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1.
Charlotte Baker Jill Powell Dominic Le Melissa S. Creary Lori-Ann Daley Mary Anne McDonald Charmaine DM. Royal 《Journal of the National Medical Association》2018,110(6):564-573
Objective
To describe the perspectives and experiences of athletic trainers, coaches, and student-athletes approximately three years post-implementation of the NCAA sickle cell trait (SCT) screening policy.Participants
Two-hundred and eight student-athletes, 32 athletic trainers, and 43 coaches from 10 NCAA Division I (DI) institutions in North Carolina from January to June 2014.Methods
Two online surveys were used to assess knowledge, perspectives, and experiences.Results
Athletic staff were more supportive than student-athletes of the need for the policy. Noted challenges included variation in implementation and follow-up for SCT-positive athletes, financial costs to institutions and athletes, and timing of the screening.Conclusions
More education about SCT is needed for student-athletes and athletic staff in order to help make the implementation more successful. All parties need to be in agreement regarding the importance of knowing which student-athletes have SCT and how that information will be utilized. 相似文献2.
Patrick M. Brunner Donald Y.M. Leung Emma Guttman-Yassky 《Annals of allergy, asthma & immunology》2018,120(1):34-41
Objective
To provide an overview of studies contributing to the understanding of immunologic, microbial, and epithelial interactions in atopic dermatitis.Data Sources
PubMed literature review (2000–2017) and meeting abstracts from recent international dermatology conferences.Study Selections
Articles discussing primarily human disease.Results
Clinical studies showed that atopic dermatitis is a type 2 immune-centered disease with a systemic inflammatory component but with heterogeneous treatment responses. This suggests that other factors are likely involved in shaping the skin disease phenotype, including microbial dysbiosis and epidermal barrier dysfunction.Conclusion
Recent clinical investigation has significantly expanded our knowledge on disease pathogenesis in atopic dermatitis, and current and future clinical trials will most likely further help to elucidate this complex, heterogeneous skin disease. 相似文献3.
Charles P. Mouton Janet H. Southerland 《Journal of the National Medical Association》2017,109(4):262-271
Background
As with many other populations, abuse of older adults is a growing problem across the Africa Diaspora. Modernization and urbanization are eroding the traditional values of respect for older adults. Also, older adults living in environments with limited social and economic resources, and having no means of economic support create a recipe for elder abuse and neglect.Methods
This article reviews the current literature on the epidemiology, risk factors, and interventions used for elder abuse across the African Diaspora.Results
Reports of elder abuse range from 24.9% to 81.1% across the Diaspora. Risk factors include cognitive and physical impairment, social isolation, lack of resources and widowhood.Conclusion
Community-based programs using the unique social networks of older populations of African descent can provide a venue to improve caregiver training and support, reinforce traditional filial and informal caregiving practices, increase the utilization of available governmental and institutional. 相似文献4.
Kenneth D. Royal 《Journal of the National Medical Association》2018,110(2):157-162
Background
Social and cultural outcomes are critically important in medical education. A large medical school located in the United States implemented a learning community model intended to promote social and cultural growth among its medical students. The purpose of this study was to evaluate the degree to which medical students from the same peer cohort were socially connected across racial and sex groups.Methods
Because most assessments involving social and cultural outcomes involve self-reported data of a personal nature, the possibility of social desirability bias is increased. To mitigate this threat, this study utilized a novel method for measuring medical students social connectedness by having peers in one's advisory college provide social connectedness ratings about one another.Results
While surface level results did not reveal any significant differences, a closer inspection of data revealed Black females were less socially connected with medical student peers from their cohort than other peer groups.Discussion
Possible explanations for this are discussed. Future research should continue to investigate the experiences of Black females in medical schools so as to better understand the needs of this important and valuable subpopulation of students. 相似文献5.
