Association of Unfavorable Social Determinants of Health With Stroke/Transient Ischemic Attack and Vascular Risk Factors in Hispanic/Latino Adults: Results From Hispanic Community Health Study/Study of Latinos / 대한뇌졸중학회지

Background@#and Purpose Social determinants of health (SDOH) are non-medical factors that may contribute to the development of diseases, with a higher representation in underserved populations. Our objective is to determine the association of unfavorable SDOH with self-reported stroke/transient ischemic attack (TIA) and vascular risk factors (VRFs) among Hispanic/Latino adults living in the US. @*Methods@#We used cross-sectional data from the Hispanic Community Health Study/Study of Latinos. SDOH and VRFs were assessed using questionnaires and validated scales and measurements. We investigated the association between the SDOH (individually and as count: ≤1, 2, 3, 4, or ≥5 SDOH), VRFs and stroke/TIA using regression analyses. @*Results@#For individuals with stroke/TIA (n=388), the mean age (58.9 years) differed from those without stroke/TIA (n=11,210; 46.8 years; P<0.0001). In bivariate analysis, income <$20,000, education less than high school, no health insurance, perceived discrimination, not currently employed, upper tertile for chronic stress, and lower tertiles for social support and language- and social-based acculturation were associated with stroke/TIA and retained further. A higher number of SDOH was directly associated with all individual VRFs investigated, except for at-risk alcohol, and with number of VRFs (β=0.11, 95% confidence interval [CI]=0.09–0.14). In the fully adjusted model, income, discrimination, social support, chronic stress, and employment status were individually associated with stroke/TIA; the odds of stroke/TIA were 2.3 times higher in individuals with 3 SDOH (95% CI 1.6–3.2) and 2.7 times (95% CI 1.9–3.7) for those with ≥5 versus ≤1 SDOH. @*Conclusion@#Among Hispanic/Latino adults, a higher number of SDOH is associated with increased odds for stroke/TIA and VRFs. The association remained significant after adjustment for VRFs, suggesting involvement of non-vascular mechanisms.

Relationship between right ventricular pacing and non-sustained ventricular arrhythmias in patients with dual-chamber pacemaker and normal range left ventricular ejection fraction

Background@#Right ventricular pacing (RVP) increases heart failure, AF, and death rates in pacemaker patients and ventricular arrhythmias (VAs) in defibrillator patients. However, the impact of RVP on VAs burden and its clinical significance in pacemaker patients with normal range LVEF of > 50–55% remains unknown. We sought to evaluate the relationship of RVP and VAs and its clinical impact in a pacemaker patient population. @*Methods@#Records of 105 patients who underwent de novo dual-chamber pacemaker implant or a generator change (Medtronic™ or Boston Scientific™) for AV block and sinus node disease at a tertiary care center between September 1, 2015, and September 1, 2016, were retrospectively reviewed. @*Results@#Data from 105 patients (51% females, mean age 76 ± 1 years, mean LVEF 61 ± 0.7%) without history of VAs (98.2%) were reviewed over 1044 ± 23 days. Dependent patients (100% RVP) exhibited the lowest VAs burden when compared to  1/h of PVC runs and increasing PVC runs/h were significantly associated with hospitalization (p = 0.04) and all-cause mortality (p = 0.03), respectively. @*Conclusions@#In pacemaker patients with normal range LVEF (> 50–55%), 100% RVP is associated with the lowest burden of NSVT. Furthermore, patients with < 1% RVP also exhibit low VA burden; however, intermittent RVP seems to significantly correlate with non-sustained VAs.

Prevalence of HIV/STIs and correlates with municipal characteristics among female sex workers in 13 Mexican cities / Prevalencia de VIH/ITS y correlaciones con carácterísticas municipales entre trabajadoras sexuales en 13 ciudades mexicanas

Abstract: Objective: To identify correlates of HIV/STI prevalence among 13 cities with varying sizes of female sex worker (FSW) populations and municipal characteristics in Mexico. Materials and methods: FSWs underwent interviews and testing for HIV, syphilis, gonorrhea and chlamydia. Logistic regression explored variations in HIV/STI prevalence. Results: Among FSWs (n=1 092), prevalence across 13 sites was: HIV: 0.4% (range: 0%-1.4%): syphilis: 7.8% (range: 0%-17.2%); chlamydia: 15.3% (range: 5.7%-32.2%); gonorrhea: 2.9% (range 0%-13.8%), and any HIV/STI: 23% (range: 9.9%-46%). Municipalities with high human development scores and a lower municipal marginalization index had higher odds of combined HIV/STI prevalence. After controlling for site-specific variability in municipal characteristics, greater risk of HIV/STIs was associated with lower education, having a spouse diagnosed or treated for an STI, unaffordability of condoms, and having non-Mexican clients. Conclusions: Prevalence of HIV/STIs varies across Mexican municipalities indicating the need for surveillance to identify hotspots for targeted resource allocation.

