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Krystin A Engelhardt, Elizabeth Hisle-Gorman, Gregory H Gorman, Nicole R Dobson
Background: The Military Health System (MHS) provides universal access to medical care to active duty service members, retirees, and their dependents. Observational data from small studies suggest lower preterm birth rates in the MHS compared with U.S. national averages. The objectives of this study are to determine the rate of preterm birth in the MHS from 2006 to 2012 compared with national rates and to analyze the impact of demographic factors on preterm birth in a universal access health care system...
March 14, 2018: Military Medicine
Oren Schwartz, Boris Kanevsky, M A J Sergey Kutikov, Cara H Olsen, Israel Dudkiewicz
Introduction: Attrition from training is associated with substantial financial and personnel loss. There is a plethora of medical literature and research of attrition rates related to initial/phase 1 training (basic combat training); however, the analysis of second phase training (commanders training, consisting of schools that qualify junior commanders and officers for infantry and non-infantry combat units) is limited. The purpose of this study is to perform a comprehensive survey regarding to medical attrition from commanders training in the IDF (Israeli Defense Forces) in order to present the commanders of the IDF a detailed situation report that will serve as an evidence-based platform for future policy planning and implementation...
March 14, 2018: Military Medicine
Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Barbara Jagels, Leila Amin, Annika Gustafson
Systematic gaps for pregnancy screening and testing of patients with cancer persist. Absent or inconsistent guidelines and policies are barriers to standardized practice. Awareness among oncology nurses is needed to promote safe cancer care, prevent patient harm, and uphold patient-centered care.
April 1, 2018: Clinical Journal of Oncology Nursing
Saverio Affatato, Alessandro Ruggiero, Sami Abdel Jaber, Massimiliano Merola, Pierangiola Bracco
Given the long-term problem of polyethylene wear, medical interest in the new improved cross-linked polyethylene (XLPE), with or without the adding of vitamin E, has risen. The main aim of this study is to gain further insights into the mutual effects of radiation cross-linking and addition of vitamin E on the wear performance of ultra-high-molecular-weight polyethylene (UHMWPE). We tested four different batches of polyethylene (namely, a standard one, a vitamin E-stabilized, and two cross-linked) in a hip joint simulator for five million cycles where bovine calf serum was used as lubricant...
March 16, 2018: Materials
Peter Clifton, Jennifer Keogh
The meta-analysis of plant sterol supplement studies suggests an 8% lowering of low density lipoprotein (LDL) cholesterol for 2 to 2.5 g/day of plant sterols. Cereal foods have been rarely tested, and one study showed a lower LDL lowering of 5.4% with 1.6 g of plant sterol in breakfast cereal. We aimed to test a breakfast wheat biscuit with 2 g of plant sterols in a single serve of two wholegrain wheat breakfast cereal biscuits. Fifty volunteers with a total cholesterol of >5.5 mmol/L were recruited for a randomised crossover study with two 4-week periods with no washout, of which 45 successfully completed the study...
March 16, 2018: Foods (Basel, Switzerland)
Nick Zwart, Shan Li Nio, Corine J Houtman, Jacob De Boer, Jeroen Kool, Timo Hamers, Marja H Lamoree
Effect-Directed Analysis (EDA) is a commonly used approach for effect-based identification of endocrine disruptive chemicals in complex (environmental) mixtures. For routine toxicity assessment of e.g. water samples however, current EDA approaches are considered time consuming and laborious. We achieved faster EDA and identification, by downscaling of sensitive cell-based hormone reporter gene assays and increasing fractionation resolution to allow testing of smaller fractions with reduced complexity. The high-resolution EDA approach is demonstrated by analysis of four environmental passive sampler extracts...
March 16, 2018: Environmental Science & Technology
Lucia Romero, Jordi Cano, Julio Gomis-Tena, Beatriz Trenor, Ferran Sanz, Manuel Pastor, Javier Saiz
Drug-induced proarrhythmicity is a major concern for regulators and pharmaceutical companies. For novel drug candidates, the standard assessment involves the evaluation of the potassium hERG channels block and the in vivo prolongation of the QT interval. However, this method is known to be too restrictive and to stop the development of potentially valuable therapeutic drugs. The aim of this work is to create an in silico tool for early detection of drug-induced proarrhythmic risk. The system is based on simulations of how different compounds affect the action potential duration (APD) of isolated endocardial, midmyocardial, and epicardial cells as well as the QT prolongation in a virtual tissue...