Steven S. Coughlin Lovoria B. Williams Gina M. Besenyi Lorraine W. Jackson Judith Anglin 《Journal of the National Medical Association》2018,110(4):391-395
Background
Few studies have examined health behavior interventions for African American women who are uterine cancer survivors. Black-white differences in uterine cancer survival suggest that there are unmet needs among these survivors.Methods
This article identifies opportunities to address disparities in uterine corpus cancer survival and quality of life, and thereby to increase uterine cancer survivorship among African American women.Results
For cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, lymphedema, and difficulty sleeping. A variety of interventions have been evaluated to address physical and mental health concerns, including exercise and dietary interventions. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among cancer survivors, but few studies have focused specifically on African American women with a uterine corpus cancer diagnosis. Research-tested culturally tailored lifestyle interventions are lacking.Conclusions
There is a need for a better understanding of uterine cancer survivorship among African American women. Additional evaluations of interventions for improving the quality of life and survival of African American uterine cancer survivors are needed. 相似文献6.
Kamal Shigli Sushma S. Nayak Sivaranjani Gali Banashree Sankeshwari Deepti Fulari K. Shyam Kishore Nagaraja Upadhya P. Vasanti Jirge 《Journal of the National Medical Association》2018,110(5):455-458
Background
Construction of appropriate test items is a challenge in preparing quality multiple choice questions. Item analysis provides valuable feedback data on validity of multiple choice questions. The present study was conducted to evaluate the difficulty index, discrimination index and distracter efficiency of the items present in the multiple choice questions of post graduate dental entrance examinations.Methods
A list consisting of 20 MCQs was taken from the entrance exam books of MCQs on an introductory topic and administered to 104 undergraduate students.Results
In the present study 15% of the MCQs related to impression making procedure were difficult with difficulty index (p) less than 30%, 15% were poor discriminators and 55% had at least one non-functional distracter.Conclusion
Item analysis of MCQs in post graduate entrance examinations demonstrated low difficulty index, discrimination index and distracter efficiency. Hence, we propose a strong need for faculty training in test constructors and their post validation. 相似文献7.
Xin Hu Qian Zhang Jia Ning Wenmeng Wu Changyi Li 《Journal of the National Medical Association》2018,110(3):250-255
Introduction
The purpose of this study was to evaluate the two-body wear resistances of natural enamel and four dental materials in vitro.Methods
The testing machine was modified to form a type of pin-on-disk wear test apparatus. Four dental material specimens (Au-Pd alloy, Ag-Pd alloy, FiltekTMP60 and FiltekTMZ350 composite resins) and enamel were used as the pins, and a steatite ceramic grinding wheel was used as the abrasive counter face. The wear volume loss and the rigidity value was measured. The worn surface and the element analysis of the debris were analyzed.Result
The wear volume loss of Au-Pd alloy and its steatite antagonists were the nearest to those of the dental enamel. SEM microphotographs showed that, the main wear mechanism of the dental materials was abrasive and adhesive wear.Conclusions
Au-Pd alloy had good wear resistance and was more suitable for dental applications than other three dental materials. 相似文献8.
Oh Samuel Jacqueise M. Unonu Kierra Dotson Soon Park Richard Parker Anthony K. Wutoh Euni Lee 《Journal of the National Medical Association》2018,110(4):378-383
Background
Human immunodeficiency virus (HIV) infection presents a significant burden, especially in the Washington, DC area. Literature is limited in describing the role of pharmacists in the outpatient clinic setting to provide patient-centered pharmaceutical care for patients with HIV.Objective
Our study aims to describe an interdisciplinary HIV care model including a clinical pharmacist at a community-based transcultural clinic in the Washington, DC area, and to describe the role of the pharmacist as indicated by an association between non-adherence to antiretroviral therapy (ART) and an ART regimen change.Methods
Using the electronic health record at the clinic from May 2011 through July 2013, 53 patients were identified who were referred to the clinical pharmacist.Results
The average age of the patients with HIV was 46.57 years in the clinic. About 28% of patients had documented non-adherence to ART and 30% of patients had one or more ART regimen changes during the study period. Medication non-adherence was a significant predictor of ART regimen change (ORadj 8.44; 95% CI 1.91–37.29). Substance use was a strong predictor of ART regimen change (ORunadj 3.47; 95% CI 1.02–11.81), but the relationship disappeared in the multivariate analysis.Conclusions
A strong association between pharmacist's evaluation of non-adherence to ART and a regimen change was demonstrated and the role of the pharmacist as the interdisciplinary team member was described. A follow-up study should be made to assess the services provided by the pharmacist on clinical, economic, and humanistic outcomes in the community-based clinical setting. 相似文献9.