Resumen: Objetivo: Identificar correlaciones de la prevalencia de VIH / ITS entre 13 ciudades con diferentes tamaños de población de trabajadoras sexuales y características municipales en México. Material y métodos: Las trabajadoras sexuales fueron entrevistadas y recibieron pruebas de VIH, sífilis, gonorrea y clamidia. La regresión logística exploró las variaciones en la prevalencia del VIH/ITS. Resultados: Entre las trabajadoras sexuales (n = 1 092), la prevalencia en 13 sitios fue: VIH: 0.4% (rango: 0-1.4%): sífilis: 7.8% (rango: 0-17.2%); clamidia: 15.3% (rango: 5.7-32.2%); gonorrea: 2.9% (rango 0-13.8%) y cualquier VIH/ITS: 23% (rango: 9.9-46%). Los municipios con altos puntajes de desarrollo humano y menor índice de marginación municipal tuvieron una mayor probabilidad de prevalencia combinada de VIH/ITS. Después de controlar la variabilidad específica del sitio en las características municipales, el mayor riesgo de VIH / ITS se asoció con menor educación, tener un cónyuge diagnosticado o tratado para una ITS, imposibilidad de conseguir condones y tener clientes no mexicanos. Conclusiones: La prevalencia de VIH/ITS varía entre los municipios mexicanos, lo que indica la necesidad de una vigilancia para identificar hotspots para la asignación selectiva.

Cardiovascular Disease Epidemiology in Portuguese-Speaking Countries: data from the Global Burden of Disease, 1990 to 2016 / Epidemiologia das Doenças Cardiovasculares em Países de Língua Portuguesa: Dados do "Global Burden of Disease", 1990 a 2016

Abstract Background: Portuguese-speaking countries (PSC) share the influence of the Portuguese culture but have socioeconomic development patterns that differ from that of Portugal. Objective: To describe trends in cardiovascular disease (CVD) morbidity and mortality in the PSC between 1990 and 2016, stratified by sex, and their association with the respective sociodemographic indexes (SDI). Methods: This study used the Global Burden of Disease (GBD) 2016 data and methodology. Data collection followed international standards for death certification, through information systems on vital statistics and mortality surveillance, surveys, and hospital registries. Techniques were used to standardize causes of death by the direct method, as were corrections for underreporting of deaths and garbage codes. To determine the number of deaths due to each cause, the CODEm (Cause of Death Ensemble Model) algorithm was applied. Disability-adjusted life years (DALYs) and SDI (income per capita, educational attainment and total fertility rate) were estimated for each country. A p-value <0.05 was considered significant. Results: There are large differences, mainly related to socioeconomic conditions, in the relative impact of CVD burden in PSC. Among CVD, ischemic heart disease was the leading cause of death in all PSC in 2016, except for Mozambique and Sao Tome and Principe, where cerebrovascular diseases have supplanted it. The most relevant attributable risk factors for CVD among all PSC are hypertension and dietary factors. Conclusion: Collaboration among PSC may allow successful experiences in combating CVD to be shared between those countries.

