Informed Inclusion Model: Medical Student Wheelchair User in an Obstetrics and Gynecology Clerkship.

Students with physical disabilities are underrepresented in medicine, driven in part by ableist beliefs about the ability of individuals with disabilities to complete procedure-based or surgically oriented clerkships, including obstetrics and gynecology (Ob/Gyn). There is a growing commitment to disability inclusion by medical and specialty training associations. Yet published case studies and accommodation protocols for medical student wheelchair users navigating an Ob/Gyn clerkship are absent in the literature.

Vascular Imaging for the Primary Care Provider: Venous and Arterial Disease.

The vascular laboratory provides important contributions to the diagnosis, workup, and treatment of known or suspected vascular disease. Knowing what tests to order (and when to order them) allows for the best utilization of these resources. This article will focus on the appropriate use of the vascular lab for the primary care clinician regarding a variety of vascular presentations, including swollen leg, suspected peripheral artery disease, vasospastic disease, carotid artery stenosis, and abdominal aortic aneurysms.

Update on pneumococcal vaccination in adults: Simpler is better.

Recommendations for pneumococcal vaccination in adults have been updated in the hopes not only of preventing more cases of invasive pneumococcal disease but also of making the recommendations simpler and easier to follow.

"Flipped" clinical rotations: A novel approach.

Background: Near the beginning of the COVID-19 pandemic in the United States, medical students were pulled out of all in-person patient care activities. This resulted in massive disruption to the required clinical rotations (clerkships), necessitating creative curricular solutions to ensure continued education for medical students.

Approach: In response to the lockout, our school adopted a "flipped" clinical rotations model that assigned students to remote learning activities prior to in-person patient care activities.

Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline.

Background: Adult patients with diabetes or newly recognized hyperglycemia account for over 30% of noncritically ill hospitalized patients. These patients are at increased risk for adverse clinical outcomes in the absence of defined approaches to glycemic management.

Objective: To review and update the 2012 Management of Hyperglycemia in Hospitalized Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline and to address emerging areas specific to the target population of noncritically ill hospitalized patients with diabetes or newly recognized or stress-induced hyperglycemia.

Correction: Men's health 2018.

In the article by Chaitoff et al (Men's health 2018: BPH, prostate cancer, erectile dysfunction, supplements. Cleve Clin J Med 2018; 85(11):871-880, doi:10.3949/ccjm.

Men's health 2018: BPH, prostate cancer, erectile dysfunction, supplements.

This review describes the latest research and guidelines for 4 topics in men's health commonly addressed by primary care physicians: the diagnosis and treatment of benign prostatic hyperplasia (BPH), prostate cancer, and erectile dysfunction and the evidence concerning the use of dietary supplements in men.

Medication management in older adults.

Managing medications is a major part of providing care to older adults. Polypharmacy is common in the elderly and is fraught with risks. A careful and systematic approach is needed for managing drug therapy in these patients, recognizing the patient's specific goals.

Probability of developing proximal deep-vein thrombosis and/or pulmonary embolism after distal deep-vein thrombosis.

Isolated distal deep-vein thrombosis (DDVT) of the lower extremities can be associated with subsequent proximal deep-vein thrombosis (PDVT) and/or acute pulmonary embolism (PE). We aimed to develop a model predicting the probability of developing PDVT and/or PE within three months after an isolated episode of DDVT. We conducted a retrospective cohort study of patients with symptomatic DDVT confirmed by lower extremity vein ultrasounds between 2001-2012 in the Cleveland Clinic Health System.

Starting insulin in patients with type 2 diabetes: An individualized approach.

Because type 2 diabetes mellitus is a progressive disease, most patients eventually need insulin. When and how to start insulin therapy are not one-size-fits-all decisions but rather must be individualized. This paper reviews the indications, goals, and options for insulin therapy in type 2 diabetes.

Six screening tests for adults: What's recommended? What's controversial?

This paper discusses guidelines from the US Preventive Services Task Force (USPSTF) and other recommending bodies for screening for abdominal aortic aneurysm and cancers of the colon, cervix, lung, breast, and prostate.

Keeping up with immunizations for adults.

This paper discusses recommendations from the US Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices for vaccinating adults against influenza, tetanus, measles, mumps, rubella, varicella, hepatitis A and B, human papillomavirus, shingles (zoster), pneumonia, and meningitis.

Physicians caring for physicians: the perspective of the primary care physician.

Objectives: How physicians provide longitudinal primary care to physician-patients (ie, physicians as patients) has not been well studied. The potential challenges of providing care to physician-patients include maintaining professional boundaries and adhering to practice guidelines. The objective was to explore the differences in identifying how physicians perceive caring for physicians-patients in the longitudinal setting versus caring for other patients in the general population.

Transitioning from a noon conference to an academic half-day curriculum model: effect on medical knowledge acquisition and learning satisfaction.

Background: The academic half-day (AHD) curriculum is an alternative to the traditional noon conference in graduate medical education, yet little is known regarding its effect on knowledge acquisition and resident satisfaction.

Objective: We investigated the association between the 2 approaches for delivering the curriculum and knowledge acquisition, as reflected by the Internal Medicine In-Training Examination (IM-ITE) scores and assessed resident learning satisfaction under both curricula.

Methods: The Cleveland Clinic Internal Medicine Residency Program transitioned from the noon conference to the AHD curriculum in 2011.

Priapism induced by boceprevir-CYP3A4 inhibition and α-adrenergic blockade: case report.

A 44-year-old white man presented to the emergency department with a 3-day history of priapism requiring a surgically performed distal penile shunt. A drug-drug interaction is the suspected cause whereby CYP3A4 inhibition by boceprevir led to increased exposures of doxazosin, tamsulosin, and/or quetiapine, resulting in additional α-adrenergic blockade.

A nomogram to predict the probability of passing the American Board of Internal Medicine examination.

Background: Although the American Board of Internal Medicine (ABIM) certification is valued as a reflection of physicians' experience, education, and expertise, limited methods exist to predict performance in the examination.

Purpose: The objective of this study was to develop and validate a predictive tool based on variables common to all residency programs, regarding the probability of an internal medicine graduate passing the ABIM certification examination.

Methods: The development cohort was obtained from the files of the Cleveland Clinic internal medicine residents who began training between 2004 and 2008.