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Sethi SK, Mahan J, Hu J, Koratala A, Soni K, Singh Y, Abitbol C, DeFreitas M, Reisinger N, Argaiz ER, Yap HK, Badeli H, Kalra M, VanGeest J, Nair N, Raynor J, Alhasan KA, McCulloch M, Bunchman T, Sharma V, Raina R. Point-of-care-Ultrasound (POCUS) Training Curriculum for Pediatric Nephrology: PCRRT-ICONIC Group Recommendations. Kidney360 2024:02200512-990000000-00357. [PMID: 38477662 DOI: 10.34067/kid.0000000000000415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Point of care ultrasound (POCUS) is commonly used in adult specialties, pediatric emergency medicine, and neonatal and pediatric critical care. Specifically, in the field of pediatric nephrology, POCUS plays a valuable role in the critical inpatient and outpatient settings. However, the lack of guidelines and a standardized curriculum for POCUS in pediatric nephrology has led to substantial discrepancies in both clinical practice and training. METHODS A multinational, multicenter survey regarding POCUS usefulness and training was sent to 225 pediatric nephrology residents, fellows, and physicians with expertise in pediatric nephrology. Based on the results, an ideal pediatric nephrology POCUS curriculum was formulated with a panel of experts from across the world. Eighteen experts were included, with each expert having greater than 10 years of experience in using POCUS in adult and pediatric nephrology. A Delphi method was utilized to further solidify guidelines regarding the content, curriculum, and vital skills of using POCUS in pediatric nephrology. RESULTS A total of 134 pediatric nephrology trainees, specialists, and faculty responded to the survey (59.6% completion rate). A total of 87.4% of respondents believe that formal POCUS training is either highly desirable or should be mandatory in pediatric nephrology fellowship programs. Identified barriers to receiving training included lack of an organized curriculum, lack of POCUS experts and Pediatric intensivists, lack of ultrasound equipment, lack of financial support, and lack of dedicated time during training. An expert panel was convened and a Delphi survey was conducted to formulate guidelines to overcome the barriers to pediatric nephrology POCUS and standardize the training process. CONCLUSIONS After collaborating with prominent pediatric nephrologists and global POCUS experts proposed a comprehensive POCUS training curriculum tailored specifically for pediatric nephrology trainees, with an appeal for all pediatric nephrology education programs to integrate POCUS instruction into their curricula.
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Affiliation(s)
| | - John Mahan
- Pediatric Nephrology, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio; USA
| | - Jieji Hu
- College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA
| | - Abhilash Koratala
- Division of Nephrology, Medical College of Wisconsin, Milwaukee, USA
| | - Kritika Soni
- Pediatric Nephrology, Medanta, The Medicity, Gurgaon, India, 122001
| | - Yogen Singh
- Department of Pediatrics, Division of Neonatology, Loma Linda University School of Medicine
| | - Carolyn Abitbol
- Division of Nephrology, Department of Pediatrics, University of Miami/Holtz Children's Hospital, Miami, FL, USA
| | - Marissa DeFreitas
- Division of Nephrology, Department of Pediatrics, University of Miami/Holtz Children's Hospital, Miami, FL, USA
| | - Nathaniel Reisinger
- Division of Renal Electrolyte and Hypertension, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eduardo R Argaiz
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud
| | - Hui Kim Yap
- Children's Kidney Centre, Khoo Teck Puat - National University Children's Medical Institute, Singapore
| | - Hamidreza Badeli
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Meenal Kalra
- Department of Paediatrics, Kasturba Medical College, Manipal, Karnataka, India
| | | | - Nikhil Nair
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - James Raynor
- College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA
| | - Khalid A Alhasan
- Pediatric Nephrology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mignon McCulloch
- Department of Paediatric Nephrology and Transplantation, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - Timothy Bunchman
- Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Vivek Sharma
- Department of Imaging and Radiology, Medanta, The Medicity, Gurgaon, Haryana, India
| | - Rupesh Raina
- Akron Children's Hospital, Akron, Cleveland, Ohio, USA
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2
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Kiryluk K, Sanchez-Rodriguez E, Zhou XJ, Zanoni F, Liu L, Mladkova N, Khan A, Marasa M, Zhang JY, Balderes O, Sanna-Cherchi S, Bomback AS, Canetta PA, Appel GB, Radhakrishnan J, Trimarchi H, Sprangers B, Cattran DC, Reich H, Pei Y, Ravani P, Galesic K, Maixnerova D, Tesar V, Stengel B, Metzger M, Canaud G, Maillard N, Berthoux F, Berthelot L, Pillebout E, Monteiro R, Nelson R, Wyatt RJ, Smoyer W, Mahan J, Samhar AA, Hidalgo G, Quiroga A, Weng P, Sreedharan R, Selewski D, Davis K, Kallash M, Vasylyeva TL, Rheault M, Chishti A, Ranch D, Wenderfer SE, Samsonov D, Claes DJ, Akchurin O, Goumenos D, Stangou M, Nagy J, Kovacs T, Fiaccadori E, Amoroso A, Barlassina C, Cusi D, Del Vecchio L, Battaglia GG, Bodria M, Boer E, Bono L, Boscutti G, Caridi G, Lugani F, Ghiggeri G, Coppo R, Peruzzi L, Esposito V, Esposito C, Feriozzi S, Polci R, Frasca G, Galliani M, Garozzo M, Mitrotti A, Gesualdo L, Granata S, Zaza G, Londrino F, Magistroni R, Pisani I, Magnano A, Marcantoni C, Messa P, Mignani R, Pani A, Ponticelli C, Roccatello D, Salvadori M, Salvi E, Santoro D, Gembillo G, Savoldi S, Spotti D, Zamboli P, Izzi C, Alberici F, Delbarba E, Florczak M, Krata N, Mucha K, Pączek L, Niemczyk S, Moszczuk B, Pańczyk-Tomaszewska M, Mizerska-Wasiak M, Perkowska-Ptasińska A, Bączkowska T, Durlik M, Pawlaczyk K, Sikora P, Zaniew M, Kaminska D, Krajewska M, Kuzmiuk-Glembin I, Heleniak Z, Bullo-Piontecka B, Liberek T, Dębska-Slizien A, Hryszko T, Materna-Kiryluk A, Miklaszewska M, Szczepańska M, Dyga K, Machura E, Siniewicz-Luzeńczyk K, Pawlak-Bratkowska M, Tkaczyk M, Runowski D, Kwella N, Drożdż D, Habura I, Kronenberg F, Prikhodina L, van Heel D, Fontaine B, Cotsapas C, Wijmenga C, Franke A, Annese V, Gregersen PK, Parameswaran S, Weirauch M, Kottyan L, Harley JB, Suzuki H, Narita I, Goto S, Lee H, Kim DK, Kim YS, Park JH, Cho B, Choi M, Van Wijk A, Huerta A, Ars E, Ballarin J, Lundberg S, Vogt B, Mani LY, Caliskan Y, Barratt J, Abeygunaratne T, Kalra PA, Gale DP, Panzer U, Rauen T, Floege J, Schlosser P, Ekici AB, Eckardt KU, Chen N, Xie J, Lifton RP, Loos RJF, Kenny EE, Ionita-Laza I, Köttgen A, Julian BA, Novak J, Scolari F, Zhang H, Gharavi AG. Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy. Nat Genet 2023; 55:1091-1105. [PMID: 37337107 DOI: 10.1038/s41588-023-01422-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/05/2023] [Indexed: 06/21/2023]
Abstract
IgA nephropathy (IgAN) is a progressive form of kidney disease defined by glomerular deposition of IgA. Here we performed a genome-wide association study of 10,146 kidney-biopsy-diagnosed IgAN cases and 28,751 controls across 17 international cohorts. We defined 30 genome-wide significant risk loci explaining 11% of disease risk. A total of 16 loci were new, including TNFSF4/TNFSF18, REL, CD28, PF4V1, LY86, LYN, ANXA3, TNFSF8/TNFSF15, REEP3, ZMIZ1, OVOL1/RELA, ETS1, IGH, IRF8, TNFRSF13B and FCAR. The risk loci were enriched in gene orthologs causing abnormal IgA levels when genetically manipulated in mice. We also observed a positive genetic correlation between IgAN and serum IgA levels. High polygenic score for IgAN was associated with earlier onset of kidney failure. In a comprehensive functional annotation analysis of candidate causal genes, we observed convergence of biological candidates on a common set of inflammatory signaling pathways and cytokine ligand-receptor pairs, prioritizing potential new drug targets.
