Training the eye, virtually: adapting an art in medicine curriculum for on-line learning.

Unlabelled: Training the Eye: Improving the Art of Physical Diagnosis is an elective fine art-based medical humanities course at Harvard Medical School held at the Museum of Fine Arts, Boston that aims to improve skills of observation. Due to COVID-19, this curriculum was converted from in-person to a virtual format for the first time in 2020. Students enrolled in the course prior to the pandemic and completed one session in person before transitioning unexpectedly to nine remote sessions through Zoom.

The Women Before Me: My Journey Painting Honor Wall Portraits of Women Physicians.

In this article, the authors briefly review the history and status of institutional honor wall portraits at medical schools, and they highlight the implications of a lack of diversity in these portraits for current medical students and the academic medicine pipeline. The authors then describe how contemporary portrait artists have used art as a tool for advocacy. They detail the first author's empowering and intimate journey as a medical student as she identified, connected with, and painted a portrait gallery of some of her medical school's prominent alumnae of color.

Teaching healthcare professionals to see.

Prerequisite to establishing a diagnosis, healthcare providers must detect and appreciate subtle cues to dysfunction, disease and dysmorphology. A medical school course designed to connect art observation and diagnosis addresses the ongoing erosion of careful looking, which is at the core of detecting malformations and dysmorphologies, among other medical conditions. We present an example from within the field of medical genetics of how the skill of deep looking can be taught.

Food intake, plate waste and its association with malnutrition in hospitalized patients.

Background: Hospital malnutrition is a worldwide dilemma and challenge. High levels of plate waste contribute to malnutrition-related complications in hospital. We investigated the association between the levels of plate waste, food intake and patient satisfaction with nutritional risk and malnutrition prevalence in three hospital settings.

Sacral agenesis and neurogenic bladder: Long-term outcomes of bladder and kidney function.

Background: Sacral agenesis (SA) is a rare congenital condition that refers to the absence of part or all of two or more lower sacral vertebral bodies. It can be associated with neurogenic bladder dysfunction that does not necessarily correlate with the level of spinal or skeletal defect. Patients with SA should undergo urodynamic studies (UDS) to guide lower urinary tract (LUT) management.

Can visual arts training improve physician performance?

Clinical educators use medical humanities as a means to improve patient care by training more self-aware, thoughtful, and collaborative physicians. We present three examples of integrating fine arts - a subset of medical humanities - into the preclinical and clinical training as models that can be adapted to other medical environments to address a wide variety of perceived deficiencies. This novel teaching method has promise to improve physician skills, but requires further validation.

Combined cystometrography and electromyography of the external urethral sphincter following complete primary repair of bladder exstrophy.

Purpose: Concern in patients with bladder exstrophy after reconstruction regarding potential injury to pelvic neurourological anatomy and a resultant functional deficit prompted combined (simultaneous) cystometrography and electromyography after complete primary repair of bladder exstrophy. We determined whether complete primary repair of bladder exstrophy would adversely affect the innervation controlling bladder and external urethral sphincter function.

Materials And Methods: Complete primary repair of bladder exstrophy was performed via a modified Mitchell technique in newborns without osteotomy.

From the galleries to the clinic: applying art museum lessons to patient care.

Increasingly, medical educators integrate art-viewing into curricular interventions that teach clinical observation-often with local art museum educators. How can cross-disciplinary collaborators explicitly connect the skills learned in the art museum with those used at the bedside? One approach is for educators to align their pedagogical approach using similar teaching methods in the separate contexts of the galleries and the clinic. We describe two linked pedagogical exercises--Visual Thinking Strategies (VTS) in the museum galleries and observation at the bedside--from "Training the Eye: Improving the Art of Physical Diagnosis," an elective museum-based course at Harvard Medical School.

First Report on Self-Rated Health in a Nationally-Representative Sample of Iranian Adolescents: The CASPIAN-iii study.

Objective: To evaluate predictive factors of adolescents' appraisal of their health.

Methods: The nationwide study, entitled "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Diseases (CASPIAN) study", was conducted in 2010 among Iranian school students, aged 10-18. In addition to demographic factors and physical examination, variables as family structure, nutrition habits, physical activity, smoking, hygienic habits, violence, school attachment, family smoking, and family history of chronic diseases were assessed.

Inter-rater agreement for diagnoses of epilepsy in pregnant women.

We report on inter-rater agreement in assessing the types of seizures exhibited by one hundred mothers ascertained in a study of the teratogenicity of maternal epilepsy and antiepileptic drugs. A summary of each woman's medical record and a one-page report of her responses to questions about her epilepsy were reviewed independently by six neurologists, three in pediatric neurology and three in adult neurology. Agreement was measured by the kappa statistic and log-linear modeling techniques.

