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https://www.readbyqxmd.com/read/28930942/surgical-residents-interpretation-of-diagnostic-radiologic-imaging-in-the-traumatically-injured-patient
#1
Elias Fakhoury, Daria Abolghasemi, Justin McKinney, Alena Naumova, Scott Wessner, Osama Elsawy, Jamshed Zuberi, Robert V Madlinger
BACKGROUND: Senior surgical residents are of paramount importance in directing further therapeutic modalities based on their interpretation of critical diagnostic imaging. We propose that senior surgical residents are proficient with interpreting radiologic imaging studies in the trauma patient. METHODS: A prospective cohort study was performed comparing surgery resident interpretations of computerized tomography (CT) scans of the head, maxillofacial bones, spine (cervical, thoracic, lumbar), chest, abdomen, pelvis, and chest X-rays versus final radiologists' reports at a level II trauma center from September 2014 to May 2015...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930765/encouraging-reflexivity-in-a-residency-leadership-development-program-expanding-outside-the-competency-approach
#2
Justin T Clapp, Emily K B Gordon, Dimitry J Baranov, Beulah Trey, Felice Y Tilin, Lee A Fleisher
PROBLEM: While leadership development is increasingly a goal of academic medicine, it is typically framed as competency acquisition, which can limit its focus to a circumscribed set of social behaviors. This orientation may also reinforce the cultural characteristics of academic medicine that can make effective leadership difficult, rather than training leaders capable of examining and changing this culture. Expanding leadership development so it promotes social reflexivity presents a way to bolster some of the weaknesses of the competency paradigm...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28930762/competency-based-medical-education-in-the-internal-medicine-clerkship-a-report-from-the-alliance-for-academic-internal-medicine-undergraduate-medical-education-task-force
#3
Sara B Fazio, Cynthia H Ledford, Paul B Aronowitz, Shobhina G Chheda, John H Choe, Stephanie A Call, Scott D Gitlin, Marty Muntz, L James Nixon, Anne G Pereira, John W Ragsdale, Emily A Stewart, Karen E Hauer
As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28930612/genetic-addiction-risk-score-gars-%C3%A2-a-predictor-of-vulnerability-to-opioid-dependence
#4
Kenneth Blum, Amanda L C Chen, Panayotis K Thanos, Marcelo Febo, Zsolt Demetrovics, Kristina Dushaj, Abraham Kovoor, David Baron, David E Smith, Alphonso Kenison Roy Iii, Lyle Fried, Thomas J H Chen, Edwin Chapman, Edward Modestino, Bruce Steinberg, Rajendra D Badgaiyan
The interaction of neurotransmitters and genes that control the release of dopamine is the Brain Reward Cascade (BRC). Variations within the BRC, whether genetic or epigenetic, may predispose individuals to addictive behaviors and altered pain tolerance. This discussion authored by a group of concerned scientists and clinicians examines the Genetic Addiction Risk Score (GARS), the first test to accurately predict vulnerability to pain, addiction, and other compulsive behaviors, defined as Reward Deficiency Syndrome (RDS)...
January 1, 2018: Frontiers in Bioscience (Elite Edition)
https://www.readbyqxmd.com/read/28929862/the-accuracy-of-the-computed-tomography-diagnosis-of-acute-appendicitis-does-the-experience-of-the-radiologist-matter
#5
E Lietzén, P Salminen, I Rinta-Kiikka, H Paajanen, T Rautio, P Nordström, M Aarnio, T Rantanen, J Sand, J-P Mecklin, A Jartti, J Virtanen, P Ohtonen, N Ånäs, J M Grönroos
BACKGROUND AND AIMS: To assess the accuracy of computed tomography in diagnosing acute appendicitis with a special reference to radiologist experience. MATERIAL AND METHODS: Data were collected prospectively in our randomized controlled trial comparing surgery and antibiotic treatment for uncomplicated acute appendicitis (APPAC trial, NCT01022567). We evaluated 1065 patients who underwent computed tomography for suspected appendicitis. The on-call radiologist preoperatively analyzed these computed tomography images...
September 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28929785/relationship-of-hemodialysis-shift-with-sleep-quality-and-depression-in-hemodialysis-patients
#6
Masomeh Norozi Firoz, Vida Shafipour, Hedayat Jafari, Seyed Hamzeh Hosseini, Jamshid Yazdani-Charati
This descriptive correlational study was aimed at determining the relationship of hemodialysis shift with sleep quality and depression in 310 hemodialysis patients. Demographic and Clinical Questionnaires, the Pittsburgh sleep quality index, and Beck's Depression Inventory were used to ascertain the aforementioned relationship. Among the patients, 59.6% reported poor sleep quality and 44.8% reported experiencing depression. Results show that these conditions were significantly related to many factors. Although dialysis shift was not significantly related to sleep quality and depression, sleep quality was found significantly associated with age, female gender, illiteracy, unemployment, residence in rural areas, diabetes, addiction to sedatives, and phosphorus levels...