March 16, 2018: Journal of Chemical Information and Modeling
Parkinson Soubam, Shashwat Mishra, Ashish Suri, Renu Dhingra, Sankat Mochan, Sanjeev Lalwani, T S Roy, Ashok K Mahapatra
A surgeon's understanding of the surgical anatomy can be greatly enhanced by the dissection of preserved cadaveric specimens. A reliable and inexpensive biological model for testing and standardization of dye injection concentrations is proposed utilizing the goat's head as a biological model. The first phase was concerned with standardization of the dye by titrating its concentration and injecting various amounts into cerebral vessels of a goat's head until an optimal concentration had been ascertained. In the second phase, this optimum concentration of the dye was injected into four human cadaveric heads following the same technique standardized using the goat's head...
March 2018: Neurology India
Takuma Ohmichi, Masaki Kondo, Masahiro Itsukage, Hidetaka Koizumi, Shigenori Matsushima, Nagato Kuriyama, Kazunari Ishii, Etsuro Mori, Kei Yamada, Toshiki Mizuno, Takahiko Tokuda
OBJECTIVE The gold standard for the diagnosis of idiopathic normal pressure hydrocephalus (iNPH) is the CSF removal test. For elderly patients, however, a less invasive diagnostic method is required. On MRI, high-convexity tightness was reported to be an important finding for the diagnosis of iNPH. On SPECT, patients with iNPH often show hyperperfusion of the high-convexity area. The authors tested 2 hypotheses regarding the SPECT finding: 1) it is relative hyperperfusion reflecting the increased gray matter density of the convexity, and 2) it is useful for the diagnosis of iNPH...
March 16, 2018: Journal of Neurosurgery
Nicola Schieda, Robert S Lim, Satheesh Krishna, Matthew D F McInnes, Trevor A Flood, Rebecca E Thornhill
OBJECTIVE: The objective of our study was to evaluate tumor attenuation and texture on unenhanced CT for potential differentiation of low-grade from high-grade chromophobe renal cell carcinoma (RCC). MATERIALS AND METHODS: A retrospective study of 37 consecutive patients with chromophobe RCC (high-grade, n = 13; low-grade, n = 24) who underwent preoperative unenhanced CT between 2011 and 2016 was performed. Two radiologists (readers 1 and 2) blinded to the histologic grade of the tumor and outcome of the patients subjectively evaluated tumor homogeneity (3-point scale: completely homogeneous, mildly heterogeneous, or mostly heterogeneous)...
March 16, 2018: AJR. American Journal of Roentgenology
Naomi Weintrob, Anita Schachter Davidov, Anat Segev Becker, Galit Israeli, Asaf Oren, Ori Eyal
OBJECTIVE: The total cortisol (TC) response may be measured during the glucagon stimulation test (GST) for growth hormone (GH) reserve in order to assess the integrity of the hypothalamic-pituitary-adrenal (HPA) axis. Measurements of TC are unreliable in conditions of albumin and cortisol-binding globulin (CBG) alterations (e.g., hypoproteinemia or CBG deficiency). We aimed to measure the serum free cortisol (sFC) response to the GST in children and adolescents and determine whether it could predict the GH response to glucagon stimulation...
March 2018: Endocrine Practice
Nora Stünkel-Grees, Jens Clausen, Alexander Wünsch
Outpatient Psychotherapy for Children and Adolescents with Intellectual Disability The psychiatric morbidity risk for people with intellectual disability is considerably increased. Psychotherapy is considered as one possible treatment. Among experts the caresituation is described as substantial insufficient. This study investigated the perspective of psychotherapists for children and adolescents in the German state North Rhine-Westphalia regarding the care situation of outpatient psychotherapy for children and adolescents with intellectual disability...
