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Observed structured clinical exam

Robert W Irwin, Jeffrey Smith, S Barry Issenberg
The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center...
March 15, 2018: American Journal of Physical Medicine & Rehabilitation
Ramiro Manzano Núñez, James Alejandro Zapata, Herney A García-Perdomo, Diego A Gomez, Mónica A Solís Velasco
INTRODUCTION: Few reports are available about perinatal dengue, with controversial results in regards the risk of perinatal outcome. OBJECTIVE: To report a case of perinatal dengue as a differential diagno sis with neonatal sepsis, which must be considered in endemic areas. CLINICAL CASE: Male newborn of a 23 year-old female, who presented a Non-Structural Protein 1 (NS1) antigen positive to dengue at 36 weeks of gestation and negative anti-dengue antibodies...
December 2017: Revista Chilena de Pediatría
James A McClintic, Clifford L Snyder, Kimberly M Brown
OBJECTIVE: Although key clinical skills have been defined in the Core Entrustable Professional Activities, there is a need to improve medical school curricula with standardized training opportunities and assessments of these skills. Thus, we aimed to develop an innovative curriculum that emphasized critical thinking and clinical skills. We hypothesized that we would be able to observe measurable improvement on assessments of students' critical thinking and clinical skills after the implementation of the new curriculum...
March 12, 2018: Journal of Surgical Education
Komathy Munusamy, Jamuna Vadivelu, Sun Tee Tay
BACKGROUND: Biofilm is known to contribute to the antifungal resistance of Candida yeasts. Aureobasidin A (AbA), a cyclic depsipeptide targeting fungal sphingolipid biosynthesis, has been shown to be effective against several Candida species. AIMS: The aim of this study was to investigate Candida biofilm growth morphology, its biomass, metabolic activity, and to determine the effects of AbA on the biofilm growth. METHODS: The biofilm forming ability of several clinical isolates of different Candida species from our culture collection was determined using established methods (crystal violet and XTT assays)...
March 12, 2018: Revista Iberoamericana de Micología
Sainan Bian, Hua Chen, Li Wang, Yunyun Fei, Yunjiao Yang, Linyi Peng, Yongzhe Li, Fengchun Zhang
Patients with primary biliary cholangitis (PBC) can have extrahepatic manifestations. However, data about cardiac involvement of PBC is limited. We aimed in this study to analyze the clinical characteristics in patients with PBC complicated with and without cardiac involvement, and the risk factors of cardiac involvement in PBC. PBC patients admitted to Peking Union Medical College Hospital between January 2002 and February 2016 were consecutively enrolled. Structured interview, systemic rheumatologic examination, and laboratory tests were conducted for each patient, and risk factors of cardiac involvement were analyzed by comparing patients with and without cardiac involvement...
2018: PloS One
James Baker, Andrew Dickman, Stephen Mason, John Ellershaw
BACKGROUND: A continuous subcutaneous infusion (CSCI) is an effective method of multiple drug administration commonly encountered in end of life care when the oral route is compromised. At present, current practice is to limit syringe driver infusion time to a maximum of 24 hours as dictated by available chemical stability data. However, the ability to deliver prescribed medication by a CSCI over 48 hours may have numerous benefits in both patient care and health service resource utilisation...
2018: PloS One
Hui-Fen Mao, Ling-Hui Chang, Athena Yi-Jung Tsai, Wen-Ni Wennie Huang, Li-Yu Tang, Huey-Jane Lee, Yu Sun, Ta-Fu Chen, Ker-Neng Lin, Pei-Ning Wang, Yea-Ing Lotus Shyu, Ming-Jang Chiu
Background: many people living with dementia remain underdiagnosed and unrecognised. Screening strategies are important for early detection. Objective: to examine whether the Lawton's Instrumental Activities of Daily Living (IADL) scale, compared with other cognitive screening tools-the Mini-Mental State Examination (MMSE), and the Ascertain Dementia 8-item Informant Questionnaire (AD8)-can identify older (≥ 65 years) adults with dementia. Design: population-based cross-sectional observational study...
March 8, 2018: Age and Ageing
Simon J Craddock Lee, Stephen J Inrig, Bijal A Balasubramanian, Celette Sugg Skinner, Robin T Higashi, Katharine McCallister, Wendy Pechero Bishop, Noel O Santini, Jasmin A Tiro
The colorectal cancer (CRC) screening process involves multiple interfaces (communication exchanges and transfers of responsibility for specific actions) among primary care and gastroenterology providers, laboratory, and administrative staff. After a retrospective electronic health record (EHR) analysis discovered substantial clinic variation and low CRC screening prevalence overall in an urban, integrated safety-net system, we launched a qualitative analysis to identify potential quality improvement targets to enhance fecal immunochemical test (FIT) completion, the system's preferred screening modality...