Tohru Daikoku Mineyuki Mizuguchi Takayuki Obita Takeshi Yokoyama Yoshihiro Yoshida Masaya Takemoto Kimiyasu Shiraki 《Journal of microbiology, immunology, and infection》2018,51(5):581-586
Background
T-705 (favipiravir) is a potent inhibitor of RNA-dependent RNA polymerases of influenza viruses and no favipiravir-resistant virus has been isolated. Poliovirus RNA polymerase has been well characterized and isolation of resistant virus was examined in poliovirus.Methods
Susceptibility variants of poliovirus I (Sabin strain) were isolated during passages in the presence of favipiravir and characterized for their susceptibility and the sequence of RNA polymerase.Results
Five variants with 0.47–1.88 times the 50% inhibitory concentration for plaque formation of the parent poliovirus had amino acid variations in the 3D gene of the RNA polymerase. The distribution of amino acid variations was not related to ribavirin resistance, and two amino acid variation sites were found near the finger domain.Conclusion
Favipiravir as a chain terminator would not be incorporated and replicate to cause lethal mutagenesis as a mutagen like ribavirin, and resistant mutants were not isolated. A high replication level would generate mutations leading to favipiravir resistance as ribavirin resistance was generated, but generated mutations would be lethal to the RNA polymerase function. 相似文献10.
11.
Dong Ho Huh Seung Beom Han Hye Jo Shin Dong Ho Ahn Gi Sub Choi Kyu Ri Kang Bo Ram Kim Jin Han Kang 《Journal of microbiology, immunology, and infection》2018,51(6):732-739
Background/Purpose
Although assessing the immunogenicity and protective efficacy of acellular pertussis (aP) vaccines via murine model studies faces limitations, preliminary assessments have been achieved by evaluating respiratory challenge and humoral and cellular immunity.Methods
We performed a long-term intranasal respiratory challenge with reference and clinically isolated strains of Bordetella pertussis. Simultaneously, we assessed humoral and cellular immunity for evaluating the immunogenicity of a newly developed tri-component diphtheria-tetanus-aP (DTaP) vaccine. Moreover, comparative assessment was made by performing the same evaluations with a commercially available tri-component DTaP vaccine as the positive control.Results
Both groups showed significantly increased levels of antibodies against pertussis toxin, filamentous hemagglutinin and pertactin, and the levels of interferon-γ and interleukin-10 were significantly increased after two doses of vaccination. Furthermore, since cross cell-mediated immune reactivity between the two vaccines was detected, the possibility of interchangeability was indirectly suggested. Although the positive control group showed significantly higher titers in antibody responses for filamentous hemagglutinin and pertactin compared to the experimental group, anti-pertussis toxin antibody titers of the two groups were not significantly different and the protective efficacy against the clinical and reference strains was maintained in both groups for 18 weeks.Conclusion
The results showed inferior immunogenicity of the new DTaP vaccine compared to a commercial vaccine despite comparable cellular immunity and protective efficacy. Some efforts are necessary for improving immunogenicity against filamentous hemagglutinin and pertactin before conducting human clinical trials. 相似文献12.
Faith A. Birnbaum 《Journal of the National Medical Association》2018,110(5):473-479
Purpose
The purpose of this review is to describe the demographics (age, gender, race and iris color) of subjects enrolled in clinical trials supportive of approved New Molecular Entities (NMEs) in ophthalmology over the last 10 years (2006–2016).Methods
Publicly available data on Drugs@FDA were reviewed for all 9 approved NMEs, including biologics, from 2006 to 2016.Results
All NMEs have publicly available data on the race, gender and age of clinical trial participants. Women and white subjects comprise a majority of clinical trial participants (68% and 92%, respectively). FDA analyses on all 9 NMEs did not find any differences across age, gender, race, or iris color subgroups. 相似文献13.