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Affiliation(s)
- Krzysztof Kiryluk
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA.
- Institute for Genomic Medicine, Columbia University, New York City, NY, USA.
| | - Elena Sanchez-Rodriguez
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Xu-Jie Zhou
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Francesca Zanoni
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Lili Liu
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Nikol Mladkova
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Atlas Khan
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Maddalena Marasa
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Jun Y Zhang
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Olivia Balderes
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Simone Sanna-Cherchi
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
- Institute for Genomic Medicine, Columbia University, New York City, NY, USA
| | - Andrew S Bomback
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Pietro A Canetta
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Gerald B Appel
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Jai Radhakrishnan
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - Hernan Trimarchi
- Nephrology Service, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Ben Sprangers
- Department of Microbiology and Immunology, Laboratory of Molecular Immunology, KU Leuven, Leuven, Belgium
- Division of Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Daniel C Cattran
- Department of Nephrology, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Heather Reich
- Department of Nephrology, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - York Pei
- Department of Nephrology, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Pietro Ravani
- Division of Nephrology, Department of Internal Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Dita Maixnerova
- 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Vladimir Tesar
- 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Benedicte Stengel
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM Clinical Epidemiology Team, Villejuif, France
| | - Marie Metzger
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM Clinical Epidemiology Team, Villejuif, France
| | - Guillaume Canaud
- Université de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Nicolas Maillard
- Nephrology, Dialysis, and Renal Transplantation Department, University North Hospital, Saint Etienne, France
| | - Francois Berthoux
- Nephrology, Dialysis, and Renal Transplantation Department, University North Hospital, Saint Etienne, France
| | | | - Evangeline Pillebout
- Center for Research on Inflammation, University of Paris, INSERM and CNRS, Paris, France
| | - Renato Monteiro
- Center for Research on Inflammation, University of Paris, INSERM and CNRS, Paris, France
| | - Raoul Nelson
- Division of Pediatric Nephrology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Robert J Wyatt
- Division of Pediatric Nephrology, University of Tennessee Health Sciences Center, Memphis, TN, USA
- Children's Foundation Research Center, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - William Smoyer
- Division of Pediatric Nephrology, Nationwide Children's Hospital, Columbus, OH, USA
| | - John Mahan
- Division of Pediatric Nephrology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Al-Akash Samhar
- Division of Pediatric Nephrology, Driscoll Children's Hospital, Corpus Christi, TX, USA
| | - Guillermo Hidalgo
- Division of Pediatric Nephrology, Department of Pediatrics, HMH Hackensack University Medical Center, Hackensack, NJ, USA
| | - Alejandro Quiroga
- Division of Pediatric Nephrology, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - Patricia Weng
- Division of Pediatric Nephrology, Mattel Children's Hospital, Los Angeles, CA, USA
| | - Raji Sreedharan
- Division of Pediatric Nephrology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David Selewski
- Division of Pediatric Nephrology, Mott Children's Hospital, Ann Arbor, MI, USA
| | - Keefe Davis
- Division of Pediatric Nephrology, Department of Pediatrics, The Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Mahmoud Kallash
- Division of Pediatric Nephrology, SUNY Buffalo, Buffalo, NY, USA
| | - Tetyana L Vasylyeva
- Division of Pediatric Nephrology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Michelle Rheault
- Division of Pediatric Nephrology, University of Minnesota, Minneapolis, MN, USA
| | - Aftab Chishti
- Division of Pediatric Nephrology, University of Kentucky, Lexington, KY, USA
| | - Daniel Ranch
- Division of Pediatric Nephrology, Department of Pediatrics, University of Kentucky, Lexington, KY, USA
| | - Scott E Wenderfer
- Division of Pediatric Nephrology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Dmitry Samsonov
- Division of Pediatric Nephrology, Boston Children's Hospital, Boston, MA, USA
| | - Donna J Claes
- Division of Pediatric Nephrology, Department of Pediatrics, New York Medical College, New York City, NY, USA
| | - Oleh Akchurin
- Division of Pediatric Nephrology, Department of Pediatrics, Weill Cornell Medical College, New York City, NY, USA
| | | | - Maria Stangou
- The Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Judit Nagy
- 2nd Department of Internal Medicine, Nephrological and Diabetological Center, University of Pécs, Pécs, Hungary
| | - Tibor Kovacs
- 2nd Department of Internal Medicine, Nephrological and Diabetological Center, University of Pécs, Pécs, Hungary
| | - Enrico Fiaccadori
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Antonio Amoroso
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Cristina Barlassina
- Renal Division, Dipartimento di Medicina, Chirurgia e Odontoiatria, San Paolo Hospital, School of Medicine, University of Milan, Milan, Italy
| | - Daniele Cusi
- Renal Division, Dipartimento di Medicina, Chirurgia e Odontoiatria, San Paolo Hospital, School of Medicine, University of Milan, Milan, Italy
| | | | | | | | - Emanuela Boer
- Division of Nephrology and Dialysis, Gorizia Hospital, Gorizia, Italy
| | - Luisa Bono
- Nephrology and Dialysis, A.R.N.A.S. Civico and Benfratelli, Palermo, Italy
| | - Giuliano Boscutti
- Nephrology, Dialysis and Renal Transplant Unit, S. Maria della Misericordia Hospital, ASUFC, Udine, Italy
| | - Gianluca Caridi
- Division of Nephrology, Dialysis and Transplantation, IRCCS Giannina Gaslini Institute, Genova, Italy
| | - Francesca Lugani
- Division of Nephrology, Dialysis and Transplantation, IRCCS Giannina Gaslini Institute, Genova, Italy
| | - GianMarco Ghiggeri
- Division of Nephrology, Dialysis and Transplantation, IRCCS Giannina Gaslini Institute, Genova, Italy
| | - Rosanna Coppo
- Regina Margherita Children's Hospital, Torino, Italy
| | - Licia Peruzzi
- Regina Margherita Children's Hospital, Torino, Italy
| | | | | | | | | | - Giovanni Frasca
- Division of Nephrology, Dialysis and Renal Transplantation, Riuniti Hospital, Ancona, Italy
| | | | - Maurizio Garozzo
- Unità Operativa di Nefrologia e Dialisi, Ospedale di Acireale, Acireale, Italy
| | - Adele Mitrotti
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy
| | - Simona Granata
- Renal Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Gianluigi Zaza
- Renal Unit, Department of Medicine, University of Verona, Verona, Italy
| | | | - Riccardo Magistroni
- Department of Surgical, Medical, Dental, Oncologic and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Isabella Pisani
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Andrea Magnano
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Piergiorgio Messa
- Nephrology Dialysis and Kidney Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Renzo Mignani
- Azienda Unità Sanitaria Locale Rimini, Rimini, Italy
| | - Antonello Pani
- Department of Nephrology and Dialysis, G. Brotzu Hospital, Cagliari, Italy
| | | | - Dario Roccatello
- Nephrology and Dialysis Unit, G. Bosco Hub Hospital (ERK-net Member) and University of Torino, Torino, Italy
| | - Maurizio Salvadori
