3,672 results match your criteria Mount Sinai Journal of Medicine [Journal]


Minority undergraduate programs intended to increase participation in biomedical careers.

Mt Sinai J Med 2012 Nov-Dec;79(6):769-81

University of California Berkeley, Berkeley, CA, USA.

This article reviews a selection of undergraduate programs intended to increase successful minority participation in science, technology, engineering, and mathematics majors, potentially leading to biomedical careers. The object is to examine their structure, consider how well they address the issues of the target population, and assess the extent to which they have met/meet their goals. As a means of conducting this review, the first step is to examine the concepts used as the building blocks for program design. Read More

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http://dx.doi.org/10.1002/msj.21350DOI Listing
December 2013
6 Reads

Future of electronic health records: implications for decision support.

Mt Sinai J Med 2012 Nov-Dec;79(6):757-68

Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN, USA.

The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Read More

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http://doi.wiley.com/10.1002/msj.21351
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http://dx.doi.org/10.1002/msj.21351DOI Listing
December 2013
17 Reads

AA amyloidosis: Mount Sinai experience, 1997-2012.

Mt Sinai J Med 2012 Nov-Dec;79(6):749-56

Mount Sinai Medical Center, New York, NY, USA.

Background: AA amyloidosis is a systemic disease characterized by the extracellular deposition of amyloid fibrils derived from the acute-phase reactant serum amyloid A protein. It is typically a consequence of chronic inflammatory conditions like rheumatoid arthritis or Crohn's disease, although more patients are being identified who have more unusual causes or no known inflammatory stimulus.

Methods: We performed a retrospective chart review of all patients with AA amyloidosis seen at Mount Sinai during the period of 1997-2012. Read More

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http://dx.doi.org/10.1002/msj.21342DOI Listing
December 2013
11 Reads

Amyloid neuropathies.

Mt Sinai J Med 2012 Nov-Dec;79(6):733-48

Mount Sinai School of Medicine, New York, NY, USA.

Peripheral neuropathy is a common complication of many of the systemic amyloidoses. Although the cause of neuropathy is not entirely clear, it is likely related to amyloid deposition within the nerve. This may lead to focal, multifocal, or diffuse neuropathies involving sensory, motor and/or autonomic fibers. Read More

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http://doi.wiley.com/10.1002/msj.21352
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http://dx.doi.org/10.1002/msj.21352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531896PMC
December 2013
5 Reads

Should your family history of coronary heart disease scare you?

Mt Sinai J Med 2012 Nov-Dec;79(6):721-32

Centre for Chronic Disease Control, New Delhi, India.

Traditional risk factors explain most of the risk associated with coronary heart disease, and after adjustment for risk factors family history was believed to contribute very little to population-attributable risk of coronary heart disease. However, the INTERHEART study demonstrated an independent association of family history of coronary heart disease with acute myocardial infarction. To assess this relationship more comprehensively in multiple datasets in different populations, we carried out a detailed review of the available evidence. Read More

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http://dx.doi.org/10.1002/msj.21348DOI Listing
December 2013
23 Reads

Management of atrial fibrillation: direct factor IIa and Xa inhibitors or "warfarin shotgun"?

Mt Sinai J Med 2012 Nov-Dec;79(6):705-20

The Cardiovascular Institute, Mount Sinai Medical Center, New York, NY, USA.

Nonvalvular atrial fibrillation increases in prevalence with age and often requires long-term oral anticoagulation to prevent ischemic stroke. Vitamin K antagonists are highly effective for stroke prevention. However, suboptimal risk assessment, variability in response, drug and food interactions, and monitoring requirements result in underprescription of warfarin by physicians and poor adherence to therapy by patients. Read More

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http://dx.doi.org/10.1002/msj.21346DOI Listing
December 2013
3 Reads

Evaluating efficacy of pharmaceutical interventions in atherosclerosis: role of magnetic resonance imaging and positron emission tomography.

