Airway responses to antigen challenge in allergic rhinitis and allergic asthma

The density dependence of the maximum expiratory flow-volume curve, functional residual capacity (FRC), and specific airway conductance (SGaw) were determined before and during bronchial provocation with ragweed extract in 27 subjects with ragweed hypersensitivity and a history of either bronchial asthma (16 subjects) or allergic rhinitis (11 subjects). Mean baseline SGaw was significantly lower while mean volume of isoflow (Visov) and FrC were significantly higher in subjects with bronchial asthma. During antigen challenge, 10 of 16 subjects with bronchial asthma (63%) and five of 11 subjects with allergic rhinitis (45%) showed a greater than 35% decrease in SGaw ("reactors"): mean relative decreases in SGaw from baseline were 46% and 53%, respectively. The remaining subjects showed a less than 35% decrease in SGaw ("nonreactors") with mean relative decreases of 9% (allergic asthma) and 6% (allergic rhinitis). Mean Visov increased in all subjects with bronchial asthma and in eight of 11 subjects with allergic rhinitis. A significant increase in FRC (6%) was seen only in the "reactors" with bronchial asthma. Following antigen challenge, the beta adrenergic agonist, isoetharine, increased SGaw and decreased Visov. We conclude that in asymptomatic subjects with ragweed hypersensitivity, (1) central and peripheral airway function is more abnormal in subjects with bronchial asthma than in subjects with allergic rhinitis, (2) subjects of both groups show quantitatively and qualitatively comparable airway responses during antigen challenge with a decrease in SGaw or an increase in Visov, possibly representing increase in central and/or peripheral airflow resistance, respectively, (3) Visov may be a more sensitive indicator of airway response to antigen challenge than SGaw, and (4) the bronchodilator effects of a beta adrenergic agonist on antigen-induced bronchospasm are similar in both groups.     

Clinical information technology in hospitals: a comparison between the state of Iowa and two provinces in Canada

Despite the growing interest in adopting information technology (IT) in healthcare, the degree of technology sophistication varies among healthcare organizations. Changes in the health care sector and continuous pressure to improve the quality of care have driven the evolution of IT in hospitals. This paper provides an overview of clinical IT sophistication in a sample of U.S. hospitals, and compares clinical IT capacities in this sample with a sample of Canadian hospitals. The instrument used for the comparison measures three clinical dimensions of IT sophistication: functional sophistication, technological sophistication and integration level. Clinical areas that were considered include patient management, patient care activities and clinical support activities. The comparison between hospitals in Iowa and Canada shows differences in clinical IT sophistication between the two settings. Hospitals in Iowa appear to have more technologies but fewer computerized processes and integration of patient management activities. Technological sophistication however, was low in both samples. Our findings confirm the construct validity of the measurement instrument and show initial evidence of its generalizability. More initiatives using the instrument would lead to enhancement in IT assessment tools that can be used for evaluation of IT in relation to patient management and quality outcomes.     

改进的小波域医学图像序列的运动估计

医学图像序列压缩是远程医疗系统中的重要技术，而运动估计在视频序列压缩中起着关键作用。我们提出了一种改进的正方形-菱形搜索算法来实现医学图像序列的运动估计。这种改进的正方形-菱形算法减少了搜索点数。我们将其应用于小波域的医学图像序列的运动估计，并对数字减影血管造影图像序列（DSA）进行实验。结果表明，改进后的小波域正方形-菱形算法较其他算法精度高。     

Gross anatomy: An outdated subject or an essential part of a modern medical curriculum? Results of a questionnaire circulated to final-year medical students

Final-year undergraduate medical students were given a questionnaire on the gross anatomy curriculum they had experienced in their first year at medical school 5 years earlier. They were asked to evaluate the relevance of the dissection course, lectures and seminars in gross anatomy for clinical courses, clerkships, and everyday practical work on the ward. About two-thirds of the students found the time spent on 10 different regions in anatomy to be adequate, and a considerable number of students would have liked even more details. The vast majority expressed a wish to repeat topographical anatomy during their clinical teaching. Furthermore, ～75% of the students showed interest in short, specialized dissection courses during the clinical curriculum. Medical students just before graduation ranked gross anatomy with the dissection course and integrated clinical topics as a keystone for their clinical courses. The results of such surveys should be taken into consideration when discussing modification to teaching gross anatomy or arguing about a balanced dissection course. © 1993 Wiley-Liss, Inc.     

Diferencias en la nota del ENAM y el promedio ponderado universitario en postulantes al servicio rural peruano, 2008-2015

Introduction

The Rural and Urban Marginal Health Service (SERUMS) is a mandatory program at the end of the medical career in Peru. The promotional grade point average (PPP) and the national medical examination (ENAM) grades are used when awarding places.

Role of ubiquitin-mediated proteolysis in the pathogenesis of neurodegenerative disorders

Intraneuronal inclusions containing ubiquitylated filamentous protein aggregates are a common feature of many of the major human neurodegenerative disorders, including Alzheimer's and Parkinson's disease. Loss of function mutations in enzymes of the ubiquitin conjugation/deconjugation pathway are sufficient to cause familial forms of neurodegenerative diseases, suggesting that failure of ubiquitin-mediated proteolysis could also be central to inclusion formation in the more common sporadic cases. Examination of ubiquitin-positive inclusions at the protein level provides evidence of attempted proteasomal proteolysis, however close inspection of the temporal aspects of inclusion formation indicates that ubiquitylation is probably a late event. In this regard, the presence of ubiquitin within inclusions of idiopathic neurodegenerative disorders may indicate not a primary dysfunction of ubiquitin-mediated proteolysis, but rather a secondary, presumably protective cellular response. Within this model, other factors are likely to be initiating in inclusion biogenesis. Consistent with these proposals, non-ubiquitylated forms of the principal ubiquitylated components of Alzheimer's disease neurofibrillary tangles and Parkinson's disease Lewy bodies, tau and alpha-synuclein proteins, respectively, can be degraded by proteasomes in a pathway which does not have an absolute requirement for ubiquitylation. Inhibition of proteasome function in the pathological state, as has been reported in both Alzheimer's and Parkinson's disease, could therefore contribute both to accumulation of non-ubiquitylated forms of aggregation-prone neuronal proteins, as well as impaired clearance of ubiquitylated aggregates.     

Producción científica en educación médica en Latinoamérica en Scopus, 2011-2015

Objective

To describe the scientific production in medical education in Latin America in Scopus, in the period 2011-2015.

Engulfment of mast cell secretory granules on skin inflammation boosts dendritic cell migration and priming efficiency

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医学毕业生心理调查分析及对策

目的调查分析医学毕业生心理,采取教育对策。方法应用Zung焦虑抑郁自评量表(SAS、SDS)对医学院校187名应届医学毕业生进行抽样调查。结果本组SAS、SDS标准分平均值为37.04±9.08与40.18±10.57;SAS男性37.07±9.38,与女性略同;SDS男性40.55±10.95高于女性39.90±10.30,差异不显著。SAS、SDS≥50的高分人数57例,占30.46%,其中≥50轻度焦虑抑郁为19.24%,≥60重度焦虑11.22%;男、女性别组焦虑抑郁者分别为25例与33例,各占28.09%与33.67%,女性轻度抑郁比例多于男性,差异显著。结论本组医学生情绪状态整体水平尚可,少数学生偏离正常。女性焦虑抑郁人数分布高于男性。应加强素质教育,开展心理咨询,完善就业工作体制,拓宽就业渠道。