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991.
992.
Jenepher Martin John Blennerhassett David Hardman Julie Mundy 《ANZ journal of surgery》2009,79(3):169-174
Basic science knowledge is a foundational element of surgical practice. Increasing surgical specialization may merit a reconsideration of the ‘whole‐body’ approach to basic science curriculum in favour of specialty specific depth. The conundrum of depth or breadth of basic science curriculum is currently being addressed by the Royal Australasian College of Surgeons, which introduced a new surgical education and training programme for nine surgical specialties in 2008. This paper describes an innovative solution to the design of a basic science curriculum in the nine different surgical specialty streams of this programme. The task was to develop a curriculum and rigorous assessment in basic sciences to meet the needs of the training programme, for implementation within the first year. A number of political/cultural and technical issues were identified as critical to success. To achieve a robust assessment within the required time frame attention was paid to engagement, governance, curriculum definition, assessment development, and implementation. The pragmatic solution to curriculum and assessment was to use the existing assessment items and blueprint to determine a new curriculum definition and assessment. The resulting curriculum comprises a generic component, undertaken by all trainees, and specialty specific components. In a time critical environment, a pragmatic solution to curriculum, applied with predetermined, structured and meticulous methodology, allowed explicit definition of breadth for the generic basic science curriculum for surgical training in Australia and New Zealand. Implicit definition of specialty specific‐basic science curricula was through the creation of a blueprinted assessment. 相似文献
993.
Bhattacharya K Orton RC Qi X Mundy H Morley DW Champion MP Eaton S Tester RF Lee PJ 《Journal of inherited metabolic disease》2007,30(3):350-357
Summary
Objective: To determine whether a new starch offers better short-term metabolic control than uncooked cornstarch in patients with glycogen
storage diseases (GSDs).
Study design: A short-term double-blind cross-over pilot study comparing uncooked physically modified cornstarch (WMHM20) with uncooked
cornstarch in patients with GSD types Ia, Ib and III. Twenty-one patients (ages 3–47, 9 female) were given 2 g/kg cornstarch
or WMHM20 mixed in water. Blood glucose, lactate and insulin, and breath hydrogen and 13CO2 enrichment were measured, at baseline and after each load. The hourly biochemical evaluations terminated when blood glucose
was ≤3.0 mmol/L, when the study period had lasted 10 h or when the patient wished to end the test. The alternative starch
was administered under similar trial conditions a median of 10 days later.
Results: The median starch load duration was 9 h for WMHM20 versus 7 h for cornstarch. Glucose decreased more slowly (p = 0.05) and lactate was suppressed faster (p = 0.17) for WMHM20 compared with cornstarch. Peak hydrogen excretion was increased (p = 0.05) when cornstarch was taken.
Conclusion: These data indicate longer duration of euglycaemia and better short-term metabolic control in the majority of GSD patients
with WMHM20 compared to cornstarch.
Competing interests: None declared
References to electronic databases: Glycogen storage disease I, OMIM 232200. Glycogen storage disease III, OMIM 232400. Glucose-6-phosphatase, EC 3.1.3.9. Amylo-1,6-glucosidase,
EC 3.2.1.33. Oligo-1,4–1,4-glucanotransferase, EC 2.4.1.25 相似文献
994.
Uriel Y. Moreno-Nieves Joshua K. Tay Saumyaa Saumyaa Nina B. Horowitz June Ho Shin Imran A. Mohammad Bogdan Luca David C. Mundy Gunsagar S. Gulati Nikita Bedi Serena Chang Chen Chen Michael J. Kaplan Eben L. Rosenthal F. Christopher Holsinger Vasu Divi Fred M. Baik Davud B. Sirjani Andrew J. Gentles Aaron M. Newman Aharon G. Freud John B. Sunwoo 《Proceedings of the National Academy of Sciences of the United States of America》2021,118(28)
995.
996.
Al Kindi M Mundy J Sullivan T Smith W Kette F Smith A Heddle R Hissaria P 《Clinical and experimental immunology》2012,167(2):275-281
Abnormalities in peripheral blood B cell subsets have been identified in common variable immunodeficiency (CVID) patients and classification systems based upon their numbers have been proposed to predict the clinical features. We analysed B lymphocyte subsets by multi-colour flow cytometry (MFC) in a cohort of well-characterized CVID patients to look at their clinical relevance and validate the published association of different classification criteria (Freiburg, Paris and Euroclass) with clinical manifestations. CVID patients had a reduced proportion of total and switched memory B cells (MBC, swMBC) compared to normal controls (P < 0·0006). Patients classified in Freiburg Ia had a higher prevalence of granulomatous diseases (P = 0·0034). The previously published associations with autoimmune diseases could not be confirmed. The Euroclass classification was not predictive of clinical phenotypes. The absolute numbers of all B cell subsets were reduced in CVID patients compared to controls. There was a significant linear correlation between low absolute total B cells and MBC with granulomatous disease (P < 0·05) and a trend towards lower B cells in patients with autoimmune diseases (P = 0·07). Absolute number of different B cell subsets may be more meaningful than their relative percentages in assessing the risk of granulomatous diseases and possibly autoimmunity. 相似文献
997.
