A Clinical and Ethical Investigation of Pre-medical and Medical Students' Attitudes, Knowledge, and Understanding of HIV.
HIV; Psychosocial; Ethics; Medical education
Ninety-five students participated in a qualitative study examining pre-medical and firstyear medical students' knowledge, understanding, and attitudes surrounding HIV. Participants were given a questionnaire to assess general knowledge and to assess students' ability to identify and discern psychosocial and ethical dilemmas using 2 case studies about fictionalized HIV patients and the issues they face in disclosing their diagnosis of HIV and adhering to prescribed treatment regimens. A content analysis was used to examine the students' responses for themes. Results suggested that most students have a general understanding of HIV. Many students, however, are unable to identify and differentiate psychosocial factors from ethical factors when presented with HIV case studies. Answers reflecting students' attitudes of HIV varied and contained identifiable biases and prejudices, such as placing blame on individuals who acquire the disease through "risky" behaviors. Pedagogical strategies for improving HIV education and developing students' professional and moral growth as future healthcare providers are identified.
Aultman Julie M; Borges Nicole J
Medical education online
2006
2006-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3402/meo.v11i.4596" target="_blank" rel="noreferrer noopener">10.3402/meo.v11i.4596</a>
A foreigner in my own country: forgetting the heterogeneity of our national community.
*Bioethics; *Poverty; *Social Welfare; Awareness; Empirical Research; Employment; Humans; Information Dissemination; Rural Health Services/*ethics; United States
Aultman Julie M
The American journal of bioethics : AJOB
2006
2006-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/15265160500506787" target="_blank" rel="noreferrer noopener">10.1080/15265160500506787</a>
A foreigner in my own country: forgetting the heterogeneity of our national community.
Ohio; United States; Ethics; Rural Areas; Medical; Research by Discipline; Rural Health Services – Ethical Issues
Aultman JM
American Journal of Bioethics
2006
2006-04-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/15265160500506787" target="_blank" rel="noreferrer noopener">10.1080/15265160500506787</a>
A Laparoscopic Bipolar Cutting Forceps Can Assist In A Case Of Difficult Vaginal Hysterectomy
difficult; hysterectomy; limited; obese; Obstetrics & Gynecology; vagina
Fenton B W; Hutchings T; Flora R F; Fanning J
Journal of Minimally Invasive Gynecology
2006
2006-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.jmig.2006.04.01" target="_blank" rel="noreferrer noopener">10.1016/j.jmig.2006.04.01</a>
A Prospero-related homeodomain protein is a novel co-regulator of hepatocyte nuclear factor 4alpha that regulates the cholesterol 7alpha-hydroxylase gene.
*Gene Expression Regulation; Aged; Amino Acid Motifs; Bile Acids and Salts/metabolism; Cell Line; Cell Nucleus/metabolism; Cells; Cholesterol 7-alpha-Hydroxylase/*chemistry/*genetics; Cultured/metabolism; Enzymologic; Female; Genes; Genetic; Gluconeogenesis; Glutathione Transferase/metabolism; Hepatocyte Nuclear Factor 4/metabolism/*physiology; Hepatocytes/metabolism; Homeodomain Proteins/metabolism/*physiology; Humans; Immunoprecipitation; Liver/metabolism; Luciferases/metabolism; Male; Messenger/metabolism; Middle Aged; Phosphoenolpyruvate Carboxykinase (ATP)/metabolism; Plasmids/metabolism; Protein Structure; Reporter; Response Elements; Reverse Transcriptase Polymerase Chain Reaction; RNA; Small Interfering/metabolism; Tertiary; Time Factors; Transcription; Transcriptional Activation; Transfection; Tumor Suppressor Proteins; Two-Hybrid System Techniques
Prox1, an early specific marker for developing liver and pancreas in foregut endoderm has recently been shown to interact with alpha-fetoprotein transcription factor and repress cholesterol 7alpha-hydroxylase (CYP7A1) gene transcription. Using a yeast two-hybrid assay, we found that Prox1 strongly and specifically interacted with hepatocyte nuclear factor (HNF)4alpha, an important transactivator of the human CYP7A1 gene in bile acid synthesis and phosphoenolpyruvate carboxykinase (PEPCK) gene in gluconeogenesis. A real time PCR assay detected Prox1 mRNA expression in human primary hepatocytes and HepG2 cells. Reporter assay, GST pull-down, co-immunoprecipitation, and yeast two-hybrid assays identified a specific interaction between the N-terminal LXXLL motif of Prox1 and the activation function 2 domain of HNF4alpha. Prox1 strongly inhibited HNF4alpha and peroxisome proliferators-activated receptor gamma coactivator-1alpha co-activation of the CYP7A1 and PEPCK genes. Knock down of the endogenous Prox1 by small interfering RNA resulted in significant increase of CYP7A1 and PEPCK mRNA expression and the rate of bile acid synthesis in HepG2 cells. These results suggest that Prox1 is a novel co-regulator of HNF4alpha that may play a key role in the regulation of bile acid synthesis and gluconeogenesis in the liver.
Song Kwang-Hoon; Li Tiangang; Chiang John Y L
The Journal of biological chemistry
2006
2006-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1074/jbc.M513420200" target="_blank" rel="noreferrer noopener">10.1074/jbc.M513420200</a>
A retrospective comparison of anesthetic agents in electroconvulsive therapy
anesthetics; Behavioral Sciences; ect; electroconvulsive therapy; methohexital; propofol; Psychiatry; thiopental
A recent lack of availability of the anesthetic agent methohexital in the United States allowed for a naturalistic study of the efficacy and the adverse effects of alternatives. Methohexital, propofol, and thiopental were compared as anesthetic agents for electroconvulsive therapy in 95 patients treated during a 23-month period in a general public hospital. Missed seizures and arrhythmias were infrequently observed (< 4% for any agent). Methohexital was found significantly related to longer seizure durations in comparison with both other agents (P < 0.01). The use of propofol was associated with increased risk of missed seizure (8.9%) compared with methohexital (3.9%) and thiopental (3.2%). Propofol was also associated with higher doses of administered energy, with a statistically significant difference (P = 0.018) observed between propofol and thiopental. Although propofol required the greatest energy delivery, it was associated with the shortest seizure durations. Methohexital resulted in the longest seizure duration, and thiopental was associated with the least amount of energy delivery with an intermediate seizure length.
