A Comparison of Australian and American Medical School Admission Experiences

Attaining admission into medical school has been described as a very competitive process by successful matriculants. The processes that medical schools use to classify applicants can greatly differ among institutions. These systemic differences flow over onto the applicant level, such that individuals from different geographic regions can have varied and diverse application experiences depending on local medical school admissions protocols. This piece compares the medical school admission processes of Australia and the United States of America, in the form of a narrative recount of a successful medical school matriculant in each country, with the individual experiences of matriculants from alternative pathways blended into the piece. The authors discovered significant differences in admissions protocols between the two countries, with the greatest differences revolving around admissions exams, applicant profile (high school students versus college students), degree types, and alternative entrance pathways

Anesthetic drugs: a comprehensive overview for pediatrics

The purpose of this document is to provide a unique white paper on the use of different anesthetic drugs and the key clinical pearls for ensuring patient safety in humans. This paper is designed to be a convenient guide that can be placed in work rooms for residents and medical school trainees to improve their learning and to provide remind- ers about drug-drug interactions. Finally, it is designed to be a potential living document – the first of its kind within the field. Unlike other white papers, this could be added to and modified based on the current literature and amended as newer drugs are discovered and made avail- able. This document is intended to become a ‘go-to- guide’ for clinical anesthetic drug use on humans that houses an in depth, yet condensed encyclopedia of the most pertinent, necessary information for pediatric healthcare professionals

Leontiasis ossea and post traumatic cervical cord contusion in polyostotic fibrous dysplasia

Leontiasis ossea (leonine facies) or cervical canal stenosis are rare complications of polyostotic fibrous dysplasia (PFD). This case report documents dramatic leontiasis ossea in PFD as well as post traumatic cervical cord contusion due to hyperextension injury in a patient with generalized PFD involving the cranio-facial bones, axial skeleton and entire spine with secondary cervical canal stenosis. Cervical cord contusion has not been reported earlier in PFD

“What IVC?”: Deep Vein Thrombosis in the Context of IVC Dysgenesis

Among young, otherwise healthy adults with unprovoked deep vein thrombosis (DVT), uncommon causes like variation in the normal sequential development of the inferior vena cava (IVC), must be explored. Anomalous IVC conditions are estimated to occur in up to 9% of the general population, with the rarest anomaly being IVC agenesis at 0.0005% - 1% general population prevalence. DVTs are more likely to develop in this population due to venous stasis from decreased venous return, even with the formation of extensive collateral veins. Herein, the authorial team presents a 22-year-old patient with leg pain and swelling who was found to have acute DVT, and, incidentally, the absence of the suprarenal IVC with a robust collateral system on further imaging studies. The morbidity of DVTs in this population is very high, and attention should be given to young patients who present with new-onset DVT in the setting of normal coagulation studies and lack of personal or family history of clotting disorders, as the need for specialized imaging such as venograms is necessary to secure the proper diagnosis

Men in maternity study: Results from the pre-intervention survey of pregnant women and their husbands at the three interventions, and of only women at three control Employees\u27 State Insurance Corporation dispensaries in Delhi, India: Preliminary findings

The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council, is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). The MiM intervention is facilitating the inclusion of men in their wives\u27 antenatal and postpartum care with couple and individual counseling during pregnancy and at six weeks postpartum. The data presented in this report is derived from the baseline survey conducted from November 2000 to November 2001 of pregnant women between 10 and 26 weeks of gestation who were attending antenatal clinics at the six ESIC dispensaries

Presence and Persistence of Ebola or Marburg Virus in Patients and Survivors: A Rapid Systematic Review

