Development of a Follow-Up Measure to Ensure Complete Screening for Colorectal Cancer.

Importance: The current quality performance measure for colorectal cancer (CRC) screening is limited to initial screening. Despite low rates, there is no measure for appropriate follow-up with colonoscopy after receipt of an abnormal result of a stool-based screening test (SBT) for CRC. A quality performance measure is needed.

Dynamics of Anti-influenza Mucosal IgA Over a Season in a Cohort of Individuals Living or Working in a Long-term Care Facility.

Background: Serological surveys are used to ascertain influenza infection and immunity, but evidence for the utility of mucosal immunoglobulin A (IgA) as a correlate of infection or protection is limited.

Methods: We performed influenza-like illness (ILI) surveillance on 220 individuals living or working in a retirement community in Gainesville, Florida from January to May 2018, and took pre- and postseason nasal samples of 11 individuals with polymerase chain reaction (PCR)-confirmed influenza infection and 60 randomly selected controls. Mucosal IgA against 10 strains of influenza was measured from nasal samples.

Experimental intoxication of Brahman (Bos indicus) heifers with Enterolobium cyclocarpum fruits.

Enterolobium cyclocarpum is a poisonous plant distributed throughout the Americas. The E. cyclocarpum fruits have high toxic potential for cattle in Colombia and the clinical signs and pathological lesions are ill-defined.

Experience of clinical screening for COVID-19 among patients undergoing elective orthopedic surgeries: an alternative proposal.

Background: The coronavirus disease 2019 (COVID-19) pandemic is the largest global event in recent times, with millions of infected people and hundreds of thousands of deaths worldwide. Colombia has also been affected by the pandemic, including by the cancellation of medically necessary surgical procedures that were categorized as nonessential. The objective of this study was to show the results of the program implemented in two institutions in Bogotá, Colombia, in April 2020 to support the performance of elective essential and nonessential low- and medium-complexity orthopedic surgeries during the mitigation phase of the COVID-19 pandemic, which involved a presurgical clinical protocol without serological or molecular testing.

A systematic review of antibody mediated immunity to coronaviruses: kinetics, correlates of protection, and association with severity.

Many public health responses and modeled scenarios for COVID-19 outbreaks caused by SARS-CoV-2 assume that infection results in an immune response that protects individuals from future infections or illness for some amount of time. The presence or absence of protective immunity due to infection or vaccination (when available) will affect future transmission and illness severity. Here, we review the scientific literature on antibody immunity to coronaviruses, including SARS-CoV-2 as well as the related SARS-CoV, MERS-CoV and endemic human coronaviruses (HCoVs).

A systematic review of antibody mediated immunity to coronaviruses: antibody kinetics, correlates of protection, and association of antibody responses with severity of disease.

The duration and nature of immunity generated in response to SARS-CoV-2 infection is unknown. Many public health responses and modeled scenarios for COVID-19 outbreaks caused by SARSCoV-2 assume that infection results in an immune response that protects individuals from future infections or illness for some amount of time. The timescale of protection is a critical determinant of the future impact of the pathogen.

Family Physicians' Perceived Prevalence, Safety, and Screening for Cigarettes, Marijuana, and Electronic-Nicotine Delivery Systems (ENDS) Use during Pregnancy.

Objective: Assess perceptions of prevalence, safety, and screening practices for cigarettes and secondhand smoke exposure (SHSe), marijuana (and synthetic marijuana), electronic nicotine delivery systems (ENDS; eg, e-cigarettes), nicotine-replacement therapy (NRT), and smoking-cessation medications during pregnancy, among primary care physicians (PCPs) providing obstetric care.

Methods: A web-based, cross-sectional survey was e-mailed to 3750 US physicians (belonging to organizations within the Council of Academic Family Medicine Educational Research Alliance). Several research groups' questions were included in the survey.

Aphonia after shoulder surgery: case report.

In this case report we highlight the uniqueness of aphonia as, to the best of our knowledge, cases of aphonia related to interscalene brachial plexus block (IBPB) are not described in the literature. Although hoarseness is a common complication of IBPB, aphonia is not. Therefore, we think it is important to publicize the first case of aphonia after IBPB, which may have arisen only because of a recurrent laryngeal nerve chronic injury contralateral to the IBPB site.

Antithyroid peroxidase antibodies in patients with high normal range thyroid stimulating hormone.

Background And Objectives: Hypothyroidism is linked to heart disease and decreased quality of life. Since screening guidelines for the general population are controversial, and physicians use clinical judgment in deciding to order thyroid stimulating hormone (TSH), high-normal levels of TSH pose a dilemma. This study's objective was to compare rates of positive anti-thyroid peroxidase antibodies (antiTPO) tests in persons with high-normal versus low-normal TSH levels.

Distal myopathy in multi-minicore disease.

A 52-year-old man noted distal dominant slowly progressive muscle weakness at age 36 years. On muscle CT, the red muscles of the soleus, anterior tibial and paraspinal muscles, where type 1 fiber is known to predominate, were almost totally replaced by fat tissue while quadriceps femoris, gastrocnemius and upper extremity muscles were relatively spared. Quadriceps muscle biopsy revealed multi-minicores in addition to occasional larger cores, in about 70% of the type 1 fibers.

Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects.

Background: Increased left atrial (LA) size and reduced global contractility are related to adverse cardiac events. The potential incremental value of assessing regional LA contractility is unknown. To assess the feasibility of measuring this variable angle, independent 2-dimensional speckle-tracking strain echocardiography (2D-SpTr) was used to measure regional LA strain (epsilon) and strain rate (SR) in normal individuals of various ages.