September 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28928898/lower-education-and-household-income-contribute-to-advanced-disease-less-treatment-received-and-poorer-prognosis-in-patients-with-hepatocellular-carcinoma
#7
Yuan Shen, Hui Guo, Tao Wu, Qiang Lu, Ke-Jun Nan, Yi Lv, Xu-Feng Zhang
Understanding the ways in which socioeconomic status affects prognosis of hepatocellular carcinoma (HCC) is important for building up strategies eliminating the inequalities in cancer diagnosis and treatments among different groups, which, remains undetermined. In the present study, 1485 newly diagnosed HCC patients with complete demographic and clinical data were included. Socioeconomic data, including education, annual household income and residency was also reported by patients or families. In the present study, less educated patients were older, more female involved, poorly paid, more living in rural places, had more advanced tumor burden, received less curative and loco-regional therapies, and thus showed poorer short-term and long-term outcomes (in total or after surgical resection) than the highly educated...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28928740/microbiome-derived-lipopolysaccharide-enriched-in-the-perinuclear-region-of-alzheimer-s-disease-brain
#8
Yuhai Zhao, Lin Cong, Vivian Jaber, Walter J Lukiw
Abundant clinical, epidemiological, imaging, genetic, molecular, and pathophysiological data together indicate that there occur an unusual inflammatory reaction and a disruption of the innate-immune signaling system in Alzheimer's disease (AD) brain. Despite many years of intense study, the origin and molecular mechanics of these AD-relevant pathogenic signals are still not well understood. Here, we provide evidence that an intensely pro-inflammatory bacterial lipopolysaccharide (LPS), part of a complex mixture of pro-inflammatory neurotoxins arising from abundant Gram-negative bacilli of the human gastrointestinal (GI) tract, are abundant in AD-affected brain neocortex and hippocampus...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28928631/glaucoma-biological-trabecular-and-neuroretinal-pathology-with-perspectives-of-therapy-innovation-and-preventive-diagnosis
#9
REVIEW
Raffaele Nuzzi, Federico Tridico
Glaucoma is a common degenerative disease affecting retinal ganglion cells (RGC) and optic nerve axons, with progressive and chronic course. It is one of the most important reasons of social blindness in industrialized countries. Glaucoma can lead to the development of irreversible visual field loss, if not treated. Diagnosis may be difficult due to lack of symptoms in early stages of disease. In many cases, when patients arrive at clinical evaluation, a severe neuronal damage may have already occurred. In recent years, newer perspective in glaucoma treatment have emerged...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28928179/comparison-of-anthropometric-indices-for-predicting-the-risk-of-metabolic-syndrome-and-its-components-in-chinese-adults-a-prospective-longitudinal-study
#10
Haoyu Wang, Aihua Liu, Tong Zhao, Xun Gong, Tianxiao Pang, Yingying Zhou, Yue Xiao, Yumeng Yan, Chenling Fan, Weiping Teng, Yaxin Lai, Zhongyan Shan
OBJECTIVES: Our study aimed to distinguish the ability of anthropometric indices to assess the risk of metabolic syndrome (MetS). DESIGN: Prospective cohort study. SETTING: Shenyang, China. PARTICIPANTS: A total of 379 residents aged between 40 and 65 were enrolled. 253 of them were free of MetS and had been followed up for 4.5 years. METHODS: At baseline, all the participants underwent a thorough medical examination...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28927448/barriers-and-facilitators-to-implementing-addiction-medicine-fellowships-a-qualitative-study-with-fellows-medical-students-residents-and-preceptors
#11
J Klimas, W Small, K Ahamad, W Cullen, A Mead, L Rieb, E Wood, R McNeil
BACKGROUND: Although progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has impeded addiction treatment and care. Recently, a number of training initiatives have emerged internationally, including the addiction medicine fellowships in Vancouver, Canada. This study was undertaken to examine barriers and facilitators of implementing addiction medicine fellowships...
September 20, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28927416/tumor-related-interleukins-old-validated-targets-for-new-anti-cancer-drug-development
#12
REVIEW
Sarra Setrerrahmane, Hanmei Xu
In-depth knowledge of cancer molecular and cellular mechanisms have revealed a strong regulation of cancer development and progression by the inflammation which orchestrates the tumor microenvironment. Immune cells, residents or recruited, in the inflammation milieu can have rather contrasting effects during cancer development. Accumulated clinical and experimental data support the notion that acute inflammation could exert an immunoprotective effect leading to tumor eradication. However, chronic immune response promotes tumor growth and invasion...
