Internal Medicine Commons^™

Evaluation Of Glutaminase Expression In Prostate Adenocarcinoma And Correlation With Clinicopathologic Parameters, Zin W. Myint, Ramon C. Sun, Patrick J. Hensley, Andrew C. James, Peng Wang, Stephen E. Strup, Robert J. Mcdonald, Donglin Yan, William H. St. Clair, Derek B. Allison

Internal Medicine Faculty Publications

High Glutaminase (GLS1) expression may have prognostic implications in colorectal and breast cancers; however, high quality data for expression in prostate cancer (PCa) are lacking. The purpose of this study is to investigate the status of GLS1 expression in PCa and correlated expression levels with clinicopathologic parameters. This study was conducted in two phases: an exploratory cohort analyzing RNA-Seq data for GLS1 from The Cancer Genome Atlas (TCGA) data portal (246 PCa samples) and a GLS1 immunohistochemical protein expression cohort utilizing a tissue microarray (TMA) (154 PCa samples; 41 benign samples) for correlation with clinicopathologic parameters. In the TCGA cohort, …

Bone Quality In Chronic Kidney Disease Patients: Current Concepts And Future Directions – Part Ii, Kamyar Asadipooya, Mohamed Abdalbary, Yahya Ahmad, Elijah Kakani, Marie-Claude Monier-Faugere, Amr El-Husseini

Internal Medicine Faculty Publications

Background: Patients with chronic kidney disease (CKD) have an increased risk of osteoporotic fractures, which is due not only to low bone volume and mass but also poor microarchitecture and tissue quality. The pharmacological and nonpharmacological interventions detailed, herein, are potential approaches to improve bone health in CKD patients. Various medications build up bone mass but also affect bone tissue quality. Antiresorptive therapies strikingly reduce bone turnover; however, they can impair bone mineralization and negatively affect the ability to repair bone microdamage and cause an increase in bone brittleness. On the other hand, some osteoporosis therapies may cause a redistribution …

Bone Quality In Ckd Patients: Current Concepts And Future Directions – Part I, Kamyar Asadipooya, Mohamed Abdalbary, Yahya Ahmad, Elijah Kakani, Marie-Claude Monier-Faugere, Amr El-Husseini

Internal Medicine Faculty Publications

Background: There is ample evidence that patients with CKD have an increased risk of osteoporotic fractures. Bone fragility is not only influenced by low bone volume and mass but also by poor microarchitecture and tissue quality. More emphasis has been given to the quantitative rather than qualitative assessment of bone health, both in general population and CKD patients. Although bone mineral density (BMD) is a very useful clinical tool in assessing bone strength, it may underestimate the fracture risk in CKD patients. Serum and urinary bone biomarkers have been found to be reflective of bone activities and predictive of fractures …

An Ensemble Of The Icluster Method To Analyze Longitudinal Lncrna Expression Data For Psoriasis Patients, Suyan Tian, Chi Wang

Internal Medicine Faculty Publications

BACKGROUND: Psoriasis is an immune-mediated, inflammatory disorder of the skin with chronic inflammation and hyper-proliferation of the epidermis. Since psoriasis has genetic components and the diseased tissue of psoriasis is very easily accessible, it is natural to use high-throughput technologies to characterize psoriasis and thus seek targeted therapies. Transcriptional profiles change correspondingly after an intervention. Unlike cross-sectional gene expression data, longitudinal gene expression data can capture the dynamic changes and thus facilitate causal inference.

METHODS: Using the iCluster method as a building block, an ensemble method was proposed and applied to a longitudinal gene expression dataset for psoriasis, with the …

Prevalence And Characteristics Of Self-Reported Hypothyroidism And Its Association With Nonorgan-Specific Manifestations In Us Sarcoidosis Patients: A Nationwide Registry Study, Bashar N. Alzghoul, Farah N. Amer, Diana Barb, Ayoub Innabi, Mamoun T. Mardini, Chen Bai, Bara Alzghoul, Tamara Al-Hakim, Noopur Singh, Mindy Buchanan, Leslie Serchuck, Diana Gomez Manjarres, Whitney W. Woodmansee, Lisa A. Maier, Divya C. Patel

Internal Medicine Faculty Publications

Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis.

