LATEST NEWS ON INTERNAL MEDICINE : FEB – 2020

Diagnostic Error in Internal Medicine

Background:  The goal of this study was to determine the relative contribution of system-related and cognitive components to diagnostic error and to develop a comprehensive working taxonomy.[1]

Internist-I, an Experimental Computer-Based Diagnostic Consultant for General Internal Medicine

INTERNIST-I is an experimental computer program capable of making multiple and complex diagnoses in internal medicine. It differs from most other programs for computer-assisted diagnosis in the generality of its approach and the size and diversity of its knowledge base. To document the strengths and weaknesses of the program we performed a systematic evaluation of the capabilities of INTERNIST-I. Its performance on a series of 19 clinicopathological exercises (Case Records of the Massachusetts General Hospital) published in the Journal appeared qualitatively similar to that of the hospital clinicians but inferior to that of the case discussants. [2]

Prevalence of myofascial pain in general internal medicine practice.

Myofascial pain is a regional pain syndrome characterized in part by a trigger point in a taut band of skeletal muscle and its associated referred pain. We examined a series of 172 patients presenting to a university primary care general internal medicine practice. Of 54 patients whose reason for a visit included pain, 16 (30%) satisfied criteria for a clinical diagnosis of myofascial pain. These patients were similar in age and sex to other patients with pain, and the frequency of pain as a primary complaint was similar for myofascial pain as compared with other reasons for pain. [3]

Internal Medicine as a Career Choice by Medical Undergraduates in a Developing Country

Career choice is a very crucial decision for medical students. Information regarding area of specialization of medical students is important to plan human resources for health and ensure a fair, equitable and quality health care service in a country. This study aims to determine the rate of selection of internal medicine as an area of specialization as well as factors that influence medical students when choosing specialties in a Nigerian medical school. Methods: Fourth, fifth and final year students of college of medicine, Benue State University, Makurdi, Nigeria completed a pre-validated, self-administered questionnaire on career choices, nature of career, reasons for career choices and suggestion on improvements in the teaching of medicine in medical schools. Results: One hundred and sixty questionnaires were distributed to 160 medical students. A total of 150 students responded (125 males and 25 females). The popular choices among the students [4]

Unilateral Hypoplasia of the Internal Carotid Artery

Hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly. Most of the patients are asymptomatic. When clinically symptomatic it presents as cerebral ischemia or hemorrhage. Carotid artery hypoplasia should not be confused with other conditions which may have a similar appearance such as arterial dissection, atherosclerosis, vasculitis and tubular fibromuscular hyperplasia. Hypoplasia of the ICA is usually discovered incidentally by computed tomography or magnetic resonance imaging. We report three cases of ICA hypoplasia which were discovered incidentally on computed tomography angiography (CTA). One of the three patients described an ipsilateral amaurosis fugax associated with the hypoplasia of the right internal carotid artery [5]

Reference

[1] Graber, M.L., Franklin, N. and Gordon, R., 2005. Diagnostic error in internal medicine. Archives of internal medicine165(13), pp.1493-1499.

[2] Miller, R.A., Pople Jr, H.E. and Myers, J.D., 1982. Internist-I, an experimental computer-based diagnostic consultant for general internal medicine. New England Journal of Medicine307(8), pp.468-476.

[3] Skootsky, S.A., Jaeger, B. and Oye, R.K., 1989. Prevalence of myofascial pain in general internal medicine practice. Western Journal of Medicine151(2), p.157.

[4] Ogiator, M.O., Ojo, B.A., Ieave, E.T. and Ogiator, A.B., 2017. Internal medicine as a career choice by medical undergraduates in a developing country. Asian Journal of Medicine and Health, pp.1-6.

[5] Paşaoğlu, L., Toprak, U., Akdal, B., Yagiz, G., Acar, D. and Gurel, F., 2015. Unilateral hypoplasia of the internal carotid artery. International Journal of Medical and Pharmaceutical Case Reports3(5), pp.132-137.

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