Abstract Accurate diagnosis of rheumatoid arthritis may be difficult early in its course and demands high clinical suspicion, astute examination, and appropriate investigations. Early use of ...disease-modifying antirheumatic drugs and biologics has improved outcomes but requires close monitoring of disease course and adverse events.
A Review of Mentoring in Academic Medicine Geraci, Stephen A; Thigpen, S Calvin
The American journal of the medical sciences,
2017-February, Letnik:
353, Številka:
2
Journal Article
Recenzirano
Many believe that mentoring is essential for new and developing faculty physicians to achieve their professional and personal goals, yet there are both positive and potential negative aspects of ...mentoring. Research reports on the process have few quantifiable objective outcomes, use mostly single-center study populations, lack controls and use mostly qualitative techniques. Absence of a standardized definition of mentorship has allowed widespread application of the term to other forms of protégé support. Several models have been developed, with other generalized descriptors used to differentiate the important qualities of mentoring relationships. Published evidence suggests some characteristic attitudes and personal qualities, knowledge, skills and behaviors are common among successful mentors. Identification and validation of better efficacy metrics, and use of these to design new programs to train effective mentors, are needed.
Osteoporosis, the most common human bone disease, affects 8 million American women and has significant morbidity and mortality. Screening is important in older women and younger postmenopausal women ...with additional risk factors for osteoporosis/fracture. Preventive measures include avoiding smoking, excessive alcohol/caffeine intake, and falls in addition to maintaining adequate calcium/vitamin D intake and exercise. Estrogen/hormone therapy may be considered in some patients. Various medications have proven efficacy in treating postmenopausal osteoporosis; however, potential adverse effects such as hypocalcemia, worsening of renal impairment, and osteonecrosis of the jaw must be considered. The optimal duration of therapy requires further investigation.
Allergy Medications During Pregnancy Gonzalez-Estrada, Alexei; Geraci, Stephen A
The American journal of the medical sciences,
2016-September, Letnik:
352, Številka:
3
Journal Article
Recenzirano
Allergic diseases are common in women of childbearing age. Both asthma and atopic conditions may worsen, improve or remain the same during pregnancy. Primary care physicians commonly encounter women ...receiving multiple medications for pre-existing atopic conditions, who then become pregnant and require medication changes to avoid potential fetal injury or congenital malformations. Each medication should be evaluated; intranasal and inhaled steroids are relatively safe to continue during pregnancy (budesonide is the drug of choice), second-generation antihistamines of choice are cetirizine and loratadine, leukotriene receptor antagonists are safe, sparing use of oral decongestants during the first trimester and omalizumab may be used for both uncontrolled asthma and for antihistamine-resistant urticaria. Medications to avoid during pregnancy include intranasal antihistamines, first-generation antihistamines, mycophenolate mofetil, methotrexate, cyclosporine, azathioprine and zilueton. Common allergic diseases may develop de novo during pregnancy, such as anaphylaxis.
Disruption of sleep causes adverse health outcomes and poor quality of life. People with sleep disruption have higher levels than people without disrupted sleep of depression and anxiety and ...increased rates of cardiovascular diseases. Women have a higher incidence than men of insomnia and depression related to poor sleep. The types of complaints differ significantly between the sexes. Women are more likely than men to complain of insomnia, headache, irritability, and fatigue than the "typical" symptoms of loud snoring and breathing cessation during sleep. Hormones play an important role in sleep in women. Reproductive hormones were found to have a protective effect on sleep apnea in women of premenopausal age. Pregnancy is another period when the prevalence of sleep apnea and restless leg syndrome increases from hormonal effect. Cardiovascular mortality is high in women with obstructive sleep apnea. Continuous positive airway pressure therapy improves outcomes in most cases of obstructive sleep apnea. The epidemiology, risk factors, diagnostic criteria, and therapies for the three most common sleep disorders (insomnia, obstructive sleep apnea, and restless leg syndrome), along with effects of menopause, pregnancy, and social factors on sleep in women, are key considerations for clinicians caring for female patients across the adult life span.
Subclinical Thyroid Disease Jones, Dana D., MD; May, Katherine E., MD; Geraci, Stephen A., MD
The American journal of medicine,
06/2010, Letnik:
123, Številka:
6
Journal Article
Recenzirano
Abstract Subclinical thyroid disease, a term applied to patients with no or minimal thyroid-related symptoms with abnormal laboratory values, is diagnosed more frequently with the use of ...thyroid-stimulating hormone (TSH) screening and newer high-sensitivity assays. These are laboratory diagnoses, with subclinical hypothyroidism defined as an elevated TSH with a normal free thyroxine and triiodothyronine concentration, and subclinical hyperthyroidism as a subnormal TSH with normal free thyroxine and triiodothyronine levels. Although studies defining which patients require treatment are few, decisions should be individualized based upon laboratory values and symptoms. This article reviews the etiologies, diagnoses, treatments and indications, and monitoring of patients with subclinical thyroid disease.
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