March 2018: Praxis der Kinderpsychologie und Kinderpsychiatrie
P Alex Smith, Yaxin Wang, Ralph W Metcalfe, Luiz C Sampaio, Daniel L Timms, William E Cohn, O H Frazier
PURPOSE: A minimally invasive, partial-assist, intra-atrial blood pump has been proposed, which would unload the left ventricle with a flow path from the left atrium to the arterial system. Flow modulation is a common strategy for ensuring washout in the pump, but it can increase power consumption because it is typically achieved through motor-speed variation. However, if a pump's performance curve had the proper gradient, flow modulation could be realized passively. To achieve this goal, we propose a pump performance operating curve as an alternative to the more standard operating point...
March 2018: International Journal of Artificial Organs
Mattia Bonzi, Giulia Cernuschi, Monica Solbiati, Giuliano Giusti, Nicola Montano, Elisa Ceriani
Infective endocarditis (IE) is a serious and potentially life-threatening disease, and accurate diagnosis is essential. We performed a systematic review and meta-analysis to assess the diagnostic accuracy of transthoracic echocardiography (TTE), with transesophageal echocardiography (TEE) as the reference standard, in patients with suspected IE of the native valves. We performed a systematic search in MEDLINE, EMBASE and Cochrane Library searching for studies that enrolled adult patients with suspected native valves IE where data about both TTE and TEE could be extracted...
March 15, 2018: Internal and Emergency Medicine
Lars Frings, Sabine Hellwig, Tobias Bormann, Timo S Spehl, Ralph Buchert, Philipp T Meyer
PURPOSE: The value of imaging regional glucose metabolism with [18 F]FDG PET for the prediction of progression from mild cognitive impairment (MCI) to Alzheimer's dementia (AD) is controversial. The predictive value of imaging with [18 F]FDG PET was therefore tested and compared with that of imaging beta-amyloid load with [11 C]PIB PET in the same memory clinic population of MCI patients. METHODS: Thirty-nine patients with MCI who had undergone [18 F]FDG as well as [11 C]PIB PET were identified from a single-centre clinical registry...
March 15, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Barbara Wiśniowska, Sebastian Polak
The current study is an example of drug-disease interaction modeling where a drug induces a condition which can affect the pharmacodynamics of other concomitantly taken drugs. The electrophysiological effects of hypokaliemia and heart rate changes induced by the antiasthmatic drugs were simulated with the use of the cardiac safety simulator. Biophysically detailed model of the human cardiac physiology-ten Tusscher ventricular cardiomyocyte cell model-was employed to generate pseudo-ECG signals and QTc intervals for 44 patients from four clinical studies...
March 15, 2018: Journal of Pharmacokinetics and Pharmacodynamics
Sergio Barroso Rosa, Zaid Bahho, Kenji Doma, Kaushik Hazratwala, Peter McEwen, Varaguna Manoharan, Brent Matthews, Matthew Wilkinson
INTRODUCTION: Patella alta (PA) is one of the primary correctable risk factors for patellofemoral instability (PFI). Both an accurate diagnosis of PA and a clinically relevant target for correction are necessary for optimal treatment. An ideal test for PA should relate the position of the patella to the femur rather than tibia, should do so with the quadriceps contracted and the patellar tendon under tension and should have good sensitivity and specificity. None of the currently used radiographic tests PA meet these criteria, most of which are based on the position of the patella relative to the tibia with diagnostic cutoffs based on 2 standard deviations from the mean rather than optimal sensitivity and specificity...
March 15, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Majed I Al-Sari, Mohammed A A Sarhan, Issam A Al-Khatib
Complying with the technical specifications of compost production is of high importance not only for environmental protection but also for increasing the productivity and promotion of compost use by farmers in agriculture. This study focuses on the compost quality of the Palestinian market and farmers' attitudes toward agricultural use of compost. The quality is assessed through selection of 20 compost samples of different suppliers and producers and lab testing for quality parameters, while the farmers' attitudes to compost use for agriculture are evaluated through survey questionnaire of 321 farmers in the Hebron area...
March 15, 2018: Environmental Monitoring and Assessment
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