Foot and ankle questions on the orthopaedic in-training examination: analysis of content, reference, and performance

The purpose of this study was to provide a comprehensive analysis of the Orthopaedic In-Training Examination's (OITE's) questions, question sources, and resident performance over the course of residency training.The authors analyzed all OITE questions pertaining to foot and ankle surgery between 2006 and 2010. Recorded data included the topic and area tested, imaging modality used, tested treatment method, taxonomic classification, cited references, and resident performance scores. Foot- and ankle-related questions made up 13.9% (186/1341) of the OITE questions. Thirteen general topic areas were identified, with the most common being foot and ankle trauma, the pediatric foot, and foot and ankle deformity. Imaging modalities were tested in approximately half of the questions. Knowledge of treatment modalities was required in 58.1% (108/186) of the questions. Recall-type questions were the most common. Trends existed in the recommended references, with 2 journals and 1 textbook being commonly and consistently cited: Foot and Ankle International, The Journal of Bone and Joint Surgery American Volume, and Surgery of the Foot and Ankle, respectively. Resident performance scores increased with each successive level of training.An understanding of the topics and resources used for OITE foot and ankle questions is an important aid in creating or improving residency programs' foot and ankle education curricula. With knowledge of question content, source, and resident performance, education can be optimized toward efficient learning and improved scores on this section of the examination.     

Optical coherence tomography can assess skeletal muscle tissue from mouse models of muscular dystrophy by parametric imaging of the attenuation coefficient

We present the assessment of ex vivo mouse muscle tissue by quantitative parametric imaging of the near-infrared attenuation coefficient µ_t using optical coherence tomography. The resulting values of the local total attenuation coefficient µ_t (mean ± standard error) from necrotic lesions in the dystrophic skeletal muscle tissue of mdx mice are higher (9.6 ± 0.3 mm⁻¹) than regions from the same tissue containing only necrotic myofibers (7.0 ± 0.6 mm⁻¹), and significantly higher than values from intact myofibers, whether from an adjacent region of the same sample (4.8 ± 0.3 mm⁻¹) or from healthy tissue of the wild-type C57 mouse (3.9 ± 0.2 mm⁻¹) used as a control. Our results suggest that the attenuation coefficient could be used as a quantitative means to identify necrotic lesions and assess skeletal muscle tissue in mouse models of human Duchenne muscular dystrophy.OCIS codes: (110.4500) Optical coherence tomography, (170.6935) Tissue characterization, (100.2960) Image analysis, (290.1350) Backscattering     

Addressing Female Sexual Function after Cancer by Internists and Primary Care Providers

IntroductionThere are now almost 14 million cancer survivors in the United States, and for the majority of survivors, the bulk of post‐cancer medical care is provided by community primary care providers (PCPs). Sexual dysfunction is one of the most common and distressing quality of life issues facing female cancer survivors yet it has become increasingly evident that women's cancer‐related sexual dysfunction often goes unaddressed, including in primary care treatment setting.AimBuilding on a model that calls for an integrative approach to treatment, the aim is to concisely review barriers and challenges of managing cancer‐related female sexual dysfunction for PCPs and to offer specific and effective strategies that PCPs may use to treat common sexual problems in their female cancer survivors.MethodsLiterature was reviewed for relevant publications on the topic of treating cancer‐related sexual dysfunction and primary care, and interviews were conducted with experts on state‐of‐the‐art methods for treating cancer‐related sexual dysfunction.Main Outcome MeasureClinical evidence that demonstrates the effectiveness of simple strategies to manage cancer‐related female sexual dysfunction.ResultsCancer‐related female sexual dysfunction does not seem to be appropriately acknowledged and addressed in primary care treatment settings. There is evidence to show that simple and effective strategies exist to ameliorate many of these problems.ConclusionsPCPs provide the bulk of survivorship care and are therefore in a critical position to initiate assessment and treatment for female survivors with cancer‐related sexual dysfunction. Although PCPs are in need of increased support and preparation to manage this aspect of survivorship care, simple and effective strategies are available for PCPs to offer women as part of their clinical practice. Bober SL, Carter J, and Falk S. Addressing female sexual function after cancer by internists and primary care providers. J Sex Med 2013;10(suppl 1):112–119.     

Long-term prognostic value of left atrial longitudinal strain in an elderly community-based cohort

GeroScience - Despite the well-known importance of left atrial (LA) mechanics in diastolic function, data are scarce regarding the prognostic power of LA longitudinal strain and its potential added...