- Division of Nephrology and Renal Transplantation, Carreggi Hospital, Florence, Italy
| | - Erica Salvi
- Renal Division, DMCO (Dipartimento di Medicina, Chirurgia e Odontoiatria), San Paolo Hospital, School of Medicine, University of Milan, Milan, Italy
| | - Domenico Santoro
- Unit of Nephrology and Dialysis, AOU G Martino, University of Messina, Messina, Italy
| | - Guido Gembillo
- Unit of Nephrology and Dialysis, AOU G Martino, University of Messina, Messina, Italy
| | - Silvana Savoldi
- Unit of Nephrology and Dialysis, ASL TO4-Consultorio Cirié, Turin, Italy
| | | | | | - Claudia Izzi
- Department of Medical and Surgical Specialties and Nephrology Unit, University of Brescia-ASST Spedali Civili, Brescia, Italy
| | - Federico Alberici
- Department of Medical and Surgical Specialties and Nephrology Unit, University of Brescia-ASST Spedali Civili, Brescia, Italy
| | - Elisa Delbarba
- Department of Medical and Surgical Specialties and Nephrology Unit, University of Brescia-ASST Spedali Civili, Brescia, Italy
| | - Michał Florczak
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Natalia Krata
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Mucha
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
| | - Leszek Pączek
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
| | - Stanisław Niemczyk
- Department of Internal Disease, Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland
| | - Barbara Moszczuk
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
- Department of Clinical Immunology, Medical University of Warsaw, Warsaw, Poland
| | | | | | | | - Teresa Bączkowska
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Durlik
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan Medical University, Poznan, Poland
| | - Przemyslaw Sikora
- Department of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland
| | - Marcin Zaniew
- Department of Pediatrics, University of Zielona Góra, Zielona Góra, Poland
| | - Dorota Kaminska
- Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Magdalena Krajewska
- Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Izabella Kuzmiuk-Glembin
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Zbigniew Heleniak
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Barbara Bullo-Piontecka
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Liberek
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Alicja Dębska-Slizien
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Hryszko
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland
| | | | - Monika Miklaszewska
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Maria Szczepańska
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Katarzyna Dyga
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Edyta Machura
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Katarzyna Siniewicz-Luzeńczyk
- Department of Pediatrics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Monika Pawlak-Bratkowska
- Department of Pediatrics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Marcin Tkaczyk
- Department of Pediatrics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Dariusz Runowski
- Department of Nephrology, Kidney Transplantation and Hypertension, Children's Memorial Health Institute, Warsaw, Poland
| | - Norbert Kwella
- Department of Nephrology, Hypertension and Internal Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Dorota Drożdż
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Ireneusz Habura
- Department of Nephrology, Karol Marcinkowski Hospital, Zielona Góra, Poland
| | - Florian Kronenberg
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Larisa Prikhodina
- Division of Inherited and Acquired Kidney Diseases, Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow, Russia
| | - David van Heel
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Bertrand Fontaine
- Sorbonne University, INSERM, Center of Research in Myology, Institute of Myology, University Hospital Pitie-Salpetriere, Paris, France
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service of Neuro-Myology, University Hospital Pitie-Salpetriere, Paris, France
| | - Chris Cotsapas
- Departments of Neurology and Genetics, Yale University, New Haven, CT, USA
| | | | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Vito Annese
- CBP American Hospital, Dubai, United Arab Emirates
| | - Peter K Gregersen
- Robert S. Boas Center for Genomics and Human Genetics, Feinstein Institutes for Medical Research, North Shore LIJ Health System, New York City, NY, USA
| | | | - Matthew Weirauch
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Leah Kottyan
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - John B Harley
- US Department of Veterans Affairs Medical Center and Cincinnati Education and Research for Veterans Foundation, Cincinnati, OH, USA
| | - Hitoshi Suzuki
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shin Goto
- Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hajeong Lee
- Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Ki Kim
- Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yon Su Kim
- Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Ho Park
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea
| | - BeLong Cho
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea
- Institute on Aging, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Murim Choi
- Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ans Van Wijk
- Amsterdam University Medical Centre, VU University Medical Center (VUMC), Amsterdam, the Netherlands
| | - Ana Huerta
- Hospital Universitario Puerta del Hierro Majadahonda, REDINREN, IISCIII, Madrid, Spain
| | - Elisabet Ars
- Molecular Biology Laboratory and Nephrology Department, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau, Universitat Autònoma de Barcelona, REDINREN, IISCIII, Barcelona, Spain
| | - Jose Ballarin
- Molecular Biology Laboratory and Nephrology Department, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau, Universitat Autònoma de Barcelona, REDINREN, IISCIII, Barcelona, Spain
| | - Sigrid Lundberg
- Department of Nephrology, Danderyd University Hospital, and Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Bruno Vogt
- Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Laila-Yasmin Mani
- Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasar Caliskan
- Division of Nephrology, Saint Louis University, Saint Louis, MO, USA
| | - Jonathan Barratt
- John Walls Renal Unit, University Hospitals of Leicester, Leicester, UK
| | | | | | - Daniel P Gale
- Department of Renal Medicine, University College London, London, UK
| | | | - Thomas Rauen
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Pascal Schlosser
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Arif B Ekici
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nan Chen
- Department of Nephrology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jingyuan Xie
- Department of Nephrology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Richard P Lifton
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA
- Laboratory of Human Genetics and Genomics, The Rockefeller University, New York City, NY, USA
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eimear E Kenny
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Genetics and Genomic Sciences, Mount Sinai Health System, New York City, NY, USA
- Center for Population Genomic Health, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Iuliana Ionita-Laza
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, NY, USA
| | - Anna Köttgen
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Bruce A Julian
- Departments of Microbiology and Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jan Novak
- Departments of Microbiology and Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Francesco Scolari
- Department of Medical and Surgical Specialties and Nephrology Unit, University of Brescia-ASST Spedali Civili, Brescia, Italy
| | - Hong Zhang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Ali G Gharavi
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA.
