Postmortem imaging of blood and its characteristics using MSCT and MRI

The rapid development of computed tomography (CT) and magnetic resonance imaging (MRI) led to the introduction and establishment in postmortem investigations. The objectives of this preliminary study were to describe the imaging appearances of the early postmortem changes of blood after cessation of the circulation, such as sedimentation, postmortem clotting, and internal livores, and to give a few first suggestions on how to differentiate them from other forensic findings. In the Virtopsy project, 95 human corpses underwent postmortem imaging by CT and MRI prior to traditional autopsy and therefore 44 cases have been investigated in this study. Postmortem alterations as well as the forensic relevant findings of the blood, such as internal or subcutaneous bleedings, are presented on the basis of their imaging appearances in multislice CT and MR

Thigh and abdominal adipose tissue depot associations with testosterone levels in postmenopausal females.

Research findings on the relationship between serum androgens and adipose tissue in older females are inconsistent. We aimed to clarify the relationship using state-of-the-art techniques to evaluate associations between body fat distribution and plasma testosterone (T) levels in older postmenopausal women. Observational, cross-sectional study of healthy, community dwelling postmenopausal women. Postmenopausal women (60-80 years old) were included in this study. Overall body composition was evaluated by dual-energy X-ray absorptiometry. Abdominal and thigh fat depots were measured by magnetic resonance imaging. Circulating T concentrations were analysed by liquid chromatography-tandem mass spectrometry. Thirty-five women (66.6 ± 0.8 years) participated in this study. T levels were positively associated with clinical proxy measures of adiposity including weight (ρ = 0.39), BMI (ρ = 0.43) and waist circumference (ρ = 0.39) (all P < 0.05). Fat mass and % body fat were correlated with T levels (ρ = 0.42 and 0.38 respectively, both P < 0.05). T correlated with overall and superficial abdominal fat (ρ = 0.34 and 0.37 respectively, both P < 0.05) but not with visceral adipose tissue. T increased with greater thigh fat (ρ = 0.49, P < 0.05) in both superficial and deep depots (ρ = 0.50 and 0.35 respectively, both P < 0.05). Our results suggest that postmenopausal women with higher circulating T levels have both higher regional and overall body adiposity. These findings underscore the sexual dimorphism in the relationship between serum androgen levels and adiposity

OSSE—a SELECT Medical Student Competency Assessment

In 2011, a new medical student curriculum entitled SELECT was designed with the ultimate goal of developing a cohort of new physicians into early leaders capable of transforming healthcare in the USA. We will describe the development of an Observed Structured SELECT Examination (OSSE) to assess the core competencies of leadership, health systems and patient safety, and values-based patient-centered care of the SELECT program in second year medical students and report on the importance of faculty development in achieving reliable results with this new assessment too

The acute effects of exercise on post-exercise inflammation and iron regulation: a comparison between trained and untrained men.

This study examined whether the magnitude of the effects of an exercise bout on inflammatory markers and iron regulation in humans differs between trained and untrained men. Changes in cell count (red blood cell, white blood cell, haemoglobin, haematocrit, lymphocytes, monocytes, granulocytes) Interleukin-6 (IL-6) and serum iron in response to a running bout were compared between both groups. Seven untrained (VO2max 47.4±4.1 ml·kg(-1)·min(-1)) and seven trained (56.9±4.5 ml·kg(-1)·min(-1)) men aged 19-48 years completed a Bruce protocol treadmill test and a subsequent treadmill run (45 min at 75% of VO2max). Ethical approval was granted by Kingston University Faculty Ethics Committee and conducted in accordance to the Declaration of Helsinki. Venous whole blood was collected before, and at 0, 3, 6 and 24 after exercise. Exercise-induced plasma volume changes were accounted for. Mixed Model ANOVA was performed to examine differences within groups. Independent t-tests identified which time points differed between groups, and dependent t-tests were applied to examine changes within groups over time. Significance was accepted at P<0.05. Differences between groups were observed for haemoglobin (P<0.005) and red blood cell (P=0.007) at all time points, as well as for haematocrit at all time points except at baseline (P=0.013). Lymphocytes, Monocytes, Granulocytes, IL-6 and iron levels did not differ between groups. IL-6 levels were increased post-exercise in both groups, and iron was different 3 h post-exercise to 6 h post-exercise (P<0.05). Findings suggest haemoglobin, haematocrit and red bloods to be lower in trained individuals due to adaptations of endurance training. The single exercise running bout elicited an acute inflammatory response represented by an increase in IL-6 and decrease in serum iron. Alterations in IL-6 were not different between trained and untrained men, indicating a lack of effect of training status

Reproducibility of cerebral phenylalanine levels in patients with phenylketonuria determined by 1H-MR spectroscopy

The reproducibility of metabolite content determined by MR spectroscopy (MRS) is usually at best a few percent for the prominent singlets. When studying low-concentration metabolites, like phenylalanine (Phe), where tissue content can be <100 micromol/kg, better reproducibility is paramount-particularly in view of using MRS results for potential individual treatment advice. An optimized, targeted spectroscopy method was established at 1.5T and reproducibility was established in 21 patients with phenylketonuria (PKU) where three spectra were recorded in each of three independent sessions, two of which were in immediate succession to minimize physiologic variation. Intersession variation was found to be only 7 micromol/kg Phe for back-to-back repetition of sessions, in close agreement with the variation of 16 micromol/kg observed for single spectra within a session. Analysis of variance proved the individuality of the blood/brain Phe ratio-though this ratio seems to be influenced by physiologic factors that are not stable in time. The excellent reproducibility was achieved through optimization of various factors, including signal-to-noise ratio, repositioning, and prescan calibrations, but also by enforcing as much prior information as possible (e.g., lineshape and phase from reference scans, constant prior-knowledge-locked baseline). While the application of maximum general prior knowledge is a general method to reduce fluctuations, one should remember that it may introduce systematic errors

It Is All About Relationships—Teaching from a Distance

The University of South Florida Morsani College of Medicine (USF MCOM), Tampa, Florida, and Lehigh Valley Health Network (LVHN), Allentown, Pennsylvania, jointly created a program where medical students spend years 1 and 2 on the Tampa campus and years 3 and 4 on the Allentown campus. Across all 4 years, Scholarly Excellence, Leadership Experiences, Collaborative Training program (SELECT) students interact with faculty from both campuses. Faculty members at the distant location connect to the class using videoconferencing and participate in the session as if they were in the classroom. We describe the challenges encountered and some solutions in teaching at a distance when one faculty member is in the classroom with the students and the other is 1100 miles away

Postmortem imaging of blood and its characteristics using MSCT and MRI

The rapid development of computed tomography (CT) and magnetic resonance imaging (MRI) led to the introduction and establishment in postmortem investigations. The objectives of this preliminary study were to describe the imaging appearances of the early postmortem changes of blood after cessation of the circulation, such as sedimentation, postmortem clotting, and internal livores, and to give a few first suggestions on how to differentiate them from other forensic findings. In the Virtopsy project, 95 human corpses underwent postmortem imaging by CT and MRI prior to traditional autopsy and therefore 44 cases have been investigated in this study. Postmortem alterations as well as the forensic relevant findings of the blood, such as internal or subcutaneous bleedings, are presented on the basis of their imaging appearances in multislice CT and MRI