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Background: Enhancing the cultural competency of students is emerging as a key issue in medical education; however, students may perceive that they are more able to function within cross-cultural situations than their teachers, reducing the effectiveness of cultural competency educational efforts.Objective: The purpose of our study was to compare medical students' perceptions of their residents, attendings, and their own cultural competency.Design: Cross-sectional study.Main Measures: A questionnaire containing previously validated instruments was administered to end-of-third-year medical students at four institutions throughout the US. Repeated measures multivariate analysis was used to determine differences in student ratings.Participants: Three hundred fifty-eight medical students from four schools participated, for an overall response rate of 65%.Results: Analysis indicated overall statistically significant differences in students' ratings (p < 0.001, eta(2) = 0.33). Students rated their own cultural competency as statistically significantly higher than their residents, but similar to their attendings. For reference, students rated the patient care competency of themselves, their residents, and their attendings; they rated their attendings' skills as statistically significantly higher than residents, and residents as statistically significantly higher than themselves. There were differences between cultural competency and patient care ratings.Conclusions: Our results indicate that students perceive the cultural competency of their attendings and residents to be the same or lower than themselves. These findings indicate that this is an important area for future research and curricular reform, considering the vital role that attendings and residents play in the education of medical students. [ABSTRACT FROM AUTHOR]

We describe a 65-year-old woman with a history of hypertension and smoking who presented with an acute episode of chest pain precipitated by severe emotional stress. Her initial electrocardiogram done in the emergency room showed non-specific T wave changes in the lateral leads and her cardiac troponin levels were mildly elevated. Because of her clinical presentation, she was admitted with a presumptive diagnosis of acute myocardial infarction and managed with antiplatelet and anticoagulant therapy. Coronary angiogram did not reveal coronary artery disease and left ventriculography showed findings consistent with apical ballooning syndrome or takotsubo cardiomyopathy. Subsequent electrocardiograms displayed dramatic changes including T wave inversions, QT interval prolongation and U waves. The patient remained asymptomatic and recovered uneventfully. Three weeks post-discharge, an echocardiogram documented resolved left ventricular dysfunction. We describe the clinical features and highlight the electrocardiographic findings that may help differentiate takotsubo cardiomyopathy from myocardial infarction. [ABSTRACT FROM AUTHOR]

Through a case of a very large left atrial myxoma diagnosed in a 53-year-old woman, we feature the complementary value of multimodality imaging. Two-dimensional echocardiography continues to be the principal imaging modality for intracardiac masses due to its accessibility and ability to provide basic information on mass morphology, position, and mobility. Real-time three-dimensional echocardiography offers more precise assessment of tumor size and attachment. Cardiac magnetic resonance allows superior tissue characterization, particularly important in differentiating a myxoma from a thrombus. Appropriate use of these various non-invasive imaging modalities is a safe and comprehensive preoperative diagnostic approach for patients with intracardiac masses. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 76-year-old woman with known atrial fibrillation and congestive heart failure who was admitted to a hospital with a breathing problem. In order to assess left ventricular function, a 2-dimensional (2-D) transthoracic echocardiogram was performed on the patient. During the diagnosis, the presence of a persistent left superior vena cava (PLSVC) was confirmed.

The article presents a personal narrative by a physician describing a return trip to the Philippines and the experience of treating the medical problems of his family members.