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295


The Tarnished Legacy of a Wonder Drug: Revisiting the Complicated History of Clozapine

Poudel, Roshan; Lerner, Barron
Anecdotal evidence of superior efficacy and lack of extrapyramidal symptoms in treating schizophrenia made clozapine a promising therapy in the United States during the early 1970s. In 1975, however, numerous fatal cases of clozapine-related agranulocytosis in Finland nearly ended the drug's development. Convinced of the significant benefits to patients, some clinicians in the United States advocated having clozapine available on a case-by-case humanitarian basis, which eventually helped resurrect the drug for Food and Drug Administration approval in 1989. This article builds on previous literature by utilizing oral histories from clinicians, researchers, and a patient's family member to understand how clozapine was saved. Exploring these stakeholders' perspectives has value to modern clinicians, who underprescribe the drug despite demonstrable benefits for treatment-resistant schizophrenia and suicide prevention.
PMID: 38181102
ISSN: 1465-7309
CID: 5628432

The Autumn Ghost-The Danish Polio Epidemic of 1952 and the Birth of Intensive Care Medicine

Oshinsky, David
PMID: 37906186
ISSN: 1538-3598
CID: 5590302

The art of seeing: The impact of a visual arts course on medical student wellbeing

Noorily, Ariella R; Willieme, Anne; Belsky, Mikaela; Grogan, Katie
PURPOSE:Medical student burnout is becoming increasingly common. The Art of Seeing is a visual arts elective at one US medical school. The purpose of this study was to determine the effect of this course on attributes that are foundational to wellbeing: mindfulness, self-awareness, and stress. METHODS:A total of 40 students participated in this study from 2019 through 2021. Fifteen students participated in the pre-pandemic, in-person course, and 25 students participated in the post-pandemic, virtual course. Pre and post-tests included open-ended responses to works of art, which were coded for themes, and standardized scales: mindful attention awareness scale (MAAS), situational self-awareness scale (SSAS), and perceived stress questionnaire (PSQ). RESULTS: = 0.046). Improvements in the MAAS and the SSAS did not depend on class format. Students also demonstrated increased focus on the present moment, emotional awareness, and creative expression in the post test free responses. CONCLUSIONS:This course significantly improved mindfulness, self-awareness, and stress levels in medical students, and can be used to help enhance wellbeing and mitigate burnout in this population, both in-person and virtually.
PMID: 36862139
ISSN: 1466-187x
CID: 5592112

Unfinished symphony

Ofri, Danielle
PMID: 37516533
ISSN: 1474-547x
CID: 5618922

Evidence over Politics - The U.S. Preventive Services Task Force

Lerner, Barron H; Curtiss-Rowlands, Graham
PMID: 36592339
ISSN: 1533-4406
CID: 5409822

Why Was the US Preventive Services Task Force's 2009 Breast Cancer Screening Recommendation So Objectionable? A Historical Analysis

Lerner, Barron H; Curtiss-Rowlands, Graham
PMID: 36148791
ISSN: 1468-0009
CID: 5335732

What Constitutes Evidence? Colorectal Cancer Screening and the U.S. Preventive Services Task Force

Lerner, Barron H; Curtiss-Rowlands, Graham
The United States Preventive Services Task Force is perhaps America's best-known source of evidence-based medicine (EBM) recommendations. This paper reviews aspects of the history of one such recommendation-screening for colorectal cancer (CRC)-to explore how the Task Force evaluates the best available evidence to reach its conclusions.Although the Task Force initially believed there was inadequate evidence to recommend CRC screening in the 1980s, it later changed its mind. Indeed, by 2002, it was recommending screening colonoscopy for those aged 50 and older, "extrapolating" from the existing evidence as there were no randomized controlled trials of the procedure. By 2016, due in part to the use of an emerging analytic modality known as modeling, the Task Force supported four additional CRC screening tests that lacked randomized data. Among the reasons the Task Force gave for these decisions was the desire to improve adherence for a strategy-screening healthy, asymptomatic individuals-that it believed saved lives.During these same years, the Task Force diverged from other organizations by declining to advocate screening otherwise healthy Black patients earlier than age 50-despite the fact that such individuals had higher rates of CRC than the general population, higher mortality from the disease and earlier onset of the disease. In declining to extrapolate in this instance, the Task Force underscored the lack of reliable data that proved that the benefits of such testing would outweigh the harms.The history of CRC screening reminds us that scientific evaluation relies not only on methodological sophistication but also on a combination of intellectual, cognitive and social processes. General internists-and their patients-should realize that EBM recommendations are often not definitive but rather thoughtful data-based advice.
PMID: 35428902
ISSN: 1525-1497
CID: 5219172

[S.l.] : KevinMD.com, 2022

Getting an appointment with primary care is the Achilles’ heel of medicine

Ofri, Danielle
(Website)
CID: 5284682

Memorialising COVID-19

Ofri, Danielle
PMCID:9212448
PMID: 35717980
ISSN: 1474-547x
CID: 5277952

I feel safest in my hospital : The U.S. may feel ready to move on from the pandemic, but I’m not

Ofri, Danielle
ORIGINAL:0015706
ISSN: 1072-7825
CID: 5284632