2,778 research outputs found
A Web-based interactive training for the selfacquisition of information retrieval skills targeting the PBL students
No full textOBJECTIVE: To provide the medical students involved in Problem-Based Learning (PBL) with a remotely accessible training tool for the self acquisition of information retrieval skills.
CONTENT: Access to the training tool is made trough a portal Web site. The tool is initiated with a clinical case. A selection of relevant electronic resources such as dictionaries, encyclopaedias, textbooks, and bibliographical databases is proposed. Each resource comes with search examples achieved by librarians concerning the subject of the clinical case. Each step of the strategy is described, commented and illustrated with a screen copy of the original resource. To reinforce the realism, users are invited to click on the appropriate areas of the screen copy to progress in the search. A catalogue is created with the documents retrieved from the different resources. The catalogue is searchable independently and provides links to full-text when available.
The technical support for the training tool consists of a set of related databases (FileMaker Pro, FileMaker Inc., USA). Data concerning the clinical case, including medical imaging, is contained in a first database. Description of – and links to resources are collected in a second database as well as basic user instructions. For every search example in a specific resource, a database is created from a template, containing all the searched terms and screen copies necessary to provide an interactive demonstration. The catalogue of documents constitutes the last database.
The prototype must now be presented to teachers and students and evaluated for quality, performance and user-friendliness. Results will help us to improve the design and content of the training tool
George McClellan [1849-1913]: A Memoir read before the College of Physicians of Philadelphia, by J. Chalmers Da Costa, M.D., LL.D., Samuel D. Gross Professor of Surgery in Jefferson Medical College
No full textA memoir of Dr. George McClellan (1849-1913). Dr. McClellan was the author of the book Regional Anatomy, and grandson of George McClellan, M.D.; the founder of Jefferson Medical College
2000 Commencement Address: G. Timothy Johnson, M.D.
No full textTimothy Johnson, M.D., medical editor for ABC News will deliver the principal address and receive an honorary degree at the 154th commencement exercises at the College of the Holy Cross on Friday, May 26, beginning at 10:30 a.m. at Fitton Field.
Johnson, one of the nation’s leading medical communicators of health care information, has provided commentary on medical problems and answers for viewers since 1975. In addition to commentary on Good Morning America, Johnson provides on-air analysis of medical news for World News Tonight, Nightline and 20/20. He consults with ABC News regardingcoverage of medical news. He is also medical editor for WCVB-TV, Channel 5 in Boston.
Johnson holds joint positions in medicine at Harvard University and Massachusetts General Hospital in Boston. He is the founding editor of the Harvard Medical School Health Letter and co-editor of the Harvard Medical School Health Letter Book. He is also coeditor of the book, “Your Good Health,” published by Harvard Press, as well as co-author with former US Surgeon General Dr. C. Everett Koop of the book, “Let’s Talk,” published by Zondervan in 1992.
He originally intended to join the ministry and graduated from the North Park Seminary in 1963. Two years later he decided to enter medicine. Johnson, who is a Phi Beta Kappa graduate of Augustana College, graduated summa cum laude from Albany Medical College and holds a master’s degree in public health from Harvard University. Johnson served as an assisting minister at the Community Covenant Church in West Peabody, Mass.https://crossworks.holycross.edu/commence_address/1012/thumbnail.jp
Gleason score concordance on biopsy-confirmed prostate cancer : is pathological re-evaluation necessary prior to radical prostatectomy?
No full textLevel of Evidence 4
What's known on the subject? and What does the study add?
Following the updated Gleason grading system in 2005 by the International Society of Urological Pathologists (ISUP), studies demonstrated improved prediction of biochemical (PSA) progression-free outcome by needle core biopsy specimens. To our knowledge, no studies have investigated the impact of the modified grading system on inter-laboratory agreement of biopsy Gleason score (bGS) and the effect of re-evaluation on accuracy in predicting the true underlying histopathology. We report that when biopsy re-evaluation resulted in a change in bGS, there was a marked improvement in the prediction of underlying pathology as determined by prostatectomy Gleason score suggesting that when outside referral of bGS results in an equivocal clinical decision, biopsy re-evaluation can provide clarity on the true underlying tumour architecture.
OBJECTIVES
center dot Gleason sum from prostate biopsy (bGS) is an important tool in classifying severity of disease, ultimately influencing clinical management.
center dot Commonly, pathology specimens are re-evaluated internally prior to surgery.
center dot We evaluate agreement of bGS with prostatectomy Gleason sum (pGS) and the impact of re-grading on prediction of true underlying tumor architecture.