We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted …

Radiopharmaceutical Validation For Clinical Use, Charles A. Kunos, Rodney Howells, Aman Chauhan, Zin W. Myint, Mark E. Bernard, Riham H. El Khouli, Jacek Capala

Internal Medicine Faculty Publications

Radiopharmaceuticals are reemerging as attractive anticancer agents, but there are no universally adopted guidelines or standardized procedures for evaluating agent validity before early-phase trial implementation. To validate a radiopharmaceutical, it is desirous for the radiopharmaceutical to be specific, selective, and deliverable against tumors of a given, molecularly defined cancer for which it is intended to treat. In this article, we discuss four levels of evidence—target antigen immunohistochemistry, in vitro and in vivo preclinical experiments, animal biodistribution and dosimetry studies, and first-in-human microdose biodistribution studies—that might be used to justify oncology therapeutic radiopharmaceuticals in a drug-development sequence involving early-phase trials. We …

International Medical Graduates In Nephrology: Impressions Of The Implications Of Visa Status In A Cohort Of Program Directors And Division Chiefs, Flor Alvarado, Deidra C. Crews, Cynthia Delgado, Javier A. Neyra

Internal Medicine Faculty Publications

No abstract provided.

Gene Expression Barcode Values Reveal A Potential Link Between Parkinson's Disease And Gastric Cancer, Suyan Tian, Shishun Zhao, Mingbo Tang, Chi Wang

Internal Medicine Faculty Publications

Gastric cancer is a disease that develops from the lining of the stomach, whereas Parkinson's disease is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. Although these two diseases seem to be distinct from each other, increasing evidence suggests that they might be linked. To explore the linkage between these two diseases, differentially expressed genes between the diseased people and their normal controls were identified using the barcode algorithm. This algorithm transforms actual gene expression values into barcode values comprised of 1's (expressed genes) and 0's (silenced genes). Once the overlapped differentially expressed …

Laboratory Markers Predictive Of Fulminant Clostridioides Difficile Infection Refractory To Fluid Resuscitation, Omar Ahmad, Timothy N. Crawford, Vaneet Arora, Mitu Karki Maskey

Internal Medicine Faculty Publications

Background

Old age, leucocytosis, hypoalbuminemia, and elevated creatinine have been identified as risk factors for fulminant Clostridioides difficile infection (CDI). High ATLAS scores have also been linked to fatal disease. The affiliated studies, however, involved patients prescribed metronidazole - a regimen no longer standard of care. The variables were thus reassessed in patients prescribed optimal therapy.

Methods

Adults hospitalized with CDI at University of Kentucky Medical Center were retrospectively reviewed. Enrolled subjects were separated according to disease classification i.e. non-severe/severe versus fulminant CDI. Fulminant patients were further subdivided into hypotensive persons responsive to fluid resuscitation, and those with sequent shock, …

Gold In Practice: Chronic Obstructive Pulmonary Disease Treatment And Management In The Primary Care Setting, Barbara P. Yawn, Matthew L. Mintz, Dennis E. Doherty

Internal Medicine Faculty Publications

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Early detection and appropriate treatment and management of COPD can lower morbidity and perhaps mortality. Clinicians in the primary care setting provide the majority of COPD care and are pivotal in the diagnosis and management of COPD. In this review, we provide an overview of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 report, with a focus on the management of COPD in the primary care setting. We discuss the pathophysiology of COPD; describe COPD risk factors, signs, and symptoms that may facilitate earlier diagnosis …

Hemothorax Following Traumatic Dobhoff Tube Insertion, Lindsey M. Shain, Leslie Mchale, Taha Ahmed

Internal Medicine Faculty Publications

Dobhoff tube is a specialized small-bore and flexible nasogastric tube that makes it more comfortable for placement than a usual nasogastric tube. Dobhoff tube insertion is commonly considered a relatively safe bedside procedure, but it is not without its associated risks. Inadvertent tracheobronchial placement of Dobhoff tube has been associated with severe complications, most notably pneumothorax. We present a rare cause of right-sided hemothorax following tracheobronchial insertion of a Dobhoff tube with a prolonged and arduous clinical course.