- Institute for Genomic Medicine, Columbia University, New York City, NY, USA.
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Priest KC, Balasanova AA, Levander XA, Chan B, Blazes CK, Mahan J, Brown J, Mahoney S, Peng L, Mahoney S, Lundy T, Englander H. Caring for Hospitalized Adults with Methamphetamine Use Disorder: A Proposed Clinical Roadmap. Am J Med 2023; 136:507-509. [PMID: 36739062 PMCID: PMC10947159 DOI: 10.1016/j.amjmed.2023.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 02/05/2023]
Affiliation(s)
- Kelsey C Priest
- School of Medicine, MD/PhD Program, Oregon Health & Science University, Portland, OR; Department of Psychiatry, Stanford University School of Medicine, Stanford, CA; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | - Alëna A Balasanova
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE
| | - Ximena A Levander
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR; IMPACT Team, Oregon Health & Science University, Portland, OR
| | - Brian Chan
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR; IMPACT Team, Oregon Health & Science University, Portland, OR
| | | | - John Mahan
- Jackson County Health and Human Services, Medford, OR
| | - Jessica Brown
- IMPACT Team, Oregon Health & Science University, Portland, OR
| | - Stacey Mahoney
- IMPACT Team, Oregon Health & Science University, Portland, OR; Harmony Academy Recovery High School, Lake Oswego, OR
| | - Linda Peng
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR; IMPACT Team, Oregon Health & Science University, Portland, OR
| | - Sean Mahoney
- IMPACT Team, Oregon Health & Science University, Portland, OR; Mental Health & Addiction Association of Oregon, Portland, OR
| | - Traci Lundy
- IMPACT Team, Oregon Health & Science University, Portland, OR; Mental Health & Addiction Association of Oregon, Portland, OR
| | - Honora Englander
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR; IMPACT Team, Oregon Health & Science University, Portland, OR
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Chmielewski J, Chaudhry PM, Harer MW, Menon S, South AM, Chappell A, Griffin R, Askenazi D, Jetton J, Starr MC, Selewski DT, Sarkar S, Kent A, Fletcher J, Abitbol CL, DeFreitas M, Duara S, Charlton JR, Swanson JR, Guillet R, D’Angio C, Mian A, Rademacher E, Mhanna MJ, Raina R, Kumar D, Jetton JG, Brophy PD, Colaizy TT, Klein JM, Arikan AA, Rhee CJ, Goldstein SL, Nathan AT, Kupferman JC, Bhutada A, Rastogi S, Bonachea E, Ingraham S, Mahan J, Nada A, Cole FS, Davis TK, Dower J, Milner L, Smith A, Fuloria M, Reidy K, Kaskel FJ, Soranno DE, Gien J, Gist KM, Chishti AS, Hanna MH, Hingorani S, Juul S, Wong CS, Joseph C, DuPont T, Ohls R, Staples A, Rohatgi S, Sethi SK, Wazir S, Khokhar S, Perazzo S, Ray PE, Revenis M, Mammen C, Synnes A, Wintermark P, Zappitelli M, Woroniecki R, Sridhar S. Documentation of acute kidney injury at discharge from the neonatal intensive care unit and role of nephrology consultation. J Perinatol 2022; 42:930-936. [PMID: 35676535 PMCID: PMC9280854 DOI: 10.1038/s41372-022-01424-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/29/2022] [Accepted: 05/27/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate whether NICU discharge summaries documented neonatal AKI and estimate if nephrology consultation mediated this association. STUDY DESIGN Secondary analysis of AWAKEN multicenter retrospective cohort. EXPOSURES AKI severity and diagnostic criteria. OUTCOME AKI documentation on NICU discharge summaries using multivariable logistic regression to estimate associations and test for causal mediation. RESULTS Among 605 neonates with AKI, 13% had documented AKI. Those with documented AKI were more likely to have severe AKI (70.5% vs. 51%, p < 0.001) and SCr-only AKI (76.9% vs. 50.1%, p = 0.04). Nephrology consultation mediated 78.0% (95% CL 46.5-109.4%) of the total effect of AKI severity and 82.8% (95% CL 70.3-95.3%) of the total effect of AKI diagnostic criteria on documentation. CONCLUSION We report a low prevalence of AKI documentation at NICU discharge. AKI severity and SCr-only AKI increased odds of AKI documentation. Nephrology consultation mediated the associations of AKI severity and diagnostic criteria with documentation.
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Affiliation(s)
- Jennifer Chmielewski
- Department of Pediatrics, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Paulomi M. Chaudhry
- Department of Pediatrics, Division of Neonatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Matthew W. Harer
- Department of Pediatrics, Division of Neonatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Shina Menon
- Division of Nephrology, University of Washington and Seattle Children’s Hospital, Seattle, WA, USA
| | - Andrew M. South
- Department of Pediatrics, Section of Nephrology, Brenner Children’s, Wake Forest School of Medicine, Winston Salem, NC, USA.,Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Ashley Chappell
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Russell Griffin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Askenazi
- Department of Pediatrics, Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jennifer Jetton
- Division of Nephrology, Dialysis and Transplantation, Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Michelle C. Starr
- Department of Pediatrics, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.,Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.,Correspondence and requests for materials should be addressed to Michelle C. Starr.