MATERIALS AND METHODS
center dot Retrospective analysis of men who underwent robotic-assisted radical prostatectomy (RARP) by two surgeons from 2005-2009. Initial transrectal ultrasound (TRUS) biopsy demonstrated carcinoma at an outside lab. Specimens were re-evaluated by our GU pathologists prior to surgery. Biopsy data were correlated with pGS.
center dot Kappa (kappa) statistics for agreement and linear regression analyses were used for categorical variables. Coefficient of concordance was used for continuous variables.
RESULTS
center dot 100 patients had 331 positive biopsies. Agreement (kappa) for bGS between outside labs and our pathologists was 0.55 (p < 0.001).
center dot Internal read was twice as likely to upgrade vs. downgrade outside bGS (23% vs. 11%).
center dot When re-evaluation resulted in a change in bGS, agreement with pGS was kappa = 0.29, vs. kappa = -0.04 for agreement of initial (outside) bGS with pGS.
center dot When no change was made to bGS, agreement with pGS was kappa = 0.40 (p < 0.001).
CONCLUSION
center dot Good reproducibility seen between outside labs and our institution on bGS. Internal pathology re-reads correlated better with pGS than original community bGS. When re-reads result in a change in bGS, there is a marked improvement in prediction of underlying tumor architecture confirming the value of re-evaluating all external biopsies prior to definitive surgery
Robust energy transfer mechanism via precession resonance in nonlinear turbulent wave systems
No full textA robust energy transfer mechanism is found in nonlinear wave systems, which favours transfers towards modes interacting via triads with nonzero frequency mismatch, applicable in meteorology, nonlinear optics and plasma wave turbulence. We emphasise the concepts of truly dynamical degrees of freedom and triad precession. Transfer efficiency is maximal when the triads' precession frequencies resonate with the system's nonlinear frequencies, leading to a collective state of synchronised triads with strong turbulent cascades at intermediate nonlinearity. Numerical simulations confirm analytical predictions
SOME SOCIAL AND POLITICAL VIEWS M.D. SKOBELEVS
No full textThe article analyzes social and political views of M.D. Skobelev, an outstanding military commander, a hero of the Russian-Turkish and Balkan wars¸ who contributed greatly to the entry of Central Asia (Turkestan) and other regions into the Russian Empire. The author concludes that M.D. Skobelev’s views were close to those of the Slavophiles, though they differed greatly on a number of key issues. They both considered that it was necessary to restore national identity, to consolidate Orthodoxy, to give up European values to the detriment of national ones, to search for the own development way instead of the western one, which was deadlock and destructive
Gleason score concordance in transrectal prostate biopsy and radical prostatectomy in Hospital Militar Central patients
No full textEl puntaje de Gleason como herramienta de estadificación histológica en pacientes con cáncer de próstata juega un papel de suma importancia en la determinación de pronóstico y comportamiento de la enfermedad por lo que es factor que debe ser tenido en cuenta al momento de la toma de decisiones en cuanto al tratamiento a realizar. Sin embargo, a pesar de la confiabilidad del puntaje de Gleason con respecto al mismo espécimen, la correlación entre el resultado de la biopsia de próstata y de la pieza quirúrgica obtenida de la prostatectomía radical es variable. Lo que podría impactar en la toma de decisiones terapéuticas y finalmente en la sobrevida del paciente Objetivo: Determinar la concordancia entre el puntaje de Gleason de la biopsia transrectal de próstata con el Gleason de la prostatectomía radical. Materiales y Métodos: Se realizó un estudio de concordancia de pruebas diagnósticas de 90 registros de patología de prostatectomía radical realizadas entre 2014-2018. Todos los pacientes debían tener biopsia de próstata previa a la prostatectomía radical, y ambos procedimientos realizados en el Hospital Militar Central. El índice correlación de Kappa de Cohen se usó para determinar la concordancia entre las variables. Resultados: El índice de concordancia de Kappa de Cohen para el gleason en grupo de riesgo fue de 0.154 y Kappa ponderado fue de 0.379, implicando una concordancia pobre y débil respectivamente entre el resultado anatomopatológico de la biopsia transrectal de próstata con el de la prostatectomía radical.. Conclusiones: En general, la confiabilidad de la puntuación de Gleason de las biopsias con aguja para predecir la patología final fue débil. Sin embargo, no se determinó que esta concordancia sea significativa al momento de tomar decisiones en el manejo del paciente, ya que el grado de sub estadificación y sobre estadificación son comparables con centros de referencia mundial y la decisión terapéutica toma en cuenta esta diferencia y otros factores clínicos que permiten una adecuada elección.The Gleason score as a histological staging tool in patients with prostate cancer plays an important role on prognosis determination and the disease behavior, which is a factor that must be taken into account at the moment of the taking of decisions regarding the treatment to be performed. However, despite the reliability of Gleason score with respect to the same specimen, the correlation between the result of the prostate biopsy and the surgical specimen of the radical prostatectomy is variable. Objective: Determine the concordance between the Gleason score of the transrectal prostate biopsy and the Gleason score of the radical prostatectomy. Materials and methods: Concordance study. 