Designing Prefaculty Competencies for Diverse Learners Through a Modified Delphi Process.

Importance: Faculty diversity in academic medicine may better prepare the next generation of equity-minded health care practitioners and leaders. Prefaculty development is an emerging concept to support trainees in achieving key knowledge, skills, and experiences to become successful faculty.

Objective: To outline competencies, with corresponding milestones, to support the academic career development of learners, inclusive of racial, ethnic, sexual, and gender identities minoritized in medicine.

A Validity Study of COMLEX-USA Level 2-CE and COMAT Clinical Subjects: Concurrent and Predictive Evidence.

Background: The Comprehensive Osteopathic Medical Licensure Examination (COMLEX-USA) Level 2-Cognitive Examination (CE) and the Comprehensive Osteopathic Medical Achievement Test (COMAT) are administered to similar populations (third- and fourth-year osteopathic students) at similar points in time. Examining the relationship between scores on the 2 assessments that measure similar constructs ultimately supports the validity of both.

Objective: The purpose of this study is to provide empirical evidence of the concurrent and predictive validity of COMAT and COMLEX-USA Level 2-CE.

Leadership and Academic Medicine: Preparing Medical Students and Residents to Be Effective Leaders for the 21st Century.

Introduction: Physician leadership positions have evolved from autonomous roles in clinical medicine to those of leaders in interdisciplinary teams managing population-based care in a value-based care-delivery system, to C-suite administrative roles in hospitals and other health care systems. Unfortunately, many practicing physicians are ill prepared to take on these new roles.

Methods: In response to the evolution of the role of the physician leader in the 21st century, an educational workshop consisting of didactics and interactive case discussion was developed to introduce medical students and residents to the concepts and practices of physician leadership.

Bleeding disorders in Noonan syndrome.

Noonan Syndrome (NS) is a common genetic disease with multiple organ defects including bleeding disorders, which was last reviewed in 1997. Since then significant information has been acquired regarding bleeding problems in NS, specifically on the underlying genetics. Associations between mutated genes and bleeding disorders are reviewed along with prevalence and underlying etiologies.

The late effects of childhood cancer therapy.

In this article the difficulties that face survivors of childhood cancer therapy are presented, and the late effects of such therapy, separated into nonmalignant and malignant late effects, are discussed according to organ system. Recommendations for monitoring the late effects are set forth. A table listing radiation-therapy site and chemotherapeutic agents and selected late effects that result from their use is provided.

Hereditary thrombophilia.

Thrombophilia can be defined as a predisposition to form clots inappropriately. Thrombotic events during infancy and childhood are increasingly recognized as a significant source of mortality and morbidity. The predisposition to form clots can arise from genetic factors, acquired changes in the clotting mechanism, or, more commonly, an interaction between genetic and acquired factors.

Severe acquired vitamin K deficiency: a hypothesis for rapid response to therapy.

The potential mechanism underlying the rapid response to vitamin K replacement in acquired deficiency states is incompletely understood. To examine vitamin K metabolism, a 10-year-old boy with autoimmune enteropathy on oral vitamin K supplementation, who presented with profuse nosebleeds and calf tenderness, was evaluated. Laboratory analyses were consistent with severe vitamin K deficiency: vitamin K dependent protein (VKDP) levels < 5%, normal vitamin K epoxide level and depressed total prothrombin antigen (carboxylated and undercarboxyated forms).

Guidelines and Techniques for Improving the NEPA Process.

/ The Council on Environmental Quality's (CEQ's) principal aims in implementing the National Environmental Policy Act (NEPA) are (1) to reduce paperwork, (2) to avoid delay, and most importantly (3) to produce better decisions that protect, restore, and enhance the environment. This paper presents four strategies for improving the NEPA process along with tools that can be used to implement each strategy. The tools include guidelines for project management and problem definition, tips for acquiring existing information and identifying issues of public concern, worksheets on how to identify and analyze potential impacts on resources, ideas for enhancing NEPA documents, and a NEPA process checklist.

Curriculum goals for the training of osteopathic family practice residents for the year 2000.

The osteopathic family practitioner of the future will play a larger role in the delivery of healthcare under managed care. To prepare for this role, osteopathic family practice residents must develop skills in direct medical care, medical education, and healthcare administration. Likewise, these residents need to become familiar with the clinical setting in which these skills are needed, specifically, ambulatory, rural, hospital, and minor emergency care environments.

Extrarenal Wilms' tumor: an ultrastructural and immunoelectron microscopic case report.

Wilms' tumor is the most common malignancy of the genitourinary tract in children but the occurrence of extrarenal Wilms' tumor is extremely rare. Extrarenal Wilms' tumor, which by definition excludes a primary tumor in the kidney, has been reported less than fifty times. The ultrastructural appearance of renal Wilms' tumor has been well documented, but the present report is believed to be the first description of the ultrastructural appearance of extrarenal Wilms' tumor.

Ifosfamide/carboplatin/etoposide (ICE) for recurrent malignant solid tumors of childhood: a Pediatric Oncology Group Phase I/II study.

Purpose: The combination of ifosfamide (I) and etoposide (E) was useful in salvaging patients with recurrent/resistant malignant solid tumors of childhood. Carboplatin (C), active against a number of pediatric cancers, was added to I and E to form a three-drug combination called ICE to improve the response rate.

Patients And Methods: ICE, consisting of I 1.

Extraskeletal Ewing's sarcoma of primary cardiac origin.

A 13-year-old boy presented with cardiac tamponade. Echocardiography revealed a large mass extending from the right and left ventricles into a large pericardial effusion. Pathology confirmed the first reported case of a primary cardiac extraskeletal Ewing's sarcoma.

Ophthalmoplegia with headache. Be aware of diabetes.

Cranial neuropathy affecting the eyes is a possible symptom of type II diabetes. In this article, Dr Dickerman describes a case in which diabetes was diagnosed in a 63-year-old woman who presented with unilateral headache and eye pain.

Gallbladder disease and coronary artery disease: is there a link?

Both gallstones and coronary artery disease are associated with cholesterol. Therefore, the literature was searched for evidence that gallbladder disease can be considered a risk factor for coronary artery disease. The problem has been approached from several angles.

Rebound thymic hyperplasia five years after chemotherapy for Wilms' tumor.

Rebound thymic hyperplasia following chemotherapy is well documented, usually occurring within the first year. A delayed presentation makes distinction from an anterior mediastinal mass problematic in view of the increased risk of a second primary malignancy in pediatric cancer survivors. An unusual case of rebound thymic hyperplasia is described, presenting five years after completion of chemotherapy for Wilms' tumors.