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Turner DA, Schwartz A, Carraccio C, Herman B, Weiss P, Baffa JM, Chess P, Curran M, Dammann C, High P, Hsu D, Pitts S, Sauer C, Aye T, Fussell J, Kesselheim J, Mahan J, McGann K, Myers A, Mink R. Continued Supervision for the Common Pediatric Subspecialty Entrustable Professional Activities May Be Needed Following Fellowship Graduation. Acad Med 2021; 96:S22-S28. [PMID: 34183598 DOI: 10.1097/acm.0000000000004091] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE Entrustable professional activities (EPAs) are one approach to competency-based medical education (CBME), and 7 EPAs have been developed that address content relevant for all pediatric subspecialties. However, it is not known what level of supervision fellowship program directors (FPDs) deem necessary for graduation. The Subspecialty Pediatrics Investigator Network (SPIN) investigated FPD perceptions of the minimum level of supervision required for a trainee to successfully graduate. METHOD In 2017, SPIN surveyed all FPDs of accredited fellowships for 14 subspecialties. For each EPA, the minimum supervision level for graduation (ranging from observation only to unsupervised practice) was set such that no more than 20% of FPDs would accept a lower level. RESULTS The survey response rate was 82% (660/802). The minimum supervision level for graduation varied across the 7 EPAs from 2 (direct) to 4 (indirect for complex cases), with significant differences between EPAs. The percentage of FPDs desiring a lower minimum supervision level ranged from 3% to 17%. Compared with the 4 nonclinical EPAs (quality improvement, management, lead within the profession, scholarship), the 3 clinical EPAs (consultation, handover, lead a team) had higher minimum supervision graduation levels (P < .001), with less likelihood that an FPD would graduate a learner below their minimum level (P < .001). CONCLUSIONS Consensus among FPDs across all pediatric subspecialties demonstrates the potential need for ongoing supervision for graduates in all 7 common pediatric subspecialty EPAs after fellowship. As CBME programs are implemented, processes and infrastructure to support new graduates are important considerations for leaders.
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Affiliation(s)
- David A Turner
- D.A. Turner is vice president of competency-based medical education, American Board of Pediatrics, Chapel Hill, North Carolina, and consulting professor, Duke University Medical Center, Durham, North Carolina. At the time this work was completed, he was associate professor, Duke University Medical Center, Durham, North Carolina
| | - Alan Schwartz
- A. Schwartz is the Michael Reese Endowed Professor of Medical Education, interim head, Department of Medical Education, and research professor, Department of Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Carol Carraccio
- C. Carraccio was vice president of competency-based medical education, American Board of Pediatrics, Chapel Hill, North Carolina at the time this work was completed
| | - Bruce Herman
- B. Herman is professor and vice chair of education, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Pnina Weiss
- P. Weiss is vice chair of education and associate professor, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Jeanne M Baffa
- J.M. Baffa is emeritus associate professor of pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Patricia Chess
- P. Chess is professor, University of Rochester Medical Center, Rochester, New York
| | - Megan Curran
- M. Curran is associate professor, Department of Pediatrics, University of Colorado-Denver, Denver, Colorado
| | - Christiane Dammann
- C. Damman is professor, Department of Pediatrics, Tufts Children's Hospital, Boston, Massachusetts
| | - Pamela High
- P. High is professor, the Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Deborah Hsu
- D. Hsu is professor, Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Sarah Pitts
- S. Pitts is assistant professor, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Cary Sauer
- C. Sauer is associate professor, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Tandy Aye
- T. Aye is associate professor, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Jill Fussell
- J. Fussell is professor, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Jennifer Kesselheim
- J. Kesselheim is associate professor, Department of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts
| | - John Mahan
- J. Mahan is professor, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Kathleen McGann
- K. McGann is vice chair of education and professor, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Angie Myers
- A. Myers is professor of pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Richard Mink
- R. Mink is professor of pediatrics, The David Geffen School of Medicine at University of California Los Angeles (UCLA) and The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
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Little-Wienert K, Chang T, Agarwal R, Cramton R, Hillenbrand K, Panchal A, Stubblefield W, Mahan J, Wright M, Donato L, Chandran L. Enhancing pediatricians' engagement on social media: the role of board style questions. MedEdPublish (2016) 2021; 10:177. [PMID: 38486542 PMCID: PMC10939574 DOI: 10.15694/mep.2021.000177.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: Social Media is used among medical professionals for collaborative education. Little is known about how case discussions prompt engagement. Objective: To determine the association between item characteristics of board exam-style questions to social media engagement. Methods: This was a prospective cohort study through the American Academy of Pediatrics (AAP) PediaLink FaceBook page, conducted in 2018 over 9 months. Items from the 2017 PREP® questions were ranked in difficulty, then rated in relevance to general pediatrics through content-expert consensus. Thirty-six questions were randomly posted on FaceBook and Twitter weekly. Independent variables included item difficulty rank, difficulty level (easy vs hard), relevance to general pediatrics, and word count. Outcome variables included percent correct responses and total comments under the post. Results: More difficult questions were associated with fewer comments (rho=0.63, p<0.001) and lower correct response percentages (rho=0.39, p=0.02). Easy questions garnered more comments than hard questions (median 18 IQR 13-23 vs median 9.5 IQR 5-14, p=0.001). Correct response percentage was lower for hard questions (90% IQR 85-95% vs. 77% IQR 60-94%, p=0.04). Relevance to general pediatrics and word count did not affect engagement (p > 0.1). Conclusion: Easier practice test items attracted more responses from pediatricians on social media, increasing engagement.
