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internal medicine

Hellen J Amuguni, Melissa Mazan, Robert Kibuuka
Infectious diseases of grave concern to human health are emerging from wildlife and livestock populations in multiple regions of the world. Responding effectively to these emerging pandemics requires engagement of multidisciplinary groups of professionals. Using a One Health approach, One Health Central and Eastern Africa (OHCEA), a network of seven schools of public health and seven veterinary schools, with the support of the United States Agency for International Development (USAID), has engaged in curriculum review with the aim of building the skills of multidisciplinary groups of professionals to improve their capacity to respond to emerging infectious diseases...
October 25, 2016: Journal of Veterinary Medical Education
Jason Ostenson, Akshat C Pujara, Artem Mikheev, Linda Moy, Sungheon G Kim, Amy N Melsaether, Komal Jhaveri, Sylvia Adams, David Faul, Christopher Glielmi, Christian Geppert, Thorsten Feiweier, Kimberly Jackson, Gene Y Cho, Fernando E Boada, Eric E Sigmund
PURPOSE: Diffusion-weighted imaging (DWI) and (18) F-fluorodeoxyglucose-positron emission tomography ((18) F-FDG-PET) independently correlate with malignancy in breast cancer, but the relationship between their structural and metabolic metrics is not completely understood. This study spatially correlates diffusion, perfusion, and glucose avidity in breast cancer with simultaneous PET/MR imaging and compares correlations with clinical prognostics. METHODS: In this Health Insurance Portability and Accountability Act-compliant prospective study, with written informed consent and approval of the institutional review board and using simultaneously acquired FDG-PET and DWI, tissue diffusion (Dt ), and perfusion fraction (fp ) from intravoxel incoherent motion (IVIM) analysis were registered to FDG-PET within 14 locally advanced breast cancers...
October 25, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Simone A Winkler, Paul A Picot, Michael M Thornton, Brian K Rutt
PURPOSE: To develop a new method capable of directly measuring specific absorption rate (SAR) deposited in tissue using the thermoacoustic signal induced by short radiofrequency (RF) pulse excitation. THEORY: A detailed model based on the thermoacoustic wave generation and propagation is presented. METHODS: We propose a new concept for direct measurement of SAR, to be used as a safety assessment/monitoring tool for MRI. The concept involves the use of short bursts of RF energy and the measurement of the resulting thermoacoustic excitation pattern by an array of ultrasound transducers, followed by image reconstruction to yield the 3D SAR distribution...
October 25, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Maryna Lapotka, María Ruz, Alberto Salamanca Ballesteros, Olga Ocón Hernández
PURPOSE: This study describes a new methodology-the cold pressor gel test (CPGT)-for delivering an accessible experimental pain stimulus, which is reproducible and safe for functional MRI (fMRI). METHODS: The cold pressor test was modified to put safety precautions into the CPGT. The material used is cool gelled water with a thickening product, which provides a stable temperature at 0.2 °C. Thirteen women with chronic pelvic pain were scanned using a 3 Tesla (T) MR scanner equipped with a 12-channel head coil...
October 25, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Rajkishen Narayanan, Hye Na Kim, Narayanan K Narayanan, Dominick Nargi, Bhagavathi Narayanan
Following the publication of this article, which was concerned with the expression of phosphorylated epidermal growth factor receptor (pEGFR) and cyclin D1 activation independently of the expression levels of cyclo-oxygenase-2, an interested reader drew to our attention apparent anomalies associated with the western blot data shown in Fig. 2C. Following an internal investigation at the New York University School of Medicine, we were requested to produce the original film, or the scan of the image of the film, for verification...
October 18, 2016: International Journal of Oncology
Ryan M J Ivie, Emily A Vail, Hannah Wunsch, Monica P Goldklang, Robert Fowler, Vivek K Moitra
OBJECTIVE: We conducted this study to determine the generalizability of information gained from randomized controlled trials in critically ill patients by assessing the incidence of eligibility for each trial. DESIGN: Prospective, observational cohort study. We identified the 15 most highly cited randomized controlled trials in critical care medicine published between 1998 and 2008. We examined the inclusion and exclusion criteria for each randomized controlled trial and then assessed the eligibility of each patient admitted to a study ICU for each randomized controlled trial and calculated rates of potential trial eligibility in the cohort...
