31 research outputs found

    Pyomyositis: A Complicated and Curious Case Report

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    Introduction: In the elderly (over the age of 50), the risk of urinary tract infections is estimated at 8% per year in men. Anatomic abnormalities such as prostatic hypertrophy, leading to urinary retention is considered as the main reason. Pyomyositis is an uncommon condition of optical urethrotomy, especially in patients who have received local radiation therapy in the past. Till date no cases of pectineus muscle abscess and only two cases of obturator externus muscle abscess have been reported in the literature, with only one developing as a result of genitourinary intervention such as urethrotomy. Case presentation: Here we are presenting a case of a very unusual and serious complication in an elderly man presenting with urosepsis several months after undergoing urethrotomy. Conclusion: Elderly men have an increased risk of sepsis, higher than that in women with UTI

    Teaching health advocacy to medical students: a comparison study.

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    CONTEXT: Many encourage service learning and health advocacy training in medical student education, but related evaluation is limited. OBJECTIVES: To assess (1) impact of a required community health advocacy training for medical students on student attitudes, knowledge, and skills; (2) student characteristics associated with higher advocacy knowledge and skills; and (3) perspectives of community-based organizations (CBOs). DESIGN: Cross-sectional surveys. SETTING: University of Miami Miller School of Medicine (UMMSM) Regional Medical Campus and main campus. PARTICIPANTS: Medical students at both UMMSM campuses. INTERVENTION: Required community health advocacy training for first- and second-year students including classroom experiences and hands-on project in partnership with a CBO. MAIN OUTCOME MEASURES: Student characteristics, health advocacy-related attitudes, self-reported and objective knowledge, and skills. Scores were compared between campuses, with multivariable modeling adjusting for individual student characteristics. Community-based organization perspectives were assessed via separate surveys. RESULTS: Ninety-eight (77%) regional campus students (intervention group) and 139 (30%) main campus students (comparison group) completed surveys. Versus the comparison group, the intervention group reported greater: mean knowledge of community health needs: 34.6 versus 31.1 (range: 11-44, P \u3c .01), knowledge about CBOs: 3.0 versus 2.7 (range 1-4, P \u3c .01) and knowledge of community resources: 5.4 versus 2.3 (range, 0-11, P \u3c .01), and mean skill scores: 12.7 versus 10.5 (score range: 4-16, P \u3c .01), following the intervention. Using adjusted analysis across both groups, female gender was associated with higher attitudes score. High level of previous community involvement was associated with higher attitude and skill scores. Higher self-reported educational debt was associated with higher skill scores. Community-based organization perspectives included high satisfaction and a desire to influence the training of future physicians. CONCLUSIONS: Medical student advocacy training in partnership with community-based organizations could be beneficial in improving student advocacy knowledge and skills in addressing community health issues and in developing sustainable community partnerships

    The approach to a diagnostic dilemma

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    Diagnostic dilemmas refer to situations in which physicians face a challenging clinical scenario. The goal of our paper is to outline strategies which we have found to be most helpful in the approach to a diagnostic dilemma. We review each strategy and provide illustrative clinical examples. Among the most helpful strategies are performing a thorough history and physical examination (H&P) (including pertinent epidemiological factors and careful medication review), avoidance of non-specific testing and empiric treatment, judicious use of consultants, maintaining an open-mind and humility and ongoing, open communication with your patient