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Delbarba E, Marasa M, Canetta PA, Piva SE, Chatterjee D, Kil BH, Mu X, Gibson KL, Hladunewich MA, Hogan JJ, Julian BA, Kidd JM, Laurin LP, Nachman PH, Rheault MN, Rizk DV, Sanghani NS, Trachtman H, Wenderfer SE, Gharavi AG, Bomback AS, Ahn W, Appel GB, Babayev R, Batal I, Bomback AS, Brown E, Campenot ES, Canetta P, Chan B, Chatterjee D, D’Agati VD, Delbarba E, Fernandez H, Foroncewicz B, Gharavi AG, Ghiggeri GM, Hines WH, Jain NG, Kil BH, Kiryluk K, Lau WL, Lin F, Lugani F, Marasa M, Markowitz G, Mohan S, Mu X, Mucha K, Nickolas TL, Piva S, Radhakrishnan J, Rao MK, Sanna-Cherchi S, Santoriello D, Stokes MB, Yu N, Valeri AM, Zviti R, Greenbaum LA, Smoyer WE, Al-Uzri A, Ashoor I, Aviles D, Baracco R, Barcia J, Bartosh S, Belsha C, Bowers C, Braun MC, Chishti A, Claes D, Cramer C, Davis K, Erkan E, Feig D, Freundlich M, Gbadegesin R, Hanna M, Hidalgo G, Hunley TE, Jain A, Kallash M, Khalid M, Klein JB, Lane JC, Mahan J, Mathews N, Nester C, Pan C, Patterson L, Patel H, Revell A, Rheault MN, Silva C, Sreedharan R, Srivastava T, Steinke J, Twombley K, Wenderfer SE, Vasylyeva TL, Weaver DJ, Wong CS, Almaani S, Ayoub I, Budisavljevic M, Derebail V, Fatima H, Falk R, Fogo A, Gehr T, Gibson K, Glenn D, Harris R, Hogan S, Jain K, Jennette JC, Julian B, Kidd J, Laurin LP, Massey HD, Mottl A, Nachman P, Nadasdy T, Novak J, Parikh S, Pichette V, Poulton C, Powell TB, Renfrow M, Rizk D, Rovin B, Royal V, Saha M, Sanghani N, Self S, Adler S, Alpers C, Matar RB, Brown E, Cattran D, Choi M, Dell KM, Dukkipati R, Fervenza FC, Fornoni A, Gadegbeku C, Gipson P, Hasely L, Hingorani S, Hladunewich M, Hogan J, Holzman LB, Jefferson JA, Jhaveri K, Johnstone DB, Kaskel F, Kogan A, Kopp J, Lafayette R, Lemley KV, Malaga-Dieguez L, Meyers K, Neu A, O’Shaughnessy MM, O’Toole JF, Parekh R, Reich H, Reidy K, Rondon H, Sambandam KK, Sedor JR, Selewski DT, Sethna CB, Schelling J, Sperati JC, Swiatecka-Urban A, Trachtman H, Tuttle KR, Weisstuch J, Vento S, Zhdanova O, Gillespie B, Gipson DS, Hill-Callahan P, Helmuth M, Herreshoff E, Kretzler M, Lienczewski C, Mansfield S, Mariani L, Nast CC, Robinson BM, Troost J, Wladkowski M, Zee J, Zinsser D, Guay-Woodford LM. Persistent Disease Activity in Patients With Long-Standing Glomerular Disease. Kidney Int Rep 2020; 5:860-871. [PMID: 32518868 PMCID: PMC7270998 DOI: 10.1016/j.ekir.2020.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/11/2020] [Accepted: 03/09/2020] [Indexed: 11/03/2022] Open
Abstract
Introduction Methods Results Conclusion
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Fernandes AK, Wilson S, Kasick R, Humphrey L, Mahan J, Spencer S. Team-Based Learning in Bioethics Education: Creating a Successful Curriculum for Residents in an Era of "Curricular Squeeze". Med Sci Educ 2020; 30:649-658. [PMID: 34457718 PMCID: PMC8368489 DOI: 10.1007/s40670-019-00836-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Team-based learning has been utilized inside and outside of medical education with success. Its use in bioethics education-particularly in graduate medical education-has been limited, despite its proven pedagogical strength and the critical importance of ethics and professionalism. ACTIVITY From 2015-2018, we created and administered 10 TBL bioethics modular exercises using L. Dee Fink's "Principles of Significant Learning" and the evidence-based methodology of TBL (with some modifications, given the nature of graduate medical education) to pediatric residents. We evaluated the TBL curriculum and report satisfaction scores and qualitative thematic analysis of strengths and weaknesses. RESULTS AND DISCUSSION Pediatric residents, despite a perception of "curricular squeeze" and lack of interest in ethics, were highly engaged and satisfied with a TBL-only-based bioethics curriculum. We were able to successfully adapt the TBL structure to the situational factors surrounding the rigors and unpredictable nature of clinical graduate education. We offer four "Lessons Learned" for creating and implementing TBL exercises in graduate medical education. TBL can be used in bioethics education successfully, not just for individual exercises, but also to create a comprehensive ethics curriculum.
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Affiliation(s)
- Ashley K. Fernandes
- Division of Ambulatory Medicine, Nationwide Children’s Hospital, Columbus, USA
| | - Sheria Wilson
- Division of Neonatology, Nationwide Children’s Hospital, Columbus, USA
| | - Rena Kasick
- Division of Hospital Medicine, Nationwide Children’s Hospital, Columbus, USA
| | - Lisa Humphrey
- Division of Palliative Medicine, Nationwide Children’s Hospital, Columbus, USA
| | - John Mahan
- Division of Nephrology, Nationwide Children’s Hospital, Columbus, USA
| | - Sandra Spencer
- Division of Emergency Medicine, Nationwide Children’s Hospital, Columbus, USA