Background: The 2013-15 Ebola outbreak was unprecedented due to sustainedtransmission within urban environments and thousands of survivors. In 2014 the World Health Organization stated that there was insufficient evidence to give definitive guidance about which body fluids are infectious and when they pose a risk to humans. We report a rapid systematic review of published evidence on the presence of filoviruses in body fluids of infected people and survivors. Methods: Scientific articles were screened for information about filovirus in human body fluids. The aim was to find primary data that suggested high likelihood of actively infectious filovirus in human body fluids (viral RNA). Eligible infections were from Marburg virus (MARV or RAVV) and Zaire, Sudan, Taï Forest and Bundibugyo species of Ebola. [1] Cause of infection had to be laboratory confirmed (in practice either tissue culture or RT-PCR tests), or evidenced by compatible clinical history with subsequent positivity for filovirus antibodies or inflammatory factors. Data were extracted and summarized narratively. Results: 6831 unique articles were found, and after screening, 33 studies were eligible. For most body fluid types there were insufficient patients to draw strong conclusions, and prevalence of positivity was highly variable. Body fluids taken >16 days after onset were usually negative. In the six studies that used both assay methods RT-PCR tests for filovirus RNA gave positive results about 4 times more often than tissue culture. Conclusions: Filovirus was reported in most types of body fluid, but not in every sample from every otherwise confirmed patient. Apart from semen, most non-blood, RT-PCR positive samples are likely to be culture negative and so possibly of low infectious risk. Nevertheless, it is not apparent how relatively infectious many body fluids are during or after illness, even when culture-positive, not least because most test results come from more severe cases. Contact with blood and blood-stained body fluids remains the major risk for disease transmission because of the known high viral loads in blood

Men in maternity study: A summary of the findings from pre-intervention interviews with women and their husbands attending antenatal clinics at ESIC facilities in Delhi

The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). The MiM intervention is facilitating the inclusion of men in their wives\u27 antenatal and postpartum care with couple and individual counseling during pregnancy and at six weeks postpartum. The data presented in this update derives from a detailed Preliminary Findings Report. Interviews, conducted from November 2000 to November 2001, took place in all cases only after consent was first given by the women

A host transcriptional signature for presymptomatic detection of infection in humans exposed to influenza H1N1 or H3N2.

There is great potential for host-based gene expression analysis to impact the early diagnosis of infectious diseases. In particular, the influenza pandemic of 2009 highlighted the challenges and limitations of traditional pathogen-based testing for suspected upper respiratory viral infection. We inoculated human volunteers with either influenza A (A/Brisbane/59/2007 (H1N1) or A/Wisconsin/67/2005 (H3N2)), and assayed the peripheral blood transcriptome every 8 hours for 7 days. Of 41 inoculated volunteers, 18 (44%) developed symptomatic infection. Using unbiased sparse latent factor regression analysis, we generated a gene signature (or factor) for symptomatic influenza capable of detecting 94% of infected cases. This gene signature is detectable as early as 29 hours post-exposure and achieves maximal accuracy on average 43 hours (p = 0.003, H1N1) and 38 hours (p-value = 0.005, H3N2) before peak clinical symptoms. In order to test the relevance of these findings in naturally acquired disease, a composite influenza A signature built from these challenge studies was applied to Emergency Department patients where it discriminates between swine-origin influenza A/H1N1 (2009) infected and non-infected individuals with 92% accuracy. The host genomic response to Influenza infection is robust and may provide the means for detection before typical clinical symptoms are apparent

Get screened: a pragmatic randomized controlled trial to increase mammography and colorectal cancer screening in a large, safety net practice

Abstract Background Most randomized controlled trials of interventions designed to promote cancer screening, particularly those targeting poor and minority patients, enroll selected patients. Relatively little is known about the benefits of these interventions among unselected patients. Methods/Design "Get Screened" is an American Cancer Society-sponsored randomized controlled trial designed to promote mammography and colorectal cancer screening in a primary care practice serving low-income patients. Eligible patients who are past due for mammography or colorectal cancer screening are entered into a tracking registry and randomly assigned to early or delayed intervention. This 6-month intervention is multimodal, involving patient prompts, clinician prompts, and outreach. At the time of the patient visit, eligible patients receive a low-literacy patient education tool. At the same time, clinicians receive a prompt to remind them to order the test and, when appropriate, a tool designed to simplify colorectal cancer screening decision-making. Patient outreach consists of personalized letters, automated telephone reminders, assistance with scheduling, and linkage of uninsured patients to the local National Breast and Cervical Cancer Early Detection program. Interventions are repeated for patients who fail to respond to early interventions. We will compare rates of screening between randomized groups, as well as planned secondary analyses of minority patients and uninsured patients. Data from the pilot phase show that this multimodal intervention triples rates of cancer screening (adjusted odds ratio 3.63; 95% CI 2.35 - 5.61). Discussion This study protocol is designed to assess a multimodal approach to promotion of breast and colorectal cancer screening among underserved patients. We hypothesize that a multimodal approach will significantly improve cancer screening rates. The trial was registered at Clinical Trials.gov NCT00818857http://deepblue.lib.umich.edu/bitstream/2027.42/78264/1/1472-6963-10-280.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78264/2/1472-6963-10-280.pdfPeer Reviewe