Implementation of Primary Care Pandemic Plan: Respiratory Clinic Model

Implementation articleObjective: In an effort to keep our patients and staff safe while providing necessary care, we implemented phases 2 and 3 of the Primary Care Pandemic Plan as described by Krist et al.1 We consolidated clinics, we converted nearly all visits to virtual visits and separated the remaining face to face visits into sick and well patient cohorts.https://deepblue.lib.umich.edu/bitstream/2027.42/154742/1/Respiratory clinic for Amb Care during COVID_ revised_FINAL.pdfDescription of Respiratory clinic for Amb Care during COVID_ revised_FINAL.pdf : Main Articl

Danger‐associated molecular patterns ( DAMPs ) in acute lung injury

Danger‐associated molecular patterns ( DAMPs ) are host‐derived molecules that can function to regulate the activation of pathogen recognition receptors ( PRRs ). These molecules play a critical role in modulating the lung injury response. DAMPs originate from multiple sources, including injured and dying cells, the extracellular matrix, or exist as immunomodulatory proteins within the airspace and interstitium. DAMPs can function as either toll‐like receptor ( TLR ) agonists or antagonists, and can modulate both TLR and nod‐like receptor ( NLR ) signalling cascades. Collectively, this diverse group of molecules may represent important therapeutic targets in the prevention and/or treatment of acute lung injury ( ALI ) and its more severe form, acute respiratory distress syndrome ( ARDS ).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94713/1/path4124.pd

Effects of CETP inhibition with anacetrapib on metabolism of VLDL-TG and plasma apolipoproteins C-II, C-III, and E

Cholesteryl ester transfer protein (CETP) mediates the transfer of HDL cholesteryl esters for triglyceride (TG) in VLDL/LDL. CETP inhibition, with anacetrapib, increases HDL-cholesterol, reduces LDL-cholesterol, and lowers TG levels. This study describes the mechanisms responsible for TG lowering by examining the kinetics of VLDL-TG, apoC-II, apoC-III, and apoE. Mildly hypercholesterolemic subjects were randomized to either placebo (N = 10) or atorvastatin 20 mg/qd (N = 29) for 4 weeks (period 1) followed by 8 weeks of anacetrapib, 100 mg/qd (period 2). Following each period, subjects underwent stable isotope metabolic studies to determine the fractional catabolic rates (FCRs) and production rates (PRs) of VLDL-TG and plasma apoC-II, apoC-III, and apoE. Anacetrapib reduced the VLDL-TG pool on a statin background due to an increased VLDL-TG FCR (29%; P = 0.002). Despite an increased VLDL-TG FCR following anacetrapib monotherapy (41%; P = 0.11), the VLDL-TG pool was unchanged due to an increase in the VLDL-TG PR (39%; P = 0.014). apoC-II, apoC-III, and apoE pool sizes increased following anacetrapib; however, the mechanisms responsible for these changes differed by treatment group. Anacetrapib increased the VLDL-TG FCR by enhancing the lipolytic potential of VLDL, which lowered the VLDL-TG pool on atorvastatin background. There was no change in the VLDL-TG pool in subjects treated with anacetrapib monotherapy due to an accompanying increase in the VLDL-TG PR

Mechanisms Involved in Childhood Obesity-Related Bone Fragility

Childhood obesity is one of the major health problems in western countries. The excessive accumulation of adipose tissue causes inflammation, oxidative stress, apoptosis, and mitochondrial dysfunctions. Thus, obesity leads to the development of severe co-morbidities including type 2 diabetes mellitus, liver steatosis, cardiovascular, and neurodegenerative diseases which can develop early in life. Furthermore, obese children have low bone mineral density and a greater risk of osteoporosis and fractures. The knowledge about the interplay bone tissue and between adipose is still growing, although recent findings suggest that adipose tissue activity on bone can be fat-depot specific. Obesity is associated to a low-grade inflammation that alters the expression of adiponectin, leptin, IL-6, Monocyte Chemotactic Protein 1 (MCP1), TRAIL, LIGHT/TNFSF14, OPG, and TNFα. These molecules can affect bone metabolism, thus resulting in osteoporosis. The purpose of this review was to deepen the cellular mechanisms by which obesity may facilitate osteoporosis and bone fractures

Medical Educational Consulting Group (Med ECG)

Medical Schoolhttp://deepblue.lib.umich.edu/bitstream/2027.42/170607/1/TaylorStandiford_1.docxhttp://deepblue.lib.umich.edu/bitstream/2027.42/170607/2/TaylorStandiford_2.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/170607/3/TaylorStandiford_3.zi

The Case for Capping Residency Interviews

Objective To determine 2020 residency cycle application practices and to model potential consequences in the 2021 cycle if (1) applicants scheduled an uncapped number of interviews; (2) applicants were capped to schedule 12 interviews; (3) residency programs kept their number of interview offers unchanged; and (4) programs increased their interview offers by 20%. Design and Setting The authors sent an anonymous survey to all obstetrics and gynecology applicants registered through the Electronic Residency Application Service in February 2020 asking respondents to share demographics and number of interview offers received and completed. Based on prior estimates that 12 interviews are needed to match in obstetrics and gynecology, respondents were divided into Group 12+ (those receiving ≥12 interview offers) and Group \u3c12 \u3e(those receiving \u3c12 \u3eoffers). Model assumptions were (1) applicants can complete all interviews they are offered because they are virtual; (2) interview offers that applicants in Group 12+ decline are subsequently offered to applicants in Group Participants Among 2508 applicants, 750 (30%) provided the number of interview offers received and completed: 417 (56%) in Group 12+ and 333 (44%) in Group \u3c12. Results In models where applicants are uncapped in the number of interviews, Groupoffer, even if programs increase the number of interviews offered and performed. If applicants are capped at 12 interviews, Group20%. Conclusions This work highlights how current inefficiencies may lead to negative consequences with virtual interviews. Interview caps and preference signaling systems need to be urgently considered