Design and effectiveness of a required pre-clinical simulation-based curriculum for fundamental clinical skills and procedures.

Background: For more than 20 years, medical literature has increasingly documented the need for students to learn, practice and demonstrate competence in basic clinical knowledge and skills. In 2001, the Louisiana State University Health Science Centers (LSUHSC) School of Medicine - New Orleans replaced its traditional Introduction in to Clinical Medicine (ICM) course with the Science and Practice of Medicine (SPM) course. The main component within the SPM course is the Clinical Skills Lab (CSL).

Comparison of methylene blue/gentian violet stain to Gram's stain for the rapid diagnosis of gonococcal urethritis in men.

We compared a simple, one-step staining procedure using a mixture of methylene blue and gentian violet to Gram stain for the detection of gonococcal urethritis. The sensitivity and specificity of both Gram stain and methylene blue/gentian violet stain were 97.3% and 99.

In for the long haul: sustaining and rebuilding educational operations after Hurricane Katrina.

In 2005, Hurricane Katrina and the subsequent levee breaks left 80% of New Orleans under water for weeks. Within 4 short weeks, the Louisiana State University Health Sciences Center at New Orleans had relocated its campus temporarily to Baton Rouge and resumed operations. Many lessons were learned in the first year of recovery and disseminated to the field regarding emergency and disaster preparedness and response.

Survival and recovery: maintaining the educational mission of the Louisiana state university school of medicine in the aftermath of hurricane Katrina.

Hurricane Katrina devastated New Orleans and the coastlines of Louisiana, Mississippi, and Alabama on August 29, 2005. The flooding in New Orleans left hundreds of thousands of people homeless and threatened to close businesses and institutions, including Louisiana State University (LSU) School of Medicine and its two principle training sites in New Orleans, Charity Hospital and University Hospital. In the weeks immediately after the storm, LSU School of Medicine resumed undergraduate and graduate medical education in Baton Rouge, Louisiana and elsewhere.

The relationship between condom use and herpes simplex virus acquisition.

Background: Few studies have evaluated the relationship between condom use and herpes simplex virus type 2 (HSV-2) and HSV type 1 (HSV-1) acquisition.

Objective: To assess the relationship between condom use and acquisition of HSV-2 and HSV-1 among men and women.

Design: Analysis of data collected as part of a clinical trial of an ineffective candidate vaccine for HSV-2.

A student-initiated elective on end-of-life care: a unique perspective.

Traditionally, curriculum change is a faculty responsibility. However, a first-year medical student, inspired by previous interactions with cancer patients and disillusioned with her education on the physician's role at the end of life, successfully initiated and sustained an end-of-life curriculum change. This article briefly describes the Preceptorship on End of Life Care and then shifts focus to five key dilemmas associated with student-led curriculum change.

Seroepidemiology of low and high oncogenic risk types of human papillomavirus in a predominantly male cohort of STD clinic patients.

Human papillomaviruses (HPV) infecting the genital tract are associated with warts and anogenital malignancies. Although HPV is a highly prevalent sexually transmitted disease (STD), the majority of research has focused on female cohorts due to gender specific sequelae. Our objective was to measure the epidemiological features and seroprevalences of HPV-6/11 and 16 in a predominantly male group of STD clinic patients.

Can self-reported behavioral factors predict incident sexually transmitted diseases in high-risk African-American men?

The known link between sexually transmitted diseases (STD) and human immunodeficiency virus (HIV), coupled with the increasing prevalence of HIV in African-American men, makes understanding STD transmission trends in this group important for directing future preventive measures. The goal of this study was to determine if self-reported behavioral factors are predictive of incident sexually transmitted diseases in a group of high risk, HIV-negative African-American men. Five hundred and sixty-two "high risk" (defined as having four or more partners in the last year or having been diagnosed with an STD in the last year) HIV-negative African-American men were administered a baseline behavioral survey and followed to detect an incident STD.

Detection of circulating epithelial cells after surgery for benign breast disease.