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Lewis K, Demiroz E, Chen H, Albold C, Mahan J. A Four-Pronged Approach for Evaluating e-Learning Modules with a Newly Developed Instructional Design Scale. ACTA ACUST UNITED AC 2020. [DOI: 10.5455/jcme.20190307082154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Mink R, Schwartz A, Carraccio C, High P, Dammann C, McGann KA, Kesselheim J, Herman B, Baffa G, Herman B, Turner DA, Fussell J, High P, Hsu D, Stafford D, Aye T, Sauer C, Kesselheim J, Myers A, McGann K, Dammann C, Chess P, Mahan J, Weiss P, Curran M, Schwartz A, Carraccio C, Herman B, Mink R, Havalad V, Pinheiro J, Alderman E, Fuloria M, McCabe ME, Mehta J, Rivas Y, Rosenberg M, Doughty C, Hergenroeder A, Kale A, Lee-Kim Y, Rama JA, Steuber P, Voigt B, Hardy K, Johnston S, Boyer D, Mauras C, Schonwald A, Sharma T, Barron C, Dennehy P, Jacobs ES, Welch J, Kumar D, Mason K, Roizen N, Rose JA, Bokor B, Chapman JI, Frank L, Sami I, Schuette J, Lutes RE, Savelli S, Amirnovin R, Harb R, Kato R, Marzan K, Monzavi R, Vanderbilt D, Doughty L, McAneney C, Rice W, Widdice L, Erenberg F, Gonzalez BE, Adkins D, Green D, Narayan A, Rehder K, Clingenpeel J, Starling S, Karpen HE, Rouster-Stevens K, Bhatia J, Fuqua J, Anders J, Trent M, Ramanathan R, Nicolau Y, Dozor AJ, Kinane TB, Stanley T, Rao AN, Bone M, Camarda L, Heffner V, Kim O, Nocton J, Rabbitt AL, Tower R, Amaya M, Jaroscak J, Kiger J, Macias M, Titus O, Awonuga M, Vogt K, Warwick A, Coury D, Hall M, Letson M, Rose M, Glickstein J, Lusman S, Roskind C, Soren K, Katz J, Siqueira L, Atlas M, Blaufox A, Gottleib B, Meryash D, Vuguin P, Weinstein T, Armsby L, Madison L, Scottoline B, Shereck E, Henry M, Teaford PA, Long S, Varlotta L, Zubrow A, Barlow C, Feldman H, Ganz H, Grimm P, Lee T, Weiner LB, Molle-Rios Z, Slamon N, Guillen U, Miller K, Federman M, Cron R, Hoover W, Simpson T, Winkler M, Harik N, Ross A, Al-Ibrahim O, Carnevale FP, Waz W, Bany-Mohammed F, Kim JH, Printz B, Brook M, Hermiston M, Lawson E, van Schaik S, McQueen A, Booth KVP, Tesher M, Barker J, Friedman S, Mohon R, Sirotnak A, Brancato J, Sayej WN, Maraqa N, Haller M, Stryjewski B, Brophy P, Rahhal R, Reinking B, Volk P, Bryant K, Currie M, Potter K, Falck A, Weiner J, Carney MM, Felt B, Barnes A, Bendel CM, Binstadt B, Carlson K, Garrison C, Moffatt M, Rosen J, Sharma J, Tieves KS, Hsu H, Kugler J, Simonsen K, Fastle RK, Dannaway D, Krishnan S, McGuinn L, Lowe M, Witchel SF, Matheo L, Abell R, Caserta M, Nazarian E, Yussman S, Thomas AD, Hains DS, Talati AJ, Adderson E, Kellogg N, Vasquez M, Allen C, Brion LP, Green M, Journeycake J, Yen K, Quigley R, Blaschke A, Bratton SL, Yost CC, Etheridge SP, Laskey T, Pohl J, Soprano J, Fairchild K, Norwood V, Johnston TA, Klein E, Kronman M, Nanda K, Smith L, Allen D, Frohna JG, Patel N, Estrada C, Fleming GM, Gillam-Krakauer M, Moore P, El Khoury JC, Helderman J, Barretto G, Levasseur K, Johnston L. Creating the Subspecialty Pediatrics Investigator Network. J Pediatr 2018; 192:3-4.e2. [PMID: 29246355 DOI: 10.1016/j.jpeds.2017.09.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Richard Mink
- Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Torrance, CA
| | | | | | - Pamela High
- W Alpert Medical School of Brown University, Providence, RI
| | | | | | | | - Bruce Herman
- University of Utah/Primary Children's Hospital, Salt Lake City, UT
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Ee C, Thuraisingam S, Pirotta M, French S, Xue C, Teede H, Kristoffersen AE, Sirois F, Stub T, Engler J, Joos S, Güthlin C, Felenda J, Beckmann C, Stintzing F, Evans R, Bronfort G, Keefe D, Taberko A, Hanson L, Haley A, Ma H, Jolton J, Yarosh L, Keefe F, Nam J, Evans R, Ojala L, Kreitzer MJ, Hanson L, Fink C, Kraft K, Flower A, Lewith G, Harman K, Stuart B, Bishop FL, Frawley J, Füleki L, Kiss E, Vancsik T, Krenacs T, Funabashi M, Pohlman KA, Mior S, Thiel H, Hill MD, Cassidy DJ, Westaway M, Yager J, Hurwitz E, Kawchuk GN, O’Beirne M, Vohra S, Gaboury I, Morin C, Gaertner K, Torchetti L, Frei-Erb M, Kundi M, Frass M, Gallo E, Maggini V, Comite M, Sofi F, Baccetti S, Vannacci A, Di Stefano M, Monechi MV, Gori L, Rossi E, Firenzuoli F, Mediati RD, Ballerini G, Gardiner P, Lestoquoy AS, Negash L, Stillman S, Shah P, Liebschutz J, Adelstein P, Farrell-Riley C, Brackup I, Penti B, Saper R, Sampedro IG, Carvajal G, Gleiss A, Gross MM, Brendlin D, Röttger J, Stritter W, Seifert G, Grzanna N, Stange R, Guendling PW, Gu W, Lu Y, Wang J, Zhang C, Hajimonfarednejad M, Hannan N, Hellsing R, Wode K, Nordberg JH, Nordberg JH, Andermo S, Arman M, von Hörsten I, Torrielo PV, Bai H, Vilaró CLA, Cabrera FC, Huber R, Hui H, Ziea E, Tsui D, Hsieh J, Lam C, Chan E, Jensen MP, He Y, Battalio SL, Chan J, Edwards KA, Gertz KJ, Day MA, Sherlin LH, Ehde DM, Kim KH, Jang S, Jang BH, Zhang X, Go HY, Park S, Ko SG, Kraft K, Janik H, Börner A, Lee J, Lee B, Chang GT, Menassa A, Zhang Z, Motoo Y, Müller J, Rabini S, Vinson B, Kelber O, Storr M, Kraft K, Niemeijer M, Baars E, Hoekman J, Wang D, Ruijssenaaars W, Njoku FC, Klose P, Brinkhaus B, Michalsen