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Preoperative Evaluation/Testing of Otolaryngologic Patient

Chapter by: Janjigian, Michael P; Charap, Mitchell H
in: Encyclopedia of Otolaryngology, Head and Neck Surgery by Kountakis, Stilianos E [Eds]
Berlin, Heidelberg : Springer Berlin Heidelberg, 2013
pp. 2179-2187
ISBN: 3642234992
CID: 1808172

Development of a hospitalist-led-and-directed physical examination curriculum

Janjigian, Michael P; Charap, Mitchell; Kalet, Adina
BACKGROUND: Deficiencies in physical examination skills among medical students, housestaff, and even faculty have been reported for decades, though specifics on how to address this deficit are lacking. METHODS: Our institution has made a commitment to improving key physical examination competencies across our general medicine faculty. Development of the Merrin Bedside Teaching Program was guided by a comprehensive needs assessment and based on a learner-centered educational model. First, selected faculty fellows achieve expertise through mentorship with a master clinician. They then develop a bedside teaching curriculum in the selected domain and conclude by delivering the curriculum to peer faculty. RESULTS: We have developed curricula in examination of the heart, shoulder, knee, and skin. Currently, curricula are being developed in the examination of the lungs, critical care bedside rounds, and motivational interviewing. Curricula are integrated with educational activities of the internal medicine residency and medical school whenever possible. CONCLUSIONS: A hospitalist-led physical examination curriculum is an innovative way to address deficits in physical exam skills at all levels of training, engenders enthusiasm for skills development from faculty and learners, offers scholarship opportunities to general medicine faculty, encourages collaboration within and between institutions, and augments the education of residents and medical students. Journal of Hospital Medicine 2012. (c) 2012 Society of Hospital Medicine.
PMID: 22791266
ISSN: 1553-5592
CID: 179078

Management of perioperative hypertensive urgencies with parenteral medications

Ahuja, Kartikya; Charap, Mitchell H
BACKGROUND: Hypertension is the major risk factor for cardiovascular (CV) disease such as myocardial infarction (MI) and stroke. This risk is well known to extend into the perioperative period. Although most perioperative hypertension can be managed with the patient's outpatient regimen, there are situations in which oral medications cannot be administered and parenteral medications become necessary. They include postoperative nil per os status, severe pancreatitis, and mechanical ventilation. This article reviews the management of perioperative hypertensive urgency with parenteral medications. METHODS: A PubMed search was conducted by cross-referencing the terms 'perioperative hypertension,' 'hypertensive urgency,' 'hypertensive emergency,' 'parenteral anti-hypertensive,' and 'medication.' The search was limited to English-language articles published between 1970 and 2008. Subsequent PubMed searches were performed to clarify data from the initial search. RESULTS: As patients with hypertensive urgency are not at great risk for target-organ damage (TOD), continuous infusions that require intensive care unit (ICU) monitoring and intraarterial catheters seem to be unnecessary and a possible misuse of resources. CONCLUSIONS: When oral therapy cannot be administered, patients with hypertensive urgency can have their blood pressure (BP) reduced with hydralazine, enalaprilat, metoprolol, or labetalol. Due to the scarcity of comparative trials looking at clinically significant outcomes, the medication should be chosen based on comorbidity, efficacy, toxicity, and cost
PMID: 20104635
ISSN: 1553-5606
CID: 137978

The return visit

Charap, Mitchell
PMID: 17372809
ISSN: 1525-1497
CID: 111674

Internal medicine residency training in the 21st century: aligning requirements with professional needs

Charap, Mitchell H; Levin, Richard I; Pearlman, R Ellen; Blaser, Martin J
PMID: 16164893
ISSN: 0002-9343
CID: 58700

Residents' work hours - In response [Letter]

Charap, M
ISSN: 0003-4819
CID: 46912

Reducing resident work hours: unproven assumptions and unforeseen outcomes

Charap, Mitchell
PMID: 15148068
ISSN: 0003-4819
CID: 647932

Implementation of a hospitalist program in a large public teaching hospital [Meeting Abstract]

Leviss, JA; Link, N; Charap, M
ISSN: 0884-8734
CID: 54613


ISSN: 0098-7484
CID: 54182

Diabetic ketoacidosis in prisoners without access to insulin [see comments] [Comment]

Keller AS; Link RN; Bickell NA; Charap MH; Kalet AL; Schwartz MD
OBJECTIVE--To assess the cause and clinical severity of diabetic ketoacidosis in male prisoners hospitalized in New York City. DESIGN--Retrospective chart review. SETTING--A municipal hospital in New York City. PATIENTS--Forty-nine adult male prisoners with a total of 54 hospital admissions for diabetic ketoacidosis between January 1, 1989, and June 30, 1991. MAIN OUTCOME MEASURES--Charts were reviewed for diabetic and medical history, time from arrest until hospitalization, cause of diabetic ketoacidosis, admission laboratory data, and hospital course. RESULTS--Thirty-eight (70%) of the 54 admissions for diabetic ketoacidosis among prisoners occurred because prisoners had not received insulin during the period immediately following arrest (mean number of days from arrest until hospitalization was 2.5). All of these individuals had a history of insulin-dependent diabetes and were reportedly compliant with their insulin regimen at the time of arrest. Admission laboratory data for this group of prisoners included a mean serum glucose level of 27.4 mmol/L (495 mg/dL) and a mean serum bicarbonate level of 14.4 mmol/L. Mean number of days in the hospital was 3.4 including a mean of 1 day in an intensive care unit. CONCLUSIONS--Inadequate access to medication results in serious sequelae for recently arrested prisoners in New York City with insulin-dependent diabetes. Access to health care for recently arrested prisoners needs to be improved
PMID: 8421367
ISSN: 0098-7484
CID: 13252