Swaim J C; Mansour M; Wydo S M; Moore J L
Journal of Ect
2006
2006-12
Journal Article
<a href="http://doi.org/10.1097/01.yct.0000244238.17791.a4" target="_blank" rel="noreferrer noopener">10.1097/01.yct.0000244238.17791.a4</a>
A sexual history-taking curriculum for second year medical students.
*Medical History Taking; *Sexual Behavior; Clinical Competence; Curriculum/*standards; Education; Education/standards; Educational Measurement; Humans; Medical; Students; Undergraduate/*standards
The purpose of this study is to describe the evaluation of a sexual history-taking curriculum and correlates of student performance during a Clinical Skills Assessment. Reading assignments, small group discussions, a Saturday Sex workshop and performance on a Clinical Skills Assessment were evaluated. Students most favorably rated the workshop and least favorably rated the reading assignments. Eighty-four percent of students asked at least one sexual history question on the Clinical Skills Assessment. We were unable to identify any independent predictors of sexual history-taking behavior.
Wagner Ellen; McCord Gary; Stockton LuAnne; Gilchrist Valerie J; Fedyna Dinah; Schroeder Lisa; Sheth Sandeep
Medical teacher
2006
2006-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/01421590500271274" target="_blank" rel="noreferrer noopener">10.1080/01421590500271274</a>
A sexual history-taking curriculum for second year medical students.
Female; Male; Curriculum; Educational Measurement; Students; Clinical Competence; Education; Human; Summated Rating Scaling; Medical; Patient History Taking; Attitude to Sexuality; Sexuality; Step-Wise Multiple Regression
The purpose of this study is to describe the evaluation of a sexual history-taking curriculum and correlates of student performance during a Clinical Skills Assessment. Reading assignments, small group discussions, a Saturday Sex workshop and performance on a Clinical Skills Assessment were evaluated. Students most favorably rated the workshop and least favorably rated the reading assignments. Eighty-four percent of students asked at least one sexual history question on the Clinical Skills Assessment. We were unable to identify any independent predictors of sexual history-taking behavior.
Wagner E; McCord G; Stockton L; Gilchrist V J; Fedyna D; Schroeder L; Sheth S
Medical teacher
2006
2006-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/01421590500271274" target="_blank" rel="noreferrer noopener">10.1080/01421590500271274</a>
Academic health centers and public health departments: partnership matters.
*Interinstitutional Relations; *Public Health Administration; Academic Medical Centers/*organization & administration; Community Medicine/*education; Education; Graduate; Health Care Surveys; Humans; Medical; Medical/*organization & administration; Preceptorship/*organization & administration; Public Health/*education; State Government
BACKGROUND: The Institute of Medicine has called for increased population-based training for healthcare professions students, and particularly medical students. For this to be effective, students should receive such training in the locations where population-based approaches to care take place, such as public health departments (HDs). However, little is known about currently existing relationships between academic health centers (AHCs) and HDs. METHODS: During the spring and summer of 2003, e-mail surveys on this topic were sent to the 104 members of the Association of Academic Health Centers, and 500 members of the National Association of City and County Health Officers and the Association of State and Territorial Health Officers. Results were received from 50 AHCs and 201 HDs. RESULTS: Survey results suggest that large numbers of healthcare professions students–residents, medical students, and others–are currently being trained in many HDs nationwide. The web of relationships between AHCs and HDs extends beyond education into research, service, and other purposes. CONCLUSIONS: These preliminary results require verification. Nevertheless, they raise questions about the types and quality of the education being offered in health departments, the impact of AHC/HD relationships on both parties, and how existing relationships may be enhanced to meet current and future national needs.
Boex James R; Keck C William; Piatt Elizabeth; Nunthirapikorn Thida Nita; Blacklow Robert S
American journal of preventive medicine
2006
2006-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.amepre.2005.08.044" target="_blank" rel="noreferrer noopener">10.1016/j.amepre.2005.08.044</a>
Accidental foot burns in children from contact with naturally heated surfaces during summer months: Experience from a regional burn center
abuse; environmental injury; foot burns; General & Internal Medicine; Surgery
Background: Foot burns in children often result from contact with heated surfaces due to high ambient temperatures during summer in the southwestern United States. The objective of this study was to describe the unique cause and clinical characteristics of this type of injury. Methods: A retrospective review of medical records of pediatric patients presenting with contact burns of the foot in Arizona Burn Center, which is the third largest burn center in the United States. Participants included children 5 years and under who were treated for pedal burns during a 5-year period between January 2000 and August 2005. Results: Seventy-four children with contact burns of the foot were treated of which 34 (46%) were from naturally heated surfaces. When compared with those who sustained pedal burns as a result of contact with other hot objects, children with burns from naturally heated surface more commonly had bilateral (82.4%), second degree (82.4%) burns involving primarily the plantar surface (94.1%) of the foot and the injury usually occurred in the peak of the summer. Also, physical abuse was more commonly suspected in this group. Conclusion: Contact with a hot surface during summer months is a dominant cause of foot burns in small children in the southwestern United States with characteristic clinical presentation and calls for preventive educational interventions.
