7 research outputs found
Effect of Latitude on Vitamin D Levels
No full textAbstractContextVitamin D levels have been linked to bone health and to numerous diseases; however, an element that lacks substantial direct data and limits the evidence basis regarding whom to screen for vitamin D deficiency is the effect of latitude on vitamin D levels.ObjectivesTo determine whether latitude influences vitamin D levels and to investigate the influence of other factors that may affect vitamin D levels, including sex, race, skin type, and body mass index.MethodsOsteopathic medical students were recruited from campuses in Bradenton, Florida, and Erie, Pennsylvania. Surveys were administered to obtain demographic information, and blood samples were drawn to measure total vitamin D levels. Two-samplettests, Fisher exact test, and logistic regression was used to assess differences in total vitamin D levels between the 2 locations.ResultsA total of 359 medical students (aged 22-57 years) were included in the study, 194 at the Bradenton campus and 214 at the Erie campus. The mean (SD) vitamin D level was 34.5 (11.8) ng/mL among participants in Bradenton and 28.1 (12.4) ng/mL among participants in Erie. Logistic regression models revealed an adjusted OR of 3.3 (95% CI, 1.73-6.4) for deficient total vitamin D among Erie students. Non-white race, male sex, and high body mass index were also statistically significant risk factors for vitamin D deficiency in regression models (P<.05).ConclusionLatitude was found to be a statistically significant risk factor for vitamin D deficiency. Additionally, the findings suggest that persons with darker skin tone and, to a lesser degree, men and persons who are overweight or obese are also at increased risk for vitamin D deficiency. Physicians should be cognizant of these risk factors when deciding whom to screen.</jats:sec
Reduced fluoroscopy time with physician-controlled fluoroscopy during endoscopic retrograde cholangiopancreatography: A community hospital experience
No full textBackground and objective: Fluoroscopy during endoscopic retrograde cholangiopancreatography (ERCP) is associated with radiation exposure and related health risks. Either the physician or the radiology technologist can activate fluoroscopy during ERCP. The aim of this study was to determine if physician-controlled fluoroscopy is associated with decreased fluoroscopy time, which may correspond to less radiation exposure to patients and staff.
Methods: We conducted a single-center, retrospective study; data were collected on ERCP performed using physician-controlled and technologist-controlled fluoroscopy. Fluoroscopy time, procedure complexity level, and Stanford Fluoroscopy Score were compared between the two groups.
Results: The median fluoroscopy time significantly differed between the two groups with 108 seconds for physician-controlled and 146 seconds for technologist-controlled procedures (p=0.004). The ratio of median fluoroscopy time to procedure complexity level was significantly lower in the physician-controlled group at 73.0 seconds compared to 97.0 seconds in the technologist-controlled group (p=0.002). The ratio of median fluoroscopy time to Stanford Fluoroscopy Score was 25.5 seconds in the physician-controlled group compared to 39.3 seconds in the technologist-controlled group, which was also statistically significant (p\u3c0.001). A subgroup analysis of physicians with advanced training in ERCP also showed a significantly reduced median fluoroscopy time to Stanford Fluoroscopy Complexity Score ratio: 25.5 seconds for physician-controlled versus 35.0 seconds for technologist-controlled (p=0.001).
Conclusion: The ERCP technique with physician-controlled fluoroscopy may be associated with shorter fluoroscopy time. This may correspond to decreased radiation exposure to patients compared to radiology technologist-controlled fluoroscopy. Further investigations with larger, prospective studies are warranted
Weight-based contrast administration in the computerized tomography evaluation of acute pulmonary embolism
No full textCastleman’s disease: a rare presentation in a retroperitoneal accessory spleen, treated with a minimally invasive robotic approach
No full textIncreased fetal chromosome detection with the use of operative hysteroscopy during evacuation of products of conception for diagnosed miscarriage
No full textSTUDY OBJECTIVE: To determine whether incorporation of operative hysteroscopy with biopsy of products of conception, in conjunction with a suction curettage for a first trimester missed abortion, affected the rate of maternal cell contamination when chromosomal analysis was performed on the products of conception, and to determine the rates of retained products of conception with incorporation of hysteroscopy after suction curettage.
DESIGN: Retrospective chart study.
SETTING: Private, minimally invasive surgery and infertility practice with academic-community hospital affiliation.
PATIENTS: Infertility patients undergoing evacuation of products of conception for documented first trimester miscarriages between 2006 and 2017.
INTERVENTIONS: Suction curettage or hysteroscopic biopsy and suction curettage, followed by chromosomal analysis of products of conception for determination of fetal genetics.
MEASUREMENTS AND RESULTS: A total of 264 charts were analyzed. Patients were categorized into 2 groups based on surgical collection of products of conception: group 1 (N = 174), suction curettage only, and group 2 (N = 90), a single procedure consisting of operative hysteroscopy with biopsy of products of conception followed by suction curettage and then diagnostic hysteroscopy to look for retained products. Data for chromosome detection and retained products of conception were available for 246 and 239 patients, respectively. No significant differences were detected between the groups for age, body mass index, ethnicity, gravida, parity, primary infertility, secondary infertility, spontaneous conception, single or multiple gestation, and surgical complications. Fetal chromosome detection was significantly higher without maternal contamination in group 2 (88.5%) compared with group 1 (64.8%) (p \u3c .001). There was no significant between-group difference in postoperative retained products of conception.
CONCLUSION: Obtaining fetal genetics can be useful when planning for a future successful pregnancy. The addition of operative hysteroscopy to biopsy the gestational sac, chorionic villi, and/or fetus significantly decreases the risk of maternal contamination and increases the ability to detect fetal chromosomes for genetic analysis without an increased risk of surgical complications. Despite the low risk of surgical complications, immediate second-look hysteroscopy after the completion of suction evacuation does not reduce the risk of postoperative retained products of conception
Mutations in Fbx4 Inhibit Dimerization of the SCFFbx4 Ligase and Contribute to Cyclin D1 Overexpression in Human Cancer
No full textSummarySCFFbx4 was recently identified as the E3 ligase for cyclin D1. We now describe cell-cycle-dependent phosphorylation and dimerization of Fbx4 that is regulated by GSK3β and is defective in human cancer. We present data demonstrating that a pathway involving Ras-Akt-GSK3β controls the temporal phosphorylation and dimerization of the SCFFbx4 E3 ligase. Inhibition of Fbx4 activity results in accumulation of nuclear cyclin D1 and oncogenic transformation. The importance of this regulatory pathway for normal cell growth is emphasized by the prevalence of mutations in Fbx4 in human cancer that impair dimerization. Collectively, these data reveal that inactivation of the cyclin D1 E3 ligase likely contributes to cyclin D1 overexpression in a significant fraction of human cancer
