Graduate Medical Education Works

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    A Latent Class Analysis of Sexuality Education Type and Effect on Sexual Health Outcomes Among Adolescents in the United States: Results from a Nationally Representative Study
    (Presented at Society for Adolescent Health and Medicine Conference, 2022-03) Sherwin, Nomi; Zervos, Andy; Herbenick, Debby; Paul, Bryant; Hensel, Devon
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    Diversifying Faculty Leadership in Academic Medicine: The Program to Launch Underrepresented in Medicine Success (PLUS)
    (Wolters Kluwer, 2022-02) Tucker Edmonds, Brownsyne; Tori, Alvaro J.; Ribera, Amy K.; Allen, Matthew R.; Dankoski, Mary E.; Rucker, Sydney Y.; Graduate Medical Education, School of Medicine
    PLUS (Program to Launch Underrepresented in Medicine Success) is a 2-year cohort program at Indiana University School of Medicine providing professional development; funding and skills to produce scholarship; and a community to mitigate social and/or professional isolation for underrepresented in medicine (URiM) faculty. In year 1, scholars participate in leadership and professional development seminars and regular meetings with their mentor(s). They are assigned a PLUS Advisory Council advisor with whom they meet 2-3 times annually. In year 2, scholars participate in monthly seminars focused on research methods, writing productivity, and wellness. Additionally, scholars engage in a writing accountability group and practice reflective writing. Connections events, designed to combat isolation and cultivate community, occur monthly. At program completion, scholars complete a project resulting in a scholarly product for submission and dissemination in a peer-reviewed forum. To date, 3 cohorts, totaling 24 people, have participated: 20 (83%) Black, 4 (17%) Latinx; 12 (50%) females. Five scholars have completed the full program, whose pre- and post-surveys results are described. Program surveys demonstrate significant gains in scholars' confidence to secure leadership opportunities, connect with colleagues, and advocate for themselves and others. Scholars reported statistically significant increases in confidence to pursue leadership roles (t = -3.67, P = .02) and intent to submit their dossier for promotion (t = -6.50; P = .003). They were less likely to leave academic medicine (t = 2.75; P = .05) or pursue another academic appointment (t = 2.75; P.05) after PLUS completion than at baseline. All scholars either adequately met requirements for their third-year review (tenure track only), were promoted, or achieved tenure in less than 3 years since program completion. This article describes PLUS program objectives, evaluative components, and lessons learned during implementation, as a model to support URiM faculty at other institutions.
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    Acute psychosis and serotonin syndrome in the setting of "Triple-C" overdose: a case report
    (BMC, 2021-11) Bachar, Roudi; Majewski, John Robert; Shrack, Christopher; El-Khoury, Anthony; Graduate Medical Education, School of Medicine
    BACKGROUND: Over-the-counter medication overdose is a difficult diagnostic challenge for many physicians as common drug screening assays cannot detect these substances. We present a case of acute psychosis, serotonin syndrome, and anticholinergic overdose-like properties in the setting of Coricidin HBP Cough & Cold tablets, known by their street name Triple-C. This is the first case report we are aware of involving a patient presenting with these symptoms and requiring critical-care-level support. CASE PRESENTATION: A 31-year-old African American female with a past medical history of anxiety, childhood asthma, previous methamphetamine abuse, and coronavirus disease 2019 infection in August 2020 was brought to the emergency department by the local police department with altered mental status. Initial blood work, including extended drug screens, were unremarkable for a definitive diagnosis. This patient required critical-care-level support and high sedation because of her symptoms. Collateral history revealed the patient regularly consumed Triple-C daily for the 6 weeks prior to admission. A trial off sedation was attempted after 24 hours with no complications. The patient admitted to regular Triple-C consumption and auditory hallucinations since adolescence. She was discharged safely after 48 hours back into the community. She was lost to follow-up with psychiatry and internal medicine; however, she was evaluated in the emergency room 1 month later with a similar psychiatric presentation. CONCLUSION: Overdose of Triple-C should be kept in the differential diagnosis of patients presenting with a triad of psychosis, serotonin syndrome, and anticholinergic overdose, in the setting of unknown substance ingestion.
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    PET and SPECT Imaging of the Brain: History, Technical Considerations, Applications, and Radiotracers
    (Elsevier, 2020-12) Davis, Korbin M.; Ryan, Joshua L.; Aaron, Vasantha D.; Sims, Justin B.; Graduate Medical Education, School of Medicine
    Advances in nuclear medicine have revolutionized our ability to accurately diagnose patients with a wide array of neurologic pathologies and provide appropriate therapy. The development of new radiopharmaceuticals has made possible the identification of regional differences in brain tissue composition and metabolism. In addition, the evolution of 3-dimensional molecular imaging followed by fusion with computed tomography and magnetic resonance imaging have allowed for more precise localization of pathologies. This review will introduce single photon emission computed tomography and positron emission tomographic imaging of the brain, including the history of their development, technical considerations, and a brief overview of pertinent radiopharmaceuticals and their applications.
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    Hypothermia is Associated With Poor Prognosis in Hospitalized Patients With Severe COVID-19 Symptoms
    (2021) Maait, Yousef; El Khoury, Marc; McKinley, Lee; El Khoury, Anthony; Graduate Medical Education, Office of Educational Affairs, IU School of Medicine
    Rationale Hypothermia forms a part of the diagnostic criteria for Systemic Inflammatory Response Syndrome (SIRS), National Early Warning Score (NEWS) and has repeatedly been shown to be associated with worse outcomes when compared to normothermic and hyperthermic patients with sepsis. We evaluate whether this is the case in COVID-19 patients. Objective To determine whether there is an association between hypothermia and worse prognosis in COVID-19 patients in the intensive care unit. Methods Retrospective study of a cohort of patients (n = 57) admitted to the intensive care unit of a community hospital with a positive test for COVID-19. Measurements Data relating to mortality, comorbidities and length of stay was recorded from electronic medical records for each patient. Hypothermia was defined as ≥2 recorded body temperatures of less than 96.5℉ (35.83℃) at the time of admission. Main results Of the 57 patients enrolled in the study, 21 developed hypothermia during their stay and 36 did not. Our results show that patients who have hypothermia at the time of admission spend a longer time intubated (p < 0.01) and go through longer ICU stays (p < 0.01). These patients are also 2.18 times more likely to suffer a fatal outcome compared to patients that did not develop hypothermia while in the intensive care unit (Chi-squared = 8.6209, p < 0.01, RR = 2.18). Conclusions Hypothermia in patients with severe COVID-19 at the time of admission to the ICU is associated with poorer outcomes for patients. This manifests as a longer period of intubation, longer ICU stay, and increased risk of mortality.
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    The Sin of Exclusion: Applicability of Trials Encouraging Omission of Radiation Therapy to Nonwhite Patients With Breast Cancer
    (ASCO, 2018-11) McClelland, Shearwood, III; Xanthopoulos, Eric P.; Mitin, Timur; Graduate Medical Education, School of Medicine