Survey Of Current Practices Of Outpatient Hemodialysis For Aki Patients, Victor M. Ortiz-Soriano, Catherine R. Butler, Marla Levy, Sarah C. Huen, Jorge L. Castaneda, Ankit Sakhuja, Rajit K. Basu, Kathleen D. Liu, Jorge Cerda, Javier A. Neyra

Internal Medicine Faculty Publications

No abstract provided.

Adrenal Vein Cortisol To Metanephrine Ratio For Localizing Acth-Independent Cortisol-Producing Adenoma: A Case Report, Rishi Raj, Philip A. Kern, Neelima Ghanta, Edilfavia M. Uy, Kamyar Asadipooya

Internal Medicine Faculty Publications

Context: Finding the source of adrenocorticotropic hormone (ACTH)-independent cortisol-producing adenoma in the patients with subclinical Cushing syndrome (SCS) and bilateral adrenal nodules is sometimes challenging. Computed tomography (CT) and positron emission tomography are helpful, but adrenal venous sampling (AVS) is the gold standard approach. However, interpretation of AVS is important to improve the accuracy of decision-making for surgery. We report a case and review of the literature to assess the benefit of using adrenal vein cortisol to metanephrine ratio to determine the source of cortisol production in SCS and bilateral nodules.

Evidence Acquisition: Three authors searched PubMed for data on …

Impact Of Patient Load On The Quality Of Electronic Medical Record Documentation, Aasems Jacob, Rishi Raj, Sayee Alagusundaramoorthy, Jing Wei, Jianrong Wu, Margaret Eng

Internal Medicine Faculty Publications

Objective:

American College of Graduate Medical Education (ACGME) recommends ongoing care of 10 patients per resident however its implication is unclear. We hypothesized EMR quality to vary based on patient load and call status.

Methods:

We conducted a double-blind, single-center, retrospective observational study between 2017 and 2019 to investigate the quality and accuracy of resident documentation using the Responsible Electronic Documentation (RED) Checklist, a validated scoring system.

Results:

A total of 234 independent charts were analyzed and 80 met scoring criteria. Average patients per residents was 4, 9.1, 7.2, and 5.5 on “call” day (D0), “post-call” day (D1), “mid-call” day …

Dual-Functional Phosphorene Nanocomposite Membranes For The Treatment Of Perfluorinated Water: An Investigation Of Perfluorooctanoic Acid Removal Via Filtration Combined With Ultraviolet Irradiation Or Oxygenation, Joyner Eke, Lillian Banks, M. Abdul Mottaleb, Andrew J. Morris, Olga V. Tsyusko, Isabel C. Escobar

Internal Medicine Faculty Publications

Nanomaterials with tunable properties show promise because of their size-dependent electronic structure and controllable physical properties. The purpose of this research was to develop and validate environmentally safe nanomaterial-based approach for treatment of drinking water including removal and degradation of per- and polyfluorinated chemicals (PFAS). PFAS are surfactant chemicals with broad uses that are now recognized as contaminants with a significant risk to human health. They are commonly used in household and industrial products. They are extremely persistent in the environment because they possess both hydrophobic fluorine-saturated carbon chains and hydrophilic functional groups, along with being oleophobic. Traditional drinking water …

Antibodies Against Lysophosphatidic Acid Protect Against Blast-Induced Ocular Injuries, Peethambaran Arun, Franco Rossetti, James C. Demar, Ying Wang, Andrew B. Batuure, Donna M. Wilder, Irene D. Gist, Andrew J. Morris, Roger A. Sabbadini, Joseph B. Long

Internal Medicine Faculty Publications

Exposure to blast overpressure waves is implicated as the major cause of ocular injuries and resultant visual dysfunction in veterans involved in recent combat operations. No effective therapeutic strategies have been developed so far for blast-induced ocular dysfunction. Lysophosphatidic acid (LPA) is a bioactive phospholipid generated by activated platelets, astrocytes, choroidal plexus cells, and microglia and is reported to play major roles in stimulating inflammatory processes. The levels of LPA in the cerebrospinal fluid have been reported to increase acutely in patients with traumatic brain injury (TBI) as well as in a controlled cortical impact (CCI) TBI model in mice. …