October 24, 2016: Critical Care Medicine
Saminathan Ramakrishnan, Sivaraman Subramaniam, Adrian Francis Stewart, Guido Grundmeier, Adrian Keller
DNA origami has become a widely used method for synthesizing well-defined nanostructures with promising applications in various areas of nanotechnology, biophysics, and medicine. Recently, the possibility to transfer the shape of single DNA origami nanostructures into different materials via molecular lithography approaches has received growing interest due to the great structural control provided by the DNA origami technique. Here, we use ordered monolayers of DNA origami nanostructures with internal cavities on mica surfaces as molecular lithography masks for the fabrication of regular protein patterns over large surface areas...
October 25, 2016: ACS Applied Materials & Interfaces
Anthony J Hatswell, Nick Freemantle, Gianluca Baio
BACKGROUND: Pharmaceuticals are usually granted a marketing authorisation on the basis of randomised controlled trials (RCTs). Occasionally the efficacy of a treatment is assessed without a randomised comparator group (either active or placebo). OBJECTIVE: To identify and develop a taxonomic account of economic modelling approaches for pharmaceuticals licensed without RCT data. METHODS: We searched PubMed, the websites of UK health technology assessment bodies and the International Society for Pharmacoeconomics and Outcomes Research Scientific Presentations Database for assessments of treatments granted a marketing authorisation by the US Food and Drug Administration or European Medicines Agency from January 1999 to May 2014 without RCT data (74 indications)...
October 24, 2016: PharmacoEconomics
Sharon E Card, Heather D Clark, Michelle Elizov, Narmin Kassam
General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition...
October 24, 2016: Journal of General Internal Medicine
Jason Kwah, Jennifer Weintraub, Robert Fallar, Jonathan Ripp
BACKGROUND : Burnout is a common issue in internal medicine residents, and its impact on medical errors and professionalism is an important subject of investigation. OBJECTIVE : To evaluate differences in medical errors and professionalism in internal medicine residents with and without burnout. METHODS : A single institution observational cohort study was conducted between June 2011 and July 2012. Burnout was measured using the Maslach Burnout Inventory to generate subscores for the following 3 domains: emotional exhaustion, depersonalization, and sense of personal accomplishment...
October 2016: Journal of Graduate Medical Education
Jared M Moore, David A Wininger, Bryan Martin
BACKGROUND : Developing effective leadership skills in physicians is critical for safe patient care. Few residency-based models of leadership training exist. OBJECTIVE : We evaluated residents' readiness to engage in leadership training, feasibility of implementing training for all residents, and residents' acceptance of training. METHODS : In its fourth year, the Leadership Development Program (LDP) consists of twelve 90-minute modules (eg, Team Decision Making and Bias, Leadership Styles, Authentic Leadership) targeting all categorical postgraduate year (PGY) 1 residents...
October 2016: Journal of Graduate Medical Education
Greg Ogrinc, Emily S Cohen, Robertus van Aalst, Beth Harwood, Ellyn Ercolano, Karyn D Baum, Adam J Pattison, Anne C Jones, Louise Davies, Al West
BACKGROUND : Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. OBJECTIVE : We sought to determine the clinical and educational impact of an integrated QI curriculum. METHODS : This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum...
October 2016: Journal of Graduate Medical Education
James A Town, Paul A Bergl, Akhil Narang, John F McConville
BACKGROUND : The long-term retention of knowledge and skills in bedside ultrasound by internal medicine residents after ultrasound training is not well understood. OBJECTIVE : We sought to determine whether knowledge and skills acquired from focused training in bedside ultrasound are retained over time, and whether retention is related to independent practice. METHODS : We conducted a prospective observational trial of 101 internal medicine residents at an academic medical center who participated in a bedside ultrasound workshop followed by 12 months of independent practice...