Resumo Fundamento: Os países de língua portuguesa (PLP) partilham a influência da cultura portuguesa com desenvolvimento socioeconômico diverso de Portugal. Objetivo: Descrever as tendências de morbidade e mortalidade por doenças cardiovasculares (DCV) nos PLP, entre 1990 e 2016, estratificadas por sexo, e sua associação com os respectivos índices sociodemográficos (SDI). Métodos: O estudo utilizou dados e metodologia do Global Burden of Disease (GBD) 2016. As informações seguiram padrões internacionais de certificação de óbito, através de sistemas de informação sobre estatísticas vitais e vigilância da mortalidade, pesquisas e registros hospitalares. Empregaram-se técnicas para padronização das causas de morte pelo método direto, e correções para sub-registro dos óbitos e garbage codes. Para determinar o número de mortes por cada causa, aplicou-se o algoritmo CODEm (Modelagem Agrupada de Causas de Morte). Estimaram-se os anos saudáveis de vida perdidos (DALYs) e o SDI (renda per capita, nível de escolaridade e taxa de fertilidade total) para cada país. Resultados: Existem grandes diferenças na importância relativa da carga de DCV nos PLP relacionadas principalmente às condições socioeconômicas. Entre as DCV, a doença isquêmica do coração foi a principal causa de morte nos PLP em 2016, com exceção de Moçambique e São Tomé e Príncipe, onde as doenças cerebrovasculares a suplantaram. Os fatores de risco atribuíveis mais relevantes para as DCV entre os PLP foram a hipertensão arterial e os fatores dietéticos. Um valor de p < 0,05 foi considerado significativo. Conclusão: A colaboração entre os PLP poderá permitir que experiências exitosas no combate às DCV sejam compartilhadas entre esses países.

Aceptabilidad de un atole fortificado con 21 micronutrientes e impacto en la salud y nutrición de niños menores de 6 años de edad en la ciudad de guatemala / Acceptability of a 21 micronutrient-fortified atole and its impact on health and nutrition in children under 6 years of age from guatemala city

Con el objetivo de reducir la desnutrición crónica de niños que asisten 6 jardines infantiles en la Ciudad de Guatemala, se utilizó una bebida a base de soya y maíz como vehículo para el aporte de 21 micronutrientes con niveles elevados de hierro (12mg) y zinc (9mg) y se ofreció a 747 niños entre los 6 meses y 6 años. Se realizó seguimiento antropométrico cada 3m, Hb cada 6m y se registró el número de episodios de enfermedad diarreica aguda e infección respiratoria aguda a lo largo de la intervención. Un ANOVA longitudinal de medidas repetidas demostró que la media de la Hb mejoró de manera significativa a los 6 y 12m de recibir la bebida fortificada (11,26, 11,64, y 11,89g/dL, respectivamente), p<0,01; la prevalencia de anemia disminuyó 44,2% después de 12m, p<0,01; la media del puntaje z de talla para la edad también mejoró, -1,25 (0m) y -1,07 (12m), p<0.01; la prevalencia de retardo del crecimiento disminuyó 25% a los 12m. Se observó una disminución significativa en la prevalencia de infección respiratoria aguda y no se observaron cambios en la prevalencia de diarrea. Un estudio de aceptabilidad demostró que los niños consumen más del 98% del producto. Los resultados sugieren que la intervención con el atole fortificado mejora el estado nutricional y de salud de los niños. El producto es aceptado por los niños y el personal de los jardines infantiles(AU)

With the aim to reduce chronic undernutrition in children that attended 6 Guatemala City daycare centers, a corn and soy-based beverage was used as a vehicle to provide 21 micronutrients and high concentrations of iron (12mg) and zinc (9 mg) and was provided to747 children aged 6 to 72 months. Children were followed for anthropometry every 3m, hemoglobin every 6m, and episodes of acute diarrhea and respiratory tract infections were registered throughout the intervention. A longitudinal Repeated Measures ANOVA demonstrated that mean hemoglobin significantly improved at 6 and 12m of receiving the beverage (11.26, 11.64, and 11.89g/dL, respectively), p<0.01; the prevalence of anemia decreased by 44.2% after 12m, p<0.01; mean height-for-age z score improved from -1.25 (0m) to -1.07 (12m), p<0.01; the prevalence of stunting decreased by 25% after 12m. A significant decrease in the prevalence of acute respiratory infection was observed. No changes were observed in the prevalence of diarrhea. Moreover, an acceptability study showed that children consumed more than 98% of the atole. These results suggest that this nutrition intervention with the fortified atole improves the health and nutritional status of children. The product is widely accepted by the children and staff at the nurseries(AU)

Nonsurgical Interventions for Peyronie's Disease: Update as of 2016

Peyronie's disease (PD) is a debilitating condition of the penis that leads to significant pain, erectile dysfunction, and emotional distress in men. PD is likely underreported due to lack of knowledge of the disease and the absence of well-established available treatments. Surgical treatment can lead to sustained improvements, but is often associated with penile shortening and places the patient at risk for perioperative morbidity. Nonsurgical management has been studied for several years as an alternative to surgery for men with PD. Currently, much of the data on nonsurgical management is conflicting, with only one treatment that has been recently approved by the US Food and Drug Administration. Significant effort has been devoted to advancing non-surgical treatments for PD that can be implemented outside of the operating room. This review aims to describe the research behind current nonsurgical therapies for PD and to highlight the recent advances that have been made within the last three years.