Sinha M; Salness R; Foster K N; Fenn R; Hannasch C
Journal of Trauma-Injury Infection and Critical Care
2006
2006-10
Journal Article
<a href="http://doi.org/10.1097/01.ta.0000229810.36074.36" target="_blank" rel="noreferrer noopener">10.1097/01.ta.0000229810.36074.36</a>
Accuracy of the single item screening question for restless legs syndrome within a community hospital sleep center
Neurosciences & Neurology
Shapiro H; Baughman K R; Bourguet C C
Sleep
2006
2006
Journal Article
n/a
Accuracy of theory for the breathing oscillation of a complex plasma disc
2-dimensional clusters; dusty plasma; mode; Physics; sheath
A complex plasma disc (CPD) is a stable two-dimensional arrangement of it particles, each with mass in and charge q, confined by a parabolic well and interacting through a shielded Coulomb force (i.e. a Yukawa potential). It is shown that the breathing frequency of a CPD is accurately predicted by an analytical theory in which it is assumed that the breathing mode corresponds to a uniform expansion and contraction of the disc. Predictions of the theory are compared with exact eigenmode computations for n = 2-100 particles with Debye shielding parameters K = 0.1-10. The breathing frequency is predicted exactly for n <= 8 particles due to symmetry. For n > 8 particles, the error in the square of the breathing frequency is always less than 0.4% and increases approximately linearly with K. The utility of this theory for analysing experimental data is illustrated by finding the average particle charge and Debye length for a disc with n = 40 particles.
Sheridan T E
Journal of Physics D-Applied Physics
2006
2006-02
Journal Article
<a href="http://doi.org/10.1088/0022-3727/39/4/015" target="_blank" rel="noreferrer noopener">10.1088/0022-3727/39/4/015</a>
Administrative retreats: a new twist to avoid "administrative isolation".
Humans; Education; Schools; *Interpersonal Relations; *Administrative Personnel; Pharmacy/*organization & administration
Allen David D; Calhoun Larry D
American journal of pharmaceutical education
2006
2006-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.5688/aj7006147" target="_blank" rel="noreferrer noopener">10.5688/aj7006147</a>
Aging matters: strategies for optimal care of the elderly. Which came first? Restless leg syndrome or insomnia?
Adult; Female; Male; Aged; Middle Age; Adolescence; Insomnia; Restless Legs; Restless Legs – Epidemiology
Murphy DP; Graef B
Consultant (00107069)
2006
2006-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Altered mental status in older emergency department patients.
Aged; Emergency Service; Hospital/*statistics & numerical data; Humans; Incidence; Mental Disorders/diagnosis/*epidemiology; Mental Status Schedule; United States/epidemiology
This article reviews the significance of altered mental status in older emergency department patients. Specific diagnoses are discussed, including delirium, stupor and coma, and dementia, with a focus on delirium. Finally, an approach to all older patients is suggested that should result in increased clinician comfort with older patients, improved ability to communicate with other physicians, increased quality of care, and improved patient and family satisfaction.
Wilber Scott T
Emergency medicine clinics of North America
2006
2006-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.emc.2006.01.011" target="_blank" rel="noreferrer noopener">10.1016/j.emc.2006.01.011</a>
Altered mental status in older emergency department patients.
Aged; United States; Psychological Tests; Emergency Service – Trends – United States; Mental Disorders – Diagnosis; Mental Disorders – Epidemiology – United States
This article reviews the significance of altered mental status in older emergency department patients. Specific diagnoses are discussed, including delirium, stupor and coma, and dementia, with a focus on delirium. Finally, an approach to all older patients is suggested that should result in increased clinician comfort with older patients, improved ability to communicate with other physicians, increased quality of care, and improved patient and family satisfaction. Copyright © 2006 by Elsevier Inc.
Wilber S T
Emergency medicine clinics of North America
2006
2006-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.emc.2006.01.011" target="_blank" rel="noreferrer noopener">10.1016/j.emc.2006.01.011</a>
Alveolar epithelial ion and fluid transport: recent progress.
Animals; Biological Transport; Body Fluids/*metabolism; Epithelium/*metabolism; Humans; Lung/cytology/*metabolism/pathology; Pulmonary Alveoli/*cytology; Sodium Channels/metabolism
Folkesson Hans G; Matthay Michael A
American journal of respiratory cell and molecular biology
2006
2006-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1165/rcmb.2006-0080SF" target="_blank" rel="noreferrer noopener">10.1165/rcmb.2006-0080SF</a>
An aneurysmal bone cyst in the cervical spine of a 10-year-old girl: A case report
Orthopedics; Neurosciences & Neurology; tumors; pathogenesis; laminectomy; decompression; aneurysmal bone cyst; posterior instrumented fusion; postlaminectomy kyphosis; surgical excision
Study Design. An aneurysmal bone cyst in the neural arch of the fourth cervical vertebra of a 10-year-old girl is reported, along with a brief review of the literature on the topic. Objective. To report the presentation and diagnosis of this disorder along with a discussion of the major pitfalls of treatment. Summary of Background Data. An aneurysmal bone cyst occurs commonly in the second decade, with a predilection for the lumbar spine. With occurrence in the neural arch of a cervical vertebra, the potential for instability following surgical excision is high. Methods. A 10-year-old white female presented with neck pain of 3 months' duration. Diagnostic imaging revealed an expansile lytic lesion in the spinous process and lamina of the fourth cervical vertebra. Surgical treatment consisted of excisional biopsy and a segmental instrumented posterior fusion from C3 - C5. The histopathology was consistent with an aneurysmal bone cyst. Results. Surgical excision consisting of laminectomy and instrumented segmental fusion provided a good clinical result, and minimized the risk and degree of the 2 most common complications: recurrence of the tumor; and postlaminectomy kyphosis, a frequent occurrence in the pediatric population. Conclusions. In pediatric patients who develop a bone tumor of the posterior elements of the cervical spine, careful clinical and radiologic evaluation is necessary to narrow the differential diagnosis. In most cases, a complete excision should be performed if possible. The risk of postlaminectomy kyphosis is high in the pediatric age population. As such, a fusion should be considered whenever a laminectomy is performed in the immature cervical spine. Risk factors for kyphosis include a high cervical level, multiple laminectomy levels, and postoperative irradiation.
