First year medical student performance on weekly team-based learning exercises in an infectious diseases course: insights from top performers and struggling students.

Background: In Team-Based Learning (TBL) preparation of relevant coursework during self-directed learning time is evaluated by the individual readiness assurance test (iRAT). We recently reported that student performance on iRATs is strongly correlated with final examination scores in an infectious diseases (ID) course. We now investigated how student preparation for each individual iRAT exercise relates to course performance.

Immunopathogenesis of Pediatric Localized Scleroderma.

Localized scleroderma (LS) is a complex disease characterized by a mixture of inflammation and fibrosis of the skin that, especially in the pediatric population, also affects extracutaneous tissues ranging from muscle to the central nervous system. Although developmental origins have been hypothesized, evidence points to LS as a systemic autoimmune disorder, as there is a strong correlation to family history of autoimmune disease, the presence of shared HLA types with rheumatoid arthritis, high frequency of auto-antibodies, and elevated circulating chemokines and cytokines associated with T-helper cell, IFNγ, and other inflammatory pathways. This inflammatory phenotype of the peripheral blood is reflected in the skin via microarray, RNA Sequencing and tissue staining.

Short term outcomes in term and late preterm neonates admitted to the well-baby nursery after resuscitation in the delivery room.

Objective: To determine the risk for deterioration in well-baby nursery (WBN) admissions after resuscitation.

Study Design: A single center retrospective study (2015-2016) of 370 resuscitated WBN admissions.

Results: Of the 11,307 admissions, 3.

Role of Bisphosphonate Therapy in Patients with Osteopenia: A Systemic Review.

By contrast to clinical trials exploring osteoporosis, clinical trials specifically designed for the osteopenic population are limited. Thus, less clinical data are available regarding treatment benefits and cost-effectiveness of treating a patient population with a bone mass density in the osteopenic range (T-score between -1 and -2.5).

Gastropleural Fistula: A Rare Complication of a Common Procedure.

Weight loss surgeries are evident to be highly beneficial in patients with morbid obesity (body mass index (BMI) ≥40.0 kg/m) and severe obesity (BMI between 35.0 and 39.

Model-Based Methods to Translate Adolescent Medicine Trials Network for HIV/AIDS Interventions Findings Into Policy Recommendations: Rationale and Protocol for a Modeling Core (ATN 161).

Background: The United States Centers for Disease Control and Prevention estimates that approximately 60,000 US youth are living with HIV. US youth living with HIV (YLWH) have poorer outcomes compared with adults, including lower rates of diagnosis, engagement, retention, and virologic suppression. With Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) support, new trials of youth-centered interventions to improve retention in care and medication adherence among YLWH are underway.

Procedural Volume and Outcomes for Transcatheter Aortic-Valve Replacement.

Background: During the introduction of transcatheter aortic-valve replacement (TAVR) in the United States, requirements regarding procedural volume were mandated by the Centers for Medicare and Medicaid Services as a condition of reimbursement. A better understanding of the relationship between hospital volume of TAVR procedures and patient outcomes could inform policy decisions.

Methods: We analyzed data from the Transcatheter Valve Therapy Registry regarding procedural volumes and outcomes from 2015 through 2017.

Innovations in vascular access for hemodialysis.

Worldwide, hemodialysis remains the prevalent dialysis modality for more than 2 million patients who require well-functioning vascular access for this procedure. Creation of an arteriovenous fistula for long-term hemodialysis was the first innovation since the Scribner shunt and was followed by the development of an arteriovenous graft and catheter. Bioengineered vessels were developed during the last century, but this field has been energized by recent technology relating to the creation of human vessels.

Association Between Rhinitis and Depression in United States Adults.

Background: Growing evidence suggests a link between allergic disorders and depression, but literature assessing the association between rhinitis and depression is conflicting, and large population-based studies are lacking.

Objective: To assess the association between depression and rhinitis in a representative sample of United States adults.

