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Srilekha Namala, Vijay Srinivas Guduru, Anuradha Ananthaneni, Sabitha Devi, Puneeth Horrati Kuberappa, Urmila Udayashankar
BACKGROUND: Micronuclei (MN) in oral exfoliative cells have been shown to indicate a disparaging change in genetic information of the cell. Recent studies showed correlation between the frequency of MN and severity of this damage. Grading of lesions can be used to determine the austerity of this damage. Aims: The aim of this study is to compare the MN frequency in oral exfoliated cells of normal and oral squamous cell carcinoma (OSCC) individuals and to cytologically grade the frequency of MN in cytological smears and to correlate it with histological grading...
July 2016: Journal of Cytology
James C Jeng
No abstract text is available yet for this article.
October 12, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Erwan d'Aranda, Julien Bordes, Boris Bourgeois, Jared Clay, Pierre Esnault, Pierre-Julien Cungi, Philippe Goutorbe, Eric Kaiser, Eric Meaudre
BACKGROUND: Management of critically ill patients in austere environments is a logistic challenge. Availability of oxygen cylinders for the mechanically ventilated patient may be difficult in such a context. One solution is to use a ventilator able to function with an oxygen concentrator (OC). METHODS: We tested two Elisée™ 350 ventilators paired with SeQual Integra 10-OM oxygen concentrators (OC) (Chart Industries, http://www and evaluated the delivered fraction of inspired oxygen (Fio2)...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
David Lidwell, Colin A Meghoo
Skeletal traction is a useful technique for managing proximal femur fractures in austere environments where fracture stabilization for this injury is difficult. We present a technique and a construct appropriate for field use that facilitates patient evacuation, and we provide guidelines for the use of this technique by an advanced medical provider managing these injuries. The objectives of this article are to enable to reader to (1) recognize the role of skeletal traction in managing proximal femur fractures in an austere environment, (2) identify the key steps in placing transfemoral skeletal traction pins, and (3) identify options and requirements for building a traction construct in resource-limited environments...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Robert R Brubaker
This chapter outlines the physiology of Yersinia pestis with emphasis on identifying unique functions required for tissue invasion and acute disease. These activities are opposed to often incompatible processes expressed by very closely related Yersinia pseudotuberculosis, which causes localized gastrointestinal infection. Gain of new information in Y. pestis entailed lateral transfer of plasminogen activator and anti-phagocytic capsular antigen via the plasmids pPCP and pMT, respectively, and derepression of the pigmentation locus facilitating colonization of the flea vector...
2016: Advances in Experimental Medicine and Biology
Sabine Vogler, Nina Zimmermann, Kees de Joncheere
BACKGROUND: Policy-makers can use a menu of pharmaceutical policy options. This study aimed to survey these measures that were implemented in European countries between 2010 and 2015. METHODS: We did bi-annual surveys with competent authorities of the Pharmaceutical Pricing and Reimbursement Information network. Additionally, we consulted posters produced by members of this network as well as further published literature. Information on 32 European countries (all European Union Member States excluding Luxembourg; Iceland, Norway, Serbia, Switzerland, Turkey) was included...
September 20, 2016: Health Policy
Lotte Elton
Purpose This paper aims to describe and analyse some of the ways in which good leadership can enable those working within the National Health Service (NHS) to weather the changes and difficulties likely to arise in the coming years, and takes the format of an essay written by the prize-winner of the Faculty of Medical Leadership and Management's Student Prize. The Faculty of Medical Leadership and Management ran its inaugural Student Prize in 2015-2016, which aimed at medical students with an interest in medical leadership...
October 3, 2016: Leadership in Health Services
Yossef Alnasser, Cusi Ferradas, Taryn Clark, Maritza Calderon, Alejandro Gurbillon, Dionicia Gamboa, Uri S McKakpo, Isabella A Quakyi, Kwabena M Bosompem, David J Sullivan, Joseph M Vinetz, Robert H Gilman
Plasmodium vivax is the most prevalent cause of human malaria in the world and can lead to severe disease with high potential for relapse. Its genetic and geographic diversities make it challenging to control. P. vivax is understudied and to achieve control of malaria in endemic areas, a rapid, accurate, and simple diagnostic tool is necessary. In this pilot study, we found that a colorimetric system using AuNPs and MSP10 DNA detection in urine can provide fast, easy, and inexpensive identification of P. vivax...
October 2016: PLoS Neglected Tropical Diseases
Elham Rafighi, Shoba Poduval, Helena Legido-Quigley, Natasha Howard
BACKGROUND: Recent British National Health Service (NHS) reforms, in response to austerity and alleged 'health tourism,' could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. METHODS: A qualitative study design was selected. Data were collected through document review and 22 in-depth interviews with non-EEA migrants and civil-society organisation representatives...
May 8, 2016: International Journal of Health Policy and Management
Reshma Roshania, Michaela Mallow, Nelson Dunbar, David Mansary, Pranav Shetty, Taralyn Lyon, Kacey Pham, Matthew Abad, Erin Shedd, Anh-Minh A Tran, Sarah Cundy, Adam C Levine
BACKGROUND: The 2014 outbreak of Ebola virus disease (EVD) in West Africa was the largest ever recorded. Starting in September 2014, International Medical Corps (IMC) managed 5 Ebola treatment units (ETUs) in Liberia and Sierra Leone, which cumulatively cared for about 2,500 patients. We conducted a retrospective cohort study of patient data collected at the 5 ETUs over 1 year of operations. METHODS: To collect clinical and epidemiological data from the patient care areas, each chart was either manually copied across the fence between the high-risk zone and low-risk zone, imaged across the fence, or imaged in the high-risk zone...