Variability in forelimb bone strains during non-steady locomotor activities in goats.

The purpose of this study was to investigate the effects of non-steady locomotor activities on load predictability in two goat forelimb bones and to explore the degree to which bone curvature influences load predictability. We measured in vivo bone strains in the radius and metacarpus of juvenile goats performing a variety of natural behaviors in an outdoor arena and compared these strain magnitudes and loading patterns with those measured during steady-state treadmill locomotion. We sought to test two hypotheses: our first hypothesis expects an increase in the variability of strain magnitude and pattern during outdoor non-steady behavior when compared to treadmill locomotion.

Complications of myocardial infarction.

Echocardiography is a most useful bedside tool to help in the diagnosis and management of critically ill patients after acute myocardial infarction. In most instances, the mechanism of unexplained shock will be elucidated. Transesophageal echocardiography can further delineate the mechanical complications of myocardial infarction when the transthoracic echocardiogram may not be adequate.

The noninvasive evaluation of exercise-induced changes in pulmonary artery pressure and pulmonary vascular resistance.

Background: During exercise, pulmonary artery systolic pressure (PASP) may increase. The purpose of this study was to examine the responses of PASP and pulmonary vascular resistance by Doppler echocardiography during exercise in conditioned athletes and in patients with pulmonary disease.

Methods: Fifteen participants in each group were evaluated using Doppler echocardiography at rest and during recumbent bicycle exercise.

Relation of electrocardiographic criteria for left atrial enlargement to two-dimensional echocardiographic left atrial volume measurements.

Left atrial (LA) enlargement by 2-dimensional (2-D) echocardiography predicts adverse cardiovascular outcomes. Electrocardiographic (ECG) criteria for LA enlargement are based on M-mode echocardiographic LA diameter, which is inferior to 2-D-derived LA volumes. This study compared established ECG criteria for LA enlargement with atrial volume obtained by 2-D echocardiography to determine if traditional ECG criteria accurately represent LA chamber enlargement, therefore offering a low-cost screening tool.

Device-associated nosocomial infections in 55 intensive care units of 8 developing countries.

Background: Health care-associated infections from invasive medical devices in the intensive care unit (ICU) are a major threat to patient safety. Most published studies of ICU-acquired infections have come from industrialized western countries. In a Centers for Disease Control and Prevention (CDC) National Nosocomial Infections Surveillance (NNIS) System report, the U.

Contrast echocardiography: experience in a clinical echocardiography laboratory.

Although 2-dimensional echocardiography with adjunct intravenous contrast media improves endocardial visualization and enhances quality of spectral Doppler signals, widespread use of contrast agents has not occurred for various reasons. Results from this study indicate that discretionary use of contrast media will enhance endocardial and Doppler signal visualization scores without an impact on total procedure duration, lending credence to an argument for a lower threshold for discretionary use of contrast media.

Device-associated infection rate and mortality in intensive care units of 9 Colombian hospitals: findings of the International Nosocomial Infection Control Consortium.

Objective: To perform active targeted prospective surveillance to measure device-associated infection (DAI) rates, attributable mortality due to DAI, and the microbiological and antibiotic resistance profiles of infecting pathogens at 10 intensive care units (ICUs) in 9 hospitals in Colombia, all of which are members of the International Infection Control Consortium.

Methods: We conducted prospective surveillance of healthcare-associated infection in 9 hospitals by using the definitions of the US Centers for Disease Control and Prevention National Nosocomial Surveillance System (NNIS). DAI rates were calculated as the number of infections per 100 ICU patients and per 1,000 device-days.

Doppler tissue imaging during supine and upright exercise in healthy adults.

Doppler tissue imaging variables were measured in 18 healthy men and women during supine bicycle stress exercise and upright exercise treadmill testing. From a color Doppler tissue imaging cineloop, tissue velocities in basal and mid segments of the standard 3 apical views during rest and peak exercise were assessed. Compared segments were adjusted for double product, and peak variables were compared using the paired t test.

Noninvasive measurement of systemic vascular resistance using Doppler echocardiography.

Background: Systemic vascular resistance (SVR) is an integral therapeutic component of patients with heart failure and shock. We hypothesized that the ratio of the peak mitral regurgitant velocity (MRV) (m/s) to left ventricular outflow time-velocity integral (TVI(LVOT)) (cm) by Doppler would provide a noninvasive correlate of SVR.

Methods: SVR was correlated to MRV/TVI(LVOT) in 33 patients undergoing right heart catheterization.

Discovery of a blue whale feeding and nursing ground in southern Chile.

After the extensive exploitation that reduced the Southern Hemisphere blue whale (Balaenoptera musculus) populations to less than 3% of its original numbers, studies on its recovery have been compounded by the inaccessibility of most populations and the extensive migrations between low and high latitudes, thus ensuring that knowledge about blue whale ecology and status remains limited. We report the recent discovery of, arguably, the most important blue whale feeding and nursing ground known to date in the Southern Hemisphere, which is located near the fjords off southern Chile. Through aerial and marine surveys (n = 7) 47 groups, comprising 153 blue whales including at least 11 mother-calf pairs, were sighted during the austral summer and early autumn of 2003.

Echocardiographic determination of mean pulmonary artery pressure.

We performed a simultaneous Doppler and invasive study to validate the role of Doppler-derived peak pulmonary regurgitant velocity as a reliable noninvasive measure of pulmonary artery mean pressure. Assessment of right atrial pressure, as shown in this study, enhances the use of this Doppler parameter as a correlate of pulmonary artery mean pressure.