Mt Sinai J Med 2012 Nov-Dec;79(6):689-704

Department of Nuclear Medicine, Bichat-Claude Bernard University Hospital, Paris, France.

The rate of acute complications of atherosclerosis (acute myocardial infarction, ischemic stroke) has continuously decreased over the last 20 years in Western countries. This is largely explained by improvements in the reduction and treatment of cardiovascular risk factors and by the increasing number of patients who benefit from preventive treatments such as antiplatelet, lipid-lowering, or antihypertensive drugs. This means also that, when testing new drugs aimed at either halting or even reversing the progression of atherosclerotic plaques, a large number of patients will need to be included in clinical trials to demonstrate an improvement in patient outcome with the drugs. Read More

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http://dx.doi.org/10.1002/msj.21349DOI Listing
December 2013
5 Reads

Maximizing therapeutic envelope for prevention of cardiovascular disease: role of polypill.

Mt Sinai J Med 2012 Nov-Dec;79(6):683-8

National Center for Cardiovascular Research CNIC, Madrid, Spain.

Cardiovascular-disease prevention is often inadequate due to several factors. Lack of professional adherence to guidelines, unaffordable medication, and lack of patients' adherence to treatment are the most important. It has been suggested that an affordable, fixed-dose combination drug containing evidence-based active compounds could improve cardiovascular prevention by improving patients' adherence to treatment. Read More

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http://dx.doi.org/10.1002/msj.21355DOI Listing
December 2013
3 Reads

Novel imaging strategies for assessment of cerebrovascular involvement.

Mt Sinai J Med 2012 Nov-Dec;79(6):674-82

Mount Sinai School of Medicine, New York, NY, USA.

There is an important correlation between vascular risk factors and nonspecific imaging findings in the brain such as white-matter hyperintensities. These vascular risk factors are also associated with dementia and lesser forms of cognitive impairment. One hypothesis is that these vascular risk factors lead to disruption of connective networks in the central nervous system that are supported by myelinated white-matter fibers, which in turn lead to deficits in functional signaling between various brain regions. Read More

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http://dx.doi.org/10.1002/msj.21354DOI Listing
December 2013
5 Reads

Atherosclerotic risk factors, vascular cognitive impairment, and Alzheimer disease.

Mt Sinai J Med 2012 Nov-Dec;79(6):664-73

The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY, USA.

The involvement of vascular factors in Alzheimer dementia was first appreciated over 100 years ago. Recently, significant advances in our understanding of these brain-vascular relationships have taken place. Vascular cognitive impairment is now recognized as a distinct group of interrelated vascular-based neurological insults that can accumulate and lead to dementia. Read More

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http://dx.doi.org/10.1002/msj.21347DOI Listing
December 2013
2 Reads

Predicting coronary heart disease: from Framingham Risk Score to ultrasound bioimaging.

Mt Sinai J Med 2012 Nov-Dec;79(6):654-63

Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Atherosclerosis is the leading cause of death and disabling disease. Whereas risk factors are well known and constitute therapeutic targets, they are not useful for prediction of risk of future myocardial infarction, stroke, or death. Therefore, methods to identify atherosclerosis itself have been tested and found useful (ie, coronary calcium detection by computed tomography scanning, reduction in ankle-brachial index, and ultrasound scanning of the carotid arteries). Read More

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http://dx.doi.org/10.1002/msj.21343DOI Listing
December 2013
3 Reads

Omnipresent atherosclerotic disease: time to depart from analysis of individual vascular beds.

Mt Sinai J Med 2012 Nov-Dec;79(6):641-53

CVPath Institute, Gaithersburg, MD, USA.

Atherosclerotic vascular disease not only remains the leading cause of death in the Western countries, but it has become the most common cause of morbidity and mortality in the low- and middle-income countries as well. Therefore, better understanding of the pathogenesis of atherosclerotic disease and its prevention are of fundamental importance. It is well known that it affects sequentially the aorta followed by coronary, carotid, peripheral, and intracerebral arteries, with some individual variability. Read More

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http://dx.doi.org/10.1002/msj.21353DOI Listing
December 2013
4 Reads

Recognizing global burden of cardiovascular disease and related chronic diseases.