September 28, 2016: Global Health, Science and Practice
Carlene Chun, Leon Zheng, Sean P Colgan
In recent years, studies in the gastrointestinal (GI) mucosa have taught us a number of important lessons related to tissue oxygenation and metabolism in health and disease. The highly vascularized mucosa lies immediately adjacent to an anaerobic lumen containing trillions of metabolically active microbes (i.e. the microbiome) that results in one of the more austere tissue microenvironments in the body. These studies have also implicated a prominent role for oxygen metabolism and hypoxia in inflammation, so called "inflammatory hypoxia", that results from the activation of multiple oxygen consuming enzymes...
September 28, 2016: Free Radical Biology & Medicine
James Buchan
In the autumn, the NHS Pay Review Body (RB) will take evidence from government, employers and nurses' unions. It will then deliberate before making recommendations on what should be a pay rise in April 2017. But as NHS nurses know only too well, this supposedly independent system has been compromised by top down pay freezes initiated by the Westminster government as part of its 'austerity' measures.
September 28, 2016: Nursing Standard
Thomas C F Bodewes, Joel M Johnson, Michael Auster, Cindy Huynh, Sriya Muralidharan, Mauricio Contreras, Frank W LoGerfo, Leena Pradhan-Nabzdyk
In an effort to inhibit the response to vascular injury that leads to intimal hyperplasia, this study investigated the in vivo efficacy of intraluminal delivery of thrombospondin-2 (TSP-2) small interfering RNA (siRNA). Common carotid artery (CCA) balloon angioplasty injury was performed in rats. Immediately after denudation, CCA was transfected intraluminally (15 min) with one of the following: polyethylenimine (PEI)+TSP-2 siRNA, saline, PEI only, or PEI+control siRNA. CCA was analyzed at 24 h or 21 d by using quantitative real-time PCR and immunohistochemistry...
September 26, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Heather C Yun, Clinton K Murray, Kenneth J Nelson, Michael J Bosse
Trauma to the extremities is disproportionately represented in casualties of recent conflicts, accounting for >50% of injuries sustained during operations in Iraq and Afghanistan. Infectious complications have been reported in >25% of those evacuated for trauma, and 50% of such patients were treated in the intensive care unit (ICU). Osteomyelitis has been reported in 9% (14% of intensive care unit patients), and deep-wound infection in 27% of type III open-tibia fractures. Infections complicating extremity trauma are frequently caused by multidrug-resistant bacteria and have been demonstrated to lead to failure of limb salvage, unplanned operative take-backs, late amputations, and decreased likelihood of returning to duty...
October 2016: Journal of Orthopaedic Trauma
James B Haddow, Maria Walshe, Dinesh Aggarwal, Ankur Thapar, John Hardman, Jonathan Wilson, Ayo Oshowo, Chetan Bhan, Hasan Mukhtar
We aimed to improve the lead-time and the patient experience of the diagnostic stage of the suspected colorectal cancer pathway. This project worked within the constraints of limited resources and an austere environment. The core team included a project manager trained in quality improvement methodologies. Senior and Fleming's planned change model was used as the overall framework. Baseline data supported the case for change and highlighted targets for improvement. A stakeholder workshop employed social movement theory, lean thinking, experience-based design and patient stories to engage influential leaders and secure support and commitment...
September 2016: Healthcare
Nicole Powell-Dunford, Jose F Quesada, Kirby R Gross, Stacy A Shackelford
BACKGROUND: Identify challenges and best practices in the development of an austere air ambulance transfusion program. METHODS: A search of PubMed using combinations of the key terms 'prehospital,' 'blood product,' 'red blood cells,' 'damage control resuscitation,' 'transfusion,' 'air ambulance,' 'medical evacuation,' and 'medevac' yielded 196 articles for further analysis, with 14 articles suitable for addressing the background of prehospital transfusion within a helicopter...
August 2016: Aerospace Medicine and Human Performance
Daniel Heller, Alex Heller, Samir Moujaes, Shelley J Williams, Ryan Hoffmann, Paul Sarkisian, Kaveh Khalili, Uwe Rockenfeller, Timothy D Browder, Deborah A Kuhls, John J Fildes
A battery-operated active cooling/heating device was developed to maintain thermoregulation of trauma victims in austere environments while awaiting evacuation to a hospital for further treatment. The use of a thermal manikin was adopted for this study in order to simulate load testing and evaluate the performance of this novel portable active cooling/heating device for both continuous (external power source) and battery power. The performance of the portable body temperature conditioner (PBTC) was evaluated through cooling/heating fraction tests to analyze the heat transfer between a thermal manikin and circulating water blanket to show consistent performance while operating under battery power...
September 2016: Biomedical Instrumentation & Technology
Brent Wolfrom, Geoff Hodgetts, Jyoti Kotecha, Emily Pollock, Mary Martin, Han Han, Pierre Morissette
OBJECTIVE: To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. DESIGN: A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. SETTING: Canada. PARTICIPANTS: General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters...
September 2016: Canadian Family Physician Médecin de Famille Canadien
Cara J Krulewitch
No abstract text is available yet for this article.
September 2016: Military Medicine
Lucas A Johnson, Timothy P Ballard, Mindy Kania
BACKGROUND: Transfusion of freshly collected blood products (FCBP) is sometimes necessary to save service member (SM) lives in austere deployed environments. Recipients of FCBPs are administratively tracked and offered serial serologic testing via the Armed Services Blood Program "Blood Look Back" (BLB) program to assure early detection of post-transfusion infections. OBJECTIVES: This study evaluates demographic and clinical features influencing SM completion of recommended BLB laboratory follow-up after transfusion with FCBPs...
September 2016: Military Medicine
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