90 records of radical prostatectomy pathology between 2014-2018 was carried out. All patients had to have a prostate biopsy prior to radical prostatectomy, and both procedures performed at Hospital MIlitar Central. Cohen's Kappa correlation was used to determine the agreement between the variables. Results: Cohen's Kappa concordance index for the gleason score in the risk group was 0.154 and weighted Kappa was 0.379, implying a poor and weak concordance as a result of the anatomopathological result of the transrectal prostate biopsy with radical prostatectomy. Conclusions: In general, the reliability of the cycle score of needle biopsies to predict the final pathology was weak. However, it was not determined that this concordance is significant at the time of making decisions in the management of the patient. upgrading and overgrading degree are comparable with world reference centers and the therapeutic decision takes into account this difference and other clinical factors that allow for an adequate treatment choice.1. Resumen 5
2. Marco Teórico 6
3. Planteamiento Del Problema Y Justificación 11
3.1. Pregunta De Investigación 12
4. Objetivos 13
4.1. Objetivo General 13
4.2. Objetivos Específicos 13
5. Metodología 14
5.1. Tipo De Estudio 14
5.2. Población Blanco 14
5.3. Población Objeto 14
5.4. Centro De Estudio Ejecutor 14
5.5. Criterios De Inclusión 14
5.6. Criterios De Exclusión 15
5.7. Tamaño De La Muestra 15
5.8. Definición De Las Variables 15
5.9. Procedimientos Para La Recolección De Información, Instrumentos A Utilizar Y Métodos Para El Control De Calidad De Los Datos 16
6. Plan De Análisis 17
7. Cronograma 18
8. Presupuesto 19
9. Aspectos Éticos 20
10. Resultados 21
11. Discusión 25
12. Conclusiones 28
13. Trayectoria De Los Investigadores 29
14. Referencias Bibliográficas 32Especializació
Author Correction:A 41,500 year-old decorated ivory pendant from Stajnia Cave (Poland)
No full textCorrection to: Scientific Reports https://doi.org/10.1038/s41598-021-01221-6, published online 25 November 2021The original version of this Article contained errors in the author list where Marjolein D. Bosch was omitted from the author list, and Mikołaj Urbanowski was incorrectly listed as an author of the original Article, and has subsequently been removed.The Author contributions section now reads:“S.T. W.N. and A.N. conceived the project; S.T., W.N., A.P., M.B., S.C., M.D., H.F., A.M., M.D. B., D.P., M.P.R., C.M.R., V.S-M., G.M.S., P.S., M.S., K.S., A.V., F.W., H.W., A.W., M.Z., S.B., A.N., J-J. H., performed research; S.T., A.P., W.N., M.B., M.D.B., S.C., M.D., H.F., A.M., D.P., M.P.R., C.M.R., V.S-M., G.M.S., P.S., M.S., K.S., A.V., F.W., H.W., A.W., M.Z., S.B., A.N., J-J. H. analysed all archaeological data; S.T. and A.P. wrote the paper with the collaboration of all the co-authors.”The original Article and its accompanying Supplementary Information file have been corrected
Letter from M.C. Morton, M.D., Director, Bluff Hospital, to Whom It May Concern, July 24, 1958
No full textThis letter, issued by Morton, M.C., M.D., Director, Bluff Hospital, Yokohama, Japan, explains that Tsugitada Kanamori has requested a certificate of ill health for the purpose of establishing dependency upon arrival to the Bluff Hospital in Yokohama. The letter describes his history of asthmatic attacks and the treatment for his cardiac asthma.This collection contains one box of documents belonging to Tsugitada Kanamori. Materials in this collection mostly pertain to Kanamori’s efforts regarding canceling his renunciation and reinstating his American citizenship
Edward C. Klatt, M.D.
No full textDr Klatt received his B.S. in Zoology from the University of Nevada and his M.D. degree from Loma Linda University. Dr Klatt did his residency and fellowship in pathology at the University of Southern California. Dr Klatt was chairman of the department of pathology at the Florida State University College of Medicine. Dr Klatt is currently professor of pathology at Mercer University School of Medicine. During his tenure at the University of Utah Dr Klatt developed WebPath: The Internet Pathology Laboratory for Medical Education which has been continuously hosted by the Spencer S. Eccles Health Sciences Library receiving over 100 million visits annually https://webpath.med.utah.edu/ Dr Klatt is the author of the textbook, Pathology of HIV/AIDS, now in its 31st edition. Dr Klatt the author of 4 of the 7 reference works in the Robbins & Cotran Pathological Basis of Disease used worldwide in health science education
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