Beiner J M; Sastry A; Berchuck M; Grauer J N; Kwon B K; Ratliff J K; Stock G H; Brown A K; Vaccaro A R
Spine
2006
2006-06
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1097/01.brs.0000222126.91514.cb" target="_blank" rel="noreferrer noopener">10.1097/01.brs.0000222126.91514.cb</a>
Analytical modeling of laser pulse heating of embedded biological targets: An application to cutaneous vascular lesions
therapy; medicine; tissue; vessels; duration; exposure; Physics; distributions; port-wine stains; thermal relaxation; time constants
Detailed understanding of the thermal processes in biological targets undergoing laser irradiation continues to be a challenging problem. For example, the contemporary pulsed dye laser (PDL) delivers a complex pulse format which presents specific challenges for theoretical understanding and further development. Numerical methods allow for adequate description of the thermal processes, but are lacking for clarifying the effects of the laser parameters. The purpose of this work is to derive a simplified analytical model that can guide the development of future laser designs. A mathematical model of heating and cooling processes in tissue is developed. Exact analytical solutions of the model are found when applied to specific temporal and spatial profiles of heat sources. Solutions are reduced to simple algebraic expressions. An algorithm is presented for approximating realistic cases of laser heating of skin structures by heat sources of the type found to have exact solutions. The simple algebraic expressions are used to provide insight into realistic laser irradiation cases. The model is compared with experiments on purpura threshold radiant exposure for PDL. These include data from four independent groups over a period of 20 years. Two of the data sets are taken from previously published articles. Two more data sets were collected from two groups of patients that were treated with two PDLs (585 and 595 nm) on normal buttocks skin. Laser pulse durations were varied between 0.5 and 40 ms; radiant exposures were varied between 3 and 20 J/cm(2). Treatment sites were evaluated 0.5, 1, and 24 hours later to determine purpuric threshold. The analytical model is in excellent agreement with a wide range of experimental data for purpura threshold radiant exposure. The data collected by independent research groups over the last 20 years with PDLs with wavelengths ranged from 577 to 595 nm were described accurately by this model. The simple analytical model provides an accurate description of a wide range of experimental data. The model can be used to guide the development of future laser designs and help refine laser parameters.
Mirkov M; Sherr E A; Sierra R A; Lloyd J R; Tanghetti E
Journal of Applied Physics
2006
2006-06
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1063/1.2200592" target="_blank" rel="noreferrer noopener">10.1063/1.2200592</a>
Anatomical and functional specializations of the anterior temporalis muscle of baboons as revealed by fiber type, fiber architecture, and EMG
Biochemistry & Molecular Biology; Physiology; Zoology
Wall C; Briggs M; Schachat F; Hylander W; Vinyard C; Williams S
Comparative Biochemistry and Physiology a-Molecular & Integrative Physiology
2006
2006-04
Journal Article
n/a
Angiotensin II-induced cardiac fibroblast proliferation and ERK 1/2 activation is mediated by PKC zeta
Biochemistry & Molecular Biology; Cell Biology; Life Sciences & Biomedicine - Other; Topics
Olson E R; Naugle J E; Meszaros J G
Faseb Journal
2006
2006-03
Journal Article
n/a
Auditory responses in the cochlear nucleus of awake mustached bats: precursors to spectral integration in the auditory midbrain.
Acoustic Stimulation/methods; Action Potentials/*physiology; Animals; Auditory; Brain Mapping; Brain Stem/*physiology; Chiroptera/*physiology; Cochlear Nucleus/*physiology; Evoked Potentials; Mesencephalon/physiology; Nerve Net/*physiology; Pitch Perception/*physiology; Wakefulness/physiology
In the cochlear nucleus (CN) of awake mustached bats, single- and two-tone stimuli were used to examine how responses in major CN subdivisions contribute to spectrotemporal integrative features in the inferior colliculus (IC). Across CN subdivisions, the proportional representation of frequencies differed. A striking result was the substantial number of units tuned to frequencies \textless23 kHz. Across frequency bands, temporal response patterns, latency, and spontaneous discharge differed. For example, the 23- to 30-kHz representation, which comprises the fundamental of the sonar call, had an unusually high proportion of units with onset responses (39%) and low spontaneous rates (53%). Units tuned to 58-59 kHz, corresponding to the sharply tuned cochlear resonance, had slightly but significantly longer latencies than other bands. In units tuned to frequencies \textgreater30 kHz, 31% displayed a secondary excitatory peak, usually between 10 and 22 kHz. The secondary peak may originate in cochlear mechanisms for some units, but in others it may result from convergent input onto CN neurons. In 20% of units tested with two-tone stimuli, suppression of best frequency (BF) responses was tuned at least an octave below BF. These properties may underlie similar IC responses. However, other forms of spectral interaction present in IC were absent in CN: we found no facilitatory combination-sensitive interactions and very few combination-sensitive inhibitory interactions of the dominant IC type in which inhibition was tuned to 23-30 kHz. Such interactions arise above CN. Distinct forms of spectral integration thus originate at different levels of the ascending auditory pathway.
Marsh Robert A; Nataraj Kiran; Gans Donald; Portfors Christine V; Wenstrup Jeffrey J
Journal of neurophysiology
2006
2006-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1152/jn.00634.2005" target="_blank" rel="noreferrer noopener">10.1152/jn.00634.2005</a>
BAG-1 modulates endoplasmic reticulum stress in chondrocytes
Biochemistry & Molecular Biology; Cell Biology
Yang L; Carlson S G; McBurney D; Horton W E
Matrix Biology
2006
2006-11
Journal Article
<a href="http://doi.org/10.1016/j.matbio.2006.08.195" target="_blank" rel="noreferrer noopener">10.1016/j.matbio.2006.08.195</a>
Bejel: Acquirable only in childhood?
bejel; crusades; origin; Parasitology; periosteal reaction; skeletal remains; syphilis; treponemal disease; treponematoses; Tropical Medicine; yaws
Bejel clearly has a long history in the Middle East and the Sudan, but was it transmitted to Europe? As the major manifestation of bejel is presence of periosteal reaction in 20-40% of afflicted populations, absence of significant population frequency of periosteal reaction in Europe would exclude that diagnosis. Examination of skeletal populations from continental Europe revealed no significant periosteal reaction at the time of and immediately subsequent to the Crusades. Thus, there is no evidence for bejel in Europe, in spite of clear contact (the mechanism of bejel transmission in children) between warring groups, at least during the Crusades. This supports the hypothesis that bejel is a childhood-acquired disease and apparently cannot be contracted in adulthood. (c) 2006 Elsevier B.V. All rights reserved.