Web-Based Interactive Mapping From Data Dictionaries To Ontologies, With An Application To Cancer Registry, Shiqiang Tao, Ningzhou Zeng, Isaac Hands, Joseph Hurt-Mueller, Eric B. Durbin, Licong Cui, Guoqiang Zhang

Internal Medicine Faculty Publications

BACKGROUND: The Kentucky Cancer Registry (KCR) is a central cancer registry for the state of Kentucky that receives data about incident cancer cases from all healthcare facilities in the state within 6 months of diagnosis. Similar to all other U.S. and Canadian cancer registries, KCR uses a data dictionary provided by the North American Association of Central Cancer Registries (NAACCR) for standardized data entry. The NAACCR data dictionary is not an ontological system. Mapping between the NAACCR data dictionary and the National Cancer Institute (NCI) Thesaurus (NCIt) will facilitate the enrichment, dissemination and utilization of cancer registry data. We introduce …

Pregabalin-Induced Myopathy In A Double Lung Transplant Recipient, Vishwajit Hegde, Nidhi Shekar, Filip G. Garrett, Maher A. Baz, Michael I. Anstead

Internal Medicine Faculty Publications

Pregabalin is a gamma-aminobutyric acid (GABA) derivative that was commercially approved by the Food and Drug Administration (FDA) in 2004. It is commonly used in the treatment of diabetic neuropathy, peripheral neuropathy, and spinal cord injury. We present the case of a 36-year-old Caucasian male double lung transplant recipient who presented with an 18-month history of fatigue and muscle weakness. He had elevated creatinine kinase level and his muscle biopsy showed evidence of drug-induced myopathy that improved after the cessation of pregabalin. We present a case of drug-induced myopathy as a rare complication of pregabalin therapy in a double lung …

Syphilis Hepatitis Presenting As A Mimic Of Primary Biliary Cholangitis, Cody Kern, Ahmed Elmoursi, Caroline Blake, Andrew Hoellein

Internal Medicine Faculty Publications

Syphilis hepatitis is a rare cause of acute liver injury. Primary biliary cholangitis (PBC) is a progressive autoimmune disease characterized by the typical presentation of a cholestatic liver injury and the presence of antimitochondrial antibodies (AMAs). We present a case of syphilis hepatitis that presented as a mimic to PBC with positive AMA. The eradication of syphilis led to the resolution of the liver injury and down trending of the antibody level. We recommend excluding syphilis in patients with high-risk behaviors presenting with a cholestatic liver injury and positive AMA before the diagnosis of PBC.

Postoperative Hypocalcemia Following Parathyroidectomy For Giant Parathyroid Adenoma, Rishi Raj, Adele Amine, Demetrios Herodotou

Internal Medicine Faculty Publications

Objective
Giant parathyroid adenomas (GPAs) are a rare type of parathyroid adenoma (PA) weighing > 2 to 3 g. The objective of this manuscript is to report a case of giant parathyroid adenoma and highlight the risk of postoperative hypocalcemia.

Methods
We describe the presentation and work-up of a woman with GPA confirmed with histopathology as well as management of postoperative hypocalcemia.

Results
A 66-year-old Caucasian female with chronic fatigue was found to have elevated calcium levels at 13.7 mg/dL (normal, 8.9 to 10.2 mg/dL) and elevated parathyroid hormone levels at 1,240 pg/mL (normal, 12 to 72 pg/mL). Contrast enhanced computed …

An International Study Exploring The Experience Of Survivors Of Critical Illness As Volunteers Within Icu Recovery Services, Carly Robinson, Elizabeth Hibbert, Anthony J. Bastin, Joel Meyer, Ashley A. Montgomery-Yates, Tara Quasim, Andrew Slack, Mark E. Mikkelsen, Theodore J. Iwashyna, Kimberly J. Haines, Carla M. Sevin, Joanne Mcpeake, Leanne M. Boehm

Internal Medicine Faculty Publications

Objectives:
Many clinicians have implemented follow-up and aftercare to support patients following ICU. Some of this care is supported and facilitated by peer volunteers. There is limited contemporary work that has explicitly explored volunteer roles within ICU recovery services or the experience of volunteers undertaking these roles. We sought to explore the experience of survivors of critical illness, as volunteers, involved in ICU recovery services and understand their motivation for undertaking these roles.