October 2016: Journal of Graduate Medical Education
Robert J Fortuna, Lynn Garfunkel, Michael D Mendoza, Megan Ditty, Julia West, Karen Nead, Brett W Robbins
BACKGROUND : Continuity of care is a critical element of residents' educational experience in primary care programs. OBJECTIVE : We examined how continuity in resident practices compares to nonteaching practices, identified factors associated with increased continuity, and explored the association between continuity and quality measures. METHODS : We analyzed 117 235 patient visits to 4 resident practices (26 resident teams in internal medicine, pediatrics, family medicine, and medicine-pediatrics) and 270 242 visits to nonteaching community practices between July 2013 and May 2014...
October 2016: Journal of Graduate Medical Education
Raphael Rabinowitz, Jeanne Farnan, Oliver Hulland, Lisa Kearns, Michele Long, Bradley Monash, Priti Bhansali, H Barrett Fromme
BACKGROUND : Attending rounds is a key component of patient care and education at teaching hospitals, yet there is an absence of studies addressing trainees' perceptions of rounds. OBJECTIVE : To determine perceptions of pediatrics and internal medicine residents about the current and ideal purposes of inpatient rounds on hospitalist services. METHODS : In this multi-institutional qualitative study, the authors conducted focus groups with a purposive sample of internal medicine and pediatrics residents at 4 teaching hospitals...
October 2016: Journal of Graduate Medical Education
Gurusankar Saravanabhavan, Kate Werry, Mike Walker, Douglas Haines, Morie Malowany, Cheryl Khoury
Human biomonitoring reference values are statistical estimates that indicate the upper margin of background exposure to a given chemical at a given time. Nationally representative human biomonitoring data on 176 chemicals, including several metals and trace elements, are available in Canada from 2007 to 2013 through the Canadian Health Measures Survey (CHMS). In this work, we used a systematic approach based on the reference interval concept proposed by the International Federation of Clinical Chemistry and Laboratory Medicine and the International Union of Pure and Applied Chemistry to derive reference values (RV95s) for metals and trace elements...
October 17, 2016: International Journal of Hygiene and Environmental Health
Matthew Ward
: Aim To understand the frequency, urgency, and rationale of emergency department and urgent care (ED/UC) use by diabetic patients of a Family Medicine Health Team (FHT). METHODS: A retrospective, observational study with comparison control groups was conducted from 1 January 2013 to 31 December 2014. A total of 693 diabetic patients were compared with two, age-standardized non-diabetic groups: one with a higher disease burden based on International Classification of Diseases 9 diagnoses and the other from a randomized patient pool...
October 25, 2016: Primary Health Care Research & Development
Elizabeth M Mudge, Ying Liu, Jensen A Lund, Paula N Brown
Suitably validated analytical methods that can be used to quantify medicinally active phytochemicals in natural health products are required by regulators, manufacturers, and consumers. Hawthorn (Crataegus) is a botanical ingredient in natural health products used for the treatment of cardiovascular disorders. A method for the quantitation of vitexin-2″-O- rhamnoside, vitexin, isovitexin, rutin, and hyperoside in hawthorn leaf and flower raw materials and finished products was optimized and validated according to AOAC International guidelines...
October 24, 2016: Planta Medica
Ryan K Robison, Ashley G Anderson, James G Pipe
PURPOSE: Three-dimensional ultrashort echo-time (UTE) imaging commonly makes use of an isotropic 3D radial projection acquisition. The FLORET sequence is proposed and evaluated as a more efficient alternative. METHODS: The properties of the FLORET trajectory are contrasted with those of a 3D radial projection trajectory. The theoretical advantages of FLORET, including greater sampling and SNR efficiency, are evaluated based upon experimental data. The effect of T2* decay on FLORET is analyzed in comparison to the 3D radial, Cones, and Density Adapted Radial trajectories...
October 24, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Thobias Romu, Nils Dahlström, Olof Dahlqvist Leinhard, Magnus Borga
PURPOSE: The purpose of this work was to develop and evaluate a robust water-fat separation method for T1-weighted symmetric two-point Dixon data. THEORY AND METHODS: A method for water-fat separation by phase unwrapping of the opposite-phase images by phase-sensitive reconstruction (PSR) is introduced. PSR consists of three steps; (1), identification of clusters of tissue voxels; (2), unwrapping of the phase in each cluster by solving Poisson's equation; and (3), finding the correct sign of each unwrapped opposite-phase cluster, so that the water-fat images are assigned the correct identities...
October 24, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
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