Mt Sinai J Med 2012 Nov-Dec;79(6):632-40

Institute of Medicine of the National Academies, Washington, DC, USA.

Cardiovascular disease is the leading cause of death worldwide, affecting not only high-income but also low- and middle-income countries. Nearly 80 percent of all estimated cardiovascular disease-related deaths worldwide now occur in low- and middle-income countries, where nearly 30 percent of all deaths are attributable to cardiovascular disease. The health burden of cardiovascular disease and other chronic diseases is also accompanied by a significant deleterious economic impact at the level of both national economies and households. Read More

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http://dx.doi.org/10.1002/msj.21345DOI Listing
December 2013
8 Reads

Promoting global cardiovascular and cerebrovascular health.

Mt Sinai J Med 2012 Nov-Dec;79(6):625-31

Mount Sinai Medical Center, New York, NY, USA.

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http://dx.doi.org/10.1002/msj.21344DOI Listing
December 2013
6 Reads

Meyerhoff Scholars Program: a strengths-based, institution-wide approach to increasing diversity in science, technology, engineering, and mathematics.

Mt Sinai J Med 2012 Sep-Oct;79(5):610-23

University of Maryland, Baltimore, MD, USA.

The Meyerhoff Scholars Program at the University of Maryland, Baltimore County is widely viewed as a national model of a program that enhances the number of underrepresented minority students who pursue science, technology, engineering, and mathematics PhDs. The current article provides an overview of the program and the institution-wide change process that led to its development, as well as a summary of key outcome and process evaluation research findings. African American Meyerhoff students are 5× more likely than comparison students to pursue a science, technology, engineering, and mathematics PhD. Read More

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http://doi.wiley.com/10.1002/msj.21341
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http://dx.doi.org/10.1002/msj.21341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444508PMC
April 2013
12 Reads

Family medicine: a specialty for all ages.

Mt Sinai J Med 2012 Sep-Oct;79(5):603-9

The Institute for Family Health, New York, NY, USA.

After a diminishing of its ranks following the post-World War II explosion of growth in medical discoveries, advanced medical technology, and the concomitant specialization of the physician workforce, family medicine is re-establishing itself as a leading medical specialty that has garnered growing interest among recent medical-school graduates. Family physicians provide care for patients of all ages, from newborns to the elderly. In addition to its wide scope of practice, family medicine is characterized by its emphasis on understanding of the whole person, its partnership approach with patients over many years, and its command of medical complexity. Read More

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https://www.researchgate.net/profile/Neil_Calman/publication
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http://dx.doi.org/10.1002/msj.21333DOI Listing
April 2013
11 Reads

Personal health records: meaningful use, but for whom?

Mt Sinai J Med 2012 Sep-Oct;79(5):593-602

Mount Sinai Medical Center, New York, NY, USA.

Providers and hospitals have received more than $5 billion from the federal government for meaningfully using electronic health records as of April 2012. Meaningful Use stage 1 makes adoption of the personal health record optional. The proposed Meaningful Use stage 2 regulations make personal health record use mandatory. Read More

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http://dx.doi.org/10.1002/msj.21334DOI Listing
April 2013
3 Reads

Health care for homeless and unstably housed: overcoming barriers.

Mt Sinai J Med 2012 Sep-Oct;79(5):586-92

Mount Sinai School of Medicine, New York, NY, USA.

The causes of homelessness are complex and multifactorial and the solutions equally complex. Though homelessness is not a disease process, it is directly linked to poor health outcomes. It is thus incumbent on health care professionals to know the various definitions of homelessness, the ramifications of unstable housing, and the specific living conditions of each homeless patient. Read More

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http://dx.doi.org/10.1002/msj.21339DOI Listing
April 2013
4 Reads

Integrating palliative care into primary care.

