Latest News on Internal Medicine Research: Sep – 2019

Diagnostic Error in Internal Medicine

Background: The goal of this study was to work out the relative contribution of system-related and psychological feature elements to diagnostic error and to develop a comprehensive operating taxonomy.

Methods: 100 cases of diagnostic error involving internists were known through autopsy discrepancies, quality assurance activities, and voluntary reports. every case was evaluated to spot system-related and psychological feature factors underlying error victimization record reviews and, if attainable, supplier interviews. [1]

Internist-I, an Experimental Computer-Based Diagnostic Consultant for General Internal Medicine

INTERNIST-I is Associate in Nursing experimental computer virus capable of constructing multiple and sophisticated diagnoses in medicine. It differs from most different programs for computer-assisted identification within the generality of its approach and therefore the size and variety of its content. To document the strengths and we have a tendency toaknesses of the program we performed a scientific analysis of the capabilities of INTERNIST-I. Its performance on a series of nineteen clinicopathological exercises (Case Records of the Massachusetts General Hospital) revealed within the Journal appeared qualitatively like that of the hospital clinicians however inferior thereto of the case discussants. [2]

Burnout and Self-Reported Patient Care in an Internal Medicine Residency Program

Background: Burnout could be a syndrome of depersonalization, emotional exhaustion, and a way of low personal accomplishment. very little is thought concerning burnout in residents or its relationship to patient care.

Objective: to work out the prevalence of burnout in medical residents and explore its relationship to self-reported patient care practices.

Design: Cross-sectional study victimization associate degree anonymous, armoured survey.

Setting: University-based residency program in city, Washington.

Participants: a hundred and fifteen general medicine residents. [3]

Beyond duty hours: leveraging large-scale paging data to monitor resident workload

Monitoring and managing resident employment may be a cornerstone of policy in graduate medical education, and therefore the duty hours metric is that the backbone of current rules. whereas the duty hours metric measures hours worked, it doesn’t capture variations in intensity of labor completed throughout those hours, which can severally contribute to fatigue and burnout. Few such metrics exist. Digital knowledge streams generated throughout the standard course of hospital operations will function a completely unique supply of insight into employment intensity by providing high-resolution, minute-by-minute knowledge at the individual level; but, study and use of those knowledge streams for employment observation has been restricted thus far. [4]

Internal Medicine as a Career Choice among Rotatory Interns in a Developing Country- A Multi Centre Study

There is shortage of medical work force as well as internists in African nation. Young interns like bound specialties to the neglect of others. This creates a niche in health supplying.

Objectives: The aim of the study was to see the speed of choice of general medicine as a career selection and therefore the factors influencing career selection among turning interns in 3 (3) tertiary establishments in African nation specifically Benue State University Teaching Hospital, Makurdi, University of national capital Teaching Hospital, Gwagwalada, national capital and Federal Medical Centre, Makurdi. [5]

Reference

[1] Graber, M.L., Franklin, N. and Gordon, R., 2005. Diagnostic error in internal medicine. Archives of internal medicine, 165(13), (Web Link)

[2] Miller, R.A., Pople Jr, H.E. and Myers, J.D., 1982. Internist-I, an experimental computer-based diagnostic consultant for general internal medicine. New England Journal of Medicine, 307(8), (Web Link)

[3] Shanafelt, T.D., Bradley, K.A., Wipf, J.E. and Back, A.L., 2002. Burnout and self-reported patient care in an internal medicine residency program. Annals of internal medicine, 136(5), (Web Link)

[4] Beyond duty hours: leveraging large-scale paging data to monitor resident workload
Amit Kaushal, Laurence Katznelson & Robert A. Harrington
npj Digital Medicinevolume 2, Article number: 87 (2019) (Web Link)

[5] O. Ogiator, M., A. Ojo, B., T. Ieave, E., B. Ogiator, A. and O. Abah, I. (2017) “Internal Medicine as a Career Choice among Rotatory Interns in a Developing Country- A Multi Centre Study”, Journal of Advances in Medicine and Medical Research, 19(10), (Web Link)