March 2018: Preventive Medicine Reports
Brandon J Hill, Richard Crosby, Alida Bouris, Rayna Brown, Trevor Bak, Kris Rosentel, Alicia VandeVusse, Michael Silverman, Laura Salazar
The purpose of this exploratory study was to examine the effects of legal name change on socioeconomic factors, general and transgender-related healthcare access and utilization, and transgender-related victimization in a sample of young transgender women (transwomen) of color. A cross-sectional group comparison approach was used to assess the potential effects of legal name change. A convenience sample of young transwomen enrolled in a no-cost legal name change clinic were recruited to complete a 30-minute interviewer-guided telephone survey including sociodemographic and socioeconomic factors, health and well-being, health care utilization, transgender transition-related health care, and transgender-related victimization...
March 2018: Sexuality Research & Social Policy
M А Boldyreva, I V Bondar, I S Stafeev, P I Makarevich, I B Beloglazova, E S Zubkova, E K Shevchenko, Y D Molokotina, M N Karagyaur, Е I Rаtner, Ye V Parfyonova
Peripheral nerve injury remains a common clinical problem with no satisfactory treatment options. Numerous studies have shown that hepatocyte growth factor (HGF) exerts neurotrophic effect in motor, sensory, and parasympathetic neurons in addition to mitogenic, morphogenic, angiogenic, antiapoptotic, antifibrotic, and anti-inflammatory effect on various tissues and cells. In our study we examined efficacy of gene therapy with HGF-bearing plasmid (pC4W-hHGF) to improve consequences of traumatic nerve injury in mice...
March 5, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Janika Bloemeke, Rachel Sommer, Stefanie Witt, Michaela Dabs, Francisco Javier Badia, Monika Bullinger, Julia Quitmann
BACKGROUND: This study describes the psychometric testing of the Achondroplasia Personal Life Experience Scale (APLES): a new disease- and functioning-specific health-related quality of life instrument for young people with achondroplasia, which was developed based on the International Classification of Functioning-Children and Youth Version. METHOD: The qualitative analysis of focus group statements from German patients and parents using the International Classification of Functioning-Children and Youth Version yielded 59 items, which after cognitive debriefing were included in a pilot-test...
March 8, 2018: Disability and Rehabilitation
Corine Mouton Dorey, Holger Baumann, Nikola Biller-Andorno
BACKGROUND: There is a growing interest in aggregating more biomedical and patient data into large health data sets for research and public benefits. However, collecting and processing patient data raises new ethical issues regarding patient's rights, social justice and trust in public institutions. The aim of this empirical study is to gain an in-depth understanding of the awareness of possible ethical risks and corresponding obligations among those who are involved in projects using patient data, i...
March 7, 2018: BMC Medical Ethics
William Kazanis, Mary J Pugh, Claudina Tami, Joseph K Maddry, Vikhyat S Bebarta, Erin P Finley, Don D McGeary, David H Carnahan, Jennifer S Potter
Introduction: Between 2001 and 2009, opioid analgesic prescriptions in the Military Health System quadrupled to 3.8 million. The sheer quantity of opioid analgesics available sets the stage for issues related to misuse, abuse, and diversion. To address this issue, the Department of Defense implemented several directives and clinical guidelines to improve access to appropriate pain care and safe opioid prescribing. Unfortunately, little has been done to characterize changing patterns of opioid use in active duty service members (ADSM), so little is known about how combat operations and military health care policy may have influenced this significant problem...
March 1, 2018: Military Medicine
Sushmitha Rao Uppugunduri, Mohammed Abdul Rasheed, Ashutosh Richhariya, Soumya Jana, Jay Chhablani, Kiran Kumar Vupparaboina
OBJECTIVE: To develop an algorithm for automated quantification of Haller's layer in choroid using swept-source optical coherence tomography (OCT). BACKGROUND: So far, to understand the association of various diseases with structural changes of choroid, only gross indicators such as thickness, volume and vascularity index have been examined. However, certain diseases affect specific sublayers of the choroid. Accordingly, a need for targeted quantitation arises. In particular, there is significant interest in understanding Haller's layer, a choroidal sublayer comprising relatively large blood vessels...