Mt Sinai J Med 2012 Sep-Oct;79(5):579-85

Mount Sinai School of Medicine, New York, NY, USA.

Patients with serious illnesses are living longer and with greater disabilities. Palliative-care interventions have been shown to increase quality of life, lower costs, and improve survival. In order to meet the palliative-care needs of patients, it is crucial for primary-care clinicians to understand how they can provide primary palliative care and when they should refer to palliative-care specialists. Read More

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http://www.thenpa.org/resource/resmgr/Annual_Conference/2015
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http://doi.wiley.com/10.1002/msj.21338
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http://dx.doi.org/10.1002/msj.21338DOI Listing
April 2013
7 Reads

Health maintenance in older adults: combining evidence and individual preferences.

Mt Sinai J Med 2012 Sep-Oct;79(5):560-78

Mount Sinai School of Medicine, New York, NY, USA.

There is increasing interest in maintaining health and delaying disability for older adults as this population segment expands. And instead of focusing on a traditional disease-specific approach to health maintenance, there is an ongoing shift to a patient-centered approach, and defining outcomes based on the older adults' goals. In this approach, their goals and preferences are central, and other factors such as their health status and prognosis help determine which goals may be realistic. Read More

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http://dx.doi.org/10.1002/msj.21340DOI Listing
April 2013
3 Reads

Gender disparities in health care.

Mt Sinai J Med 2012 Sep-Oct;79(5):555-9

Mount Sinai Medical Center, New York, NY, USA.

The existence of disparities in delivery of health care has been the subject of increased empirical study in recent years. Some studies have suggested that disparities between men and women exist in the diagnoses and treatment of health conditions, and as a result measures have been taken to identify these differences. This article uses several examples to illustrate health care gender bias in medicine. Read More

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http://dx.doi.org/10.1002/msj.21336DOI Listing
April 2013
25 Reads

Evidence-based medicine and primary care: keeping up is hard to do.

Mt Sinai J Med 2012 Sep-Oct;79(5):545-54

Duke University Medical Center, Durham, NC, USA.

Primary-care physicians feel pressure to be knowledgeable, efficient, comprehensive, and compassionate while delivering evidence-based medical care. Incorporating evidence-based medicine into practice requires training in the skills of finding and applying good evidence to patients, and, increasingly, infrastructure that supports the incorporation of evidence into electronic health records. Physicians cite many barriers to the use of evidence-based medicine in practice. Read More

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http://dx.doi.org/10.1002/msj.21337DOI Listing
April 2013
6 Reads

Improving transitions of care from hospital to home: what works?

Mt Sinai J Med 2012 Sep-Oct;79(5):535-44

Mount Sinai School of Medicine, New York, NY, USA.

As the cost of care rises and fragmentation of health care increases, care transitions have become critical parts of the health care system. Physicians and other inpatient providers have the responsibility to communicate to subsequent providers, but such communication occurs far less than is optimal. Timely discharge summaries for the next-level provider, postdischarge phone calls to patients, and postdischarge follow-up appointments with primary-care physicians or inpatient providers may improve postdischarge health care utilization. Read More

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http://dx.doi.org/10.1002/msj.21332DOI Listing
April 2013
26 Reads
3 Citations
1.560 Impact Factor

Primary care and health reform.

Mt Sinai J Med 2012 Sep-Oct;79(5):527-34

Department of Family Medicine and Community Health, Mount Sinai School of Medicine, The Institute for Family Health, New York, NY, USA.

Skyrocketing health care costs are burdening our people and our economy, yet health care indicators show how little we are achieving with the money we spend. Federal and state governments, along with public-health experts and policymakers, are proposing a host of new initiatives to find solutions. The Patient Protection and Affordable Care Act is designed to address both the quality and accessibility of health care, while reducing its cost. Read More

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http://dx.doi.org/10.1002/msj.21335DOI Listing
April 2013
5 Reads

Primary care: health care's leading edge, part II.

