Medical education focus in published articles related to COVID-19.

OBJECTIVE: The ongoing pandemic of Coronavirus Disease 2019 (COVID-19) has affected >2 million patients with approximately 900,000 cases in the United States alone. Medical education has possibly suffered during this time, due to disease mitigation strategies and stress on both students and teachers. We aimed to quantify the publications describing the impact of COVID-19 on medical education in the early stage of the pandemic. MATERIALS AND METHODS: Abstract and titles related to COVID-19 listed in PubMed were reviewed for an educational focus. Articles with an educational focus were further evaluated for characteristics of content. RESULTS: Out of a total of 3641 articles related to COVID-19, only 26 (0.7%) articles had an educational theme. Thirteen articles were pertaining to residency and fellowship education and twelve articles were focused on medical student education. Only one article referred to nursing education. CONCLUSIONS: Publications pertaining to medical education during the ongoing COVID-19 pandemic are few. There is an urgent need for scholarship to understand the best processes and develop innovative methods that can help improve the educational experience of students and trainees during this extraordinary time.

Blood pressure behavior in the nursing home: implications for diagnosis and treatment of hypertension.

OBJECTIVES: To determine patterns of elevated blood pressure (BP) behavior, their clinical correlates, and the relationship to diagnosis and management of hypertension. DESIGN: A cross-sectional, prevalence survey. SETTING: Forty-five nursing homes owned or managed by a large national chain. PARTICIPANTS: A total of 857 older residents (mean age = 84 years). MEASUREMENTS: Supine and standing (1 and 3 minutes) BP and heart rate, taken four times in one day (before and after breakfast, and before and after lunch) by trained nurses using a random zero sphygmomanometer; medication profile; active medical diagnoses; functional status; sociodemographics. RESULTS: The prevalence of a single, elevated, supine systolic pressure (> or = 160 mm Hg) was 14.3%, and of two to four elevated measures was 14.9%. The pre-breakfast reading was consistently the highest, and mean systolic pressures decreased after breakfast. Compared with those not treated, older residents taking antihypertensive medications had higher systolic pressures at all times and showed the same pattern of decline after breakfast. Isolated diastolic hypertension was uncommon (0.9%). Cardiovascular disease, orthostatic hypotension, diabetes, and use of angiotensin converting enzyme inhibitors or calcium channel blockers were more prevalent among older residents who had elevated pressures on multiple occasions (P < .03). Successful antihypertensive treatment was associated with a lower prevalence of orthostatic hypotension. Diuretic use was more likely to be associated with blood pressure control. CONCLUSION: The diagnosis of hypertension in frail older people would benefit from multiple, within-day measures, including postural BP, taken before and after meals. Diuretic use alone, or in conjunction with ACE inhibitors or calcium channel blockers, was more likely to be associated with normalized blood pressures.