostate cancer is a heterogeneous disease for which it is especially important to study models that represent the range of different patients. However, of the patient samples investigated by Christina Jamieson’s lab at UCSD, only 5 out of 20 (25%) were able to successfully create xenografts. The hypothesis I tested is that metastatic cells that have failed to xenograft into a patient-derived tumor xenograft mouse model will be able to successfully survive in vitro in an organoid culture system. The goals of my research were twofold: to successfully develop organoid cultures for both cells that have successfully and unsuccessfully xenografted into the mouse model and to perform...

Optimization of laboratory services and education at the UCSD student run free clinic project during electronic health record and laboratory information systems integration

Thu, 29 Oct 2020 00:00:00 +0000

Clinical notes, consults, vital signs, labs, and more are expected to be a part of a patient’s electronic file, so that they can be easily and quickly looked up to provide better patient care. The UCSD Student‐Run Free Clinic Project (SRFCP) implemented Electronic Health Records (Epic) in 2013. However, the laboratory used by the free clinics had not been integrated electronically. Therefore, the free clinics had been entering lab results into EPIC via manual data entry for four years. In 2017, the UCSD Epic Information Technology team, including the Ambulatory Offices’ Chief Medical Information Officer, decided that it was a UCSD Health Sciences priority to integrate Quest labs into Epic. This required a significant amount of retraining, writing new workflows, improving processes, re‐thinking the role of the free clinic lab manager, optimizing education, and ensuring the correct provider receives results in a timely fashion in the UCSD SRFCP setting. This ISP assessed the laboratory...

Characteristics and outcomes of geriatric patients who were screened through the Geriatric Emergency Nurse Initiative Expert (GENIE) risk screening and referral system

Thu, 29 Oct 2020 00:00:00 +0000

With a rapidly growing older adult population in the United States, the importance of age-appropriate care in the emergency department (ED) is becoming increasingly recognized. The University of California, San Diego (UCSD) La Jolla ED has adopted the use of a specialized health and welfare screening and referral system in its Senior Emergency Care Unit (SECU) to address the unique needs of older adult patients. Trained geriatric nurses screen patients and positive screens generate automatic referrals. Between December 1, 2016 and October 31, 2018 a total of 974 eligible patients were screened. Of these, 354 patients had one or more positive screens and received referrals. A retrospective chart review was used to examine clinical and demographic characteristics of patients to evaluate outcomes of the screening and referral system. Statistical analysis include: two sample t-tests to compare average age between groups; chi-square and likelihood ratio tests to compare demographic...

Off-pump versus on: long-term outcomes after coronary artery bypass in a veteran population

Thu, 29 Oct 2020 00:00:00 +0000

We sought to investigate long-term outcomes after revascularization with and without use of cardiopulmonary bypass, and hypothesized off-pump would be comparable to on-pump. Our primary outcome of interest was survival, and secondary outcomes included need for reintervention with new coronary stent, or new diagnosis of myocardial infarction (MI) occurring any time after surgery during the 8-12 year follow up period.

Identification of gestational age-dependent changes in ExRNA expression across normal human pregnancy

Thu, 29 Oct 2020 00:00:00 +0000

To develop an atlas of the serum profile of miRNA in normal human pregnancy, and compare variability across gestation, day-to-day variability, and diurnal variability

To explore whether the ability to detect gestational-age specific changes is dependent on methodology.

Evaluating current and potential clinical sites: a spatial analysis of the UCSD Student-Run Free Clinic Project: a student's guide

Thu, 29 Oct 2020 00:00:00 +0000

After 18 years of service in the same location, the UCSD Free Clinic Project (Free Clinic) had to close one its four clinic sites. Several hundred patients were faced with the challenge of commuting long distances to another clinic, and even losing access to car. Although unfortunate, this became an opportunity for the Free Clinic to examine where its patients live, the distances they travel to clinic, and determine new locations for a clinic. To complete this examination, the Free Clinic performed a spatial analysis--mapping patients and clinic locations--using specialized Geographic Information Systems (GIS) software.