2018: PloS One
Kawther Taleb, Eva Lauridsen, Jette Daugaard-Jensen, Pekka Nieminen, Sven Kreiborg
BACKGROUND: Dentinogenesis imperfecta (DI) is a rare debilitating hereditary disorder affecting dentin formation and causing loss of the overlying enamel. Clinically, DI sufferers have a discolored and weakened dentition with an increased risk of fracture. The aims of this study were to assess genotype-phenotype findings in three families with DI-II with special reference to mutations in the DSPP gene and clinical, histological, and imaging manifestations. METHODS: Nine patients participated in the study (two from family A, four from family B, and three from family C)...
March 6, 2018: Molecular Genetics & Genomic Medicine
Devika Iddawela, Sanura Malinda Pallegoda Vithana, Dhilma Atapattu, Lanka Wijekoon
BACKGROUND: Leishmaniasis, a vector borne tropical/subtropical disease caused by the protozoan Leishmania is transmitted to humans by sandfly vectors Phlebotomus and Lutzomyia. The principal form found in Sri Lanka is cutaneous leishmaniasis (CL) and is caused by Leishmania donovani. A rising trend in disease prevalence has been observed recently in Sri Lanka and the island is in fact the newest endemic focus in South Asia. Determining the prevalence of smear positivity among clinically suspected CL patients, identifying risk factors and specific clinical presentations of CL in order to implement preventive and early treatment strategies were the objectives of this study...
March 6, 2018: BMC Infectious Diseases
Seth Donal Hannah
Drawing on participant-observation and semi-structured interviews, this paper examines the local forms of clinical practice in a 26-bed acute psychiatric inpatient unit located within a private psychiatric hospital in the Northeastern United States. It focuses on how clinicians, staff, and management understand and utilize the concepts of culture, race, and ethnicity in their daily work, finding that a humanistic approach to care that that treats patients as "individuals" was dominant. Clinicians and staff categorized patients using descriptive, behavior based categories including language, propensity for violence, and whether patients are "from the streets...
March 5, 2018: Culture, Medicine and Psychiatry
Anna Boye Kromann, Lilian Bomme Ousager, Inas Kamal Mohammad Ali, Nurcan Aydemir, Anette Bygum
BACKGROUND: Pigmentary mosaicism is a term that describes varied patterns of pigmentation in the skin caused by genetic heterogeneity of the skin cells. In a substantial number of cases, pigmentary mosaicism is observed alongside extracutaneous abnormalities typically involving the central nervous system and the musculoskeletal system. We have compiled information on previous cases of pigmentary mosaicism aiming to optimize the handling of patients with this condition. Our study is based on a database search in PubMed containing papers written in English, published between January 1985 and April 2017...
March 5, 2018: Orphanet Journal of Rare Diseases
Gabrielle E Hodgins, Jared G Blommel, Boadie W Dunlop, Dan Iosifescu, Sanjay J Mathew, Thomas C Neylan, Helen S Mayberg, Philip D Harvey
PURPOSE/BACKGROUND: For a drug to acquire Food and Drug Administration approval, it must significantly outperform placebo treatment. In recent years, the placebo effect seems to be increasing in neuropsychiatric conditions. Here, we examine placebo effects across self-reported, clinically rated, and performance-based data from a trial using a corticotropin-releasing hormone receptor type 1 (CRHR1) antagonist for treatment of post-traumatic stress disorder (PTSD). METHODS/PROCEDURES: Women with chronic PTSD were randomized to treatment with either GSK561679, a CRHR1 antagonist, or placebo...
March 2, 2018: Journal of Clinical Psychopharmacology
Satoshi Katagiri, Shin Tanaka, Tadashi Yokoi, Takaaki Hayashi, Emiko Matsuzaka, Kazuko Ueda, Tomoyo Yoshida-Uemura, Akira Arakawa, Sachiko Nishina, Kazuaki Kadonosono, Noriyuki Azuma
Purpose: To report the clinical and genetic findings of a male toddler who presented bilateral bullous retinoschisis with a novel RS1 mutation. Observations: This is an observational case report of a patient referred to our hospital with esotropia. A comprehensive ophthalmic examination was performed with the boy (age, 1 year 4 months) under general anesthesia that included fundus examinations, fluorescein angiography (FA), swept-source optical coherence tomography (SS-OCT), and full-field electroretinography (FF-ERG)...
April 2017: American Journal of Ophthalmology Case Reports
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