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  1. AU="Bryant Lin"
  2. AU="Schwab, Jörg O."
  3. AU="Ke Chen"
  4. AU="Hewei Liang"
  5. AU="Abreu, Cristina"
  6. AU="Mamani Ortiz, Yercin"
  7. AU="Castro, Lucíola de Fátima Albuquerque Almeida Peixoto"
  8. AU="Šimůnek, Tomáš"
  9. AU="Ong, Lizhen"
  10. AU="Chai, Chaoqing"
  11. AU="Maheswaran Kesavan"
  12. AU="Mehta, Mrunal"
  13. AU=Paredes Sergio D
  14. AU=Ghosh Nilanjan AU=Ghosh Nilanjan
  15. AU="Hofmann, Alexander"
  16. AU="Radici, Marco"
  17. AU="Noro, Fabrizia"
  18. AU="Wang, Jianzhao"
  19. AU="Divya Jeyam"
  20. AU="Wolf, Lisette"
  21. AU="Marjanovic, Nemanja Despot"
  22. AU="Jitxin, Lim"

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  1. Artikel ; Online: Training Internal Medicine Residents in Difficult Diagnosis

    Stefano Testa / Mugdha Joshi / Justin Lotfi / Bryant Lin / Maja Artandi / Kim F. Chiang / Kevin Chang / Baldeep Singh / Linda N. Geng

    Journal of Medical Education and Curricular Development, Vol

    A Novel Diagnostic Second Opinion Clinic Experience

    2022  Band 9

    Abstract: Background In primary care clinics, time constraints and lack of exposure to highly complex cases may limit the breadth and depth of learning for internal medicine residents. To address these issues, we piloted a novel experience for residents to ... ...

    Abstract Background In primary care clinics, time constraints and lack of exposure to highly complex cases may limit the breadth and depth of learning for internal medicine residents. To address these issues, we piloted a novel experience for residents to evaluate patients with puzzling symptoms referred by another clinician. Objective To increase internal medicine residents’ exposure to patients with perplexing presentations and foster a team-based approach to solving diagnostically challenging cases. Methods During the academic year 2020–2021, residents participating in their 2-week primary care “block” rotation were given protected time to evaluate 1–2 patients from the Stanford Consultative Medicine clinic, an internist-led diagnostic second opinion service, and present their patients at the case conference. We assessed the educational value of the program with resident surveys including 5-point Lickert scale and open-ended questions. Results 21 residents participated in the pilot with a survey response rate of 66.6% (14/21). Both the educational value and overall quality of the experience were rated as 4.8 out of 5 (SD 0.4, range 4-5; 1:”very poor”; 5:”excellent”). Residents learned about new diagnostic tools as well as how to approach complex presentations and diagnostic dilemmas. Residents valued the increased time devoted to patient care, the team-based approach to tackling difficult cases, and the intellectual challenge of these cases. Barriers to implementation include patient case volume, time, and faculty engagement. Conclusions Evaluation of diagnostically challenging cases in a structured format is a highly valuable experience that offers a framework to enhance outpatient training in internal medicine.
    Schlagwörter Special aspects of education ; LC8-6691 ; Medicine (General) ; R5-920
    Thema/Rubrik (Code) 360
    Sprache Englisch
    Erscheinungsdatum 2022-03-01T00:00:00Z
    Verlag SAGE Publishing
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Pharmacogenomics in Asian Subpopulations and Impacts on Commonly Prescribed Medications

    Cody Lo / Samantha Nguyen / Christine Yang / Lana Witt / Alice Wen / T. Vivian Liao / Jennifer Nguyen / Bryant Lin / Russ B. Altman / Latha Palaniappan

    Clinical and Translational Science, Vol 13, Iss 5, Pp 861-

    2020  Band 870

    Abstract: Asians as a group comprise > 60% the world’s population. There is an incredible amount of diversity in Asian and admixed populations that has not been addressed in a pharmacogenetic context. The known pharmacogenetic differences in Asian subgroups ... ...

    Abstract Asians as a group comprise > 60% the world’s population. There is an incredible amount of diversity in Asian and admixed populations that has not been addressed in a pharmacogenetic context. The known pharmacogenetic differences in Asian subgroups generally represent previously known variants that are present at much lower or higher frequencies in Asians compared with other populations. In this review we summarize the main drugs and known genes that appear to have differences in their pharmacogenetic properties in certain Asian populations. Evidence‐based guidelines and summary statistics from the US Food and Drug Administration and the Clinical Pharmacogenetics Implementation Consortium were analyzed for ethnic differences in outcomes. Implicated drugs included commonly prescribed drugs such as warfarin, clopidogrel, carbamazepine, and allopurinol. The majority of these associations are due to Asians more commonly being poor metabolizers of cytochrome P450 (CYP) 2C19 and carriers of the human leukocyte antigen (HLA)‐B*15:02 allele. The relative risk increase was shown to vary between genes and drugs, but could be > 100‐fold higher in Asians. Specifically, there was a 172‐fold increased risk of Stevens‒Johnson syndrome and toxic epidermal necrolysis with carbamazepine use among HLA‐B*15:02 carriers. The effects ranged from relatively benign reactions such as reduced drug efficacy to severe cutaneous skin reactions. These reactions are severe and prevalent enough to warrant pharmacogenetic testing and appropriate changes in dose and medication choice for at‐risk populations. Further studies should be done on Asian cohorts to more fully understand pharmacogenetic variants in these populations and to clarify how such differences may influence drug response.
    Schlagwörter Therapeutics. Pharmacology ; RM1-950 ; Public aspects of medicine ; RA1-1270
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2020-09-01T00:00:00Z
    Verlag Wiley
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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