Less than half of respondents to the preceptor survey reported that their institutions had a policy outlining specific requirements for preceptor development. Preceptor survey respondents reported the lack of time as the primary barrier to preceptor development. Many surveyed residents indicated that providing effective verbal feedback and providing effective written feedback were the greatest challenges for their preceptors.
Spinal epidural lipomatosis (SEL) is a rare condition characterized by overgrowth of normal adipose tissue in the extradural space within the spinal canal that can lead to significant spinal cord compression. It is most commonly reported in patients receiving chronic glucocorticoid therapy. Other causes can include obesity and hypercortisolism. Occasionally, idiopathic SEL will occur in patients with no known risk factors, but cases are more generally reported in obesity and males. We present the case of a 35 year-old non-obese woman found to have rapidly progressive SEL that was not associated with any of the common causes of the disorder.
Argatroban may be an effective anticoagulant during carotid endarterectomy in patients with underlying chronic renal disease and a history of HIT. Additional research is needed to determine the ideal anticoagulant in vascular surgery when heparin cannot be utilized.
Extended-infusion eptifibatide appears to be an option for prevention of stent thrombosis in patients who require an interruption in antiplatelet therapy and are scheduled to undergo major orthopedic procedures. Careful consideration should be given regarding the risks and benefits of extended infusions of eptifibatide, as the potential for significant hemorrhage is a concern. Further research is warranted in this area.
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