Objectives. To implement a team-based learning (TBL) format in an endocrine module to promote students' active learning in a course delivered to 2 campuses. Methods. Course lectures were transformed into 13 TBL sessions consisting of content pre-assignments (self-directed learning), in-class readiness assurance tests (accountability), and team problem solving of patient cases and faculty-led class discussion (knowledge application). Student performance was evaluated through multiple assessments during the TBL sessions and on unit examinations. Students evaluated each individual TBL session and the course as a whole. Results. Course grades were higher using the TBL method compared to the traditional lecture-based method that was used previously. Individual readiness assurance tests and team contribution scores significantly predicted overall course grades (p,0.001). Students accepted the change in course format as indicated by course evaluation results. Conclusions. TBL is an effective active-learning, instructional strategy for courses with large student-tofaculty ratios and distance education environments.
Primary hyperparathyroidism is the third most common endocrine disorder after diabetes and thyroid disease, and women are affected twice as often as men. Hyperparathyroidism in pregnancy was first reported in 1931. Maternal complications in patients with hyperparathyroidism can be as high as 67%. We present a case of a pregnant patient with chronic hypertension that was exacerbated throughout the course of her pregnancy with a concomitant diagnosis of primary hyperparathyroidism and its sequelae for both the mother and fetus.
This retrospective study examined whether the goals set forth by the American Diabetes Association were being attained in an HIV specialty clinic run by internal medicine physicians. The charts of 40 HIV patients with diabetes were reviewed. Patients were divided into two groups: those who had seen a clinical pharmacist for medication adherence counseling (n = 20) and those who had not (n = 20). Overall, less than 50% of patients were achieving goals of therapy for hemoglobin A(1c), cholesterol, triglycerides, and blood pressure. Only 5% were documented as receiving aspirin therapy. The medication adherence counseling was not a significant factor in the results. Clinicians need to be aware of the concomitant disease states that HIV patients have and to treat those disease states to the standard of care set forward.
Objectives.To evaluate the impact of a 2-year, pharmacy students run, diabetes home visitation program for patients with poorly controlled diabetes mellitus. Methods. Eighty patients with poor glycemic control (Hb A1C > 10%) were randomized to intervention (home visitations) or control (no intervention) groups. Two groups of selected fourth-year pharmacy students conducted monthly home visits with assigned patients for consecutive 1-year intervals. Results. Thirty patients completed the 2-year intervention; 40 patients comprised the control group. Mean baseline Hb A1C levels of the treatment and control groups (11.2 ± 1.3% and 10.7 ± 1.6%, respectively) did not significantly change after 2 years (10.0 ± 2% and 9.9 ± 2.5%, respectively; P= 0.467). Two treatment group patients experienced a total of 2 ED visits compared to 11 control patients who had a total of 16 visits to a hospital emergency department (ED) (P =0.027 and 0.115, respectively). Thirteen treatment group patients experienced a total of 14 hospital admissions, compared to 20 control patients who had a total of 32 admissions (P = 0.58 and 0.292, respectively). Conclusion. Patients involved in a student-run diabetes home intervention program had significantly less ED visits than a control group.
Teriparatide offers a therapeutic option for patients at high risk of an osteoporotic fracture and for patients who are intolerant of or unresponsive to antiresorptive therapy.
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