Disparities in mammographic screening for Asian women in California: a cross-sectional analysis to identify meaningful groups for targeted intervention

Background  

Breast cancer is the most commonly diagnosed cancer among the rapidly growing population of Asian Americans; it is also the most common cause of cancer mortality among Filipinas. Asian women continue to have lower rates of mammographic screening than women of most other racial/ethnic groups. While prior studies have described the effects of sociodemographic and other characteristics of women on non-adherence to screening guidelines, they have not identified the distinct segments of the population who remain at highest risk of not being screened.     

Estimating health-adjusted life expectancy conditional on risk factors: results for smoking and obesity

Background  

Smoking and obesity are risk factors causing a large burden of disease. To help formulate and prioritize among smoking and obesity prevention activities, estimations of health-adjusted life expectancy (HALE) for cohorts that differ solely in their lifestyle (e.g. smoking vs. non smoking) can provide valuable information. Furthermore, in combination with estimates of life expectancy (LE), it can be tested whether prevention of obesity and smoking results in compression of morbidity.     

Comparing patient characteristics and treatment processes in patients receiving physical therapy in the United States,Israel and the Netherlands: Cross sectional analyses of data from three clinical databases

Background  

Many assume that outcomes from physical therapy research in one country can be generalized to other countries. However, no well designed studies comparing outcomes among countries have been conducted. In this exploratory study, our goal was to compare patient demographics and treatment processes in outpatient physical therapy practice in the United States, Israel and the Netherlands.     

Bilateral hydatid cyst of the fallopian tubes: a case report

We report an exceptional case of bilateral hydatid cysts that developed solely in the fallopian tubes of a young girl. The diagnosis was suggested by the clinical history, the patient's residence in an endemic area, and the ultrasound findings and was confirmed peroperatively. Due to the extensive damage bilateral salpingectomy was required compromising future reproduction potential. We discuss the pathogenesis of pelvic localizations and the ultrasound aspects of pelvic hydatid cysts.     

Fetal thoraco-omphalopagus. Prenatal ultrasonographic diagnosis at 15 weeks

A case of ultrasonographic prenatal diagnosis of conjoined thoraco-omphalopagus twins is reported at the fifteenth week of amenorrhea. Ultrasonography is the only mean of antepartum diagnosis of conjoined twins; Several diagnostic criteria are recalled as well as etiopathogenic and epidemiological considerations of this rare malformation which may concern 1/15.000 to 1/100.000 pregnancies.     

4Modulation of maturation and function of dendritic cells by female sex steroid hormones

Problem:  Pregnancy represents an exclusive situation in which the immune and the endocrine system cooperate to prevent rejection of the embryo by the maternal immune system. While immature dendritic cells (iDC) in the early pregnancy decidua presumably contribute to the establishment of peripheral tolerance, hormones like estradiol (E2), progesterone (Prog) and bHCG are candidates that could direct the differentiation of DCs into a tolerance-inducing phenotype.
Methods and Results:  To test this hypothesis we generated iDCs from peripheral-blood-monocytes and exposed them to E2, Prog, bHCG and Dexamethasone (Dex) as control. Surprisingly, E2, Prog and bHCG upregulated the expression of HLA-DR, CD 40, CD 83 and CD 86. Visualization of the F-actin cytoskeleton confirmed these observations. In contrast, the T-cell stimulatory capacity of DCs was reduced after E2, Prog and bHCG exposure.
Conclusion:  These findings suggest that E2, Prog and bHCG interfere with selected aspects of DC maturation and may thereby help preventing activation of allogenic T-cells by the embryo.     

21-氨基类固醇对脑冷冻伤大鼠局部脑葡萄糖利用率的影响

21-氨基类固醇是新发现的铁依类脂质过氧化作用的抑制剂。其中以U74006 F(U6F)的抗中枢神经损伤作用最佳。本实验使用~(14)C-脱氧葡萄糖放射自显影方法测定U6F对大鼠脑冷冻伤后局部脑葡萄糖利用率(LCGU)的影响。动物分三组,A组(n=10)正常对照;B组(n=11)冷冻伤;C组(n=9)U6F+冷冻伤。C组动物在冷冻伤前30分钟给予U6F 20mg/kg/日,分二次ip,共注射7次。冷冻伤后72小时断头处死动物。结果,冷冻伤组冻伤侧大脑皮质区平均LCGU为正常组的58±4%,而U6F预处理组为正常组的82±5%(P<0.01)。结果提示,U6F预处理能减轻冷冻伤对大鼠大脑皮质LCGU的抑制。     

The Feasibility of Longitudinal Patient Contacts in a Large Medical School

Problem: Longitudinal patient contacts are being implemented worldwide as a way to enhance a patient-centered orientation among medical students. In large medical schools, longitudinal integrated clerkships may not be feasible, so other ways must be sought to expose students to prolonged contact with patients. Intervention: Medical students were attached to a family practice and assigned a panel of 4 patients to follow over the 3 years of their clinical training. Their role was that of companion on the patient’s medical journey. The program consisted of several encounters, joining the patient in the medical setting for significant events, and written assignments. This intervention was piloted with 35 students. We describe our experiences from the 1st pilot year of this program. Context: The intervention was performed with 3rd-year students—of a 6-year curriculum—at a large medical school in the Netherlands. Outcome: Finding enough patients per practice was feasible. On the whole, students fulfilled the program’s expectations regarding frequency of patient encounters and assignments. The most frequent problems encountered by the students were uncertainty about their role and setting boundaries in their contact with the patients. They needed more preceptor supervision and coaching than they received. Lessons Learned: For junior students, close and structured supervision led by the faculty is necessary to help them navigate and learn from a panel of patients. Students need guidance about what role they should take on and on how to manage both their own and their patient’s expectations. Guided reflection is necessary to help students give meaning to their experiences with patients.