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https://www.readbyqxmd.com/read/28351062/using-national-health-care-databases-and-problem-based-practice-analysis-to-inform-integrated-curriculum-development
#1
Amy J Baker, Mark R Raymond, Steven A Haist, John R Boulet
One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments (EDs), clinics, and hospitals...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351053/macular-edema-rationale-for-therapy
#2
Thomas J Wolfensberger
Macular edema represents the end-stage of multiple pathophysiological pathways in a multitude of ocular vascular, inflammatory, and other diseases. The rationale for clinical treatment of macular edema is based on the understanding and the inhibition of these pathophysiological mechanisms. When macular edema is caused by a generalized health problem such as diabetes, high blood pressure, or generalized inflammatory conditions, treatment of these generalized diseases can in many cases cure macular edema directly...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28351042/intracellular-edema
#3
Raja Narayanan, Baruch D Kuppermann
The macula is predisposed to edema in various retinal conditions, even when the insult is remote from the macula. The various factors that may predispose the macula to edema include high metabolic activity, radial arrangement of the Henle's layer, lack of inner layers at the fovea, and lack of blood supply at the fovea. The edema is most pronounced in the outer plexiform layer (Henle's layer). Alteration in the blood-retinal barrier and ischemia cause disturbances in vascular permeability as well as with the function of Müller cells...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28351037/impact-of-laser-power-and-firing-angle-on-coagulation-efficiency-in-laser-treatment-for-twin-twin-transfusion-syndrome-an-ex-vivo-placenta-study
#4
Joost Akkermans, Loes van der Donk, Suzanne H P Peeters, Sjoerd van Tuijl, Johanna M Middeldorp, Enrico Lopriore, Dick Oepkes
OBJECTIVE: To assess the impact of laser power and firing angle on coagulation efficiency for closing placental anastomoses in the treatment of twin-twin transfusion syndrome. METHODS: We used an ex vivo blood-perfused human placenta model to compare time to complete coagulation using 30 vs. 50 W of neodymium-doped yttrium aluminum garnet laser power and using a firing angle of 90° vs. 45°. Placentas were perfused with pig blood at 5 mL/min. Differences were analyzed using independent-samples t test, Mann-Whitney U test, or χ2 test as appropriate...
March 29, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28351024/evaluating-the-prognostic-value-of-microrna-203-in-solid-tumors-based-on-a-meta-analysis-and-the-cancer-genome-atlas-tcga-datasets
#5
Yingjie Shao, Wendong Gu, Zhonghua Ning, Xing Song, Honglei Pei, Jingting Jiang
BACKGROUND: It has been reported that miR-203 expression was aberrant in various types of cancers, and it could be used as a prognostic biomarker. Therefore, in this study, we aimed to evaluate the prognostic value of miR-203 expression in solid tumors by using meta-analysis and The Cancer Genome Atlas (TCGA) datasets. METHODS: By doing a literature research in PubMed, Embase and the Cochrane Library (last update by December 2016), we were able to identify the studies assessing the prognostic role of miR-203 in various tumors...
March 24, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28351020/optimization-of-a-new-methodology-for-trace-determination-of-elements-in-biological-fluids-application-for-speciation-of-inorganic-selenium-in-children-s-blood
#6
Reza Akramipour, Mitra Hemati, Nazir Fattahi, Meghdad Pirsaheb, Toraj Ahmadi-Jouibari
The continuous sample drop flow microextraction (CSDFME) joined with the iridium-modified tube graphite furnace atomic absorption spectrometry (GFAAS) has been developed as a highly sensitive technique for the speciation of selenium in blood samples. In this method 32.0μl carbon tetrachloride is transferred to the bottom of a conical sample cup. Then the 5.0ml of aqueous solution transforms to fine droplets while passing through the organic solvent. At this stage, Se(IV)-APDC hydrophobic complex is extracted into the organic solvent...
