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Biomedical subjects

M A Antonelli

Publications and source records attributed to M A Antonelli.

10 recordsLinked to original sources
PubMed1999

Educational and career outcomes of an internal medicine preceptorship for first-year medical students.

OBJECTIVE: Medical educators have attempted in recent years to provide quality clinical experiences for medical students early in their medical training. We questioned whether participating in a preceptorship in internal medicine (PIM) resulted in better performances on subsequent clinical rotations and increased interest in internal medicine. PARTICIPANTS: Fifty-four students have participated in the PIM to date, with control groups consisting of students who applied for it but were not selected (n = 36), students participating in a preceptorship in family medicine (n = 168), and the remaining students (n = 330). DESIGN: Prospective cohort study. SETTING: University medical center and community practices. INTERVENTION: A 2-month, clinical preceptorship following the first year of medical school. MEASUREMENTS AND MAIN RESULTS: The following outcomes were assessed: scores in the introduction to clinical medicine course; grades in the medical ethics course; scores from the internal medicine clerkship; and choosing a career in internal medicine. In their second year, PIM students scored higher in both semesters of the introduction to clinical medicine course (87% and 86% vs 84% and 84%, p's <.01) and were more likely to receive honors in ethics (50% vs 29%, p <.01) than non-PIM students. During the internal medicine clerkship, PIM students' scores were significantly higher on an objective structured clinical examination (79% vs 76%, p =.05), ambulatory clinical evaluations (80% vs 76%, p <.01), and overall clerkship scores (78% vs 75%, p =.03) but not on inpatient clinical evaluations or on the National Board of Medical Examiners Subject Examination. Preceptorship students were more likely to receive honors grades in the medicine clerkship (33% vs 10%, p <.01), and they were more likely to match into internal medicine residencies than control students (54% vs 27%, p <.01). CONCLUSIONS: The PIM course is an intervention, early in students' careers, which appears to benefit them academically and increase their interest in internal medicine as a career.

Career Choice↗
PubMed1992

Nonarticular pain syndromes. Differentiating generalized, regional, and localized disorders.

Nonarticular pain syndromes, although not inherently crippling, can have significant impact on patients' comfort, daily activities, and job performance. These syndromes include fibromyalgia, bursitis, tendinitis, and localized myofascial pain syndromes. Although differentiating these conditions from one another may be difficult, early diagnosis and follow-up are important for determining appropriate treatment. Depending on the diagnosis, treatment may include use of nonsteroidal anti-inflammatory drugs, analgesics, or corticosteroid injections; trigger-point desensitization therapy; physical therapy; and patient education.

Bursitis↗
PubMed1992

Rational treatment of gout. Stopping an attack and preventing recurrence.

The most definitive method of diagnosis for acute gouty arthritis is aspiration of the affected joint and examination of the fluid for the characteristic needle-shaped monosodium urate crystals. Treatment is aimed at promptly stopping the attack and reversing complications. Colchicine and various nonsteroidal anti-inflammatory drugs are effective for both treatment and prophylaxis. Antihyperuricemic therapy may be indicated in patients who have had several attacks in a year.

Acute Disease↗
PubMed1991

Herpes zoster in patients with rheumatoid arthritis treated with weekly, low-dose methotrexate.

PURPOSE: Herpes zoster occurred in nine patients with methotrexate-treated rheumatoid arthritis. We compared these patients to a large group of methotrexate-treated rheumatoid arthritis patients in order to uncover potential factors explaining the occurrence of herpes zoster. PATIENTS AND METHODS: Data from 187 patients taking methotrexate were reviewed and compared with data from another nine patients who developed herpes zoster while taking the drug for rheumatoid arthritis, all from the same university-based arthritis clinic. Literature pertinent to infection in rheumatoid arthritis patients treated with methotrexate is reviewed. RESULTS: Herpes zoster occurred in 14.5 cases per 1,000 patient-years in our methotrexate-treated rheumatoid arthritis patients, as compared with the general population incidence of 1.3 to 4.8 cases per 1,000 patient-years. The infection was unrelated to duration of methotrexate usage, prednisone treatment, or the co-existence of diabetes mellitus, but appeared to occur in patients with high titers of rheumatoid factor and an overall longer duration of rheumatoid arthritis. There were no cases of systemic dissemination or recurrence of herpes zoster despite 27.4 years cumulative follow-up on continued methotrexate therapy. CONCLUSIONS: Herpes zoster may occur more frequently in patients with rheumatoid arthritis treated with low-dose methotrexate than in the general population. Herpes zoster in rheumatoid arthritis patients treated with methotrexate appears to be self-limited, benign, and statistically related to methotrexate use in the presence of longer-term rheumatoid disease.

Arthritis, Rheumatoid↗