Methods: We performed a cross-sectional analysis of 4320 participants in the 2005-2006 National Health and Nutrition Examination Survey.

Emerging Therapeutics for Ocular Surface Disease.

Purpose Of Review: The purpose of this article is to review treatment advances in ocular allergy that include the treatment of the various signs and symptoms of the allergic inflammatory response of the ocular surface.

Recent Findings: Recent studies have demonstrated improved pharmacological effect of topical agents with artificial tears and cold compresses; brimonidine, a new ophthalmic decongestant which has demonstrated decreased rebound conjunctivitis; and potential use of contact lens and other novel delivery instruments to increase medication retention time. Currently, there have been limited advances in novel ophthalmic treatments.

Voigt-Futcher pigmentary demarcation lines.

Pigmentary demarcation lines (PDLs) are physiological abrupt transitions between hyperpigmented and lighter skin, a common and sometimes troubling feature of normal skin. They are seen in a majority of dark-complexioned women and a substantial percentage of light-complexioned ones too. We review this salient finding and approaches to its management.

Role of Atrioventricular Junctional Ablation and Cardiac Resynchronization Therapy in Patients with Chronic Atrial Fibrillation.

There remains a great deal of uncertainty whether general application of cardiac resynchronization therapy (CRT) to patients with atrial fibrillation (AF) provides any benefit assuming all other eligibility criteria are met. Preliminary observations suggest that performing atrioventricular junction ablation can improve the results of CRT in patients with AF by rendering the patient pacemaker dependent. Ongoing randomized clinical trials may provide more definitive answers in the future.

Points & Pearls: Evaluation and management of life-threatening headaches in the emergency department.

Headache is the fourth most common reason for emergency department encounters, accounting for 3% of all visits in the United States. Though troublesome, 90% are relatively benign primary headaches --migraine, tension, and cluster headaches. The other 10% are secondary headaches, caused by separate underlying processes, with vascular, infectious, or traumatic etiologies, and they are potentially life-threatening.

Evaluation and management of life-threatening headaches in the emergency department.

Headache is the fourth most common reason for emergency department encounters, accounting for 3% of all visits in the United States. Though troublesome, 90% are relatively benign primary headaches --migraine, tension, and cluster headaches. The other 10% are secondary headaches, caused by separate underlying processes, with vascular, infectious, or traumatic etiologies, and they are potentially life-threatening.

A Novel Grading Strategy for Team-Based Learning Exercises in a Hands-on Course in Molecular Biology for Senior Undergraduate Underrepresented Students in Medicine Resulted in Stronger Student Performance.

We developed a hands-on course in molecular biology for undergraduate underrepresented in medicine (URM) students. To incentivize student preparation for team-based learning (TBL) activities, we implemented a novel grading schema that requires a minimum individual readiness assurance test (iRAT) score to share the team group readiness assurance test (gRAT) score. Fifty-one students participated in this 2-year study and were divided in teams of five or six students that worked throughout the course on a unique, hands-on project and also participated in TBL exercises.

DHS (trans-4,4'-dihydroxystilbene) suppresses DNA replication and tumor growth by inhibiting RRM2 (ribonucleotide reductase regulatory subunit M2).

DNA replication machinery is responsible for accurate and efficient duplication of the chromosome. Since inhibition of DNA replication can lead to replication fork stalling, resulting in DNA damage and apoptotic death, inhibitors of DNA replication are commonly used in cancer chemotherapy. Ribonucleotide reductase (RNR) is the rate-limiting enzyme in the biosynthesis of deoxyribonucleoside triphosphates (dNTPs) that are essential for DNA replication and DNA damage repair.

Best Vascular Access in the Elderly: Time for Innovation?

Background: Conflicting data continue to surround the optimal dialysis access for the elderly. Many propose that catheters are the best option for this population; others emphasize the creation of an arteriovenous fistula.

Summary: While an arteriovenous access is the best available access, it has a high early failure rate, particularly in the elderly.