Mt Sinai J Med 2012 Sep-Oct;79(5):525-6

Mount Sinai School of Medicine, New York, NY, USA.

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http://dx.doi.org/10.1002/msj.21331DOI Listing
April 2013
3 Reads

Cognitive and behavioral treatment options for insomnia.

Mt Sinai J Med 2012 Jul-Aug;79(4):512-23

Weill Cornell Medical College Center for Sleep Medicine, New York, NY, USA.

Insomnia is a costly disorder that affects a significant number of people. In many cases, insomnia is comorbid with other illnesses, which complicates its diagnosis and treatment. Most often it is treated with medication; however, patients are not always safe using hypnotics, and medication does not attack the source of the disorder. Read More

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http://dx.doi.org/10.1002/msj.21320DOI Listing
January 2013
3 Reads

Role of institutional climate in fostering diversity in biomedical research workforce: a case study.

Mt Sinai J Med 2012 Jul-Aug;79(4):498-511

Mount Sinai School of Medicine, New York, NY, USA.

This article reviews the barriers to diversity in biomedical research and describes the evolution of efforts to address climate issues to enhance the ability to attract, retain, and develop underrepresented minorities, whose underrepresentation is found both in science and medicine, in the graduate-school biomedical research doctoral programs (PhD and MD/PhD) at Mount Sinai School of Medicine. We also describe the potential beneficial impact of having a climate that supports diversity and inclusion in the biomedical research workforce. The Mount Sinai School of Medicine diversity-climate efforts are discussed as part of a comprehensive plan to increase diversity in all institutional programs: PhD, MD/PhD, and MD, and at the residency, postdoctoral fellow, and faculty levels. Read More

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http://dx.doi.org/10.1002/msj.21323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402161PMC
January 2013
14 Reads

Developing talent to increase diversity in biomedical sciences workforce.

Mt Sinai J Med 2012 Jul-Aug;79(4):497

Mount Sinai School of Medicine, New York, NY, USA.

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http://dx.doi.org/10.1002/msj.21330DOI Listing
January 2013
5 Reads

Primary-care physician compensation.

Authors:
Arik Olson

Mt Sinai J Med 2012 Jul-Aug;79(4):490-6

Baruch College, City University of New York, New York, NY, USA.

This article reviews existing models of physician compensation and presents information about current compensation patterns for primary-care physicians in the United States. Theories of work motivation are reviewed where they have relevance to the desired outcome of satisfied, productive physicians whose skills and expertise are retained in the workforce. Healthcare reforms that purport to bring accountability for healthcare quality and value-rather than simply volume-bring opportunities to redesign primary-care physician compensation and may allow for new compensation methodologies that increase job satisfaction. Read More

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http://dx.doi.org/10.1002/msj.21322DOI Listing
January 2013
3 Reads

Delivering psychiatric services in primary-care setting.

Mt Sinai J Med 2012 Jul-Aug;79(4):481-9

University of Washington School of Medicine, Seattle, WA, USA.

Psychiatric disorders, particularly depression and anxiety disorders, are common in primary-care settings, though often overlooked or untreated. Depression and anxiety disorders are associated with a poorer course for and complications from common chronic diseases such as diabetes mellitus and coronary heart disease. Integrating psychiatric services into primary-care settings can improve recognition and treatment of psychiatric disorders for large populations of patients. Read More

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http://dx.doi.org/10.1002/msj.21324DOI Listing
January 2013
7 Reads

Patient registries in primary care: essential element for quality improvement.

Mt Sinai J Med 2012 Jul-Aug;79(4):475-80

Institute of Family Health, Bronx, NY, USA.

Primary care in the United States has been in the midst of a transformation from a system based solely on individual office interactions to one that includes managing health at a population level. The chronic care model provides a robust framework for health systems to transform and restructure their delivery of care to one that is committed to delivering multidisciplinary quality care with a proactive approach. Patient and disease registries are the essential tools necessary to inform all elements of the chronic care model and guide practices though this transformation. Read More

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http://dx.doi.org/10.1002/msj.21328DOI Listing
January 2013
5 Reads

Global health and primary care: increasing burden of chronic diseases and need for integrated training.

