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The incidence of tuberculosis (TB) has risen since 1989 after 30 years of decline. TB is an infectious pulmonary disease caused by exposure to Mycobacterium (M.) tuberculosis. It probably existed prior to 2000 B.C. when the first evidence of TB lesions were seen. TB treatments included exercise, milk, bloodletting, purging, injected red roses and honey, smoking cow manure, injected gold salts and rib removal. Theories of TB contagion were first advanced in the 16th century, but were replaced by theories of genetic predisposition in the late 17th century due to its incidence in family groups. In 1882, M. tuberculosis was isolated and tuberculin, now used to diagnose TB, was extracted from the bacterium. Public health efforts to improve soil drainage and isolate TB patients became popular. Streptomycin, which is effective against TB, was discovered in 1943 and became available in 1947.

Medically unexplained physical symptoms (MUPS) are those without relevant organic pathology and are commonplace in primary care and specialty medical care settings. MUPS disorders include fibromyalgia (FM), irritable bowel syndrome (IBS), multiple chemical sensitivity, chronic fatigue syndrome, and others. The etiologies of FM and IBS are poorly understood and are likely multifactorial and complex. Common factors include symptom hypersensitivity or amplification, hypothalamic-pituitary-adrenal axis perturbation, and genetic vulnerability. A sexual abuse history may play a role as well. Significant comorbidity exists between IBS and FM. Patients with both disorders have more physical and psychiatric symptoms than those with only one disorder. FM and IBS can generally be diagnosed with a careful history and physical exam combined with judicious use of laboratory studies. Treatment is symptomatic and includes addressing psychiatric issues with medications, non-medication therapies, and supportive, caring attitudes. [ABSTRACT FROM AUTHOR]

Background: The 2013 closure of a public hospital in Baton Rouge, LA transformed graduate medical education (GME) at Our Lady of the Lake Regional Medical Center (OLOL). Administrators were tasked with incorporating residents into patient safety and quality improvement initiatives to fulfill regulatory obligations. This report outlines our experiences as we built these patient safety and quality improvement initiatives in a rapidly expanding independent academic medical center., Methods: We joined the Alliance of Independent Academic Medical Centers (AIAMC) to meet and learn from national peers. To fulfill the scholarly activity requirement of the AIAMC's National Initiative IV, we formed a multidisciplinary team to develop a patient safety education project. Prioritized monthly team meetings allowed for project successes to be celebrated and circulated within the organization., Results: The public-private partnership that more than quadrupled the historic size of GME at OLOL has, in the past 2 years, led to the development of an interdisciplinary team. This team has expanded to accommodate residency program leadership from across the campus. Our National Initiative IV project won a national award and inspired several follow-up initiatives. In addition, this work led to the formation of a Patient Safety and Clinical Quality Improvement fellowship that matched its first fellow in 2015., Conclusion: Through the commitment and support of hospital and medical education leaders, as well as a focus on promoting cultural change through scholarly activity, we were able to greatly expand patient safety and quality improvement efforts in our institution.