Background: Cytokeratins are predominantly expressed in epithelial cells and their malignant counterparts. Ultrasensitive methods for cytokeratin messenger RNAs (mRNAs) can detect rare circulating tumor cells consistent with hematogenous dissemination in epithelial-derived malignancies, including breast carcinomas. Intraoperative tumor-cell shedding may contribute to this process; this hypothesis is based on the assumption that only tumor cells can be mobilized during surgical manipulation.

Recombinant glycoprotein vaccine for the prevention of genital HSV-2 infection: two randomized controlled trials. Chiron HSV Vaccine Study Group.

Context: In the last 3 decades, herpes simplex virus type 2 (HSV-2) infection seroprevalence and neonatal herpes have increased substantially. An effective vaccine for the prevention of genital herpes could help control this epidemic.

Objective: To evaluate the efficacy of a vaccine for prevention of HSV-2 infection.

The clinical diagnosis of genital ulcer disease in men.

We report the sensitivity and specificity of physical examination findings for diagnosing primary syphilis, chancroid, and genital herpes. The physical features of genital ulcers in 446 men were measured in accordance with a quantitative scale. Two hundred-twenty of these men had an established, single microbiological diagnosis.

Specimen stability for DNA-based diagnostic testing.

The use of molecular diagnostic testing is increasing in the clinical setting; therefore, data regarding DNA stability in clinical specimens are essential for correct test performance and interpretation. This study was designed to determine DNA stability in peripheral blood and solid tissue under different storage conditions. DNA quality and yield were assayed by spectrophotometric absorbance, gel electrophoresis, and suitability for Southern hybridization and polymerase chain reaction (PCR), the most widely employed clinical DNA analyses.

Use of myeloperoxidase mRNA as a marker for myeloid lineage in acute leukemias.

Background: Positivity for myeloperoxidase is considered the diagnostic hallmark of myeloid lineage and is the major criterion in the classification of acute leukemias. Early myeloid precursors, however, may be cytochemically negative for myeloperoxidase enzymatic activity or protein, but positive for myeloperoxidase mRNA.

Objective: To evaluate the expression of the myeloperoxidase gene in leukemic blasts at the mRNA level and correlate the expression with blast cytochemistry and immunophenotyping.

Chancroid epidemiology in New Orleans men.

Epidemiologic, clinical, and microbiologic data were collected from 299 men with nonsyphilitic genital ulcer disease. One hundred eighteen (39%) were culture-positive for Haemophilus ducreyi, 57 (19%) were culture-positive for herpes simplex virus, and 124 (41%) were culture-negative. Patients with chancroid were significantly more likely than those with genital herpes to have been frequent users of alcohol (44% vs.

Recent changes in the epidemiology of genital ulcer disease in the United States. The crack cocaine connection.

The incidence of syphilis and chancroid began to increase in the United States among heterosexuals in the mid-1980s, with most cases reported among minorities living in Eastern cities and in the South. A number of studies have established a link between increasing syphilis incidence rates and cocaine use, specifically the smoked form of the drug, which is known as "crack." A similar link was hypothesized for chancroid, but supporting data became available only recently.

Glomerular basement membrane degradation by endogenous cysteine proteinases in isolated rat glomeruli.

Recent in vitro and in vivo studies suggest that cysteine proteinases may play an important role in degradation of the glomerular basement membrane (GBM) by renal glomeruli. However, little information is available concerning the cysteine proteinases present in glomeruli, the distribution of cysteine proteinases in other areas of the kidney, or the potential role of endogenous glomerular cysteine proteinases in GBM degradation. Using well characterized fluorogenic substrates, we have documented the presence of the cysteine proteinases, cathepsins B, H, and L, in glomeruli (0.

Effect of diethyl pyrocarbonate modification on the calcium binding mechanism of the sarcoplasmic reticulum ATPase.

Diethyl pyrocarbonate was used to modify histidyl residues on the sarcoplasmic reticulum ATPase. Difference spectra of the N-carbethoxyhistidyl derivative indicated that most all the histidyl residues on the enzyme had been modified. These residues could be divided into two populations on the basis of their reaction rate with the reagent.