Mt Sinai J Med 2012 Jul-Aug;79(4):464-74

Mount Sinai School of Medicine, New York, NY, USA.

Noncommunicable diseases, including cardiovascular disease, chronic respiratory disease, diabetes, cancer, and mental illness, are the leading causes of death and disability worldwide. These diseases are chronic and often mediated predominantly by social determinants of health. Currently there exists a global-health workforce crisis and a subsequent disparity in the distribution of providers able to manage chronic noncommunicable diseases. Read More

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http://dx.doi.org/10.1002/msj.21327DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4362673PMC
January 2013
17 Reads

Primary care training and the evolving healthcare system.

Mt Sinai J Med 2012 Jul-Aug;79(4):451-63

Mount Sinai School of Medicine, New York, NY, USA.

With growing numbers of patient-centered medical homes and accountable care organizations, and the potential implementation of the Patient Protection and Affordable Care Act, the provision of primary care in the United States is expanding and changing. Therefore, there is an urgent need to create more primary-care physicians and to train physicians to practice in this environment. In this article, we review the impact that the changing US healthcare system has on trainees, strategies to recruit and retain medical students and residents into primary-care internal medicine, and the preparation of trainees to work in the changing healthcare system. Read More

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http://dx.doi.org/10.1002/msj.21329DOI Listing
January 2013
10 Reads

The patient-centered medical home: history, components, and review of the evidence.

Mt Sinai J Med 2012 Jul-Aug;79(4):433-50

Mount Sinai School of Medicine, New York, NY, USA.

The US healthcare system is plagued by unsustainable costs and yields suboptimal outcomes, indicating that new models of healthcare delivery are needed. The patient-centered medical home is one model that is increasingly regarded as a promising strategy for improving healthcare quality, decreasing cost, and enhancing the experience of both patients and providers. Conceptually, the patient-centered medical home may be described as combination of the core attributes of primary care-access, continuity, comprehensiveness, and coordination of care-with new approaches to healthcare delivery, including office practice innovations and reimbursement reform. Read More

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http://doi.wiley.com/10.1002/msj.21326
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http://dx.doi.org/10.1002/msj.21326DOI Listing
January 2013
34 Reads

Home-based primary care: a needed primary-care model for vulnerable populations.

Mt Sinai J Med 2012 Jul-Aug;79(4):425-32

Mount Sinai School of Medicine, New York, NY, USA.

Home-based primary care has a long history in American medicine, and its prevalence is again increasing slowly in the United States in response to a changing demographic, societal, and health-policy climate. There are many models of home-based primary care, including private practice, academic, Veterans Affairs-associated, and concierge practices. There is a growing body of literature supporting the effectiveness of the medical house-call model. Read More

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http://dx.doi.org/10.1002/msj.21321DOI Listing
January 2013
7 Reads

Primary care: healthcare's leading edge.

Mt Sinai J Med 2012 Jul-Aug;79(4):423-4

Mount Sinai School of Medicine, New York, NY, USA.

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http://dx.doi.org/10.1002/msj.21325DOI Listing
January 2013
6 Reads

Computed tomography dataset postprocessing: from data to knowledge.

Mt Sinai J Med 2012 May-Jun;79(3):412-21

Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, USA.

The introduction of spiral computed tomography from the days of single-slice spiral to today's 64-row multidetector computed tomography and beyond creates datasets with unprecedented spatial and temporal resolution. The key to computed tomography imaging in the big picture is not in the acquisition of data, but in the use of the data acquired. By supplementing traditional axial interpretation with 3-dimensional rendering of the computed tomography volume, the greatest amount of information available is extracted. Read More

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http://dx.doi.org/10.1002/msj.21316DOI Listing
October 2012
2 Reads

Diversity in the biomedical research workforce: developing talent.