March 22, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28350949/state-of-the-art-in-degenerative-cervical-myelopathy-an-update-on-current-clinical-evidence
#7
Jefferson R Wilson, Lindsay A Tetreault, Jun Kim, Mohammed F Shamji, James S Harrop, Thomas Mroz, Samuel Cho, Michael G Fehlings
Degenerative cervical myelopathy (DCM) is a common cause of spinal cord dysfunction that confronts clinicians on a daily basis. Research performed over the past few decades has provided improved insight into the diagnosis, evaluation, and treatment of this disorder. We aim to provide clinicians with an update regarding the state of the art in DCM, focusing on more recent research pertaining to pathophysiology, natural history, treatment, consideration of the minimally symptomatic patient, surgical outcome prediction, and outcome measurement...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350927/association-of-childhood-blood-lead-levels-with-cognitive-function-and-socioeconomic-status-at-age-38-years-and-with-iq-change-and-socioeconomic-mobility-between-childhood-and-adulthood
#8
Aaron Reuben, Avshalom Caspi, Daniel W Belsky, Jonathan Broadbent, Honalee Harrington, Karen Sugden, Renate M Houts, Sandhya Ramrakha, Richie Poulton, Terrie E Moffitt
Importance: Many children in the United States and around the world are exposed to lead, a developmental neurotoxin. The long-term cognitive and socioeconomic consequences of lead exposure are uncertain. Objective: To test the hypothesis that childhood lead exposure is associated with cognitive function and socioeconomic status in adulthood and with changes in IQ and socioeconomic mobility between childhood and midlife. Design, Setting, and Participants: A prospective cohort study based on a population-representative 1972-1973 birth cohort from New Zealand; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years (until December 2012)...
March 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28350860/uniquely-altered-transcripts-are-associated-with-immune-preservation-in-hiv-infection
#9
Michelle Zanoni, Ítalo Karmann Aventurato, James Hunter, Maria Cecilia Araripe Sucupira, Ricardo Sobhie Diaz
The mechanisms underlying host HIV control hold much promise in the search for a functional HIV cure. We investigated the host genomic signatures in elite controllers or rapid progressors following recent infection and the correlates of immune reconstitution during combination antiretroviral therapy. We characterized the HIV-specific longitudinal host transcriptional response of peripheral blood mononuclear cells from elite controllers, rapid progressors, immune responders and non-responders using a RT-qPCR array in a cohort of recently HIV-infected Brazilian individuals...
2017: PloS One
https://www.readbyqxmd.com/read/28350824/time-and-radiation-dose-dependent-changes-in-the-plasma-proteome-after-total-body-irradiation-of-non-human-primates-implications-for-biomarker-selection
#10
Stephanie D Byrum, Marie S Burdine, Lisa Orr, Samuel G Mackintosh, Simon Authier, Mylene Pouliot, Martin Hauer-Jensen, Alan J Tackett
Acute radiation syndrome (ARS) is a complex multi-organ disease resulting from total body exposure to high doses of radiation. Individuals can be exposed to total body irradiation (TBI) in a number of ways, including terrorist radiological weapons or nuclear accidents. In order to determine whether an individual has been exposed to high doses of radiation and needs countermeasure treatment, robust biomarkers are needed to estimate radiation exposure from biospecimens such as blood or urine. In order to identity such candidate biomarkers of radiation exposure, high-resolution proteomics was used to analyze plasma from non-human primates following whole body irradiation (Co-60 at 6...
2017: PloS One
https://www.readbyqxmd.com/read/28350806/pharmacokinetics-of-a-single-1g-dose-of-azithromycin-in-rectal-tissue-in-men
#11
Fabian Y S Kong, Thusitha W Rupasinghe, Julie A Simpson, Lenka A Vodstrcil, Christopher K Fairley, Malcolm J McConville, Jane S Hocking
Chlamydia is the most common bacterial sexually transmitted infection among men who have sex with men. Repeat infection following treatment with 1g azithromycin is common and treatment failure of up to 22% has been reported. This study measured the pharmacokinetics of azithromycin in rectal tissue in men following a single 1g dose to assess whether azithromycin reaches the rectal site in adequate concentrations to kill chlamydia. Ten healthy men took a single oral dose of 1g azithromycin and provided nine self-collected swabs and one blood sample over 14 days...