The Nephroprotective Effects of Graded Concentrations of Calcium and Magnesium on Nephrotoxicities Induced by a Constant Toxic Concentration of Cadmium and Lead in Rats.

Aims: To concurrently administer constant toxic concentrations of Cd and Pb with graded concentrations of Ca and Mg using a rat model to determine their nephroprotective effects against Cd and Pb nephrotixicities. Study Design: Wistar rats were divided into five groups of four rats per group in metabolic cages. Group one was placed on tap water only, while group two to five were placed on a constant concentration of 0.327 mg/L lead and 0.079 mg/L cadmium concurrently with graded magnesium and calcium. Place and Duration of Study: The animal House of Pharmacology Department, Anatomy and Biochemistry laboratories, University of Jos, Nigeria, were used for treatments, histochemical and biochemical analyses respectively, between December 2013 and April 2014. Methodology: Their feed was mashed with the same water meant for each group. All the groups fed and freely drank from the water for a period of fourteen (14) days. Twenty-four hour (24h) urine samples were collected from the rats at their respective groups in the urine collector of the metabolic cages for fourteen days. The urine samples were kept frozen until needed for clinical analysis. At the termination of the experiments, the rats were humanely sacrificed, the kidneys identified and fixed in 10% formal saline for histopathological studies. Results: Kidney biomarkers in urine decreased, while urinary excretion of urea and creatinine increased as the concentrations of calcium and magnesium were elevated. The histopathological analyses show that there was no significant difference (P<0.05) between control and groups 4 and 5, but there was significant difference (P>0.05) between control and groups 2 and 3. Conclusion: Results suggest that calcium and magnesium could mitigate the nephrotoxicities induced by cadmium and lead. Therefore, good proportion of calcium and magnesium in the diet and water would enhance good health especially for those living in environments contaminated with heavy metals.

Chemotherapy-induced neutropenia, anemia and thrombocytopenia among Filipino breast cancer patients on adjuvant hemotherapy

INTRODUCTION: Cytotoxic chemotherapy places all cancer patients at risk of developing myelosuppression. Different chemotherapy regimens could lead to development of neutropenia, anemia and thrombocytopenia which may lead to delays in facilitating chemotherapy and also may place cancer patients at risk of developing severe complications which may be life threatening. This study determined the incidence of neutropenia, anemia, and thrombocytopenia per cycle of chemotherapy starting after the 1st cycle among non-metastatic breast cancer patients. It also evaluated if age, size of primary tumor, number of positive lymph nodes, IHC result, BMI, co-morbidities and chemotherapy used were associated with the development of neutropenia, anemia and thrombocytopenia during the 10 cycle of chemotherapy; this may help in ascertaining which patients may need more intensive monitoring during subsequent chemotherapy sessions.METHODS: This is a time series study wherein the CBC results starting prior 1° chemotherapy cycle were gathered from medical charts of non-metastatic breast cancer patients receiving cyclophosphamide/ doxorubicin/ docetaxel/ fluororuracil chemotherapy at UP-PGH and JRRMMC Medical Oncology Clinics enrolled under the DOH-NCPAM BCMAP program, from 1 January 2009 to 31 June 2014. Incidence rates of neutropenia, anemia and thrombocytopenia were recorded per cycle of chemotherapy. Severity of myelosuppression was graded based on the Common Toxicity Criteria of the National Cancer Institute Version 2.0. Possible predictors of myelosuppression were assessed focusing on the 1st cycle of chemotherapy where interventions were not yet done. Standard statistical methods were used for the descriptive analysis. Variables were analyzed using the Chi square test and logistic regression; level of significance was at pAfter the 1st chemotherapy cycle, the incidence of neutropenia was 4.67% (35 patients), anemia 2.27% (17 patients), and thrombocytopenia 0.8% (6 patients). Of these patients, only 1.17% (9 patients) experienced severe neutropenia and 0.27% (2 patients) experienced grade 3-4 anemia. No patient experienced grade 3-4 thrombocytopenia.Age, size of primary tumor, number of positive lymph nodes, IHC result, BMI, co-morbidities and chemotherapy used were not associated with risk for myelosuppression during the 1st cycle of chemotherappy.CONCLUSION: Incidence rates of neutropenia, anemia and thrombocytopenia were minimal in non-metastatic breast cancer patients undergoing cytotoxic chemotherapy, with low rates of severe myelosupression. Myelosupression from standard doxorubicin/ cyclophosphamide/ docetaxel/ fluoracil containing chemotherapy regimens can be given to non-metastatic breast cancer patients, completing required number of chemotherapy cycles with nil interruption or delay.