Design:
Qualitative exploration using in-depth semistructured interviews. The study design used an inductive content analysis process. We also documented the roles that were adopted by volunteers in …

Salmonella Meningitis Complicated By Ventriculitis And Brain Abscesses In An Hiv Positive Adult Patient, Tamoor Ahmed, Taha Ahmed

Internal Medicine Faculty Publications

Salmonella meningitis is a rare complication of Salmonella sepsis and is mostly reported in infants and young children. The incidence of Salmonella bacteremia is increased in immunocompromised adult individuals, such as those having human immunodeficiency virus (HIV) infection. Ventriculitis and brain abscess as a complication of Salmonella intracranial infection is particularly rare, even in patients who are immunosuppressed. Herein, we report a case of Salmonella meningitis complicated by ventriculitis and two brain abscesses in an HIV positive adult patient requiring mini-craniectomy and drainage along with a prolonged course of antibiotic therapy with a favorable outcome.

Axillary Artery Pseudoaneurysm Following Percutaneous Transaxillary Access For Impella Device Placement During Percutaneous Coronary Intervention, Anas A. Alharbi, Fahad S. Alqahtani, Peter Farjo, Jason A. Moreland

Internal Medicine Faculty Publications

Percutaneous transaxillary access is currently considered an acceptable alternative to transfemoral approach for large-bore access, especially in the setting of hostile iliofemoral arteries. Few published reports exist concerning complications of upper extremity access. We describe development of an axillary artery pseudoaneurysm and its management following transaxillary access. (Level of Difficulty: Advanced.)

The Β3-Adrenergic Receptor Agonist Mirabegron Improves Glucose Homeostasis In Obese Humans, Brian S. Finlin, Hasiyet Memetimin, Beibei Zhu, Amy L. Confides, Hemendra J. Vekaria, Riham H. El Khouli, Zachary R. Johnson, Philip M. Westgate, Jianzhong Chen, Andrew J. Morris, Patrick G. Sullivan, Esther E. Dupont-Versteegden, Philip A. Kern

Internal Medicine Faculty Publications

BACKGROUND. Beige adipose tissue is associated with improved glucose homeostasis in mice. Adipose tissue contains β3-adrenergic receptors (β3-ARs), and this study was intended to determine whether the treatment of obese, insulin-resistant humans with the β3-AR agonist mirabegron, which stimulates beige adipose formation in subcutaneous white adipose tissue (SC WAT), would induce other beneficial changes in fat and muscle and improve metabolic homeostasis.

METHODS. Before and after β3-AR agonist treatment, oral glucose tolerance tests and euglycemic clamps were performed, and histochemical analysis and gene expression profiling were performed on fat and muscle biopsies. PET-CT scans quantified brown adipose tissue volume and …

Comparing The Outcomes Of Ceftaroline Plus Vancomycin Or Daptomycin Combination Therapy Versus Monotherapy In Adults With Complicated And Prolonged Methicillin-Resistant Staphylococcus Aureus Bacteremia Initially Treated With Supplemental Ceftaroline, Omar Ahmad, Timothy N. Crawford, Thein Myint

Internal Medicine Faculty Publications

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia confers considerable morbidity and mortality. Although vancomycin or daptomycin monotherapy is usually curative, prolonged bacteremia necessitating supplemental ceftaroline has occurred. The practice has led to the question of whether to continue with ceftaroline following bacteremia resolution.

METHODS: Adult patients hospitalized with MRSA bacteremia at the University of Kentucky Medical Center between January 2015 and December 2017 were retrospectively reviewed. Study subjects required supplemental ceftaroline due to 4 or more days of bacteremia despite vancomycin or daptomycin. They additionally had accompanying native valve infective endocarditis, osteomyelitis, or brain abscess. Patients were divided into two cohorts. …

Gynecologic Large Cell Neuroendocrine Carcinoma: A Review, Grant Burkeen, Aman Chauhan, Rohitashva Agrawal, Riva Raiker, Jill M. Kolesar, Lowell B. Anthony, B. Mark Evers, Susanne Arnold

