Development of In-situ Simulation Lab for Training Gynecology Residents in Basic Laparoscopic and Hysteroscopic Operative Skills.

Introduction: Mounting evidence suggests that practice on simulators leads to improved operative skills and patient safety. With restrictions on resident work hours resulting in less exposure to procedures, simulation is the key to developing operative skills during residency and beyond. Residency programs struggle with implementing a simulation program due to timing and availability of residents.

7000 miles and 7 days from the battlefield.

Critically injured combat casualties are rapidly evacuated from the battlefield, and within hours of their injuries they begin a 7000-mile journey home, often arriving in the United States within 7 days. National Naval Medical Center in Bethesda, Maryland, is a major facility for wounded warrior care in the Military Health System. Throughout the facility, the staff from a variety of disciplines and all military services provides care for military personnel with injuries and illnesses, with the goal of optimizing recovery and quality of life.

Operative splenectomy for treatment of homozygous thalassemia major in Afghan children at a US military hospital.

Afghanistan is a war-ravaged country surrounded by mountainous terrain. Due to the geography and harsh living conditions, people have intermarried among tribes for centuries. The right familial combinations can cause manifestations of genetic linked diseases.

A single-blinded, randomized pilot study to evaluate the effect of exercise-induced sweat on truncal acne.

To assess the effect of exercise-induced sweat on truncal acne, a prospective, single-blinded, randomized, controlled, institution review board-approved clinical trial was conducted on physically active males. Subjects were instructed to exercise long enough to break a sweat 5 days a week for 2 weeks. Group 1 did not exercise (n = 7), group 2 showered within 1 hour of exercise (n = 8), and group 3 waited at least 4 hours to shower after exercising (n = 8).

Heat-related illness in athletes.

Heat stroke in athletes is entirely preventable. Exertional heat illness is generally the result of increased heat production and impaired dissipation of heat. It should be treated aggressively to avoid life-threatening complications.

Development of a clinical prediction rule to identify patients with knee pain and clinical evidence of knee osteoarthritis who demonstrate a favorable short-term response to hip mobilization.

Background And Purpose: The primary purpose of this study was to develop a clinical prediction rule (CPR) for identifying patients with knee pain and clinical evidence of knee osteoarthritis (OA) with favorable short-term response to hip mobilizations. The secondary purpose was to determine the predictive validity of individual clinical tests for identifying these same patients.

Subjects And Methods: Sixty subjects with knee OA, aged 51 to 79 years, completed self-report questionnaires, a clinical examination of the hip and knee, and functional tests and were treated with 4 hip mobilizations.

Timing of return of subscapularis function in open capsular shift patients.

Loss of subscapularis function can be a significant complication after any surgery that involves its tenotomy. Recently, this complication has received more recognition after anterior approaches for shoulder replacement. It is unclear, however, whether this occurs in younger patients, and if so, how long it persists postoperatively.

The role of psychiatry in U.S. Air Force primary care: research-based models for clinical consultation and education.

The integration of mental health treatment with primary care is a U.S. Air Force priority.

Effects of moisturization on epidermal homeostasis and differentiation.

Moisturizers are commonly used for routine skin care. This study assessed the effects of a moisturizer on barrier function, epidermal architecture, keratinocyte proliferation, and physiological regulation of the epidermis in photoaged but otherwise normal skin. Fifteen women with moderately photoaged forearms were treated twice a day for 4 weeks with a moisturizer containing dimethicone and glycerine.

A neural systems-based neurobiology and neuropsychiatry course: integrating biology, psychodynamics, and psychology in the psychiatric curriculum.

Objective: Psychotherapy and biological psychiatry remain divided in psychiatry residency curricula. Behavioral neurobiology and neuropsychiatry provide a systems-level framework that allows teachers to integrate biology, psychodynamics, and psychology.

Method: The authors detail the underlying assumptions and outline of a neural systems-based neuroscience course they teach at the National Capital Consortium Psychiatry Residency Program.

Endoscopic laser vs open approach for cricopharyngeal myotomy.

Objective: To illustrate the safety and efficacy of the endoscopic laser approach for cricopharyngeal myotomy (CPM) compared to the traditional transcervical approach.

