Screening Mammography: Revisiting Assumptions About Early Detection

Recommendations for the frequency of mammography screening vary across several professional advisory groups. In 2009, the United States Preventive Services Task Force Guidelines reduced screening to biennially for women 50-74 years old. Drivers of this change were false-positive results and unnecessary biopsies, exposure to radiation, and treatment of cancers that would never develop. Despite the recommendation, surveys show that screening has actually increased since the change. A review of the individual woman's risk and a more balanced approach addressing both the benefits and harms of screening is required so that patients can make an informed choice.     

Selecting a Medical School Advisor

Having an advisor offers medical students many advantages, including increased likelihood of matching into their top choices. Interestingly, students who choose emergency medicine (EM) as a specialty are more likely to seek advising. However, finding and optimally utilizing an EM faculty advisor is often challenging for the medical student. In this article, we tackle the different ways to seek advising, including the ‘virtual advisor program’ implemented by the Society for Academic Emergency Medicine, the ‘e-Advisor Program’ instigated by the Clerkship Director in EM Group, the ‘member exclusive mentorship program’ of the Emergency Medicine Residency Association, as well as peer-based mentoring. More so, we discuss the consensus recommendations developed by the Student Advising Task Force to guide both students planning to apply to EM and their advisors to ensure high-caliber advising.     

Circulating CCL20: A potential biomarker for active vitiligo together with the number of Th1/17 cells

Background

Vitiligo is an autoimmune disease with varying pathological features. Activation of the CCL20-CCR6 axis plays an important role in chronic inflammatory diseases. However, whether CCL20-CCR6 and Th1/17 cells are indicative of active vitiligo is unclear.

Analysis of reversed L-loops as closing loops with anterior intrusive force

Objective: Intrusive forces on anterior brackets are preferable for avoiding overbite deepening. Reversing plain L-loops may create such advantageous force system during space closure.

Design: Force systems of reversed L-loops were compared with T-loops at three interbracket distances (IBD).

Setting: Computational study.

Methods: Using finite element analysis, loop response during simulated loop-pulling was determined for plain reversed L- and T-loop configurations at three IBDs and two sizes. Force systems were calculated on both loop ends for two activation forces.

Results: The 12?mm IBD reversed L-loops had almost equal M/F ratios in opposite directions at both ends. A small intrusive force was found at the canine bracket (CB). The 6?mm IBD reversed L-loops showed larger M/F ratios and extrusive forces at the premolar bracket (PB) and smaller M/F with intrusive forces at CB. The force system of 12?mm IBD T-loops showed the similar force systems as off-centered V-bends with extrusive force at CB, whilst plain 6?mm IBD T-loops showed properties similar to centered V-bends with less extrusive force at CB.

Conclusions: Reversed L closing loops placed no extrusive force on the CB end at various IBDs, indicating that reversed loops will generate an intrusive force at anterior teeth during space closure.     

Issues with implementing a high‐quality lung cancer screening program

Answer questions and earn CME/CNE After a comprehensive review of the evidence, the United States Preventive Services Task Force recently endorsed screening with low‐dose computed tomography as an early detection approach that has the potential to significantly reduce deaths due to lung cancer. Prudent implementation of lung cancer screening as a high‐quality preventive health service is a complex challenge. The clinical evaluation and management of high‐risk cohorts in the absence of symptoms mandates an approach that differs significantly from that of symptom‐detected lung cancer. As with other cancer screenings, it is essential to provide to informed at‐risk individuals a safe, high‐quality, cost‐effective, and accessible service. In this review, the components of a successful screening program are discussed as we begin to disseminate lung cancer screening as a national resource to improve outcomes with this lethal cancer. This information about lung cancer screening will assist clinicians with communications about the potential benefits and harms of this service for high‐risk individuals considering participation in the screening process. CA Cancer J Clin 2014;64:351–363. © 2014 American Cancer Society.     

Equipment Note MUPRO: A MULTIPURPOSE ROBOT

The aim of this article was to describe an apparatus, called multipurpose neck robot (MUPRO), designed to record both the forces exerted at head level and the head rotations in the horizontal plane in the behaving monkey. It consists of a mechanical device, comprising a cardan joint, a potentiometer, an electromagnetic brake, and four flexion load cells, plus an oleodynamic system allowing head rotation in the horizontal plane between &#45 20° These components are assembled on a column bolted to the primate s chair. An electrical device provides DC power for the potentiometer and the brake. The apparatus enables us to measure both the force fields and the head movements during training sessions and electrophysiological investigations.     

A Comparative Analysis of Current Lipid Treatment Guidelines: Nothing Stands Still

Lipid treatment guidelines have continued to evolve as new evidence emerges. We sought to review similarities and differences of 5 lipid treatment guidelines from the American College of Cardiology/American Heart Association, Canadian Cardiovascular Society, European Society for Cardiology/European Atherosclerosis Society, U.S. Preventive Services Task Force, and U.S. Veterans Affairs/Department of Defense. All guidelines utilize rigorous evidentiary review, highlight statin therapy for primary and secondary prevention of atherosclerotic cardiovascular disease, and emphasize a clinician-patient risk discussion. However, there are differences in statin intensities, use of risk estimators, treatment of specific patient subgroups, and consideration of safety concerns. Clinicians should understand these similarities and differences in current and future guideline recommendations when considering if and how to treat their patients with statin therapy.     

某校招收飞行学员外科、皮肤科疾病淘汰情况分析

目的招收飞行学员2年间外科、皮肤科疾病淘汰情况分析。方法由同一组外科、皮肤科医师按同一标准进行全身检查。结果2010年体检应征学生1355名，淘汰49名（3．62％），检出疾病21种（1．55％）；2009年体检应征学生1385名，淘汰39名（2．81％），检出疾病18种（1．33％）。2010年淘汰人数百分比与2009年相比显著增加（P〈0．01）；总病种百分比与2009年相比显著增加（P〈0．01）。结论各军区体检掌握标准不一，需要加强沟通，定期培训。     

Meet EBE: The Development of an Evidence-Based Endoscopy Simulator

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