In 2015, disparities in salary and rank persist among full-time U.S. academic EM faculty. There were gender and URM disparities in rank and leadership positions. Women earned less than men regardless of rank, clinical hours, or training. Future efforts should focus on evaluating salary data by race and developing systemwide practices to eliminate disparities.

Background: The purpose of this study was to complete a comprehensive analysis of gender differences in faculty rank among U.S. emergency physicians that reflected all academic emergency physicians.Methods: We assembled a comprehensive list of academic emergency medicine (EM) physicians with U.S. medical school faculty appointments from Doximity.com linked to detailed information on physician gender, age, years since residency completion, scientific authorship, National Institutes of Health (NIH) research funding, and participation in clinical trials. To estimate gender differences in faculty rank, multivariable logistic regression models were used that adjusted for these factors.Results: Our study included 3,600 academic physicians (28%, or 1,016, female). Female emergency physicians were younger than their male colleagues (mean [AESD] age was 43.8 [AE8.7] years for females and 47.4 [AE9.9] years for males [p < 0.001]), had fewer years since residency completion (12.4 years vs. 15.6 years, p < 0.001), had fewer total and first/last author publications (4.7 vs. 8.6 total publications, p < 0.001; 4.3 vs. 7.1 first or last author publications, p < 0.001), and were less likely to be principal investigators on NIH grants (1.2% vs. 2.9%, p = 0.002) or clinical trials (1.8% vs. 4.4%, p < 0.001). In unadjusted analysis, male physicians were more likely than female physicians to hold the rank of associate or full professor versus assistant professor (13.7 percentage point difference, p < 0.001), a relationship that persisted after multivariable adjustment (5.5 percentage point difference, p = 0.001).Conclusions: Female academic EM physicians are less likely to hold the rank of associate or full professor compared to male physicians even after detailed adjustment for other factors that may influence faculty rank. W hile gender parity in academic medicine has improved since women were first admitted to medical school in 1849, there has been minimal progress over the past decade. [1][2][3][4] As few as one-third of medical school faculty are female and female faculty comprise a lower proportion of those who are full professors, have senior authorship, or have National Institutes of Health (NIH) funding. 4 This is an issue in multiple medical specialties and, despite attempts at promoting workforce diversity, includes academic emergency medicine (EM). [5][6][7][8] Recent work has demonstrated that as little as onethird of academic EM physicians are female and these

Background: Women in medicine continue to experience disparities in earnings, promotion, and leadership roles. There are few guidelines in place defining organization-level factors that promote a supportive workplace environment beneficial to women in emergency medicine (EM). We assembled a working group with the goal of developing specific and feasible recommendations to support women's professional development in both community and academic EM settings.

A change in urine color can be distressing for patients and physicians alike. Many of the causes of abnormal urine color are benign effects of medications and foods; however, a change in urine color may be a sign of an underlying pathological condition. The good news is that in many cases the diagnosis can be determined from a thorough history and urinalysis. This article presents many of the conditions physicians may encounter and will help them form a narrow differential diagnosis and treatment plan.

There is a large therapeutic gap in sickle cell disease (SCD). Hydroxyurea reduces acute sickle cell-related events, but does not appear to protect patients from cardiopulmonary complications, 1 which are the major causes of death in SCD patients. The long-term effects of newer agents such as crizanlizumab and L-glutamine on the disease course remain to be determined. The only cure currently available for SCD is allogeneic stem cell transplant (allo-SCT); however, many barriers 2 prevent allo-SCT from being readily offered to these patients.Investigations into other therapeutic approaches are, therefore, appropriate.Activated and circulating aged neutrophils (CANs) adhere to vascular endothelium and are pivotal for the pathogenesis of sickle cell vaso-occlusive crisis (VOC). CANs in mice are regulated by intestinal microbiota. 3 Treatment of SCD mice with a cocktail of ampicillin, neomycin, metronidazole, and vancomycin (ANMV) induced reduction in CANs and protected the mice from fatal tumor necrosis factorα-induced VOC. 3 Therefore, antibiotic therapy might be a potential therapeutic approach for SCD. It is, however, unclear whether the benefits of the ANMV cocktail were related to its effects on the intestinal microbiota or to the systemic effects of the absorbed ampicillin and metronidazole. Long-term use of the ANMV cocktail might also not be clinically practical and safe. An oral antibiotic that has a good safety track record for long-term use and is capable of reducing CANs would be ideal. The question of whether the benefits of the ANMV cocktail are due to its local effects on the intestinal microbiota or due to the systemic effects of the absorbed components of ANMV may also be answered if the candidate oral antibiotic is also not intestinally absorbed.Rifaximin is a minimally absorbed oral antibiotic and it fits the required safety profile. It has been used for a long term in patients with advanced liver disease. 4 Its long-term use is not associated with increased risks for the development of Clostridium difficile infection (CDI), an important consideration in order not to abrogate the protective effects from CDI that SCD patients enjoy. 5 To determine whether rifaximin was capable of reducing CANs in SCD, 11 patients (6 males and 5 females) with HbSS received rifaximin 550 mg twice a day (ClinicalTrials.gov Identifier: NCT03719729).The median age was 29 years (range 23-56). Median duration of therapy was 2 months (range 1-4). Five patients were taking hydroxyurea at the time of the study. CANs were measured by multicolor flow cytometry. Neutrophils were gated by Gr-1 hi CD115 lo SSC hi and CANs by CD62L lo CXCR4 hi within the neutrophil population.Rifaximin was well tolerated in all patients without significant side effects; in particular, we did not observe CDI during rifaximin therapy.There was a dramatic reduction in CANs after 2-4 weeks of rifaximin therapy (median 12.65% [range 6.07-40.05] vs 4.55% [range 2.63-20.25]) (two-tailed P = 0.0036) ( Figure 1A). CANs continued to decrease at the 3-month ...