A practical guide for translating in-person simulation curriculum to telesimulation.

This article provides a road map, along with recommendations, for the adoption and implementation of telesimulation at a large scale. We provide tools for translating an in-presence simulation curriculum into a telesimulation curriculum using a combination off-the-shelf telecommunication platform. We also describe the roles and tasks that emerged within the simulation team when planning and delivering a telesimulation curriculum.

Simulation-based multiple-choice test assessment of clinical competence for large groups of medical students: a comparison of auscultation sound identification either with or without clinical context.

Background: Although simulation-based teaching is popular, high-fidelity, high-cost approaches may be unsuitable or unavailable for use with large groups. We designed a multiple-choice test for large groups of medical students to explore a low-cost approach in assessing clinical competence. We tested two different scenarios in assessing student's ability to identify heart and lung sounds: by hearing the sounds alone, or in an enhanced scenario where sounds are incorporated into clinical vignettes to give clinical context.

Early Initiation Rather Than Prolonged Duration of Antiretroviral Therapy in HIV Infection Contributes to the Normalization of CD8 T-Cell Counts.

Background: CD8 T-cell counts remain elevated in human immunodeficiency virus (HIV) infection even after long-term antiretroviral therapy (ART), which is associated with an increased risk of non-AIDS-related events. We assessed the impact of ART initiation in early versus chronic HIV infection on trajectories of CD8 cell counts over time.

Methods: Of 280 individuals enrolled during primary HIV infection (PHI), 251 were followed up for 24 months; 84 started ART before 6 months of infection (eART), 49 started between 6 and 24 months, and 118 remained untreated.

Clinical prediction and diagnosis of neurosyphilis in HIV-infected patients with early Syphilis.

The diagnosis of neurosyphilis (NS) is a challenge, especially in HIV-infected patients, and the criteria for deciding when to perform a lumbar puncture (LP) in HIV-infected patients with syphilis are controversial. We retrospectively reviewed demographic, clinical, and laboratory data from 122 cases of HIV-infected patients with documented early syphilis who underwent an LP to rule out NS, and we evaluated 3 laboratory-developed validated real-time PCR assays, the Treponema pallidum particle agglutination (TPPA) assay, the fluorescent treponemal antibody absorption (FTA-ABS) assay, and the line immunoassay INNO-LIA Syphilis, for the diagnosis of NS from cerebrospinal fluid (CSF) samples of these patients. NS was defined by a reactive CSF-VDRL test result and/or a CSF white blood cell (WBC) count of >20 cells/μl.

Basic components and patterns of acute ischemia recovery assessed from continuous ST monitoring in acute myocardial infarction treated by thrombolytic therapy.

Continuous ST monitoring of the lead showing the highest ST elevation on the admission 12-lead electrocardiogram was performed in patients with acute myocardial infarction of 6 hours or less enrolled in the OSIRIS and GUSTO trials. ST elevation measured at j + 50 ms was averaged from all normal beats every 20 seconds. ST trends were visually analyzed by two observers blinded from the thrombolytic treatment, its onset, and coronary angiograms performed 21 hours (median) after thrombolysis.