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BMC Medical Education (1)
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons (1)
McNish, Sean (2)
Adams, Michael (1)
Attinger, Christopher E. (1)
Desale, Sameer (1)
Dunning, David M. (1)
Hubley, Katherine J. (1)
Kallakury, Bhaskar (1)
Mete, Mihriye (1)
Schilling, Amber (1)
Shanmugam, Victoria K (1)
Shanmugam, Victoria K. (1)
Shara, Nawar (1)
Steinberg, John S. (1)
Tsagaris, Katina (1)
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Chronic Leg Ulceration Associated with Polycythemia Vera Responding to Ruxolitinib (Jakafi®)
Shanmugam, Victoria K.
Hubley, Katherine J.
Dunning, David M.
Attinger, Christopher E.
Steinberg, John S.
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
We present the case of a 63-year-old white male with bilateral chronic leg ulcers due to polycythemia vera and hydroxyurea therapy who demonstrated dramatic healing of his wounds in response to ruxolitinib (Jakafi®, Novartis), a novel Janus kinase-1 and -2 inhibitor. This patient’s wound had previously been refractory to multiple surgical interventions and immunosuppression. After the initiation of ruxolitinib, the patient underwent successful split-thickness skin grafting, with resultant healing of his wounds. He was stable without prednisone and other immunosuppressant therapy and had healed at 6 months. Ruxolitinib therapy could represent a novel option for patients who develop persistent inflammatory wounds in the setting of polycythemia vera and hydroxyurea therapy.
chronic wound; hydroxyurea; leg ulcer; polycythemia vera; pyoderma gangrenosum; split-thickness skin graft
Impact of subspecialty elective exposures on outcomes on the American board of internal medicine certification examination
Shanmugam, Victoria K
BMC Medical Education
The American Board of Internal Medicine Certification Examination (ABIM-CE) is one of several methods used to assess medical knowledge, an Accreditation Council for Graduate Medical Education (ACGME) core competency for graduating internal medicine residents. With recent changes in graduate medical education program directors and internal medicine residents are seeking evidence to guide decisions regarding residency elective choices. Prior studies have shown that formalized elective curricula improve subspecialty ABIM-CE scores. The primary aim of this study was to evaluate whether the number of subspecialty elective exposures or the specific subspecialties which residents complete electives in impact ABIM-CE scores.
ABIM-CE scores, elective exposures and demographic characteristics were collected for MedStar Georgetown University Hospital internal medicine residents who were first-time takers of the ABIM-CE in 2006–2010 (n=152). Elective exposures were defined as a two-week period assigned to the respective subspecialty. ABIM-CE score was analyzed using the difference between the ABIM-CE score and the standardized passing score (delta-SPS). Subspecialty scores were analyzed using percentage of correct responses. Data was analyzed using GraphPad Prism version 5.00 for Windows.
Paired elective exposure and ABIM-CE scores were available in 131 residents. There was no linear correlation between ABIM-CE mean delta-SPS and the total number of electives or the number of unique elective exposures. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures (143.4 compared to 129.7, p=0.051). Repeated electives in individual subspecialties were not associated with significant difference in mean ABIM-CE delta-SPS.
This study did not demonstrate significant positive associations between individual subspecialty elective exposures and ABIM-CE mean delta-SPS score. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures suggesting there may be an “ideal” number of elective exposures that supports improved ABIM-CE performance. Repeated elective exposures in an individual specialty did not correlate with overall or subspecialty ABIM-CE performance.
Resident education; Gender; Elective; Subspecialty; Graduate medical education
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