Articles: cations.
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Arch. Pathol. Lab. Med. · Jan 2022
Hot Seat Diagnosis: Competency-Based Tool Is Superior to Time-Based Tool for the Formative In-Service Assessment of Pathology Trainees.
Competency-based medical education relies on frequent formative in-service assessments to ascertain trainee progression. Currently at our institution, trainees receive a summative end-of-rotation In-Training Evaluation Report based on feedback collected from staff pathologists. There is no method of simulating report sign-out. ⋯ Hot Seat Diagnosis is an effective tool for the formative in-service assessment of pathology trainees and simulation of report sign-out, with the competency-based model outperforming the time-based model.
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The present study investigated the clinical efficacy of percutaneous kyphoplasty (PKP) combined with calcitriol and calcium in the treatment of traumatic nonosteoporotic vertebral compression fractures (TNVCFs). ⋯ PKP combined with calcitriol and calcium medications could significantly relieve pain, alleviate the loss of compressed vertebral height and kyphosis, and improve the spinal function and the life quality of the TNVCF patients.
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Percutaneous cervical cordotomy (PCC), which selectively interrupts ascending nociceptive pathways in the spinal cord, can mitigate severe refractory cancer pain. It has an impressive success rate, with most patients emerging pain-free. Aside from the usual complications of neurosurgical procedures, the risks of PCC include development of contralateral pain, which is less understood. ⋯ The development of contralateral pain in patients postcordotomy for cancer pain might be due to central sensitization. Temporal summation could serve as a potential screening tool to identify those who are most likely at risk to develop contralateral pain. Analysis of PCC affords a unique opportunity to investigate how a specific lesion to the nociceptive system affects pain processes.
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Temporomandibular disease (TMD) is a general term including a group of conditions that cause pain and dysfunction in the masticatory muscles, the temporomandibular joint (TMJ), and their related structures. The painful forms of these dysfunctions have become an increasing phenomenon among dental patients. A number of scientific publications indicated the relationship between the presence of postural dysfunctions and functional disorders of the masticatory system in humans. Nevertheless, dental procedures still very rarely include comprehensive diagnostics and procedures aimed at the normalization of the locomotor system related to TMD. Scientific literature usually refers to and describes the coexistence of postural disorders in patients with TMD in the context of anatomical connections, the so-called biokinematic chains, indicating specific types of postures that correlate with different positions of the mandible and/or teeth. ⋯ Diagnostic and therapeutic management in the course of TMD should be holistic. Nevertheless, the observed changes are often varied and largely dependent on individual posture defects, which is an important postulate for further research on a larger study group.
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J Neurosurg Anesthesiol · Jan 2022
Insights into Fibrinogen-Mediated COVID-19 Hypercoagubility in Critically Ill Patients.
Coronavirus disease-2019 (COVID-19) is associated with hypercoagulability that may cause thromobembolic complications. We describe our recent studies investigating the mechanisms of hypercoagulability in patients with severe COVID-19 requiring mechanical ventilation during the COVID-19 crisis in New York City in spring 2020. Using rotational thombelastometry we found that almost all patients with severe COVID-19 had signs of hypercoagulability compared with non-COVID-19 controls. ⋯ Fibrinogen, tissue plasminogen activator and plasminogen activator inhibitor-1, but not plasminogen levels were elevated in patients with severe COVID-19. Our studies indicate that hypercoagulability in COVID-19 may be because of decreased fibrinolysis resulting from inhibition of plasmin through high levels of plasminogen activator inhibitor-1. Clinicians creating treatment protocols for anticoagulation in critically ill COVID-19 patients should consider these potential mechanisms of hypercoaguability.