Rothschild B M; Rothschild C; Naples V; Billard M; Panero B
Acta Tropica
2006
2006-10
Journal Article
<a href="http://doi.org/10.1016/j.actatropica.2006.07.012" target="_blank" rel="noreferrer noopener">10.1016/j.actatropica.2006.07.012</a>
Bile acids and cytokines inhibit the human cholesterol 7 alpha-hydroxylase gene via the JNK/c-jun pathway in human liver cells.
Bile Acids and Salts/*metabolism; Cells; Chenodeoxycholic Acid/pharmacology; Cholesterol 7-alpha-Hydroxylase/*genetics/metabolism; Cultured; Cytokines/*metabolism; Gene Expression Regulation; Genetic; Hepatocytes/*cytology/drug effects; Humans; Immunoblotting; In Vitro Techniques; Interleukin-1/pharmacology; Messenger/analysis; Probability; Proto-Oncogene Proteins c-jun/*metabolism; Reverse Transcriptase Polymerase Chain Reaction; RNA; Sensitivity and Specificity; Signal Transduction/genetics; Transcription
Cholesterol 7 alpha-hydroxylase (CYP7A1) of the bile acid biosynthesis pathway is suppressed by bile acids and inflammatory cytokines. Bile acids are known to induce inflammatory cytokines to activate the mitogen-activated protein kinase/c-Jun N-terminal kinase (JNK) signaling pathway that inhibits CYP7A1 gene transcription. c-Jun has been postulated to mediate bile acid inhibition of CYP7A1. However, the c-Jun target involved in the regulation of CYP7A1 is unknown. Human primary hepatocytes and HepG2 cells were used as models to study chenodeoxycholic acid (CDCA) and interleukin-1 beta (IL-1 beta) regulation of human CYP7A1 gene expression via real-time polymerase chain reaction, reporter assays, co-immunoprecipitation and chromatin immunocipitation (ChIP) assays. IL-1 beta and CDCA reduced CYP7A1 but induced c-Jun messenger RNA expression in human primary hepatocytes. IL-1beta inhibited human CYP7A1 reporter activity via the HNF4 alpha binding site. A JNK-specific inhibitor blocked the inhibitory effect of IL-1 beta on HNF4 alpha expression and CYP7A1 reporter activity. c-Jun inhibited HNF4 alpha and PPARgamma coactivator-1 alpha (PGC-1 alpha) coactivation of CYP7A1 reporter activity, whereas a dominant negative c-Jun did not. Co-immunoprecipitation and ChIP assays revealed that IL-1 beta and CDCA reduced HNF4 alpha bound to the CYP7A1 chromatin, and that c-Jun interacted with HNF4 alpha and blocked HNF4 alpha recruitment of PGC-1 alpha to the CYP7A1 chromatin. In conclusion, IL-1 beta and CDCA inhibit HNF4 alpha but induce c-Jun, which in turn blocks HNF 4 alpha recruitment of PGC-1 alpha to the CYP7A1 chromatin and results in inhibition of CYP7A1 gene transcription. The JNK/c-Jun signaling pathway inhibits bile acid synthesis and protects hepatocytes against the toxic effect of inflammatory agents.
Li Tiangang; Jahan Asmeen; Chiang John Y L
Hepatology (Baltimore, Md.)
2006
2006-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/hep.21183" target="_blank" rel="noreferrer noopener">10.1002/hep.21183</a>
Body Weight And Composition Changes In Ovarian Cancer Patients During Adjuvant Chemotherapy
body composition; breast cancer; chemotherapy; gain; Obstetrics & Gynecology; Oncology; ovarian cancer; weight; women
Gil K M; Frasure H E; Hopkins M P; Jenison E L; Von Gruenigen V E
Gynecologic Oncology
2006
2006-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.ygyno.2006.03.005" target="_blank" rel="noreferrer noopener">10.1016/j.ygyno.2006.03.005</a>
Bone manifestations of actinomycosis.
Actinomycosis/complications/*pathology; Bone Diseases; Diagnosis; Differential; Humans; Infectious/microbiology/*pathology; Multiple Myeloma/diagnosis; Mycoses/diagnosis; Tibia/microbiology/pathology
Actinomycosis, originally classified as a fungus, is now considered a branching bacteria. Although jaw involvement often presents with classic pathognomonic signs, postcranial disease has not been so characterized. Affected bones from individuals diagnosed in life with actinomycosis were macroscopically and radiologically examined for their macroscopic character. The bones were riddled with spheroid, occasionally coalescing defects associated with periosteal reaction. Erosion penetrated cortical bone as readily as through cortical bone or subchondral bone. X-ray revealed circular lesions with a slight sclerotic margin. Actinomycosis apparently has unique features, which should allow it to be distinguished from multiple myeloma (because of presence of reactive new bone formation) and from fungal disease (because of lack of "fronts of resorption" and penetrating spicules). Similarity to fungal infection is especially of interest because of the earlier phylogenetic classification question.
