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INTRODUCTION: Our goal was to develop a successful research collaboration program, Military Ob/Gyn HeadHunters, to connect military medical students with residents, fellows, and staff physicians across the Military Health System (MHS) to foster research collaboration and mentorship. MATERIALS AND METHODS: We conducted a needs assessment of medical students from the Uniformed Services University and Health Professions Scholarship Program as well as staff physicians, residents, and fellows practicing in the MHS to better understand the barriers to initiating and conducting research within the MHS. We used the survey results to create a secure online spreadsheet to match medical students to researchers recruiting student researchers. A follow-up survey was sent to all respondents 3 months after the program launch to evaluate the program. RESULTS: Of the medical students who completed the needs assessment, 82.56% (n = 71/86) reported barriers in participating in research. The most common barrier was "I don't know where to look for research opportunities." Of the staff surveyed, 88.24% (n = 15/17) indicated that they were interested in medical student involvement in their research. However, 53.33% (n = 8/15) of the surveyed staff reported that they did not know any students who would be good candidates. Since the launch in April 2021, our 3-month follow-up survey had a response rate of 40.00% (n = 6/15) for staff and 47.06% (n = 32/68) for students. Hundred percent (n = 6/6) of faculty advertising projects recruited at least one student to join their project. 85.71% (n = 12/14) of students actively seeking participation joined a research team. CONCLUSIONS: Our novel research collaboration program successfully connected military medical students with active researchers in the MHS. Leaders in medical education can consider adopting this framework to improve trainee participation in research.
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BACKGROUND: Obesity increases susceptibility to chronic pain, increases metabolism, and is associated with obstructive sleep apnea syndrome (OSAS), all which can complicate perioperative pain management of patients. In addition, obesity and OSAS can cause elevation of the adipose-derived hormone leptin, which increases metabolism. We hypothesized that obesity along with sleep apnea and leptin independently enhance morphine pharmacokinetics. METHODS: Children 5-12 years of age who were presenting for surgery were administered a morphine dose of 0.05 mg/kg. Blood was collected at baseline and at subsequent preset times for pharmacokinetic analysis of morphine and its metabolites. Three groups were studied: a nonobese group with severe OSAS, an obese group with severe OSAS, and a control group. RESULTS: Thirty-four patients consisting of controls (n = 16), nonobese/OSAS (n = 8), and obese/OSAS (n = 10) underwent analysis. The obese/OSAS group had a higher dose-adjusted mean maximum morphine concentration (CMAX) over 540 minutes compared to the controls (P < .001) and those with only OSAS (P = .014). The obese/OSAS group also had lower volume of distribution (Vd) when compared to OSAS-only patients (P = .007). In addition, those in the obese/OSAS group had a higher morphine 3-glucuronide (M3G) maximum concentration (P = .012) and a higher ratio of M3G to morphine than did the control group (P = .011). Time to maximum morphine 6-glucuronide (M6G) concentration was significantly lower in both nonobese/OSAS and obese/OSAS groups than in the control group (P < .005). C-reactive protein (CRP), interleukin (IL)-10, and leptin were all higher in the obese/OSAS group than in controls (P = .004, 0.026, and <0.001, respectively), and compared to OSAS-only patients, CRP (P = .013) and leptin (P = .002) levels were higher in the obese/OSAS group. CONCLUSIONS: The combination of obesity and OSAS was associated with an increase in morphine metabolism compared with that in normal-weight controls. Our previous study in mice demonstrated that obesity from leptin deficiency decreased morphine metabolism, but that metabolism normalized after leptin replacement. Leptin may be a cause of the increased morphine metabolism observed in obese patients.
