Family planning competency following medical school Ob/Gyn clerkships at faith-based and secular sites.

Contraception and abortion topics are variably, but often poorly, addressed in medical school curricula. Restrictions on contraceptive and abortion care at faith-based hospitals may hinder comprehensive family planning training for medical students during Ob/Gyn clerkships. Here we investigated whether medical students at faith-based and non-faith-based clerkships experienced different observations during their Ob/Gyn clerkship and/or differences in self-perceived competency in patient counseling, objective knowledge, and perceived adequacy of training in contraception and abortion topics post-clerkship. A survey was distributed to third- and fourth-year medical students at New York Institute of Technology, College of Osteopathic Medicine. Across all clerkship sites (n = 102 students), observations of, and competency in, contraceptive care was higher than in abortion care. Students at non-faith-based clerkship sites (n = 54) reported the highest levels of observation of contraceptive and abortion care (19.6-90.7%), while those at Catholic sites (n = 26) typically reported the lowest (7.7-34.6%). Students at non-faith-based sites reported significantly higher competency in contraceptive care and some aspects of abortion care, than those at Catholic, and some other faith-based sites (n = 48). Clerkship training at faith-based sites, specifically Catholic sites, resulted in poorer Ob/Gyn training, particularly in contraceptive care. Training outcomes in abortion care were poor at all Ob/Gyn clerkship sites.

Essential anatomy for core clerkships: A clinical perspective.

Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as essential or more important. Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.

Laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass in the pediatric population: a MBSAQIP analysis.

BACKGROUND: The growing prevalence of childhood obesity has resulted in an increased number of children and adolescents who undergo bariatric surgery. The safety of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) remains controversial in the pediatric population. OBJECTIVE: To assess the safety of LSG compared with LRYGB in patients aged ≤21 years. SETTING: A retrospective analysis of the 2016 to 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. METHODS: Patients aged ≤21 years who underwent LSG or LRYGB were identified in the 2016 to 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. A logistic regression model was used to create a 1:1 propensity-score matched cohort adjusting for age, sex, body mass index, and obesity-related co-morbidities. Unmatched and propensity-score matched analyses were performed to compare baseline characteristics and outcome data between LSG and LRYGB procedure groups. Primary outcomes of interest included 30-day major complications, such as death, reoperation, and anastomotic leak. RESULTS: Of 3571 patients included in our study, 2911 (81.52%) underwent LSG and 660 (18.48%) underwent LRYGB. Patients who underwent LRYGB had an increased body mass index and a higher rate of obesity-related co-morbidities. The LRYGB group had a significantly increased rate of major complications within the first 30 days in both the unmatched cohort (4.55% versus 1.34%, P < .001) and the propensity-score matched cohort (4.57% versus .91%, P < .001). CONCLUSIONS: LSG and LRYGB are both relatively safe to perform in the pediatric population with acceptable complication rates and low mortality. However, LSG demonstrated a significantly decreased rate of major complications in the first 30 days compared with LRYGB.

A case report of an ovarian lipoma.

BACKGROUND: Ovarian lipomas are a rare entity, with most being described as part of a teratomatous origin. This is a case report of a lipoma of an ovary not associated with a teratoma or an hyperandrogenic state. CASE: A 66-year-old female underwent an exploratory laparotomy and a left ovarian tumor measuring about 7 to 8 cm was removed. Microscopic examination demonstrated a pattern of proliferation of benign adipose tissue with focal areas of fibrovascular septae and no other tissue of different origin. CONCLUSIONS: A MEDLINE search did not reveal any well-documented cases of a pure ovarian lipoma. The cases reported were associated with teratomas, lipid cell tumors, and lipoleiomyomas. Thus, it appears that lipomas of the ovary are rare, but can occur.

Comparative study of dentition among species of Poecilia (Pisces).

Many studies in the genus Poecilia have focused on reproductive and genetic characteristics of Poecilia formosa, the Amazon molly, and its sympatric species P. latipinna and P. mexicana. The research literature of Poecilia dentition has been limited to general tooth morphology. Essentially absent are comparative analyses of dentition patterns and total numbers of teeth. The current study uses dentition analysis as a method to compare species in the genus Poecilia and to address some taxonomic issues related to these fish. The study focused on fish from the areas of southern Texas and northeastern Mexico. Through the use of scanning electron microscopy, the lower jaws of Poecilia spp were examined to determine total numbers of outer and inner teeth. In addition, the differences in distribution patterns of the inner teeth were recorded and compared. Statistical analyses were performed to determine which comparisons were significant. This study reveals several observations: 1) variations in the numbers of outer and inner teeth exist in some of these fish with respect to site of collection; 2) differences in total teeth numbers and dentition patterns were found both interspecifically and intraspecifically; and 3) in addition, dentition analysis provided evidence regarding the origin of P. formosa. This study supports the current notion that P. latipinna, the proported paternal component, and P. mexicana limantouri, the purported maternal component, are the progenitor species of P. formosa. Two unresolved taxonomic questions were addressed through dentition analysis. First, the present study supports the exclusion of the triploid associate of P. formosa as a separate species from P. formosa. Second, this study shows a significant difference in the number of inner teeth and in dentition patterns between P. mexicana limantouri and P. mexicana mexicana. Such differences, in addition to previously known distinguishing characteristics, should prompt careful consideration of whether or not these taxa deserve specific status or retention of their current subspecific status. J. Morphol. 239:271-282, 1999. © 1999 Wiley-Liss, Inc.