Internal Medicine Faculty Publications

Large cell neuroendocrine carcinomas (LCNEC) are rare, aggressive high-grade neuroendocrine neoplasms within the neuroendocrine cell lineage spectrum. This manuscript provides a detailed review of published literature on LCNEC of gynecological origin. We performed a PubMed search for material available on gynecologic LCNEC. We analyzed 104 unique cases of gynecologic LCNECs, of which 45 were cervical primary, 45 were ovarian, 13 were uterine, and 1 was vaginal. A total of 45 cases of cervical LCNEC were identified with a median age of 36 years. Median overall survival was 16 months. We identified 45 ovarian LCNEC cases in the published literature with …

The Late Stage Of Copi Vesicle Fission Requires Shorter Forms Of Phosphatidic Acid And Diacylglycerol, Seung-Yeol Park, Jia-Shu Yang, Zhen Li, Pan Deng, Xiaohong Zhu, David Young, Maria Ericsson, Ruben L. H. Andringa, Adriaan J. Minnaard, Chunmei Zhu, Fei Sun, D. Branch Moody, Andrew J. Morris, Jun Fan, Victor W. Hsu

Internal Medicine Faculty Publications

Studies on vesicle formation by the Coat Protein I (COPI) complex have contributed to a basic understanding of how vesicular transport is initiated. Phosphatidic acid (PA) and diacylglycerol (DAG) have been found previously to be required for the fission stage of COPI vesicle formation. Here, we find that PA with varying lipid geometry can all promote early fission, but only PA with shortened acyl chains promotes late fission. Moreover, diacylglycerol (DAG) acts after PA in late fission, with this role of DAG also requiring shorter acyl chains. Further highlighting the importance of the short-chain lipid geometry for late fission, we …

Thalidomide For The Treatment Of Metastatic Hepatic Epithelioid Hemangioendothelioma: A Case Report With A Long Term Follow-Up, Felipe Salech, Sebastián Valderrama, Bruno Nervi, Juan Carlos Rodriguez, Danny Oksenberg, Alvaro Koch, Gladys Smok, Ignacio Duarte, Rosa María Pérez-Ayuso, Nicolás Jarufe, Jorge Martínez, Alejandro Soza, Marco Arrese, Arnoldo Riquelme

Internal Medicine Faculty Publications

Hepatic epithelioid hemangioendothelioma (HEH) is an unusual, low-grade malignant vascular tumor of the liver. Here we describe a case of a 40-year-old woman who presented with abdominal pain in the upper right quadrant and giant hepatomegaly, in which imaging studies and a fine-needle liver biopsy confirmed the presence of a large EHE with an isolated lung metastasis. After balancing all possible therapeutic modalities the patient was treated conservatively with thalidomide (300 mg/day). The drug was well tolerated with minimal toxicity and thepatient continues on therapy 109 months after treatment was started with no disease progression. Current therapeutic options for HEH …

Should A Fully Covered Self-Expandable Biliary Metal Stent Be Anchored With A Double-Pigtail Plastic Stent? A Retrospective Study, Saad Emhmed Ali, Wesam M. Frandah, Leon Su, Cory M. Fielding, Houssam Mardini

Internal Medicine Faculty Publications

BACKGROUND

The migration rate of fully covered self-expandable metal stents (FCSEMSs) has been reported to be between 14% to 37%. Anchoring of FCSEMSs using a double-pigtail plastic stent (DPS) may decrease migration.

AIM

To compare stent migration rates between patients who received FCSEMS alone and those who received both an FCSEMS and anchoring DPS.

METHODS

We conducted a retrospective analysis of endoscopy reporting system and medical records of 1366 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with FCSEMS placement at the University of Kentucky health care. Between July 2015 and April 2017, 203 patients with FCSEMS insertion for the treatment …

Cancer Screening For Transgender Patients: An Online Case-Based Module, Devin Oller

Internal Medicine Faculty Publications

Introduction: Guidelines recommend that primary care providers complete organ-based routine cancer screening for all transgender patients. Training on critical transgender health topics like cancer screening, as well as residents' confidence in addressing issues their transgender patients may face, remains limited among graduate medical education (GME) programs. Online case-based modules are an effective tool for skills improvement in GME, but their application to transgender health topics has not been assessed.

Methods: I developed a brief online module on cancer screening for transgender patients using Google Forms and offered it to first-year internal medicine residents. The module was optional and asynchronous with …