Study Design And Setting: Retrospective chart review of 22 patients undergoing CPM from 1996 to 2003 at the Mayo Clinic, Jacksonville.

Results: The laser CPM technique was used in 14 patients, and an open approach in 8.

Comparing the incidence of anterior cruciate ligament injury in collegiate lacrosse, soccer, and basketball players: implications for anterior cruciate ligament mechanism and prevention.

Background: Female college basketball and soccer athletes have higher rates of anterior cruciate ligament injury than do their male counterparts. Rates of anterior cruciate ligament injuries for women and men in collegiate lacrosse have not been examined. Understanding anterior cruciate ligament injury patterns in lacrosse, a full-contact sport for men and noncontact sport for women, could further injury prevention efforts.

Supervision and boundaries in a combined family practice and psychiatry residency training program: the National Capital Consortium experience.

Objectives: The combined discipline of family practice and psychiatry was created in 1995. There are no established guidelines for 1) teaching residents how to integrate these two specialties, 2) providing appropriate supervision, and 3) helping residents develop personal and professional boundaries. The authors share their approach and aim to stimulate dialogue and promote the establishment of standards for combined programs.

Teaching psychiatry to family practice residents.

Objective: This article outlines a psychiatry curriculum developed for family practice residents by family practice-psychiatry residents.

Methods: A literature review, needs assessment, planning, implementation, and initial assessment were conducted.

Conclusion: Early results demonstrated improved general psychiatric knowledge and a high level of satisfaction.

Allopathic family medicine residents can learn osteopathic manipulation techniques in a 1-month elective.

Background: Graduating family medicine residents report a relative lack of confidence in managing musculoskeletal problems, and many primary care physicians desire more instruction in manual medicine.

Methods: We conducted a 1-month osteopathic manipulative treatment elective with five allopathic family medicine residents, utilizing multiple teaching and assessment strategies.

Results: Residents averaged 30 patient encounters each.

Use of resequencing oligonucleotide microarrays for identification of Streptococcus pyogenes and associated antibiotic resistance determinants.

Group A streptococci (GAS) are responsible for a wide variety of human infections associated with considerable morbidity and mortality. Ever since the first systematic effort by Lancefield to group Streptococcus species by M protein variants, the detection and characterization of Streptococcus by different methods have been an evolving process. The ideal assay for GAS identification not only would provide quick and accurate diagnostic results but also would reveal antibiotic resistance patterns and genotype information, aiding not only in treatment but in epidemiologic assessment as well.

Pneumomediastinum and subcutaneous emphysema in a synchronized swimmer.

Pneumomediastinum is a rare injury that has been documented in both recreational and competitive athletes. It has been reported in a variety of situations, but it is often a result of chest trauma. Repeated and prolonged use of Valsalva's maneuvers is also believed to lead to pneumomediastinum, as was the case with the synchronized swimmer presented here.

Pimecrolimus for treatment of acne rosacea.

Background: Rosacea is a common disease, which is often resistant to treatment. Topical calcineurin inhibitors have been efficacious in the treatment of other inflammatory disorders of the skin, and tacrolimus has been reported as an effective treatment option for erythrotelangiectatic rosacea.

Objective: Because of the benefits seen with tacrolimus in previous publications, we investigated the efficacy of a closely related compound, pimecrolimus, in patients with erythrotelangiectatic, papulopustular, and edematous rosacea.

Nevoid basal cell carcinoma syndrome or multiple hereditary infundibulocystic basal cell carcinoma syndrome?

We present a case of nevoid basal cell carcinoma syndrome, also known as Gorlin syndrome, or basal cell nevus syndrome, which clinically follows a course more consistent with multiple hereditary infundibulocystic basal cell carcinomas or multiple hereditary trichoepitheliomas. The following article describes the case in detail and gives an overview of other genodermatosis, which were initially considered in the differential and which may be linked pathogenetically.

Pimecrolimus-induced tinea incognito.

A 6-year-old boy was brought to his primary care provider by his mother, who complained of a pruritic rash near his right eye. The eruption was described as a small, erythematous, slightly scaly plaque at the lateral margin of the right eyelid. The child was in good health and took no medications.