The maintenance of adequate bone mass is dependent upon the controlled and timely removal of old, damaged bone. This complex process is performed by the highly specialized, multinucleated osteoclast. Over the past 15 years, a detailed picture has emerged describing the origins, differentiation pathways and activation stages that contribute to normal osteoclast function. This information has primarily been obtained by the development and skeletal analysis of genetically modified mouse models. Mice harboring mutations in specific genetic loci exhibit bone defects as a direct result of aberrations in normal osteoclast recruitment, formation or function. These findings include the identification of the RANK-RANKL-OPG system as a primary mediator of osteoclastogenesis, the characterization of ion transport and cellular attachment mechanisms and the recognition that matrix-degrading enzymes are essential components of resorptive activity. This Review focuses on the principal observations in osteoclast biology derived from genetic mouse models, and highlights emerging concepts that describe how the osteoclast is thought to contribute to the maintenance of adequate bone mass and integrity throughout life. 相似文献
998.
What’s known on the subject? and What does the study add? Urethral strictures are common and increasingly common in an ageing population. The treatment is controversial and particularly the relative roles of urethrotomy or urethral dilatation on the one hand and urethroplasty on the other. This review aims to provide a comprehensive overview of the subject including less commonly discussed issues such as the history and pathology of stricture disease. We would hope that a comprehensive overview of the subject will give a sharper perspective to aid the investigation and management of patients with urethral strictures. 相似文献
999.
Harvey R Haluska B Mundy J Wood A Griffin R Shah P 《Asian cardiovascular & thoracic annals》2011,19(5):333-338
Studies have shown disparate findings regarding body mass index and outcomes after coronary artery bypass. We analyzed body mass index and other clinical variables that might predict morbidity and mortality after primary isolated coronary artery bypass. Data on 4,425 patients (79% men) were reviewed retrospectively. They were classified as underweight (1.6%), normal weight (65%), obese (32%), and morbidly obese (1.4%) according to body mass index <20, 20-29, 30-39, and >40 kg·m(-2), respectively. Multiple logistic regression was used for correlates of 30-day outcome. Cox regression was used for predictors of late outcome in underweight and morbidly obese patients. There were 45 (1%) deaths and 234 (5%) cases of morbidity within 30 days. Independent correlates of 30-day morbidity were smoking, logistic EuroSCORE, blood and blood product transfusions. Correlates of 30-day mortality were logistic EuroSCORE and blood transfusion. The only independent predictor of late death in underweight and morbidly obese patients was preoperative arrhythmia. Body mass index was not a predictor of 30-day morbidity or mortality. The 1-, 3-, and 7-year survival rates were not significantly different between underweight and morbidly obese patients. Body mass index did not affect short-term outcomes after primary coronary artery bypass grafting. 相似文献
1000.
Nayak A Mundy J Wood A Griffin R Pinto N Peters P Shah P 《Heart, lung & circulation》2011,20(8):532-537
This study evaluates the early and mid-term outcomes, predictors of mortality and morbidity and quality of life of patients operated for infective endocarditis. Data on 108 patients undergoing 113 surgical procedures during October 1998 to January 2010 was prospectively collected. NYHA Class was >III in 49 (43.4%) cases. Thirty-seven (33%) patients had isolated mitral valve procedures, 58 (51%) had aortic valve, two had tricuspid valve and 16 had multivalvular procedures. Active endocarditis was noted in 86 (76%) procedures, native valve endocarditis in 105 (93%) and prosthetic valve endocarditis in eight procedures. Logistic EuroSCORE at presentation was >14 in 18 (17%) patients. Staphylococcus aureus was the most common organism isolated. Follow-up was carried out in 76/85 (88.37%) of surviving patients, and the mean follow-up time was 37.2 months. Functional class and quality of life (using EQ-5D Health Questionnaire) were assessed by telephone interviews. NYHA Class on follow-up was I-II in 62/76 (83%). Multivariate predictor of 30-day mortality was peripheral vascular disease (p = 0.025) whilst multivariate predictors of long-term survival were male sex (p = 0.01), peripheral vascular disease (p = 0.02) and bypass time (p = 0.006). The overall survival was 87% at one year and 80% at five years. Thirty-three percent (25/76) patients reported a score reflecting full health. Optimal antibiotic therapy and timely surgical intervention were associated with improved functional class, quality of life and mid-term survival. 相似文献