#EUROmicroMOOC: using Twitter to share trends in Microbiology worldwide.

Twitter is one of the most popular social media networks that, in recent years, has been increasingly used by researchers as a platform to share science and discuss ongoing work. Despite its popularity, Twitter is not commonly used as a medium to teach science. Here, we summarize the results of #EUROmicroMOOC: the first worldwide Microbiology Massive Open Online Course taught in English using Twitter. Content analytics indicated that more than 3 million users saw posts with the hashtag #EUROmicroMOOC, which resulted in over 42 million Twitter impressions worldwide. These analyses demonstrate that free Microbiology MOOCs shared on Twitter are valuable educational tools that reach broad audiences throughout the world. We also describe our experience teaching an entire Microbiology course using Twitter and provide recommendations when using social media to communicate science to a broad audience.

A cross-sectional study on preoperative anxiety in adults.

OBJECTIVE: The main objective of this study was a detailed comparison of the level of anxiety about surgery and anesthesia. Other objectives included the assessment of the prevalence and intensity of preoperative anxiety. METHODS: This cross-sectional single-center survey used the validated Amsterdam anxiety and information scale (APAIS) and a modified numeric rating scale (mNRS) to assess preoperative anxiety, anxiety about surgery and anxiety about anesthesia. Prevalences and intensities of anxieties were predominantly analyzed descriptively. RESULTS: 3200 patients were enrolled and 3087 (57% females) were analyzed. 92.6% reported preoperative anxiety according to APAIS scores. The average total APAIS anxiety score (APAIS-A-T) was 9.9 (SD 3.6). 40.5% reported high anxiety (defined as APAIS-A-T > 10). Mean anxiety about surgery (APAIS-A-Su) was higher than mean anxiety about anesthesia (APAIS-A-An): 5.5 (SD 2.1) vs. 4.3 (SD 1.9), p < 0.0001. Accordingly, more patients were substantially more afraid (score difference > 2) of surgery (642, 20.8%, 95% CI 19.4-22.3) than of anesthesia (48, 1.6%, 95% CI 1.2-2.1). CONCLUSION: Preoperative anxiety is still very common among adult patients scheduled to undergo an elective procedure. Therefore, it should be evaluated routinely. Anxiety about surgery and anxiety about anesthesia differ in many patients. For this reason, anxiety about surgery and anxiety about anesthesia should be assessed separately. This would allow providing a more individualized support of patients to cope with their anxiety and could require particular attention by the surgeon or the anesthetist.

[Clinical-diagnostic hit rates and differential diagnoses depending on the sampling site of 2109 presumptively malignant canine and feline tumour submissions]. / Klinisch-diagnostische Trefferquoten und Differenzialdiagnosen bei 2109 kaninen und felinen Tumorproben mit Malignitätsverdacht. Evaluierung in Abhängigkeit der Entnahmelokalisation.

OBJECTIVE: The frequency of correct clinical presumptive diagnosis and the spectrum of important differential diagnoses were investigated in common canine and feline malignant tumours. MATERIAL AND METHODS: Based on 2109 presumptive malignant tumour samples submitted to the Institute of Veterinary Pathology of the Justus-Liebig-University, Giessen, the hit rates of the presumed diagnoses of the submitting veterinarians and the actual histopathological diagnosis were calculated for the specific sampling sites. These hit rates were statistically evaluated for significant deviations between the different sampling sites using the chi-square test and Fisher's exact test. Additionally, the more common differential diagnoses with respect to the sampling site were established. RESULTS: This compilation of histopathological diagnoses, with respect to the varying sampling sites, combined with the hit rates of the presumed diagnoses of the submitting veterinarians, yields quantitative knowledge on the frequency of occurrence, correct clinical diagnosis and macroscopic appearance of the malignant tumours investigated. The correctness of the presumptive clinical diagnosis largely depends on tumour type and localization. For the more frequent tumours, it varies from 19% to 83%. CONCLUSION AND CLINICAL RELEVANCE: The results show the importance of a histopathological evaluation of all tumour samples as the presumptive clinical diagnosis based on appearance only corresponds in a few cases with the histopathological diagnosis.

[Non-invasive extended hemodynamic monitoring. Reduction of circulatory risk situations]. / Nichtinvasives erweitertes hämodynamisches Monitoring. Reduktion von zirkulatorischen Risikosituationen.

BACKGROUND: Cardiac output and the cardiac index (CI) are not routinely monitored during major abdominal surgery for economic as well as medical reasons. This practice, however, might be changed by the application of newer non-invasive technologies like the partial CO(2) rebreathing method based on the inverse Fick's principle. In this prospective randomized study we investigated the impact of a non-invasive monitoring of CI on the incidence of hemodynamic instability and interventions by the attending anesthesiologist during major abdominal surgery. PATIENTS AND METHODS: Additionally to routine hemodynamic monitoring we measured CI using the partial CO(2) rebreathing method in 28 patients (9 female, 19 male) undergoing major abdominal surgery. In group I the anesthesiologists were aware of the results of the extended hemodynamic monitoring and in group II the attending anesthesiologist was blinded to the information obtained by these measurements of CI. RESULTS: Groups did not differ with regard to the baseline hemodynamic parameters. We obtained 923 measurements in both groups and 95 situations of hemodynamic instability (CI<2.5 l/minxm(2)) were detected in group I compared to 147 situations in group II (p<0.05). There were significantly more hemodynamic interventions in group I than in group II (p<0.0001). The cardiac index remained higher in group I in comparison to group II (p<0.0001). Measurement of CI was the only method to detect situations of hemodynamic instability in our setting. CONCLUSION: The incidence of hemodynamic instability was significantly reduced during major abdominal surgery when anesthesiologists were aware of the measurement results of extended hemodynamic monitoring.