Rothschild Bruce; Naples Virginia; Barbian Lenore
Annals of diagnostic pathology
2006
2006-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.anndiagpath.2005.09.017" target="_blank" rel="noreferrer noopener">10.1016/j.anndiagpath.2005.09.017</a>
Cancer risk assessment: Examining the family physician's role
colonoscopy; colorectal-cancer; General & Internal Medicine; history; individuals; knowledge; ovarian-cancer; racial-differences; screening practices; surveillance; susceptibility
Background: Cancer risk assessment begins in the primary care clinician's office. Essential components of that process include: 1) documentation of personal and family cancer information; 2) identification of families at increased risk for cancer; 3) modification of cancer screening recommendations according to degree of risk; 4) referral of high-risk individuals to cancer genetics clinics. The purpose of this study was to examine these 4 components of primary care cancer risk assessment using data abstracted from patient records at an academic family medicine center. Methods: Ambulatory records of 734 patients were reviewed in their entirety for information relevant to cancer risk assessment. Detail of cancer information was categorized as comprehensive, adequate, or inadequate. Patient records were categorized as suggestive of average, moderate, or high genetic risk for cancer. For patients with a family history of colorectal cancer, modification of colon cancer screening to reflect degree of cancer risk was assessed. Finally, the frequency of cancer genetic referral in high-risk individuals was noted. Results: The presence or absence of a family history of cancer was documented in 97.8% of records. There was insufficient information to adequately assess risk in 69.5% of charts. Detail of family cancer documentation was associated with personal history of cancer ( P =.001), patient age ( P =.001), and physician training status ( P =.042), but not with patient or physician gender, duration of care, or completion of a genogram. For persons with a family history of colorectal cancer, compliance with cancer screening individualized to degree of risk was achieved in 50% of patients. Ten patients met criteria for moderate or high genetic risk for cancer. None had been offered cancer genetics consultation. Conclusions: Nearly all records documented the presence or absence of a family history of cancer. However, in those with a positive family history, the detail of information was insufficient to permit risk assessment in over two thirds of individuals; risk-stratified colon cancer screening was not achieved in half of the patients with a family history of colorectal cancer; individuals at moderate or high cancer risk were not identified as such; and those at high risk were not offered cancer genetics referral. In addition to collecting adequate family cancer information, family physicians need to adopt explicit risk assessment criteria to identify, and to optimally care for, those at increased genetic risk for cancer.
Tyler C V; Snyder C W
Journal of the American Board of Family Medicine
2006
2006-09
Journal Article
<a href="http://doi.org/10.3122/jabfm.19.5.468" target="_blank" rel="noreferrer noopener">10.3122/jabfm.19.5.468</a>
Case in point: an intriguing diagnosis. Woman with cough and dyspnea.
Female; Middle Age; Lung Diseases; Pneumonia – Etiology; Mineral Oil – Adverse Effects; Obstructive – Complications
Berreiro TJ; Pietropaoli A
Consultant (00107069)
2006
2006-04-15
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Cells in auditory cortex that project to the cochlear nucleus in guinea pigs.
Animals; Auditory Cortex/*cytology; Cochlear Nucleus/*cytology; Fluorescent Dyes; Guinea Pigs; Pyramidal Cells/*cytology
Fluorescent retrograde tracers were used to identify the cells in auditory cortex that project directly to the cochlear nucleus (CN). Following injection of a tracer into the CN, cells were labeled bilaterally in primary auditory cortex and the dorsocaudal auditory field as well as several surrounding fields. On both sides, the cells were limited to layer V. The size of labeled cell bodies varied considerably, suggesting that different cell types may project to the CN. Cells ranging from small to medium in size were present bilaterally, whereas the largest cells were labeled only ipsilaterally. In optimal cases, the extent of dendritic labeling was sufficient to identify the morphologic class. Many cells had an apical dendrite that could be traced to a terminal tuft in layer I. Such "tufted" pyramidal cells were identified both ipsilateral and contralateral to the injected CN. The results suggest that the direct pathway from auditory cortex to the cochlear nucleus is substantial and is likely to play a role in modulating the way the cochlear nucleus processes acoustic stimuli.
Schofield Brett R; Coomes Diana L; Schofield Ryan M
Journal of the Association for Research in Otolaryngology : JARO
2006
2006-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10162-005-0025-4" target="_blank" rel="noreferrer noopener">10.1007/s10162-005-0025-4</a>
Cellular, molecular, and matrix changes in cartilage during aging and osteoarthritis.
Humans; Animals; Cell Proliferation; Biomechanical Phenomena; Homeostasis/physiology; Aging/*pathology/physiology; Bone Matrix/*pathology/physiopathology; Cartilage/*pathology/physiology; Chondrocytes/pathology/physiology; Endoplasmic Reticulum/pathology/physiology; Osteoarthritis/*pathology/physiopathology
Horton W E Jr; Bennion P; Yang L
Journal of musculoskeletal & neuronal interactions
2006
2006-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Characteristics of emergency medicine program directors.
