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Background Promoting a diversified healthcare force fosters more culturally centered care, expands the approach to high-quality healthcare for poorly served populations, improves patient contentment, and broadens research agendas, all components essential to minimize healthcare imbalances. Our study reviews the trends of gender and racial disparity in Internal Medicine residency programs. Methodology In this retrospective analysis, we extracted data from the Accreditation Council for Graduate Medical Education's annual Data Resource Books from 2007 to 2019. Gender was reported as males and females. Race/ethnicity was cataloged as White/non-Hispanic, Black/non-Hispanic, Hispanic, Asian or Pacific Islander, Native American/Alaskan, others, and unknown. Results The representation of women increased progressively, with a relative increase of 4.7% from 2007 to 2019. For race/ethnicity, the study period started from the year 2011. When averaged across the eight-year study period, 27% of the study sample were White (non-Hispanic), followed by Asian/Pacific Islanders at 21%. The representation of other races was even lower. For 36.2% of the residents, the racial data were not known and categorized as unknown racial distribution. Conclusions Our study reports that gender and racial/ethnic imbalance persists within the training programs of Internal Medicine. Effectual strategies should be implemented to improve access to care to the underrepresented communities, address physician shortages in different areas of the country, and strengthen our ability to address long-established disparities in healthcare and outcomes.
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Hypertriglyceridemia is believed to be independently associated with an elevated risk of cardiovascular disease (CVD) events. Lifestyle changes and dietary modifications are recommended for individuals with high serum triglyceride (TG) levels (150-499 mg/dl), and pharmacological therapy in addition to lifestyle modification is recommended when serum TG levels ≥ 500 mg/dl. A residual cardiovascular risk remains even in statin appropriate treated patients with CVD risk factors, and in this patient population, hypertriglyceridemia poses an independent and increased risk of ischemic events. In December 2019, the US FDA approved icosapent ethyl (IPE) as an adjunct to a maximally tolerated statin to reduce the risk of CVD events in adults with serum triglycerides > 150 mg/dl and have either established cardiovascular disease or diabetes and two or more additional CVD risk factors. Since IPE significantly decreases total ischemic events in the aforementioned patient population, it would be intriguing to know whether IPE alone added an advantage to lifestyle modification in the low-risk population, who has serum triglyceride between 150 mg/dl and 499 mg/dl.
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Background Women physicians continue to comprise the minority of leadership roles in Academic Family Medicine (AFM) faculty across North American medical schools. Our study quantified the current state of gender disparity by analyzing academic position, leadership ranking, and research productivity. Methods We generated a database for 6,746 AFM faculty members. Gender and academic profiles were obtained for 2,892 academic ranks and 1,706 leadership roles by searching faculty listings enlisted in Fellowship and Residency Electronic Interactive Database (FREIDA) and Canadian Resident Matching Service (CaRMS). To measure research productivity, we obtained bibliometric data: h-index, citations, and tenure from 2,383 faculty members using Elsevier's SCOPUS archives. Data analysis and h-index were formulated using Stata version 14.2 (StataCorp LP, College Station, TX). Results Our results indicated that women hold 46.11% (3,110/6,746) of faculty positions. The proportional composition decreased with increasing academic ranking (49.84% assistant, 46.78% associate, and 41.5% full professor). The same decreasing trend was demonstrated with leadership rank (57.14% minor leadership, 47.65% second-in-command, and 36.61 first-in-command). Compared to their gender counterparts, women in AFM demonstrated lower publication productivity as measured by citation number (p=0.04) and years of study (p=0.008). The final prediction equation model after multivariable analyses included gender, publications, citations, country of graduation, and years of active research (p<0.05). Conclusions The composition of academic family medicine faculty members included in this study demonstrated gender disparity. Inclusivity initiatives and policies to tackle the issue of female retention, promotion, and recruitment need to be further explored.
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BACKGROUND: Parvimonas micra is a gram-positive anaerobe and a part of the normal commensal flora of the gastrointestinal tract. Factors predisposing to anaerobic bacteremia include malignant neoplasms, periodontal disease, immune deficiencies, chronic renal insufficiency, decubitus ulcers and perforated abdominal viscus. Cases of Parvimonas bacteremia in a patient with esophageal carcinoma and in a patient following ERCP procedure have been reported but to our best knowledge no case has been reported yet in which a patient had colonic carcinoma. CASE PRESENTATION: We present a rare case of a 94-year-old male who presented with chief complaint of fever and constipation. Complete blood count revealed normal white blood cell count anemia. Urinalysis came out to be unremarkable for any evidence of infection. Two blood cultures grew Parvimonas micra and Gamella morbillorum and patient was later switched to ampicillin-sulbactam as per blood culture susceptibility results. Echocardiogram came negative for any evidence of infective endocarditis. CT abdomen/pelvis showed soft tissue mass in the ascending colon just superior to the ileocecal valve (fig.1, 2). Colonoscopy showed non-obstructing eccentric mass (fig. 3). Biopsy of the mass revealed moderately differentiated adenocarcinoma. Because of lack of distant metastasis, surgical resection of the mass as definitive curative treatment was done. CONCLUSION: Immune deficiency is a risk factor for anaerobic bacteremia. Apart from immediately starting the patient on antibiotics, a thorough search for malignancy may be considered when a patient presents with anaerobic bacteremia, especially, when the source of infection is not known. Identifying malignancy in earliest stages may improve treatment outcome.