Immunohistochemical profile, pattern of recurrence, and time to progression of non-metastatic breast cancer patients of the Department of Health-Breast Cancer Medicines Access Program

BACKGROUND: Breast cancer remains to be the leading cause of malignancy among women and survival rates vary worldwide. Molecular and immunohistochemical (NC) profiling of breast cancer has emerged to improve treatment, which led to 6 different breast cancer subtypes luminal-A, luminal-B, Her-2 enriched, basal-like, daudin low, and normal breast. Essentially, this guides clinicians as to the choice of treatment and prognostication of disease. This study evaluates the characteristics of the different IHC subtypes of breast cancer among Filipinos as to pattern of recurrence and time to progression (TIP) within their 1st 2 years of follow-up.METHODS: This is a retrospective cohort study, approved by the University of the Philippines Manila Research Ethics Board (UPMREB). Study population included breast cancer patients enrolled in the DOH-BCMAP and managed at the medical oncology clinics of the Philippine General Hospital (PGH) and Jose R. Reyes Memorial Medical Center (JRRMMC) from 1 May 2011 to 31 December 2013. Patients' demographics, disease and treatment profile were gathered from the medical charts. Patients were grouped into 12 different IHC subtypes utilizing only IHC staining results of Her2neu, ER and PR. Disease progression/ relapse and time to progression (UP) were primary outcomes analyzed and compared between subtypes using SPSS.RESULTS: There were 368 eligible patients; 50% were >50 years old, 48% postmenopausal, 34% stage IIA, and 94% had invasive ductal carcinoma. About 88% completed their chemotherapy regimen, mostly AC-T. At 1 to 2 years follow-up, 18% had disease progression, mostly distant metastasis, with HER2neu(-)/ER(-)/PR(-), HER2(+), and HER2neu(-)/ER(+)/PR(+) subtypes having the most number of disease progression. The HER2neu(-)/ER(-)/PR(-) subtype had the shortest median TTP (11 months 9sd). HER2(+) subtype had median TTP of 14±8 sd, while HER2neu(-)/ER(+)/PR(+) had median TTP at 11.6±7.41 sd. The median TTPs among the different IHC subtypes were statistically comparable. CONCLUSION: Filipinas with non-metastatic breast cancer after surgery and mainly on adjuvant chemotherapy started to develop disease progression/ relapse within the first 2 years of follow-up; 82% had no relapse. At these early years of follow-up, the median TTPs among the different breast cancer IHC subtypes who went into relapse were comparable, although HER2neu(+) regardless of ER/PR subtype tended to have more disease progression, followed by HER2neu(-)/ ER(-)/ regardless of PR subtype, and then HER2neu(-)/ ER(+)/ regardless of PR subtype. IHC resultant HER2neu(+) regardless of ER/PR and HER2neu(-)/ER(-)/PR(-/+) subtypes can serve as early prognosticators of breast cancer relapse.  

A Case-Study of Implementation of Improved Strategies for Prevention of Laboratory-acquired Brucellosis

BACKGROUND: In 2012, the Alaska Section of Epidemiology investigated personnel potentially exposed to a Brucella suis isolate as it transited through three laboratories. METHODS: We summarize the first implementation of the United States Centers for Disease Control and Prevention 2013 revised recommendations for monitoring such exposures: (1) risk classification; (2) antimicrobial postexposure prophylaxis; (3) serologic monitoring; and (4) symptom surveillance. RESULTS: Over 30 people were assessed for exposure and subsequently monitored for development of illness. No cases of laboratory-associated brucellosis occurred. Changes were made to gaps in laboratory biosafety practices that had been identified in the investigation. CONCLUSION: Achieving full compliance for the precise schedule of serologic monitoring was challenging and resource intensive for the laboratory performing testing. More refined exposure assessments could inform decision making for follow-up to maximize likelihood of detecting persons at risk while not overtaxing resources.