Adult; Career Mobility; Emergency Medicine/education/*organization & administration; Female; Health Care Surveys; Humans; Job Satisfaction; Male; Physician Executives/classification/*statistics & numerical data; United States; Workforce
OBJECTIVES: To characterize emergency medicine (EM) program directors (PDs) and compare the data, where possible, with those from other related published studies. METHODS: An online survey was e-mailed in 2002 to all EM PDs of programs that were approved by the Accreditation Council of Graduate Medical Education. The survey included questions concerning demographics, work hours, support staff, potential problems and solutions, salary and expenses, and satisfaction. RESULTS: One hundred nine of 124 (88%) PDs (69.7% university, 27.5% community, and 2.8% military) completed the survey; 85.3% were male. Mean age was 43.6 years (95% confidence interval [CI] = 42.6 to 44.7 yr). The mean time as a PD was 5.7 years (95% CI = 4.9 to 6.5 yr), with 56% serving five years or less. The mean time expected to remain as PD is an additional 6.0 years (95% CI = 5.2 to 6.8). A 1995 study noted that 50% of EM PDs had been in the position for less than three years, and 68% anticipated continuing in their position for less than five years. On a scale of 1 to 10 (with 10 as highest), the mean satisfaction with the position of PD was 8.0 (95% CI = 7.2 to 8.3). Those PDs who stated that the previous PD had mentored them planned to stay a mean of 2.0 years longer than did those who were not mentored (95% CI of difference of means = 0.53 to 3.53). Sixty-five percent of PDs had served previously as an associate PD. Most PDs (92%) have an associate or assistant PD, with 54% reporting one; 25%, two; and 9%, three associate or assistant PDs. A 1995 study noted that 62% had an associate PD. Ninety-two percent have a program coordinator, and 35% stated that they have both a residency secretary and a program coordinator. Program directors worked a median of 195 hours per month: clinical, 75 hours; scholarly activity, 20 hours; administrative, 80 hours; and teaching and residency conferences, 20 hours; compared with a median total hours of 220 previously reported. Lack of adequate time to do the job required, career needs interfering with family needs, and lack of adequate faculty help with residency matters were identified as the most important problems (means of 3.5 [95% CI = 3.2 to 3.7], 3.4 [95% CI = 3.2 to 3.6], and 3.1 [95% CI = 2.9 to 3.3], respectively, on a scale of 1 to 5, with 5 as maximum). This study identified multiple resources that were found to be useful by \textgreater50% of PDs, including national meetings, lectures, advice from others, and self-study. CONCLUSIONS: Emergency medicine PDs generally are very satisfied with the position of PD, perhaps because of increased support and resources. Although PD turnover remains an issue, PDs intend to remain in the position for a longer period of time than noted before this study. This may reflect the overall satisfaction with the position as well as the increased resources and support now available to the PD. PDs have greater satisfaction if they have been mentored for the position.
Beeson Michael S; Gerson Lowell W; Weigand John V; Jwayyed Sharhabeel; Kuhn Gloria J
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
2006
2006-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1197/j.aem.2005.08.010" target="_blank" rel="noreferrer noopener">10.1197/j.aem.2005.08.010</a>
Chronic mucocutaneous candidiasis associated with malignant thymoma and systemic lupus erythematosus with hypergammaglobulinemia: a case report and literature review.
Adult; Humans; Male; Antifungal Agents/therapeutic use; Itraconazole/therapeutic use; Ketoconazole/therapeutic use; Hypergammaglobulinemia/*complications; Thymoma/*complications; Thymus Neoplasms/*complications; Candidiasis; Lupus Erythematosus; Chronic Mucocutaneous/*complications/drug therapy; Systemic/*complications
Chronic mucocutaneous candidiasis (CMC) is characterized by recurrent candidal infections of the mucous membranes, nails, and skin. Systemic involvement is rare. CMC in adults with coexistent thymoma, benign or malignant, is well-known and is often associated with hypogammaglobulinemia. There is an unusually high frequency of thymoma and systemic lupus erythematosus (SLE). I present a case of a patient with a history of malignant thymoma, SLE, and hypergammaglobulinemia who was found to have CMC. Discussion of the relationship of these findings is presented.
San Filippo James
Cutis
2006
2006-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Clinical implications and treatment of multiresistant Streptococcus pneumoniae pneumonia.
Anti-Infective Agents/*therapeutic use; Bacterial; Community-Acquired Infections/*drug therapy/economics/*microbiology; Drug Resistance; Fluoroquinolones/*therapeutic use; Humans; Ketolides/therapeutic use; Multiple; Pneumococcal/*drug therapy/economics/*microbiology; Pneumonia; Streptococcus pneumoniae/*growth & development
Streptococcus pneumoniae is the leading bacterial cause of community-acquired respiratory tract infections. Prior to the 1970s this pathogen was uniformly susceptible to penicillin and most other antimicrobials. However, since the 1990s there has been a significant increase in drug-resistant Streptococcus pneumoniae (DRSP) due, in large part, to increased use of antimicrobials. The clinical significance of this resistance is not definitely established, but appears to be most relevant to specific MICs for specific antimicrobials. Certain beta-lactams (amoxicillin, cefotaxime, ceftriaxone), the respiratory fluoroquinolones, and telithromycin are among several agents that remain effective against DRSP. Continued surveillance studies, appropriate antimicrobial usage campaigns, stratification of patients based on known risk factors for resistance, and vaccination programmes are needed to appropriately manage DRSP and limit its spread.
File T M Jr
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
2006
2006-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/j.1469-0691.2006.01395.x" target="_blank" rel="noreferrer noopener">10.1111/j.1469-0691.2006.01395.x</a>
Clinical outcomes associated with conversion from epoetin alfa to darbepoetin alfa in hospitalized hemodialysis patients
anemia; anemia darbepoetin alfa; dialysis; disease; dose conversion; epoetin alfa; Health; hemodialysis; hospital; left-ventricular hypertrophy; mortality; patients; recombinant-human-erythropoietin; Urology & Nephrology
Background/Aims: Hemodialysis patients are often hospitalized, during which time they require continuity of care in the inpatient setting. The goal of the present study was to evaluate the clinical outcomes associated with a conversion algorithm from outpatient epoetin alfa to inpatient darbepoetin alfa in hospitalized hemodialysis patients at the St. Elizabeth Health Center. Methods: We conducted a retrospective chart review of hemodialysis patient hospital admissions after a therapeutic interchange from epoetin alfa to darbepoetin alfa was implemented at St. Elizabeth Health Center. Chronic hemodialysis patients admitted from December 2002 to October 2003 were identified as part of a therapeutic interchange cohort receiving inpatient darbepoetin alfa after conversion from outpatient epoetin alfa according to the Aranesp((R)) package insert during their hospitalization. After discharge, these patients were returned to their preadmission outpatient epoetin alfa dosages and frequencies. Patients admitted prior to implementation of the therapeutic interchange (January 2002 to April 2002) received epoetin alfa during hospitalization and served as a historical control. Hemoglobin values were recorded prior to hospital admission, at the time of discharge, and 30 days after discharge. Results: Mean hemoglobin levels declined from preadmission to discharge, in both the interchange and historical cohorts (6.6 and 2.5%, respectively) and rebounded at 30 days after discharge. Using a linear regression model, the only variables significantly associated with the hemoglobin level at discharge were the hemoglobin level before admission and receipt of a blood transfusion. Conclusion: An algorithm-based conversion from outpatient epoetin alfa to inpatient darbepoetin alfa for hospitalized chronic hemodialysis patients utilizing the dose conversion table specified in the Aranesp((R)) package insert is associated with hemoglobin outcomes similar to inpatient epoetin alfa. Copyright (c) 2006 S. Karger AG, Basel.