2017: PloS One
https://www.readbyqxmd.com/read/28350715/continuous-cardiac-autonomic-and-haemodynamic-responses-to-isometric-exercise
#12
Katrina A Taylor, Jonathan D Wiles, Damian D Coleman, Rajan Sharma, Jamie M O'Driscoll
PURPOSE: Elevated arterial blood pressure (BP) is associated with autonomic dysfunction and impaired haemodynamic control mechanisms. Isometric exercise (IE) training has been demonstrated effective at reducing BP; however, the continuous cardiovascular responses during IE are underinvestigated. We hypothesized that reflex autonomic cardiovascular control is an important mediator in reducing BP. To test our hypothesis, we investigated continuous cardiac autonomic modulation and baroreceptor reflex sensitivity (BRS) in response to IE...
March 27, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28350665/moderate-intensity-intermittent-external-volume-expansion-optimizes-the-soft-tissue-response-in-a-murine-model
#13
Giorgio Giatsidis, Liying Cheng, Federico Facchin, Anthony Haddad, Jorge Lujan-Hernandez, Luca Lancerotto, Christoph Gunther Nabzdyk, Hajime Matsumine, Dennis P Orgill
BACKGROUND: Intermittent external volume expansion using suction enhances the vascular network of soft tissues, possibly increasing fat graft survival. However, the optimal kinetics of application have not been determined. Based on their previous experience, the authors hypothesized that moderate-intensity intermittent external volume expansion application may further enhance both the angiogenic and adipogenic potential. METHODS: Fifty 12-week-old wild-type mice were assigned to five experimental groups (n = 10 per group) and underwent five different intermittent applications of external volume expansion (i...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350621/visit-to-visit-sbp-variability-and-cardiovascular-disease-in-a-multiethnic-primary-care-setting-10-year-retrospective-cohort-study
#14
Yook Chin Chia, Siew Mooi Ching, Hooi Min Lim
OBJECTIVES: The current study aims to determine the relationship of long-term visit-to-visit variability of SBP to cardiovascular disease (CVD) in a multiethnic primary care setting. METHOD: This is a retrospective study of a cohort of 807 hypertensive patients over a period of 10 years. Three-monthly clinic blood pressure readings were used to derive blood pressure variability (BPV), and CVD events were captured from patient records. RESULTS: Mean age at baseline was 57...
May 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28350575/influence-of-carotid-atherosclerotic-plaques-on-pulse-wave-assessment-with-arterial-tonometry
#15
Andrea Grillo, Giulia Simon, Paolo Salvi, Matteo Rovina, Corrado Baldi, Ilaria Prearo, Stella Bernardi, Bruno Fabris, Andrea Faini, Gianfranco Parati, Moreno Bardelli, Renzo Carretta
OBJECTIVE: Aortic stiffness and central pressure measurements have become increasingly important for the overall estimation of cardiovascular risk. The aim of this study is to verify whether the presence of stenosis in the carotid arteries due to atherosclerotic plaques may induce a bias in the measurement of carotid-femoral pulse wave velocity (PWV) and in the analysis of central pulse waveform variables assessed by carotid tonometry. METHODS: Eighty-four patients (age: 67...
March 27, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28350554/high-sensitivity-and-specificity-of-the-cepheid-xpert%C3%A2-hiv-1-qualitative-point-of-care-test-among-newborns-in-botswana
#16
Maryanne Ibrahim, Sikhulile Moyo, Terence Mohammed, Lucy Mupfumi, Simani Gaseitsiwe, Kenneth Maswabi, Gbolahan Ajibola, Rebecca Gelman, Oganne Batlang, Maureen Sakoi, Chloe Auletta-Young, Joseph Makhema, Shahin Lockman, Roger L Shapiro
BACKGROUND: HIV point-of-care (POC) testing allows for early infant HIV diagnosis and treatment, but POC accuracy at birth and in the setting of antiretroviral prophylaxis for the prevention of mother-to-child HIV transmission (MTCT) is unknown. METHODS: We evaluated the Cepheid Xpert® HIV-1 Qual POC test against the Roche Taqman HIV-1 PCR platform using dried blood spots from 15 HIV-infected and 75 HIV-exposed uninfected newborns. These infants were screened for HIV at <96 hours of life at 5 hospital maternity wards in Botswana; all infants received post-exposure antiretroviral prophylaxis (PEP) and most mothers received 3-drug antiretroviral therapy in pregnancy and at delivery...