News Update on Thyroid Function Research: Sep – 2019

Thyroid Function and Human Reproductive Health

Via its interaction in many pathways, traditional thyroid operate is very important to keep up traditional replica. In each genders, changes in SHBG and sex steroids area unit a uniform feature related to hyper- and adenosis and were already rumored a few years agone. Male replica is adversely tormented by each hyperthyroidism and adenosis. Erectile abnormalities are rumored. hyperthyroidism induces abnormalities in gamete motility, whereas adenosis is related to abnormalities in gamete morphology; the latter normalize once euthyroidism is reached. In females, hyperthyroidism and adenosis will cause emission disturbances. hyperthyroidism is associated in the main with hypomenorrhea and polymenorrhea, whereas adenosis is associated in the main with period. [1]

Thyroid Function in Nonthyroidal Illnesses

Alterations in thyroid physiology and thyroid operate tests occur in some patients with nonthyroidal diseases. Low concentrations of humor thyroid hormone (T3) typically occur in nonthyroidal diseases and are traceable mostly to reduced extrathyroidal conversion of thyroxin (T4) to T3. Concentrations of humor total T4 could also be low, normal, or high; alterations in humor binding of T4 make a case for the abnormality in most cases. Concentrations of humor reverse T3 are typically high as a result of metabolic clearance is reduced. [2]

Obesity and thyroid function

A moderate elevation of TSH (TSH) concentrations, that is related to thyroid hormone (T3) values in or slightly on top of the higher traditional vary, is usually found in weighty humans. These alterations appear rather a consequence than a explanation for blubber since weight loss results in a social control of elevated endocrine levels. Elevated endocrine concentrations increase the resting energy expenditure (REE). The underlying pathways don’t seem to be absolutely understood. As a consequence of the exaggerated REE, the supply of accumulated energy for conversion into fat is diminished. last, the alterations of thyroid hormones in blubber counsel associate degree adaptation method. [3]

Interconnection between circadian clocks and thyroid function

Circadian sound property is AN just about 24-h cell-autonomous amount driven by transcription–translation feedback loops of specific genes, that are spoken as ‘circadian clock genes’. In mammals, the central unit of time pacemaker, that is found within the neural structure suprachiasmatic nucleus, controls peripheral unit of time clocks. The unit of time system regulates just about all physiological processes, that are more modulated by changes within the external setting, like light-weight exposure and therefore the temporal arrangement of food intake. Chronic unit of time disruption caused by shift work, travel across time zones or irregular sleep–wake cycles has semipermanent consequences for our health and is a very important life-style issue that contributes to the danger of fat, sort two diabetes and cancer. [4]

Assessment of Thyroid Function Parameters among Sudanese Pregnant Women in Different Trimesters

Background: The thyroid plays a vital role in maternity outcome furthermore as in craniate development. The changes caused by maternity within the mother establish a replacement physiological condition equilibrium. Thyroid disorders square measure common throughout maternity, and adequate treatment is important to stop adverse maternal and craniate outcomes.

Objectives: To assess FT3, FT4 and hormone levels in pregnant Sudanese ladies, and to correlate their levels with the gestation age. [5]

Reference

[1] Krassas, G.E., Poppe, K. and Glinoer, D., 2010. Thyroid function and human reproductive health. Endocrine reviews, 31(5), (Web Link)

[2] CHOPRA, I.J., HERSHMAN, J.M., PARDRIDGE, W.M. and NICOLOFF, J.T., 1983. Thyroid function in nonthyroidal illnesses. Annals of Internal Medicine, 98(6), (Web Link)

[3] Reinehr, T., 2010. Obesity and thyroid function. Molecular and cellular endocrinology, 316(2), (Web Link)

[4] Interconnection between circadian clocks and thyroid function
Keisuke Ikegami, Samuel Refetoff, Eve Van Cauter & Takashi Yoshimura
Nature Reviews Endocrinologyvolume 15, pages590–600 (2019) (Web Link)

[5] Alamin Hussin, O., Modawe, G. and Abdalla, A. M. (2018) “Assessment of Thyroid Function Parameters among Sudanese Pregnant Women in Different Trimesters”, Journal of Advances in Medicine and Medical Research, 25(6), (Web Link)