September 19, 2017: Molecular Cancer
https://www.readbyqxmd.com/read/28927372/potentially-inappropriate-medication-use-in-nursing-homes-an-observational-study-using-the-norgep-nh-criteria
#13
Gunhild Nyborg, Mette Brekke, Jørund Straand, Svein Gjelstad, Maria Romøren
BACKGROUND: Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors. METHODS: Cross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway...
September 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28927229/creation-and-evaluation-of-a-laboratory-administration-curriculum-for-pathology-residents
#14
Jeannette Guarner, Charles E Hill, Timothy Amukele
Objectives: A clinical laboratory management (CLM) curriculum that can objectively assess the Accreditation Council for Graduate Medical Education pathology systems-based practice milestones and can provide consistent resident training across institutions is needed. Methods: Faculty at Emory University created a curriculum that consists of assay verification exercises and interactive, case-based online modules. Beta testing was done at Emory University and Johns Hopkins...
September 11, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28926874/-multicenter-epidemiological-investigation-of-hospitalized-elderly-young-and-middle-aged-patients-with-severe-burn
#15
Y Tang, L X Wang, W G Xie, Z A Shen, G H Guo, J J Chen, C M Han, L C Ren, Z G Chu, M F Yin, Y Wang, D X Zhang, Y S Huang, J P Zhang
Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926579/cervical-screening-with-primary-hpv-testing-or-cytology-in-a-population-of-women-in-which-those-aged-33-years-or-younger-had-previously-been-offered-hpv-vaccination-results-of-the-compass-pilot-randomised-trial
#16
Karen Canfell, Michael Caruana, Val Gebski, Jessica Darlington-Brown, Stella Heley, Julia Brotherton, Dorota Gertig, Chloe J Jennett, Annabelle Farnsworth, Jeffrey Tan, C David Wrede, Philip E Castle, Marion Saville
BACKGROUND: Using primary human papillomavirus (HPV) testing for cervical screening increases detection of high-grade cervical intraepithelial neoplastic lesions and invasive cancer (cervical intraepithelial neoplasia grade 2+ [CIN2+]) compared to cytology, but no evaluation has been conducted in a population previously offered HPV vaccination. We aimed to assess colposcopy referral and CIN2+ detection rates for HPV-screened versus cytology-screened women in Australia's HPV-vaccinated population (by 2014, resident women ≤33 years had been age-eligible for HPV vaccination, with 3-dose uptake across age cohorts being about 50%-77%)...
September 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28926390/misconceptions-misuses-and-misinterpretations-of-p-values-and-significance-testing
#17
Joel J Gagnier, Hal Morgenstern
The interpretation and reporting of p values and significance testing in biomedical research are fraught with misconceptions and inaccuracies. Publications of peer-reviewed research in orthopaedics are not immune to such problems. The American Statistical Association (ASA) recently published an official statement on the use, misuse, and misinterpretation of statistical testing and p values in applied research. The ASA statement discussed 6 principles: (1) "P-values can indicate how incompatible the data are with a specified statistical model...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28926151/hospital-in-the-home-nurses-recognition-and-response-to-clinical-deterioration
#18
Erika Gray, Judy Currey, Julie Considine
AIMS AND OBJECTIVES: To obtain an understanding of how HITH (Hospital in the Home) nurses recognise and respond to clinical deterioration in patients receiving care at home or in their usual place of residence. BACKGROUND: Recognising and responding to clinical deterioration is an international safety priority and a key nursing responsibility. Despite an increase in care delivery in home environments, how HITH nurses recognise and respond to clinical deterioration is not yet fully understood...
September 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28925925/entrustable-professional-activities-for-residency-training-in-physical-medicine-and-rehabilitation
#19
Michael Mallow, Heather Baer, Alex Moroz, Vu Q C Nguyen
Entrustable professional activities are observable units of professional practice that can potentially provide a link between competency-based medical education and clinical practice. The authors, part of a subcommittee of the Association of Academic Physiatrists Education Committee, identified a set of entrustable professional activities that would serve residency training programs in the specialty of physical medicine and rehabilitation. Using a modified Delphi process, residency program directors in the field reviewed and validated a set of entrustable professional activities...
October 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28925794/developments-in-the-formulation-and-delivery-of-spray-dried-vaccines
#20
Gaurav Kanojia, Rimko Ten Have, Peter C Soema, Henderik Frijlink, Jean-Pierre Amorij, Gideon Kersten
Spray drying is a promising method for the stabilization of vaccines, which are usually formulated as liquids. Usually, vaccine stability is improved by spray drying in the presence of a range of excipients. Unlike freeze drying, there is no freezing step involved, thus the damage related to this step is avoided. The edge of spray drying resides in its ability for particles to be engineered to desired requirements, which can be used in various vaccine delivery methods and routes. Although several spray dried vaccines have shown encouraging preclinical results, the number of vaccines that have been tested in clinical trials is limited, indicating a relatively new area of vaccine stabilization and delivery...
September 19, 2017: Human Vaccines & Immunotherapeutics
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