Can The Humanities Humanize Health Care?

Science can exist without context just as medicine can exist without patients, but should it? Data supporting a need for medical students to learn literature, philosophy, language, religion, art, and music are limited, but study findings indicate that the humanities can enhance empathy in medical students

Treatment of Intractable Hiccups With an Oral Agent Monotherapy of Baclofen -A Case Report-

Hiccups are an involuntarily powerful spasm of the diaphragm, followed by a sudden inspiration with a closure of the glottis. Hiccups that are caused by gastric distention, spicy foods and neural dysfunction can resolve themselves without any treatment. Some hiccups are associated with certain diseases or they occur postsurgically, and life-restricting intractable hiccups should be treated. The cause of hiccups should be quickly determined so as to administer the proper treatment. Hiccups often remit spontaneously within a short period of time, but they may also occur without remission for a prolonged period in some cases. We report here on a 36-year-old man who suffered with intractable hiccups for 5 years. We administered a single oral dose of baclofen, and then the hiccups disappeared. We conclude that a single dose of baclofen is a good treatment for intractable hiccups

Does sport participation (including level of performance and previous injury) increase risk of osteoarthritis? A systematic review and meta-analysis

Background: To assess the relationship between sport and osteoarthritis, and specifically to determine whether previous participation, in terms of level (elite or non-elite), type of sport, intensity or previous injury were associated with osteoarthritis. Methods: This systematic review was developed using PRISMA guidelines. Databases were searched (to May 2016). Narrative review and meta-analysis (with risk ratio (RR) and 95% confidence intervals (CI)) approaches were undertaken where appropriate. Study quality was assessed using GRADE. Results: Forty-six studies were included. Narratively, 31 studies reported an increased risk of osteoarthritis, with 19 demonstrating an increased risk in elite athletes. There was an increased risk after sports exposure (irrespective of type) (RR:1.37; 95% CI:1.14, 1.64; 21 studies). It remained uncertain whether there was a difference in risk of osteoarthritis between elite and non-elite athletes (RR:1.37; 95% CI:0.84, 2.22; 17 studies). Risk was higher in soccer (RR:1.42; 95% CI:1.14, 1.77; 15 studies), but lower runners (RR:0.86; 95% CI:0.53, 1.41; 12 studies). Nine studies showed an association with the intensity of sport undertaken and osteoarthritis. Five studies demonstrated a higher prevalence of osteoarthritis following meniscectomies and anterior cruciate ligament tears. Overall the evidence was of GRADE 'very low' quality. Conclusions: There was very low quality evidence to support an increased relationship between sports participation and osteoarthritis in elite participants. It is unclear whether there is a difference in risk between elite and non-elite participants with further prospective studies needed to evaluate this. Pooled findings suggested significant injuries were associated with OA in soccer players

Meniscal T1rho and T2 measured with 3.0T MRI increases directly after running a marathon

PURPOSE: To prospectively evaluate changes in T1rho and T2 relaxation time in the meniscus using 3.0 T MRI in asymptomatic knees of marathon runners and to compare these findings with those of age-matched healthy subjects. MATERIAL AND METHODS: Thirteen marathon runners underwent 3.0 T MRI including T1rho and T2 mapping sequences before, 48-72 h after, and 3 months after competition. Ten controls were examined at baseline and after 3 months. All images were analyzed by two musculoskeletal radiologists identifying and grading cartilage, meniscal, ligamentous. and other knee abnormalities with WORMS scores. Meniscal segmentation was performed to generate T1rho and T2 maps in six compartments. RESULTS: No differences in morphological knee abnormalities were found before and after the marathon. However, all marathon runners showed a significant increase in T1rho and T2 values after competition in all meniscus compartments (p < 0.0001), which may indicate changes in the biochemical composition of meniscal tissue. While T2 values decreased after 3 months T1rho values remained at a high level, indicating persisting changes in the meniscal matrix composition after a marathon. CONCLUSION: T2 values in menisci have the potential to be used as biomarkers for identifying reversible meniscus matrix changes indicating potential tissue damage. T1rho values need further study, but may be a valuable marker for diagnosing early, degenerative changes in the menisci following exercise

Strengthening the morphological study of informal settlements

Methods of articulating the morphological structure of slums can have considerable potential in better planning for site-specific design or policy responses for these areas in the contemporary city. Although urban morphology traditionally studies landscapes as stratified residues with distinct divisions between lot and boundary, built and unbuilt, the authors find these definitions insufficient to address the complexity of slum morphology. Through this article, the authors’ identify that morphological analysis of informal settlements needs to be sensitive to the dynamics and the absence (or blurring) of physical boundaries. By analyzing the spatial impact of social, economic, and political factors, situational and site factors, building typologies, and configurations of circulation space, an attempt to articulate the morphological structure of slums is made. Aiming to overcome the current polarization in the literature between the formal and informal city, this article adds to the ongoing research on the study of challenges within contemporary cities, by providing new methodologies for studying the morphology of slum urbanization and shaping planning practice

Housing need assessment in the state of Colima, Mexico

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies, 1983.Bibliography: leaves 158-159.by David Cymet Lerer.M.C.P