Sarac E; Chikyarappa A; Sabol B; Gemmel D; Globe D; Barlev A; Audhya P
American Journal of Nephrology
2006
2006
Journal Article
<a href="http://doi.org/10.1159/000098027" target="_blank" rel="noreferrer noopener">10.1159/000098027</a>
Collagen As A Scaffold For Biomimetic Mineralization Of Vertebrate Tissues
3 dimensions; bone; Chemistry; elastic energy-storage; electron-microscopic tomography; fibril structure; i collagen; Materials Science; matrix; mechanical-properties; molecular packing; organic; turkey tendons
Collagen is a well known protein component that has the capacity to mineralize in a variety of vertebrate tissues. In its mineralized form, collagen potentially can be utilized as a biomimetic material for a variety of applications, including, for example, the augmentation and repair of damaged, congenitally defective, diseased or otherwise impaired calcified tissues such as bone and cartilage. In order to effect an optimal response in this regard, the manner in which collagen becomes mineralized is critically important to understand. This paper provides details concerning collagen-mineral interaction and its implications with respect to designing biomimetic mineralizing collagen that will be functionally competent in its biological, chemical, and biomechanical properties.
Landis W J; Silver F H; Freeman J W
Journal of Materials Chemistry
2006
2006
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1039/b505706j" target="_blank" rel="noreferrer noopener">10.1039/b505706j</a>
Comparative development of mammalian and alligator metapodial growth plate formation
Developmental Biology
Reno P L; Lovejoy C O; Elsey R M; Horton W E
Developmental Biology
2006
2006-07
Journal Article
<a href="http://doi.org/10.1016/j.ydbio.2006.04.276" target="_blank" rel="noreferrer noopener">10.1016/j.ydbio.2006.04.276</a>
Comparing millennial and generation X medical students at one medical school.
*Personality; Adolescent; Adult; Cohort Effect; Female; Humans; Male; Medical/*classification/psychology/statistics & numerical data; Multivariate Analysis; Ohio; Students; Surveys and Questionnaires
PURPOSE: Two main generational cohorts comprising students enrolled in medical schools today are Generation Xers (born 1965-1980) and Millennial students (born
Borges Nicole J; Manuel R Stephen; Elam Carol L; Jones Bonnie J
Academic medicine : journal of the Association of American Medical Colleges
2006
2006-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/01.ACM.0000225222.38078.47" target="_blank" rel="noreferrer noopener">10.1097/01.ACM.0000225222.38078.47</a>
Comparison Of Different Chondrocytes For Use In Tissue Engineering Of Cartilage Model Structures
articular-cartilage; auricular cartilage; Cell Biology; construct; growth; in-vitro; regeneration; scaffold; shape; stem-cells; vivo
This study compares bovine chondrocytes harvested from four different animal locations-nasoseptal, articular, costal, and auricular-for tissue-engineered cartilage modeling. While the work serves as a preliminary investigation for fabricating a human ear model, the results are important to tissue-engineered cartilage in general. Chondrocytes were cultured and examined to determine relative cell proliferation rates, type II collagen and aggrecan gene expression, and extracellular matrix production. Respective chondrocytes were then seeded onto biodegradable poly(L-lactide-epsilon-caprolactone) disc-shaped scaffolds. Cell-copolymer constructs were cultured and subsequently implanted in the subcutaneous space of athymic mice for up to 20 weeks. Neocartilage development in harvested constructs was assessed by molecular and histological means. Cell culture followed over periods of up to 4 weeks showed chondrocyte proliferation from the tissue sources varied, as did levels of type II collagen and aggrecan gene expression. For both genes, highest expression was found for costal chondrocytes, followed by nasoseptal, articular, and auricular cells. Retrieval of 20-week discs from mice revealed changes in construct dimensions with different chondrocytes. Greatest disc diameter was found for scaffolds seeded with auricular chondrocytes, followed by those with costal, nasoseptal, and articular cells. Greatest disc thickness was measured for scaffolds containing costal chondrocytes, followed by those with nasoseptal, auricular, and articular cells. Retrieved copolymer alone was smallest in diameter and thickness. Only auricular scaffolds developed elastic fibers after 20 weeks of implantation. Type II collagen and aggrecan were detected with differing expression levels on quantitative RT-PCR of discs implanted for 20 weeks. These data demonstrate that bovine chondrocytes obtained from different cartilaginous sites in an animal may elicit distinct responses during their respective development of a tissue-engineered neocartilage. Thus, each chondrocyte type establishes or maintains its particular developmental characteristics, and this observation is critical in the design and elaboration of any tissue-engineered cartilage model.
Isogai N; Kusuhara H; Ikada Y; Ohtani H; Jacquet R; Hillyer J; Lowder E; Landis W J
Tissue Engineering
2006
2006-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1089/ten.2006.12.691" target="_blank" rel="noreferrer noopener">10.1089/ten.2006.12.691</a>
Complications of an expandable hip nail: Implant and instrumentation failure - A report of two cases
fixation; intertrochanteric femoral fractures; Orthopedics; screw; Surgery
Nossa-Berrera J; Ziran B H; Smith W
Journal of Bone and Joint Surgery-American Volume
2006
2006-07
Journal Article
<a href="http://doi.org/10.2106/jbjs.e.00451" target="_blank" rel="noreferrer noopener">10.2106/jbjs.e.00451</a>