Técnicas didácticas: método de caso clínico con la utilización de video como herramienta de apoyo en la enseñanza de la medicina / Teaching techniques: clinical case approach to the use of video as a tool to support

La enseñanza de las ciencias biomédicas o denominadas también básicas, en los programas de medicina de las Universidades de Colombia, es la base fundamental para el desarrollo continuo del razonamiento científico y clínico en los futuros profesionales facultativos para la evolución social y científica del país. La evaluación autónoma de la calidad interna, por parte de las instituciones educativas, se hace imprescindible para lograr, no sólo, la adquisición de conocimientos fácticos en forma significativa, sino también, la formación ética, estética y humanística de los estudiantes. La enseñanza y el aprendizaje de las ciencias Biomédicas implican aspectos teóricos, metodológicos e investigativos, así como una reflexión constante sobre el quehacer pedagógico, lo que implica la interdisciplinaridad, la integración básico-clínica y, por extensión, la didáctica y la aplicación de tecnologías de la información y la comunicación (TIC). En este escrito, se expone una experiencia pedagógica de tipo cualitativo fundamentada en Método de Caso Clínico (MdC), la cual se llevó a cabo dentro de la sección de Bioclínica de la Universidad El Bosque, se estructuró con el uso de TIC y se basó en un problema de impacto de morbilidad de Salud Pública para Colombia.

The teaching of biomedical sciences or also called basic medical programs at the Universities of Colombia, is the fundamental basis for the continued development of scientific reasoning and clinical professionals in future physicians, and therefore to the social and scientific the country. Therefore, the independent evaluation of internal quality by educational institutions is essential to achieve not only the acquisition of factual knowledge significantly, but also the ethical, aesthetic and humanistic students. Teaching and learning science involves Biomedical theoretical, methodological and research and a constant reflection on the pedagogical practice, which involves interdisciplinary, basic clinical integration, and by extension the teaching and application of new Information and Communication Technology (ICT). In this paper, presents a qualitative learning experience based on Clinical Case Method (MdC), which was held in the section Bioclinic of the University El Bosque, and was structured with the use of TICS and which was based on a problem of impact of disease of public health for Colombia.

Knowledge of thromboprophylaxis guidelines pre- and post-didactic lectures during a venous thromboembolism awareness day at a tertiary-care hospital

Didactic lectures are frequently used to improve compliance with practice guidelines. This study assessed the knowledge of health-care providers [HCPs] at a tertiary-care hospital of its evidence-based thromboprophylaxis guidelines and the impact of didactic lectures on their knowledge. The hospital launched a multifaceted approach to improve thromboprophylaxis practices, which included posters, a pocket-size guidelines summary and didactic lectures during the annual thromboprophylaxis awareness days. A self-administered questionnaire was distributed to HCPs before and after lectures on thromboprophylaxis guidelines [June 2010]. The questionnaire, formulated and validated by two physicians, two nurses and a clinical pharmacist, covered various subjects such as risk stratification, anticoagulant dosing and the choice of anticoagulants in specific clinical situations. Seventy-two and 63 HCPs submitted the pre- and post-test, respectively [62% physicians, 28% nurses, from different clinical disciplines]. The mean scores were 7.8 +/- 2.1 [median = 8.0, range = 2-12, maximum possible score = 15] for the pre-test and 8.4 +/- 1.8 for the post-test, P = 0.053. There was no significant difference in the pre-test scores of nurses and physicians [7.9 +/- 1.7 and 8.2 +/- 2.4, respectively, P = 0.67]. For the 35 HCPs who completed the pre- and post-tests, their scores were 7.7 +/- 1.7 and 8.8 +/- 1.6, respectively, P = 0.003. Knowledge of appropriate anticoagulant administration in specific clinical situations was frequently inadequate, with approximately two-thirds of participants failing to adjust low-molecular-weight heparin doses in patients with renal failure. Education via didactic lectures resulted in a modest improvement of HCPs' knowledge of thromboprophylaxis guidelines. This supports the need for a multifaceted approach to improve the awareness and implementation of thromboprophylaxis guidelines

Sera of Chagasic patients react with antigens from the tomato parasite Phytomonas serpens

