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Benjamin J. Lee Sheila K. Wang Chunkit So Brandon G. Chiu Wesley Y. Wang Radhika Polisetty Ana Qui?ones-Boex Hong Liu 《American journal of pharmaceutical education》2015,79(9)
Together with community advocates, professional student organizations can help improve access to health care and sustain services to address the health disparities of a community in need. This paper examines the health concerns of an underserved Chinese community and introduces a student-led health education initiative that fosters service learning and student leadership. The initiative was recognized by the American Association of Colleges of Pharmacy (AACP) and received the 2012-2013 Student Community Engaged Service Award. 相似文献
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Scott G. McLean Sarah M. Lucey Suzan Rohrer Catherine Brandon 《Clinical biomechanics (Bristol, Avon)》2010,25(8):781-788
BackgroundWith knee morphology being a non-modifiable anterior cruciate ligament injury risk factor, its consideration within injury prevention models is limited. Knee anatomy, however, directly influences joint mechanics and the potential for injurious loads. With this in mind, we explored associations between key knee anatomical and three-dimensional biomechanical parameters exhibited during landings. We hypothesized that lateral and medial posterior tibial slopes and their ratio, and tibial plateau width, intercondylar distance and their ratio, were proportional to peak stance anterior knee joint reaction force, knee abduction and internal rotation angles.MethodsTwenty recreationally active females (21.2 (1.7) years) had stance phase three-dimensional dominant limb knee biomechanics recorded during ten single leg land-and-cut tasks. Six anatomical indices were quantified for the same limb via a series of two dimensional (sagittal, transverse and coronal) magnetic resonance images. Linear stepwise regression analyses examined which of these anatomical factors were independently associated with each of the three mean subject-based peak knee biomechanical measures.FindingsLateral tibial slope was significantly (P < 0.0001) correlated with peak anterior knee joint reaction force, explaining 60.9% of the variance. Both tibial plateau width:intercondylar distance (P < 0.0001) and medial tibial slope:lateral tibial slope (P < 0.001) ratios were significantly correlated with peak knee abduction angle, explaining 75.4% of the variance. The medial tibial slope:lateral tibial slope ratio was also significantly (P < 0.001) correlated with peak knee internal rotation angle, explaining 49.2% of the variance.InterpretationKnee anatomy is directly associated with high-risk knee biomechanics exhibited during dynamic landings. Continued understanding of multifactorial contributions to the anterior cruciate ligament injury mechanism should dictate future injury screening and prevention efforts in order to successfully cater to individual joint vulnerabilities. 相似文献
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Primary cortisol resistance presenting as isosexual precocity 总被引:3,自引:0,他引:3
C D Malchoff E C Javier D M Malchoff T Martin A Rogol D Brandon D L Loriaux G E Reardon 《The Journal of clinical endocrinology and metabolism》1990,70(2):503-507
Primary cortisol resistance (PCR) is a rare cause of hypercortisolism and usually does not produce clinical manifestations. This report describes primary cortisol resistance in a boy with isosexual precocity. A 6 7/12-yr-old boy had Tanner stage 3 pubic hair, accelerated linear growth, and advanced bone age (10 yr), but normal (for age) tests. There were no features of glucocorticoid excess. Serum androstenedione and dehydroepiandrosterone concentrations were 4.7 +/- 0.3 nmol/L (mean +/- SEM of four measurements; normal less than 1.2) and 13.5 nmol/L (single measurement; normal, 1.0-2.2), respectively. The serum testosterone concentration was 0.9 nmol/L (normal, less than 0.7), and FSH and LH were normal. Serum cortisol concentrations were 1590 +/- 110 nmol/L (normal, 190-630) and 580 +/- 60 nmol/L (normal, 50-410) at 0800 and 2000 h, respectively. Serum cortisol responded normally to insulin-induced hypoglycemia. Glucocorticoids and adrenal androgens were resistant to suppression by dexamethasone. The Kd of [3H]dexamethasone binding to the glucocorticoid receptors of mononuclear leukocytes was increased (6.4 +/- 0.8 nM; mean +/- SEM of four determinations; normal, 1.4-3.4; P less than 0.001), but the binding capacity was normal. This patient with isosexual precocity has PCR, as indicated by functionally abnormal glucocorticoid receptors and hypercortisolism without other clinical or biochemical manifestations of Cushing's syndrome. Excessive adrenal stimulation by ACTH caused increased secretion of both cortisol and adrenal androgens, and the latter caused the clinical manifestations. PCR should be considered in other male children with isosexual precocity or female children with heterosexual precocity. 相似文献