In utero closure of myelomeningocele does not improve lower urinary tract function.

Purpose: Recent data comparing prenatal to postnatal closure of myelomeningocele showed a decreased need for ventriculoperitoneal shunting and improved lower extremity motor outcomes in patients who underwent closure prenatally. A total of 11 children whose spinal defect was closed in utero were followed at our spina bifida center. We hypothesized that in utero repair of myelomeningocele improves lower urinary tract function compared to postnatal repair.

Urodynamic findings in patients with Currarino syndrome.

Purpose: Currarino syndrome is an inherited disorder consisting of a triad of anorectal anomaly, sacrococcygeal defect and presacral mass. We evaluated the urological issues in patients with Currarino syndrome and sought to determine whether spinal cord detethering improves urinary tract function.

Materials And Methods: We retrospectively reviewed 14 patients diagnosed with Currarino syndrome.

Evaluation of postoperative sharp waveforms through EEG and magnetoencephalography.

EEGs obtained after craniotomy are difficult to read because of a breach rhythm consisting of unfiltered sharply contoured physiologic waveforms that can mimic interictal epileptiform discharges. Magnetoencephalography (MEG) is less affected by the skull breach. The postcraniotomy EEG and MEG scans of 20 patients were reviewed by two experienced electroencephalographers.

Formal art observation training improves medical students' visual diagnostic skills.

Background: Despite evidence of inadequate physical examination skills among medical students, teaching these skills has declined. One method of enhancing inspection skills is teaching "visual literacy," the ability to reason physiology and pathophysiology from careful and unbiased observation.

Objective: To improve students' visual acumen through structured observation of artworks, understanding of fine arts concepts and applying these skills to patient care.

Bladder and external urethral sphincter function after prenatal closure of myelomeningocele.

Purpose: We compared urodynamic findings in patients who underwent prenatal closure of myelomeningocele with those of patients who underwent postnatal closure, and equivalent lower urinary tract evaluations.

Materials And Methods: Urodynamic studies of 5 patients (2 boys, 3 girls) who underwent prenatal closure of myelomeningocele were compared to those of 88 patients with similar level lesions who underwent repair postnatally between 1979 and 2002.

Results: All 5 patients in the prenatally treated cohort had lower lumbosacral lesions on neurological examination.

Neurogenic bladder dysfunction after sacrococcygeal teratoma resection.

Purpose: SCT treatment in newborns consists of surgery and selective chemotherapy. Few reports document urological sequelae using this approach. This review focuses on the urological and neurourological findings following SCT treatment in the newborn period.

Lateralized cognitive dysfunction in patients with systemic lupus erythematosus.

This study was designed to determine whether there is a lateralized pattern of cognitive dysfunction in patients with systemic lupus erythematosus (SLE). Fifty right-handed patients with SLE, but no history of cerebrovascular disease participated in the study. Thirty right-handed healthy subjects matched for age and education served as controls.

Bladder growth and development after complete primary repair of bladder exstrophy in the newborn with comparison to staged approach.

Purpose: We assessed bladder growth and dynamics following complete primary repair of bladder exstrophy (CPRE) compared to the staged approach.

Materials And Methods: We reviewed the records of 16 boys and 7 girls who underwent CPRE within 3 days of life from 1996 to 2004 and compared them to the records of 8 boys and 6 girls treated with a staged repair from 1979 to 1996. Screening methods included voiding cystourethrogram, radionuclide cystogram and urodynamic study.

The teratogenicity of anticonvulsant drugs.

Background: The frequency of major malformations, growth retardation, and hypoplasia of the midface and fingers, known as the anticonvulsant embryopathy, is increased in infants exposed to anticonvulsant drugs in utero. However, whether the abnormalities are caused by the maternal epilepsy itself or by exposure to anticonvulsant drugs is not known.

Methods: We screened 128,049 pregnant women at delivery to identify three groups of infants: those exposed to anticonvulsant drugs, those unexposed to anticonvulsant drugs but with a maternal history of seizures, and those unexposed to anticonvulsant drugs with no maternal history of seizures (control group).

Prevalence of migraine in patients with systemic lupus erythematosus.

Objective: To determine the prevalence of migraine in patients with systemic lupus erythematosus (SLE), and to examine the relationships between headache type and other clinical, serologic, and treatment features of the disease.

Background: Headaches are common in SLE and are a significant source of patient disability. The exact prevalence of headaches in patients with SLE is unknown.