Valerie R. Newsome Collins O. Airhihenbuwa Shedra Amy Snipes 《Journal of the National Medical Association》2018,110(3):219-230
Background
African-Americans have the greatest gender-ratio imbalance compared to other racial groups in the United States. This has been associated with higher rates of concurrent sexual partnerships, increasing risk of HIV infection. College-educated African-American women are of particular interest as they are not often represented in studies on HIV prevention, while their dating and sexual negotiation patterns may differ from those of their lower-educated and lower-income counterparts more often the subject of study in HIV research among African-Americans.Method
In this qualitative study, we investigate: a) how the gender-ratio imbalance is perceived by college-educated African-American women, b) how they feel limited partner availability impacts heterosexual relationships in the African-American community, and c) the influence this has on their sexual decision making and HIV protective behaviors.Results
Four major themes emerged- Limited pool of available male partners, Pressure to get married, Feelings of competition among women for male partners, and Men's negotiating power in relationships.Conclusions
Using the PEN-3 Cultural Model, we discuss how this information may be used to develop interventions for this group of women designed to address their more specific barriers to HIV risk reduction. 相似文献14.
Chih-Wei Hung Wei-Che Lin Wen-Neng Chang Tsung-Ming Su Chia-Te Kung Nai-Wen Tsai Hung-Chen Wang Chih-Cheng Huang Ben-Chung Cheng Yu-Jih Su Ya-Ting Chang Chih-Min Su Sheng-Yuan Hsiao Cheng-Hsien Lu 《Journal of microbiology, immunology, and infection》2018,51(4):545-551
Purpose
Shunt procedures used to treat cryptococcal meningitis complicated with hydrocephalus and/or increased intracranial pressure (IICP) could result in cerebrospinal fluid (CSF) overdrainage, thereby presenting therapeutic challenges.Methods
We analyzed the clinical features and neuroimaging findings after the ventriculoperitoneal (VP) shunt procedure in 51 HIV (Human Immunodeficiency Virus)-negative patients with cryptococcal meningitis, to assess the risk factors associated with post-shunt CSF overdrainage.Results
Symptomatic CSF overdrainage occurred in 12% (6/51) of patients with cryptococcal meningitis who underwent the shunt procedure. Rapid deterioration of neurological conditions was found in 6 patients after the shunt procedure was performed, including disturbed consciousness, quadriparesis, and dysphasia in 5 patients and severe ataxia in 1. The mean duration of CSF overdrainage after the shunting procedure was 2–7 days (mean 4 days). The mean interval between meningitis onset to shunting procedure remained independently associated with CSF overdrainage, and the cut-off value for predicting CSF overdrainage in interval between meningitis onset to shunting procedure was 67.5 days.Conclusions
CSF overdrainage after the VP shunt procedure is not rare, especially in patients with a high-risk of cryptococcal meningitis who also have a prolonged duration of hydrocephalus and/or IICP. 相似文献15.
Ilgim Seval Kurt Erden Erol Unluer Togay Evrin Burak Katipoglu Utku Eser 《Journal of the National Medical Association》2018,110(6):579-582
Introduction
Community acquired pneumonia (CAP) is responsible for an important part of treatment costs across the world. Even though posterior-anterior lung radiography (PALG) and direct sputum smear microscopy are required or routine diagnoses. The purpose of this study is to determine the diagnostic value of the bedside urine strip tests in CAP.Methods
Patients who attended the emergency department (ED) between from February 2016 to September 2016 with expectoration complaints and suspicion of pneumonia. The sensitivity, specificity, and accuracy rate of the urine strip tests, direct sputum smear microscopy, and PALG were calculated and analyzed using SPSS 15.0.Results
During the study period, 100 patients with pneumonia suspicion were evaluated in the ED. The sample was divided into two groups: negative and positive diagnosis of CAP. The leukocytes detecting by urine strip tests are statistical differences between the two groups (p: 0.003). The results show that the sensitivity, specificity, and accuracy rate of leukocytes detected in sputum with urine strip tests in the pneumonia diagnosis were 83.3%, 44.2% and 63% respectively.Conclusion
According to the study, it is believed that the method of determination of leukocytes with urine strip tests in sputum combined with more detailed results. They can become part of CAP diagnosis methods. 相似文献16.