The genus Phytomonas comprises trypanosomatids that can parasitize a broad range of plant species. These fagellates can cause diseases in some plant families with a wide geographic distribution, which can result in great economic losses. We have demonstrated previously that Phytomonas serpens 15T, a tomato trypanosomatid, shares antigens with Trypanosoma cruzi, the agent of human Chagas disease. Herein, two-dimensional gel electrophoresis (2-DE) and mass spectrometry (MS) were used to identify proteins of P. serpens 15T that are recognized by sera from patients with Chagas disease. After 2D-electrophoresis of whole-cell lysates, 31 peptides were selected and analyzed by tandem mass spectrometry. Twenty-eight polypeptides were identifed, resulting in 22 different putative proteins. The identifed proteins were classifed into 8 groups according to biological process, most of which were clustered into a cellular metabolic process category. These results generated a collection of proteins that can provide a starting point to obtain insights into antigenic cross reactivity among trypanosomatids and to explore P. serpens antigens as candidates for vaccine and immunologic diagnosis studies.

Why Kampo? Why Now? Why Me? / 日本東洋医学雑誌

The world has now rediscovered the value of traditional medicine. Much traditional medicine in South-East Asian countries originated from the medicines of ancient China, and developed independently within those individual countries. As a measure toward information exchange and communication among these countries, the World Health Organization's Western Pacific Regional Office (WHO-WPRO) has published its International Standard Terminologies (IST) for use globally. While domestically in Japan, Kampo is now taught as a regular subject in all medical schools. In this light, there is significant meaning to holding conference with the purpose of understanding the current status of Japanese Kampo around the world, and considering the best ways to disseminate Kampo information globally. The International Conference of Kampo Medicine (provisional title) has been held thus far a total of three times, to address the current status of Japanese Kampo, Japanese Kampo issues from global point of view, as well as the current status of traditional medicine in China and Korea also originating from the ancient Chinese medicine. The conference was entitled &lsquoWhy Kampo? Why Now? Why Me?—The reason why foreign medical doctors worldwide choose Japanese Kampo, and the situation or development of Kampo medicine in their own countries”, in which foreign doctors in Japan, medical students, and leading Kampo medical practitioners were invited to give lectures, which were followed by free discussions by all participants.

Education about kampo medicine at Keio University Medical School / 医学教育

1) For third-year students at Keio University Medical School, 10 lectures are given about why <I>kampo</I> medicine is effective, Fourth-year students receive 8 lectures on <I>kampo</I> medicine and participate in independent study sessions 3 times a week for 4 months.<BR>2) In lectures entitled “Why Is <I>kampo</I> Medicine Effective?”we introduce the functional mechanism of action of <I>kampo</I> medicine and address the skepticism of medical students. In the lecture series entitled “Kampo Medicine, ”we introduce the clinical foundations of <I>kampo</I> practice and provide students with a checklist of the key points of each lecture.<BR>3) In the independent study sessions, several students perform mentored basic-science research into <I>kampo's</I> mechanism of action.

Biología y patobiología humanas del complejo de absorción y transporte epitelial MegaCUBAM / Human biology and pathobiology of the absorption and epithelial transport of MegaCUBAM

En los organismos multicelulares animales, las células epiteliales son estructuras dinámicas que están relacionadas en una compleja, exquisita y regulada serie de procesos fisiológicos, siendo de los más relevantes los relacionados con la absorción, el catabolismo y el reciclaje de nutrientes. De igual forma, estos organismos están en constante desafío debido a la continua interacción con una gran variedad de eventos aleatorios ambientales. Frente a esta serie de agentes potencialmente nocivos, las células epiteliales se constituyen en la primera línea de defensa, protección e interfase de intercambio. En esta revisión de tema se pretende realizar un abordaje de la información actual acerca de una maquinaria de transporte epitelial de absorción, que hace posible desencadenar una respuesta efectiva a tales eventos, se trata del complejo MegaCUBAM.

Teaching about Kampo Medicine in Foreign Countries Via a Web-based Virtual Class / 医学教育

1) Although many people all over the world are aware of traditional Chinese medicine, <I>kampo</I> medicine is not as well known. <I>Kampo</I>, traditional Japanese herbal medicine, is an integral part of medical practice in Japan and deserves greater attention. 2) In response to increasing interest in <I>kampo</I> we have created a web-based virtual class as a reliable source for information about <I>kampo</I> medicine. This virtual class incorporates the latest data on <I>kampo</I> and numerous features to pro- mote a basic understanding of <I>kampo</I>. 3) Through this website and virtual class for health professionals, knowledge of the reliability, usefulness, and safety of <I>kampo</I> will be shared with the world.