March 24, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28350440/identification-of-trypanosoma-brucei-adometdc-inhibitors-using-a-high-throughput-mass-spectrometry-based-assay
#17
Oleg A Volkov, Casey C Cosner, Anthony J Brockway, Martin Kramer, Michael Booker, Shihua Zhong, Ariel Ketcherside, Shuguang Wei, Jamie Longgood, Melissa K McCoy, Thomas E Richardson, Stephen A Wring, Michael Peel, Jeffrey D Klinger, Bruce A Posner, Jef K De Brabander, Margaret A Phillips
Human African trypanosomiasis (HAT) is a fatal infectious disease caused by the eukaryotic pathogen Trypanosoma brucei. Available treatments are difficult to administer and have significant safety issues. S-Adenosylmethionine decarboxylase (AdoMetDC) is an essential enzyme in the parasite polyamine biosynthetic pathway. Previous attempts to develop TbAdoMetDC inhibitors into anti-HAT therapies failed due to poor brain exposure. Here, we describe a large screening campaign of two small-molecule libraries (~400,000 compounds) employing a new high-throughput (~7 s per sample) mass spectrometry-based assay for AdoMetDC activity...
March 28, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/28346956/early-nephrectomy-in-unilateral-multicystic-dysplastic-kidney-in-children-cures-hypertension-early-an-observation
#18
Basant Kumar, Vijai Datta Upadhyaya, Manish Kumar Gupta, Laxmi Kant Bharti, Ram Nawal Rao, Sheo Kumar
Objective Surgery is still indicated as the treatment of choice in subset of patients with unilateral multicystic dysplastic kidney (UMCDK) because of its potential complications and malignant change. The purpose of this study is to present our observation that early nephrectomy may cure hypertension early in children with UMCDK and review the literature. Materials and Methods We report here four children (two males and two females) with antenatally diagnosed UMCDK with hypertension, treated in the past 4 years...
March 27, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28346955/nonischemic-priapism-in-childhood-a-case-series-and-review-of-literature
#19
Hans-Walter Hacker, Marcus G Schwoebel, Philipp O Szavay
Introduction Nonischemic priapism (NIP) in childhood is a very rare affection. In the literature, patients with NIP are described mainly incidental after perineal trauma. Many of them underwent embolization of either internal pudendal artery or bulbocavernosal arteries. Patients and Methods We report on six boys between 4 and 13 years of age with NIP, treated at our institution between 2008 and 2014. Color Doppler ultrasound (CDU) was performed in all patients as emergency diagnostic evaluation. Patients were treated conservatively, including bed rest, local cooling, and perineal compression...
March 27, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28346912/optimizing-the-dose-of-erythropoietin-required-to-prevent-acute-ventilation-induced-cerebral-white-matter-injury-in-preterm-lambs
#20
Kyra Y Y Chan, Domenic A LaRosa, Mary Tolcos, Anqi Li, Valerie A Zahra, Graeme R Polglase, Samantha K Barton
Erythropoietin (EPO) is being trialed in preterm neonates for neuroprotection. We have recently demonstrated that a single high bolus dose (5,000 IU/kg) of recombinant human EPO amplified preterm lung and brain ventilation-induced injury. We aimed to determine the optimal dose of EPO to reduce ventilation-induced cerebral white matter inflammation and injury in preterm lambs. Lambs (0.85 gestation) were ventilated with an injurious strategy for 15 min followed by conventional ventilation for 105 min. Lambs were randomized to no treatment (VENT; n = 8) or received a bolus dose of EPO (EPREX®): 300 IU/kg (EPO 300; n = 5), 1,000 IU/kg (EPO 1,000; n = 5), or 3,000 IU/kg (EPO 3,000; n = 5)...
March 28, 2017: Developmental Neuroscience
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