Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine Withdrawal.

Background: Clonidine, a central alpha-adrenoreceptor agonist, was initially developed as an antihypertensive. Though no longer commonly used for its original indication due to rebound hypertension after discontinuation, it is currently widely prescribed as a treatment for many pediatric indications including sleep disorders, behavioral concerns, and attention deficit hyperactivity disorder. Case Report. We describe a girl who developed prolonged symptoms of clonidine withdrawal, including hypertension and elevated serum metanephrines. Discussion. Clonidine withdrawal in pediatric patient can present with hypertensive urgency and other signs of sympathetic stimulation. Withdrawal can also lead to dramatic elevation in serum metanephrines. Treatment with a clonidine taper will reduce development of withdrawal symptoms. Conclusion: Given the rise in clonidine use in pediatric patients, clinicians should be aware of the risk of clonidine withdrawal and how to recognize and avoid its development.

Work-Life Balance and Career Experiences of Part-Time Versus Full-Time Faculty at the Warren Alpert Medical School of Brown University.

INTRODUCTION: Part-time faculty are an important part of the academic medical workforce, comprising 11-21% of faculty in some institutions. OBJECTIVE: To describe the part-time faculty experience at a single institution across four domains: work-life balance, work environment, leadership and advancement, and mentorship. METHODS: Faculty from the Division of Biology and Medicine at Brown University were invited to participate in an electronic survey. The authors compared responses between full-time and part-time faculty across the four domains.   Results: Survey response rate was 43% (437/1025). Of the 363 who answered the question about employment status, 333 (92%) were full-time and 30 (8%) were part-time. Part-time faculty were less likely to report forgoing personal activities for professional responsibilities, that work conflicted with personal life, that their division director took interest in their careers, and having a leadership position was important to them. CONCLUSION: Part-time and full-time faculty reported significant differences in perception of work impact on personal life, division director support, and desire for leadership positions.