Abstract The upper gastrointestinal (GI) tract, including the oesophagus, stomach and small intestine, is subject to a vast array of pathogens. While some may be a reflection of disseminated ...infection, others produce disease specific to the upper GI tract. This review focuses on the most common infectious disorders of the upper GI tract that may be encountered by the general surgical pathologist, including viral, bacterial, fungal and parasitic organisms. Clinical and diagnostic histological features are discussed, as well as useful ancillary diagnostic techniques.
Service-learning has long been regarded as a teaching strategy that promotes student learning while simultaneously contributing to the community. This article reports the service-learning experience ...of undergraduate nursing students who participated in a project with two nongovernmental organizations that enabled students to visit disadvantaged older adults on a regular basis. Fifty-two students were recruited to join the study. A content analysis of their reflective journals regarding their service-learning experience was performed. The texts were compared on the basis of their differences and similarities, sorted into categories, and then abstracted into themes. Four themes were identified: "I have learned a lot," "I have changed over time," "My perception of older people has changed," and "I have learned through experience." The students gained valuable experience from this project during a 2-year period. The main learning outcome was improved communication skills. The experience also promoted students' personal growth and professional development.
Infection with the saprophagous nematode Halicephalobus species is uncommon but has been reported in horses worldwide. Only 3 human cases have been previously described, all of which have been fatal. ...We report a fourth fatal case, which occurred in a 39-year-old woman who presented with meningeal signs, altered mental status, and a prodromal pruritic rash. Diagnostic evaluation included an open brain biopsy, which was diagnosed as granulomatous vasculitis. The patient subsequently died after a course of steroids and cyclophosphamide. At autopsy, a robust perivascular mixed inflammatory infiltration of the brain parenchyma, meninges, and ventricular system was present with larval forms and mature nematodes morphologically consistent with Halicephalobus deletrix . Although extremely rare, this organism needs to be considered in the differential diagnosis of human helminthic infection of the central nervous system.
Although permeable reactive barriers (PRB) technology appears to be a very suitable and cost effective option, the extent to which remediation results will be realized, greatly depends on the ...long-term integrity of the system. The formation of mineral precipitates is possibly a major factor in the long-term performance of PRB. Precipitates may passivate reactive surfaces by blocking electron-transfer sites, and thereby reduce the long-term reactivity of the granular iron to degrade groundwater contaminants. To evaluate the potential passivation impacts of inorganic groundwater chemistry, column experiments containing zero-valent iron (Fe super(0)) were performed under anoxic conditions to treat two contrasting Danish groundwater types spiked with trichloroethylene (TCE). For most of the experiments using Danish groundwater types, a soft low alkalinity groundwater produced slightly higher TCE dechlorination rate than did a hard high alkalinity groundwater. Compared to a soft low alkalinity baseline groundwater, it was also found the dechlorination of TCE in the column was enhanced in the presence of 1 mM CaCO sub(3) and 1 mM NaHCO sub(3). The dechlorination of TCE in the presence of 1 mM KNO sub(3) and 1 mM Na sub(2)SiO sub(3) was found to decrease considerably compared with the baseline solution. The results suggest that the composition of field groundwater is likely to strongly affect the ability of Fe super(0) barriers to degrade TCE.
Objective To assess the educational effectiveness on learning evidence based medicine of a handheld computer clinical decision support tool compared with a pocket card containing guidelines and a ...control. Design Randomised controlled trial. Setting University of Hong Kong, 2001. Participants 169 fourth year medical students. Main outcome measures Factor and individual item scores from a validated questionnaire on five key self reported measures: personal application and current use of evidence based medicine; future use of evidence based medicine; use of evidence during and after clerking patients; frequency of discussing the role of evidence during teaching rounds; and self perceived confidence in clinical decision making. Results The handheld computer improved participants' educational experience with evidence based medicine the most, with significant improvements in all outcome scores. More modest improvements were found with the pocket card, whereas the control group showed no appreciable changes in any of the key outcomes. No significant deterioration was observed in the improvements even after withdrawal of the handheld computer during an eight week washout period, suggesting at least short term sustainability of effects. Conclusions Rapid and convenient access to valid and relevant evidence on a portable computing device can improve learning in evidence based medicine, increase current and future use of evidence, and boost students' confidence in clinical decision making.
Qualitative screening for colorectal polyps via fiber bundle microendoscopy imaging has shown promising results, with studies reporting high rates of sensitivity and specificity, as well as low ...interobserver variability with trained clinicians. A quantitative image quality control and image feature extraction algorithm (QFEA) was designed to lessen the burden of training and provide objective data for improved clinical efficacy of this method. After a quantitative image quality control step, QFEA extracts field-of-view area, crypt area, crypt circularity, and crypt number per image. To develop and validate this QFEA, a training set of microendoscopy images was collected from freshly resected porcine colon epithelium. The algorithm was then further validated on ex vivo image data collected from eight human subjects, selected from clinically normal appearing regions distant from grossly visible tumor in surgically resected colorectal tissue. QFEA has proven flexible in application to both mosaics and individual images, and its automated crypt detection sensitivity ranges from 71 to 94% despite intensity and contrast variation within the field of view. It also demonstrates the ability to detect and quantify differences in grossly normal regions among different subjects, suggesting the potential efficacy of this approach in detecting occult regions of dysplasia.
The Authors’ Reply Drage, Michael G; Lai, Keith K; Lamps, Laura W
American journal of clinical pathology,
09/2019, Letnik:
152, Številka:
3
Journal Article
The Authors’ Reply Drage, Michael G; Lai, Keith K; Lamps, Laura W
American journal of clinical pathology,
08/2019, Letnik:
152, Številka:
3
Journal Article
Objectives Most evidence‐based practice (EBP) educational assessment tools evaluated to date have focused on specific knowledge components or technical skills. Other important potential barriers to ...the adoption of EBP, such as attitudinal, perceptual and behavioural factors, have yet to be studied, especially in the undergraduate setting. Therefore, we developed and validated a knowledge, attitude and behaviour questionnaire designed to evaluate EBP teaching and learning in an undergraduate medical curriculum.
Methods We derived the questionnaire from a comprehensive literature review, informed by international and local experts and a Year 5 student focus group. We determined its factor structure and refined and validated the questionnaire according to the responses of a cohort of Year 5 and a combined group of Years 2 and 3 students using principal components factor analysis with varimax rotation. Factor reliability was computed using Cronbach's alpha coefficient. We assessed construct validity by correlating the factors with other measures of EBP activity and examined responsiveness through paired t‐test of the pre/post factor mean scores.
Results A 43‐item questionnaire was developed. Four factors were identified from both student groups. The overall questionnaire as well as each factor had high construct validity (Cronbach's alpha > 0·7 for each scale). No significant correlations were found between the 4 factors, confirming their orthogonality. Positive correlations, however, resulted between factor mean scores and other EBP activities. The responsiveness of the questionnaire was satisfactory.
Conclusion A reliable knowledge, attitude and behaviour measure of EBP teaching and learning appropriate for undergraduate medical education has been developed and validated.
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