Mt Sinai J Med 2012 May-Jun;79(3):397-411

Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Much has been written about the need for and barriers to achievement of greater diversity in the biomedical workforce from the perspectives of gender, race, and ethnicity; this is not a new topic. These discussions often center around a "pipeline" metaphor that imagines students flowing through a series of experiences to eventually arrive at a science career. Here we argue that diversity will only be achieved if the primary focus is on (1) what is happening within the pipeline, not just counting individuals entering and leaving it; (2) de-emphasizing the achievement of academic milestones by typical ages; and (3) adopting approaches that most effectively develop talent. Read More

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http://dx.doi.org/10.1002/msj.21310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375909PMC
October 2012
10 Reads

Transplantation in obese patient.

Authors:
Mary T Killackey

Mt Sinai J Med 2012 May-Jun;79(3):388-96

Tulane University Medical School, New Orleans, LA, USA.

Obesity is a worldwide epidemic leading to severe comorbidity that damages end-organ function. Overall transplant outcomes in this population are inferior to those in nonobese patients. Large population studies show decreased patient and graft survival in obese kidney transplant patients. Read More

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http://dx.doi.org/10.1002/msj.21315DOI Listing
October 2012
8 Reads

Transplant immunology for non-immunologist.

Mt Sinai J Med 2012 May-Jun;79(3):376-87

Mount Sinai School of Medicine, New York, NY, USA.

Transplantation is the treatment of choice for end-stage kidney, heart, lung, and liver disease. Short-term outcomes in solid-organ transplantation are excellent, but long-term outcomes remain suboptimal. Advances in immune suppression and human leukocyte antigen matching techniques have reduced the acute rejection rate to <10%. Read More

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http://dx.doi.org/10.1002/msj.21314DOI Listing
October 2012
10 Reads

Donation after cardiac death in abdominal organ transplantation.

Mt Sinai J Med 2012 May-Jun;79(3):365-75

Division of Multi Organ Transplantation and Hepatobiliary Surgery Drexel University College of Medicine, Philadelphia, PA, USA.

This article reviews the field of donation after cardiac death, focusing on the history, ethicolegal issues, clinical outcomes, best practices, operative techniques, and emerging strategies to optimize utilization of this resource. Donation after cardiac death is one effective way to decrease the organ shortage and has contributed the largest recent increase in abdominal organ allografts. Currently, donation after cardiac death organs confer an increased risk of ischemic cholangiopathy after liver transplant and of delayed graft function after kidney transplant. Read More

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http://dx.doi.org/10.1002/msj.21309DOI Listing
October 2012
23 Reads

Innovations in organ donation.

Mt Sinai J Med 2012 May-Jun;79(3):351-64

Recanati/Miller Transplantation Institute, Mount Sinai Medical Center, New York, NY, USA.

The growing disparity between organ availability for transplantation and the number of patients in need has challenged the donation and transplantation community of practice to develop innovative processes, ideas, and techniques to bridge the gaps. Advances in the sharing of best practices in the donation community have contributed greatly over the last 8 years. Broader sharing of updated guidelines for declaration of brain death in conjunction with improvements in deceased donor management have increased opportunities for organ donation. Read More

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http://dx.doi.org/10.1002/msj.21312DOI Listing
October 2012
10 Reads

Hepatitis C and renal transplantation.

Authors:
Susan M Lerner

Mt Sinai J Med 2012 May-Jun;79(3):342-50

Mount Sinai Medical Center, New York, NY, USA.

Hepatitis C is a widespread problem, and the prevalence is higher in patients on hemodialysis than in the general population. In addition, hepatitis C reduces survival in dialysis patients and renal-transplant recipients. Kidney transplantation offers a survival advantage to those patients with chronic hepatitis C infection faced with the alternative of remaining on dialysis. Read More

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http://dx.doi.org/10.1002/msj.21318DOI Listing
October 2012
3 Reads

Live-donor nephrectomy.

