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Chelsea Eason MSCR Ahmad Aleisa MD Julie R. Jones PhD Eloise J. Prijoles MD Lara Wine Lee MD PhD 《Pediatric dermatology》2020,37(5):915-917
FILS syndrome (facial dysmorphism, immunodeficiency, livedo, and short stature) is a rare autosomal recessive disorder caused by pathogenic alterations in the POLE gene leading to multisystemic manifestations, including poorly characterized skin findings. We report a child with a homozygous variant, c.100C > T (p.Arg34Cys), in POLE and features consistent with poikiloderma, expanding the dermatologic signs associated with this rare disorder. Additionally, we review reported cases of FILS syndrome, discuss possible pathomechanisms for our patient's presentation, and consider implications for management. 相似文献
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Brownfield EL Blue AV Powell CK Geesey ME Moran WP 《Journal of general internal medicine》2008,23(7):1002-1005
BACKGROUND The synthesis of basic and clinical science knowledge during the clerkship years has failed to meet educational expectations.
OBJECTIVES We hypothesized that a small-group course emphasizing the basic science underpinnings of disease, Foundations of Clinical
Medicine (FCM), could be integrated into third year clerkships and would not negatively impact the United States Medical Licensure
Examination (USMLE) step 2 scores.
DESIGN In 2001–2002, all third year students met weekly in groups of 8–12 clustered within clerkships to discuss the clinical and
basic science aspects of prescribed, discipline-specific cases.
PARTICIPANTS Students completing USMLE step 2 between 1999 and 2004 (n = 743).
MEASUREMENTS Course evaluations were compared with the overall institutional average. Bivariate analyses compared the mean USMLE steps
1 and 2 scores across pre- and post-FCM student cohorts. We used multiple linear regression to assess the association between
USMLE step 2 scores and FCM cohort controlling for potential confounders.
RESULTS Students’ average course evaluation score rose from 66 to 77 (2001–2004) compared to an institutional average of 73. The unadjusted
mean USMLE step 1 score was higher for the post-FCM cohort (212.9 vs 207.5, respectively, p < .001) and associated with step 2 scores (estimated coefficient = 0.70, p < .001). Post-FCM cohort (2002–2004; n = 361) mean step 2 scores topped pre-FCM (1999–2001; n = 382) scores (215.9 vs 207.7, respectively, p < .001). FCM cohort remained a significant predictor of higher step 2 scores after adjustment for USMLE step 1 and demographic
characteristics (estimated coefficient = 4.3, p = .002).
CONCLUSIONS A curriculum integrating clinical and basic sciences during third year clerkships is feasible and associated with improvement
in standardized testing.
Electronic supplementary material The online version of this article (doi: ) contains supplementary material, which is available to authorized users. 相似文献
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Amye J. Tevaarwerk MD Kris Kwekkeboom RN PhD FAAN Kevin A. Buhr PhD Alexandra Dennee William Conkright MD Adedayo A. Onitilo MD PhD MSCR Emily Robinson MD Harish Ahuja MD Roger W. Kwong MD Ranveer Nanad MD Douglas A. Wiegmann PhD Karen Chen PhD Noelle K. LoConte MD Kari B. Wisinski MD Mary E. Sesto PT PhD 《Cancer》2021,127(5):801-808
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Outcome of patients with negative and unsatisfactory cytologic specimens obtained by endobronchial ultrasound‐guided transbronchial fine‐needle aspiration of mediastinal lymph nodes
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Nicole M. Marlow MSPH Heather S. Bonilha PhD E. Baron Short MD MSCR 《Pain practice》2013,13(2):131-145
Objective: To systematically review the literature to date applying repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) for patients with fibromyalgia syndrome (FMS). Method: Electronic bibliography databases screened included PubMed, Ovid MEDLINE, PsychINFO, CINAHL, and Cochrane Library. The keyword “fibromyalgia” was combined with (“transcranial” and “stimulation”) or “TMS” or “tDCS” or “transcranial magnetic stimulation” or “transcranial direct current stimulation”. Results: Nine of 23 studies were included; brain stimulation sites comprised either the primary motor cortex (M1) or the dorsolateral prefrontal cortex (DLPFC). Five studies used rTMS (high‐frequency‐M1: 2, low‐frequency‐DLPFC: 2, high‐frequency‐DLPFC: 1), while 4 applied tDCS (anodal‐M1: 1, anodal‐M1/DLPFC: 3). Eight were double‐blinded, randomized controlled trials. Most (80%) rTMS studies that measured pain reported significant decreases, while all (100%) tDCS studies with pain measures reported significant decreases. Greater longevity of significant pain reductions was observed for excitatory M1 rTMS/tDCS. Conclusion: Studies involving excitatory rTMS/tDCS at M1 showed analogous pain reductions as well as considerably fewer side effects compared to FDA apaproved FMS pharmaceuticals. The most commonly reported side effects were mild, including transient headaches and scalp discomforts at the stimulation site. Yearly use of rTMS/tDCS regimens appears costly ($11,740 to 14,507/year); however, analyses to apapropriately weigh these costs against clinical and quality of life benefits for patients with FMS are lacking. Consequently, rTMS/tDCS should be considered when treating patients with FMS, particularly those who are unable to find adequate symptom relief with other therapies. Further work into optimal stimulation parameters and standardized outcome measures is needed to clarify associated efficacy and effectiveness. 相似文献