Scott Stern

Practice trends in the management of prostate disease by family practice physicians and general internists: An internet-based survey

OBJECTIVES To assess, using an Internet-based survey, the practice patterns of primary care physicians in the management of prostate disease and to assess the differences between family physicians and general internists. Prostate cancer and benign prostatic hyperplasia are common in the elderly population. The optimal management of these diseases is debated. METHODS An 18-item survey was designed and administered on an Internet website. Members of the Society of General Internal Medicine and members of the Illinois, North Carolina, and New York chapters of the Academy of Family Physicians were surveyed. RESULTS A total of 354 responses were obtained from 381 primary care physicians who viewed the survey web page. For patients 50 years old and older, 75% of physicians (87% of family physicians and 69% of general internists; P <0.001) recommended annual prostate cancer screening with digital rectal examination and 49% (67% of family physicians and 40% of general internists; P <0.001) recommended annual prostate cancer screening with prostate-specific antigen measurement. For patients diagnosed with prostate cancer, 76% of the primary care physicians estimated that less than one half of their patients are seen by a radiation oncologist. For the treatment and/or prevention of prostate cancer, 62% of physicians surveyed (76% of family physicians and 55% of general internists; P <0.001) believe there is a potential role for alternative herbal and nutritional therapies. CONCLUSIONS Compared with general internists, family physicians are more likely to screen for prostate cancer and are more likely to believe there is a role for alternative therapies for prostate cancer.

Solid facial edema preceding a diagnosis of retro-orbital B-cell lymphoma

Persistent solid facial edema is a rare condition of unknown cause. Although acute facial edema has been associated with numerous disease processes such as infections, neoplasms, immune disorders, inflammation, neuropathic processes, drugs, mechanical obstructions, and trauma, solid facial edema has most often been associated with acne vulgaris. We report the first case, to our knowledge, of solid facial edema preceding a diagnosis of a subcutaneous scalp and orbital/periorbital B-cell lymphoma.

Medical Education Reform in Wuhan University, China: A Preliminary Report of an International Collaboration

Background : In 2008 Wuhan University Medical School in China proposed to reform its curriculum by adapting the curriculum of the University of Chicago Medical School. Description : An assessment of Wuhan University Medical Schools traditional curriculum conducted in 2009 informed the reform directions, which included course integration, use of clinical cases, improved relevance of basic sciences to clinical medicine, reduction of lecture time, increase in group and independent learning, and the use of formative assessments. Fifty student volunteers per year were chosen to participate in the reform, and the rest remained in the traditional curriculum. Evaluation : A student survey was conducted in 2011 to evaluate the reform by comparing the attitudes of those in the reform and standard curricula. Conclusions : The reform met the needs of the school, was generally well received, improved satisfaction in reform participants, and had a positive impact on students. Areas needing improvement were also identified.