Medication use among children with asthma in East Harlem.

PURPOSE: To examine daily use of antiinflammatory medication among children with asthma in East Harlem, where hospitalization rates for asthma are among the highest in the United States. METHODS: We analyzed parent/guardian reports of medications used by children with current asthma (defined as physician diagnosis and wheezing during the previous 12 months) identified from a cross-sectional survey conducted in 2 elementary schools. RESULTS: From an overall sample of 1319 children, 298 with current asthma were included in this analysis. Most of those with asthma were Puerto Rican (136 [46%]) or black (98 [33%]), 168 (57%) were boys, and the median age was 8 years old. Overall, 65 (22%) were using antiinflammatory medication on a daily basis. A subgroup of 107 children with asthma had been hospitalized during the previous 12 months or had used beta(2)-agonist on a daily basis, suggesting persistent or severe asthma. Of these 107 children, 42 (39%) were taking antiinflammatory medication on a daily basis. Multivariate analysis of these 107 children revealed that daily use of antiinflammatory medication was associated with using a spacer tube (adjusted odds ratio [AOR]: 3. 08; 95% confidence interval [CI]: 1.27,7.47) and having seen a physician in the past 6 months (AOR: 3.46; CI: 1.01,11.9). Compared with Puerto Ricans, blacks (AOR:.32; CI:.12,.89) or children of other races/ethnicities (AOR:.27; CI:.09,.85) were less likely to use antiinflammatory medication on a daily basis. CONCLUSION: Daily use of antiinflammatory medication for children with persistent or severe asthma in East Harlem was underused. Differences in access to care may explain some findings; however, reasons for ethnic differences in use remain unclear. Both community interventions and additional provider education are needed.

Single, high-dose intramuscular triamcinolone acetonide versus weekly oral methotrexate in life-threatening asthma: a double-blind study.

Effective and less toxic treatments are needed for patients with severe, steroid-dependent asthma. Both low-dose oral methotrexate and high-dose intramuscular triamcinolone have been recommended for these patients. We compared the effects of these two medications on pulmonary function, peak flow rates, airway reactivity, oral steroid use, emergency room (ER) visits, and hospitalizations in patients with steroid-dependent, life-threatening asthma. In a randomized, placebo-controlled, double-blind study, we investigated 19 such patients. Six of the patients (Group I) received a single dose of 360 mg triamcinolone intramuscularly with placebo methotrexate; seven patients (Group II) received placebo triamcinolone followed by low-dose oral methotrexate (a first dose of 7.5 mg followed by 15 mg weekly); and six patients (Group III) received placebo triamcinolone with placebo methotrexate. All patients used the same high-dose inhaled steroids. The patients took tapering courses of oral steroids when needed, but attempted to reduce their oral steroid use whenever possible. Methacholine challenge testing was performed every 6 wk, pulmonary function tests every 4 wk, and home peak-flow measurements twice daily. Oral steroid use, ER visits, and hospitalizations were also monitored. The patients in the triamcinolone treatment group showed a significant and sustained increase in home peak-flow rates, and their FEV1 persistently improved by a mean of 40% (p < 0.05), whereas the FEV1 of the patients in the methotrexate treatment and placebo groups remained near baseline. The PC20 in the triamcinolone group increased progressively (p > 0.05), and the improvements in total mean reactivity were greater in this group than in either of the other two groups (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Chronic polyarthritis and carpal tunnel syndrome. Results of follow-up]. / Chronische Polyarthritis und Carpaltunnelsyndrom. Nachuntersuchungsergebnisse.

Between July 1974 and December 1989, carpal tunnel-syndromes (CTS) were operated on in 903 hands of 746 patients. 147 of these patients (191 hands) were suffering from chronic inflammatory joint diseases. In 11 patients CTS was the first sign of rheumatoid arthritis (R.A.). The hands showed intraoperatively in 44.8% (n = 86/191) an extensive tenosynovitis with an aggressive infiltration. In 19% (n = 36/191), we had to extend the obligate tenosynovectomy on the flexor tendon parts of the fingers and ligaments (28 hands). 21 articulosynovectomies on the wrist or finger joints were performed. In 6 hands (8.0%) tendon ruptures were repaired. A questionnaire was completed for 107 of 147 patients (72.8%) (with 145 operated hands). Clinical (77 hands) and electromyographical examinations (49 hands) were performed an average of 5.1 (0.7-15) years postoperatively. 20 patients (13.6%) died, 20 could not be traced. In 86% (n = 125/145) of the patients we achieved relief of pain and a marked reduction of neurological deficits. 96.3% of the patients were content. The improvement of function of the hand after surgical intervention is of a great benefit for the patient with R. A. The overall risks of the procedure are low (complications 14%; no recidivism). Therefore, we recommend surgery in early stages after a confirmed diagnosis or a reasonable suspicion.