Potential treatments for Danon disease

Thu, 29 Oct 2020 00:00:00 +0000

Danon disease is a congenital X-linked hypertrophic cardiomyopathy that results from mutations in LAMP2, a transmembrane lysosomal protein necessary for autophagy. The disease presents in childhood or adolescence, and life expectancy is 19 for men and 34 for women. Although Danon disease is rare, no specific therapy based on its biology is currently known. Recent in vitro studies using mouse by the Cherqui Lab have shown evidence supporting hematopoetic stem cell transplant as a novel treatment option for cystinosis. Cystinosis is a metabolic disease that arises from mutations in a transmembrane lysosomal protein - cystinosin (CTNS gene). Detailed in vitro and in vivo studies have shown that rescue of the phenotype occurs because wildtype macrophages derived from the transplanted wildtype hematopoietic stem cells can transfer lysosomes containing wildtype cystinosin directly to Ctns-deficient cells in multiple organs of the host Ctns -/- mice. Because Danon disease also arises...

Current management of succinate dehydrogenase deficient gastrointestinal stromal tumors

Thu, 29 Oct 2020 00:00:00 +0000

Gastrointestinal stromal tumors (GIST) are increasingly recognized as having diverse biology. With the development of tyrosine kinase inhibitors molecularly matched to oncogenic KIT and PDGFRA mutations, GIST have become a quintessential model for precision oncology. However, about 5-10% of GIST lack these driver mutations and are deficient in succinate dehydrogenase (SDH), an enzyme that converts succinate to fumarate. SDH deficiency leads to accumulation of succinate, an oncometabolite that promotes tumorigenesis. SDH- deficient GIST are clinically unique in that they generally affect younger patients and are associated with GIST- paraganglioma hereditary syndrome, also known as Carney-Stratakis Syndrome. SDH-deficient GIST are generally resistant to tyrosine-kinase inhibitors, the standard treatment for advanced or metastatic GIST. Thus, surgical resection is the mainstay of treatment for localized disease, but recurrence is common. Clinical trials are currently underway...

Neurology clerkship review

Thu, 29 Oct 2020 00:00:00 +0000

Slides presenting a top-down, not "pattern-recognition," approach to decision-making in a clinical neurology setting.

Warm Handoff: Fact or Fiction?

Thu, 29 Oct 2020 00:00:00 +0000

1. Compare characteristics of patients in which a BHP was involved in any manner in apatient’s visit to those who did not have any BHP involvement in their visit.

2. Compare follow-through rates after referral to psychotherapy for patients who didversus did not have a warm handoff (i.e., face-to-face interaction with a BHP) at the timeof the patient’s visit to a PCP

The circle of Willis predicts the antihypertensive effects of carotid artery stenting: 12 month follow up

Thu, 29 Oct 2020 00:00:00 +0000

Stroke is one of the leading causes of death and morbidity in the United States. Various modifiable risk factors have been identified, which elevate the risk of stroke. Two such risk factors include hypertension and carotid artery stenosis. Moreover, carotid artery atherosclerosis, even when asymptomatic or when subclinical stenosis is present, has been shown to increase the risk of future stroke. As such, proper treatment of carotid artery stenosis and hypertension plays a critical role in the future reduction of stroke incidence.

MRI neuroimaging in the evaluation of post-laminectomy pain syndrome

Thu, 29 Oct 2020 00:00:00 +0000

Post-laminectomy pain syndrome refers to persistent leg and/or lumbar back pain after a surgical procedure. The pathophysiology of this syndrome is complex, as often the operation was technically successful. Evaluation with MRI plays a crucial role in the assessment of post- laminectomy pain syndrome, as it provides soft tissue resolution for evaluation for common post- surgical pain generators, including recurrent posterior disc disease and associated narrowing of the spinal canal, lateral recess or neural foramina.

Anesthesia student survival guide

Thu, 29 Oct 2020 00:00:00 +0000

At UC San Diego medical school, third year medical students’ exposure to Anesthesia is often as part of a two-week selective during their surgery rotation. Students are told to read up on Miller or Bareish (not for the faint of heart) to understand the foundational knowledge for the rotation. Fourth year medical students often feel like there should be a concise introductory document to help students before the rotation. This document is to provide a brief introduction to the field of anesthesia and ensure students feel more prepared prior to the rotation. This document is intended to be modified and altered as other students find the information outdated or irrelevant to the Anesthesia rotation.

Gender micro-inequities in medical education

Thu, 29 Oct 2020 00:00:00 +0000

To explore the topic of gender micro‐inequities, both on a personal level and on a professional level. To evaluate literature on the topic. This includes evaluating the different ways to study this topic (survey, focus group, longitudinal interviews, etc), as well as the specific populations studied and critically consider the positives and negatives of the different methods. To plan and give a professional lecture/webinar, including seeking feedback and evaluation.

Rigid segmental cervical spine instrumentation is safe and efficacious in younger children