Mt Sinai J Med 2012 May-Jun;79(3):330-41

Mount Sinai School of Medicine, New York, NY, USA.

Six decades after its first implementation, kidney transplantation remains the optimal therapy for end-stage renal disease requiring dialysis. Despite the incontrovertible mortality reduction and cost-effectiveness of kidney transplantation, the greatest remaining barrier to treatment of end-stage renal disease is organ availability. Although the waiting list of patients who stand to benefit from kidney transplantation grows at a rate proportional to the overall population and proliferation of diabetes and hypertension, the pool of deceased-donor organs available for transplantation experiences minimal to no growth. Read More

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http://dx.doi.org/10.1002/msj.21317DOI Listing
October 2012
7 Reads

Clinical outcomes following heart transplantation.

Mt Sinai J Med 2012 May-Jun;79(3):317-29

Mount Sinai Medical Center, New York, NY, USA.

Since its first performance in 1967, cardiac transplantation has emerged from a medical curiosity to become the treatment of choice for advanced heart failure. Refinements in surgical technique, development of a standardized endomyocardial biopsy grading system, and the discovery of newer immunosuppressive medications have improved the outlook for today's heart-transplant recipients. For the most recent era, median survival has increased to 10 years and median survival conditional upon surviving the first transplant year is now >14 years. Read More

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http://dx.doi.org/10.1002/msj.21311DOI Listing
October 2012
4 Reads

Indications for heart transplantation in current era of left ventricular assist devices.

Mt Sinai J Med 2012 May-Jun;79(3):305-16

Mount Sinai Medical Center, New York, NY, USA.

Although both heart transplantation and left ventricular assist device therapy have enjoyed clinical success in the treatment of patients with end-stage heart disease, newer left ventricular assist devices currently undergoing testing are likely to have a tremendous impact on the management of these patients. Smaller, more durable devices with improved safety profiles will allow for longer duration of therapy and make biventricular support more feasible, obviating the need for the total artificial heart. In this article we review the historical aspects of both forms of therapy and highlight the current use of left ventricular assist device therapy on patients awaiting heart transplantation. Read More

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http://dx.doi.org/10.1002/msj.21313DOI Listing
October 2012
5 Reads

Organ transplantation update, part II: heart and kidney.

Mt Sinai J Med 2012 May-Jun;79(3):303-4

Mount Sinai Medical Center, New York, NY, USA.

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http://dx.doi.org/10.1002/msj.21319DOI Listing
October 2012
4 Reads

Automated analysis of coronary artery disease by computed tomography.

Mt Sinai J Med 2012 Mar-Apr;79(2):295-301

Division of Cardiology, Winthrop University Hospital, Mineola, NY, USA.

Computer-assisted detection systems are widely used in many areas of radiology. Coronary computed tomography angiography is a growing area of clinical cardiology and computer-assisted detection systems play an integral part in analysis. Truly automated systems are still in clinical-trial stages, but manually assisted programs are in clinical use today for calcium scoring as well as plaque burden, composition, and stenosis analysis. Read More

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http://dx.doi.org/10.1002/msj.21297DOI Listing
August 2012
14 Reads

Geriatric vision loss due to cataracts, macular degeneration, and glaucoma.

Mt Sinai J Med 2012 Mar-Apr;79(2):276-94

Mount Sinai School of Medicine, New York, NY, USA.

The major causes of impaired vision in the elderly population of the United States are cataracts, macular degeneration, and open-angle glaucoma. Cataracts and macular degeneration usually reduce central vision, especially reading and near activities, whereas chronic glaucoma characteristically attacks peripheral vision in a silent way, impacting balance, walking, and driving. Untreated, these visual problems lead to issues with regard to taking medications, keeping track of finances and personal information, walking, watching television, and attending the theater, and often create social isolation. Read More

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http://dx.doi.org/10.1002/msj.21303DOI Listing
August 2012
4 Reads