17.
Background
Skin prick tests (SPTs) and measurements of serum specific immunoglobulin E (sIgE) antibodies are the most commonly used diagnostic tools for confirming sensitization. However, disagreement between the tests has been observed.Objective
To compare SPT and the CAP system for diagnosis of sensitization to common inhalant allergens.Methods
Subjects included 2,635 patients 10 to 90 years old who underwent analyses by SPT and CAP at the Dong-A University Hospital (Busan, Korea) from June 2011 through May 2016. The 2 test results were compared for 17 inhalant allergens.Results
Agreement between the SPT and sIgE level was 75.3%. Overall agreement was moderate (κ = 0.59), with strong agreement for house dust mites and birch (κ > 0.7) and weak agreement for Tyrophagus putrescentiae and dog (κ < 0.3). When CAP was compared with SPT as the reference, the sensitivity was 75.8% and the specificity was 75.2%. Mean wheal size by SPT showed a positive correlation with sIgE levels (r = 0.59), which decreased with age.Conclusion
There was a discrepancy between SPT and CAP for diagnosing allergic sensitization among inhalant allergens. The allergic sensitization and correlation between the tests decreased with age. Cautious interpretation of the clinical relevance of allergen sensitization based on SPT and CAP results is required, especially in older patients. 相似文献18.
Gianenrico Senna Marco Caminati Clara Bovo Giorgio Walter Canonica Giovanni Passalacqua 《Annals of allergy, asthma & immunology》2017,118(2):161-165
Objective
Pharmacists play a relevant role in the real-life management of asthma because they are a first-line referral for patients. In fact, the role of pharmacies has been underlined and evidenced also in guidelines. Nonetheless, the true effect of pharmacy-based management of asthma has been assessed in only a few studies. We review the available literature on asthma management in a territorial pharmacy setting.Data Sources
The literature was searched for the keywords pharmacy, bronchial asthma, control, and management.Study Selections
The available studies were subdivided into observational and interventional and described.Results
Seven observational studies and 14 interventional trials were found, involving approximately 20,000 individuals. Most of those studies were performed in Europe and Australia. A high proportion of patients had poorly controlled asthma in the observational studies. The active involvement of pharmacists, in the interventional trials, consistently led to an improvement of the quality of life, a better inhalation technique, and a reduction of exacerbations.Conclusion
The literature analysis confirms the relevance of the role of pharmacists in the real-life management of bronchial asthma and underlines the need for a more specific training for those health care professionals. 相似文献19.
Jung-Fu Lin Mao-Cheng Ge Tsui-Ping Liu Shih-Cheng Chang Jang-Jih Lu 《Journal of microbiology, immunology, and infection》2018,51(5):659-665
Background and purpose
Rapid identification of microbes in the bloodstream is crucial in managing septicemia because of its high disease severity, and direct identification from positive blood culture bottles through matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) can shorten the turnaround time. Therefore, we developed a simple method for rapid microbiological identification from positive blood cultures by using MALDI-TOF MS.Methods
We modified previously developed methods to propose a faster, simpler and more economical method, which includes centrifugation and hemolysis. Specifically, our method comprises two-stage centrifugation with gravitational acceleration (g) at 600g and 3000g, followed by the addition of a lysis buffer and another 3000g centrifugation.Results
In total, 324 monomicrobial bacterial cultures were identified. The success rate of species identification was 81.8%, which is comparable with other complex methods. The identification success rate was the highest for Gram-negative aerobes (85%), followed by Gram-positive aerobes (78.2%) and anaerobes (67%). The proposed method requires less than 10 min, costs less than US$0.2 per usage, and facilitates batch processing.Conclusion
We conclude that this method is feasible for clinical use in microbiology laboratories, and can serve as a reference for treatments or further complementary diagnostic testing. 相似文献20.
Birol Şafak Özgür Baykan Osman Kılınç Diğdem Özer Yıldırım 《Journal of the National Medical Association》2017,109(3):211-214