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American journal of hematology (1)
Journal of General Internal Medicine (1)
Afshar-Kharghan, Vahid (1)
Divakaran, Vijay (1)
Hassan, Saamir (1)
Mann, Douglas L. (1)
Mehta, Sachin (1)
Simpson, Steven (1)
Swinkels, Dorine W. (1)
Wiegerinck, Erwin (1)
Wright, Scott M (1)
Yao, David (1)
Yao, David C (1)
Year of Publication
Hepcidin in anemia of chronic heart failure
Swinkels, Dorine W.
Mann, Douglas L.
American journal of hematology
Anemia is a common finding among patients with chronic heart failure. Although co-morbidities, such as kidney failure, might contribute to the pathogenesis of anemia, many patients with heart failure do not have any other obvious etiology for their anemia. We investigated whether anemia in heart failure is associated with an elevation in hepcidin concentration.
We used time-of-flight mass spectrometry to measure hepcidin concentration in urine and serum samples of patients with heart failure and in control subjects. We found that the concentration of hepcidin was lower in urine samples of patients with heart failure compared to those of control subjects. Serum hepcidin was also reduced in heart failure but was not significantly lower than that in controls. There were no significant differences between hepcidin levels in patients with heart failure and anemia compared to patients with heart failure and normal hemoglobin. We concluded that hepcidin probably does not play a major role in pathogenesis of anemia in patients with chronic heart failure.
Anemias; Cytokines; Iron
The Challenge of Problem Residents
Wright, Scott M
Journal of General Internal Medicine
Internal medicine residency training is demanding and residents can experience a wide variety of professional and personal difficulties. Residency programs everywhere have had and will continue to have problem residents. Training programs should be equipped to effectively identify and manage residents who experience problems. Previous articles that have been published on the topic of problem residents primarily addressed concerns such as impairment due to depression and substance abuse. The content of this article is derived from a comprehensive review of the literature as well as other data sources such as interviews with program directors and workshops at national professional meetings. This article focuses primarily on four issues related to problem residents: their identification, underlying causes, management, and prevention. The study attempts to be evidence-based, wherever possible, highlighting what is known. Recommendations based on the synthesis of the data are also made. Future ongoing studies of problem residents will improve our understanding of the matters involved, and may ultimately lead to improved outcomes for these trainees.
medical education; internship; residency; problem resident
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