A, Dobos G, Cramer H, Norheim AJ, Alræk T, Okumus F, Meng F, Oncu-Celik H, Hagel A, Albrecht H, Vollbracht C, Dauth W, Hagel W, Vitali F, Ganzleben I, Schultis H, Konturek P, Stein J, Neurath M, Raithel M, Hagel A, Vollbracht C, Raithel M, Konturek P, Krick B, Haller H, Klose P, Dobos G, Kümmel S, Cramer H, Haller H, Saha FJ, Kowoll A, Ebner B, Berger B, Dobos G, Choi KE, He L, Wang H, He X, Gu C, Zhang Y, Zhao L, Tong X, He L, Wang H, He X, Gu C, Zhang Y, Zhao L, Tong X, He L, Wang H, He X, Gu C, Zhang Y, Zhao L, Tong X, Ho RST, Chung VCH, Wu X, Wong CHL, Wu JCY, Wong SYS, Lau AYL, Sit RWS, Wong W, Holmes M, Bishop F, Calman L, Holmes M, Bishop F, Lewith G, Newell D, Field J, Htut WL, Han D, Choi DI, Choi SJ, Kim HY, Hwang JH, Huang CW, Jang BH, Chen FP, Ko SG, Huang W, Jin D, Lian F, Jang S, Kim KH, Lee EK, Sun SH, Go HY, Ko Y, Park S, Jang BH, Shin YC, Ko SG, Janik H, Greiffenhagen N, Bolte J, Kraft K, Jaworski M, Adamus M, Dobrzynska A, Jeitler M, Jaspers J, von Scheidt C, Koch B, Michalsen A, Steckhan N, Kessler C, Jin D, Huang WJ, Pang B, Lian FM, Jong M, Baars E, Glockmann A, Hamre H, Kainuma M, Murakami A, Kubota T, Kobayashi D, Sumoto Y, Furusyo N, Ando SI, Shimazoe T, Kelber O, Verjee S, Gorgus E, Schrenk D, Kemper K, Hill E, Kemper K, Rao N, Gascon G, Mahan J, Kienle G, Dietrich J, Schmoor C, Huber R, Kim WH, Han D, Ahmed M, He L, Hwang JH, Kiss E, Vancsik T, Meggyeshazi N, Kovago C, Krenacs T, Klaus AK, Zerm R, Pranga D, Ostermann T, Reif M, von Laue HB, Brinkhaus B, Kröz M, Klaus AK, Zerm R, Pranga D, Recchia DR, Ostermann T, Reif M, von Laue HB, Brinkhaus B, Kröz M, Klein-Laansma CT, Jong M, von Hagens C, Jansen JP, van Wietmarschen H, Jong MC, Ko Y, Sun SH, Go HY, Jeon CY, Song YK, Ko SG, Koch AK, Rabsilber S, Lauche R, Kümmel S, Dobos G, Langhorst J, Cramer H, Koch AK, Trifunovic-Koenig M, Klose P, Cramer H, Dobos G, Langhorst J, Koster E, Baars E, Delnoij D, Kroll L, Weiss K, Kubo A, Hendlish S, Altschuler A, Connolly N, Avins A, Lauche R, Recchia DR, Cramer H, Wardle J, Lee D, Sibbritt D, Adams J, Ostermann T, Lauche R, Sibbritt D, Park C, Mishra G, Adams J, Cramer H, Lechner J, Lee I, Chae Y, Lee J, Cho SH, Choi Y, Lee JY, Ryu HS, Yoon SS, Oh HK, Hyun LK, Kim JO, Yoon SW, Lee JY, Shin SH, Jang M, Müller I, Park SHJ, Lestoquoy AS, Laird L, Negash L, Mitchell S, Gardiner P, Li X, Wang Y, Zhen J, Yu H, Liu T, Gu X, Liu H, Ma W, Zhang C, Shang X, Bai Y, Meng F, Liu W, Rooney C, Smith A, Lopes S, Demarzo M, do Patrocínio Nunes M, Lorenz P, Gründemann C, Heinrich M, Garcia-Käufer M, Grunewald F, Messerschmidt S, Herrick A, Gruber K, Beckmann C, Knödler M, Huber R, Steinborn C, Stintzing F, Lu T, Wang L, Wu D, Luberto CM, Hall DL, Chad-Friedman E, Lechner S, Park ER, Luberto CM, Park E, Goodman J, Luer S, Heri M, von Ammon K, Frei-Erb M, Ma W, Meng F, Maggini V, Gallo E, Landini I, Lapucci A, Nobili S, Mini E, Firenzuoli F, McDermott C, Lewith G, Richards S, Cox D, Frossell S, Leydon G, Eyles C, Raphael H, Rogers R, Selby M, Adler C, Allam J, Meng F, Gu W, Zhang C, Bai H, Zhang Z, Wang D, Bu X, Zhang H, Zhang J, Liu H, Mikolasek M, Berg J, Witt C, Barth J, Miskulin I, Lalic Z, Miskulin M, Dumic A, Sebo D, Vcev A, Mohammed NAA, Han D, Ahmed M, Choi SJ, Im HB, Hwang JH, Mukherjee A, Kandhare A, Bodhankar S, Mukherjee A, Kandhare A, Thakurdesai P, Bodhankar S, Munk N, Evans E, Froman A, Kline M, Bair MJ, Musial F, Kristoffersen AE, Alræk T, Hamre HJ, Stub T, Björkman L, Fønnebø VM, Pang B, Lian FM, Ni Q, Tong XL, Li XL, Liu WK, Feng S, Zhao XY, Zheng YJ, Zhao XM, Lin YQ, Pang B, Lian FM, Tong XL, Zhao TY, Zhao XY, Phd HC, Zhang C, Pang B, Liu F, Tong XL, Zhao LH, Zhao XM, Ye R, Gu CJ, Pang B, Ni Q, Tong XL, Lian FM, Zhao XY, Jin D, Zhao XM, Zheng YJ, Lin YQ, Peng W, Lauche R, Sibbritt D, Adams J, Peng W, Wardle J, Cramer H, Mishra G, Lauche R, Pohlman KA, Mior S, Funabashi M, De Carvalho D, El-Bayoumi M, Haig B, Kelly K, Wade DJ, O’Beirne M, Vohra S, Portalupi E, Gobo G, Bellavita L, Guglielmetti C, Raak C, Teuber M, Molsberger F, von Rath U, Reichelt U, Schwanebeck U, Zeil S, Vogelberg C, Veintimilla DR, Vollbracht C, Mery GT, Villavicencio MM, Moran SH, Sachse C, Gündlin PW, Stange R, Sahebkarkhorasani M, Azizi H, Schumann D, Lauche R, Sundberg T, Leach MJ, Cramer H, Seca S, Greten H, Selliah S, Shakya A, Han D, Kim HY, Choi DI, Im HB, Choi SJ, Sherbakova A, Ulrich-Merzenich G, Kelber O, Abdel-Aziz H, Sibinga E, Webb L, Ellen J, Skrautvol K, Nåden D, Song R, Grabowska W, Osypiuk K, Diaz GV, Bonato P, Park M, Hausdorff J, Fox M, Sudarsky LR, Tarsy D, Novakowski J, Macklin EA, Wayne PM, Song R, Hwang I, Ahn S, Lee MA, Wayne PM, Sohn MK, Sorokin O, Steckhan N, Heydeck D, Borchert A, Hohmann CD, Kühn H, Michalsen A, Kessler C, Steckhan N, Hohmann CD, Cramer H, Michalsen A, Dobos G, von Scheidt C, Kirschbaum C, Stalder T, Stöckigt B, Teut M, Suhr R, Sulmann D, Brinkhaus B, Streeter C, Gerbarg P, Silveri M, Brown R, Jensen J, Stritter W, Rutert B, Eggert A, Längler A, Seifert G, Holmberg C, Sun J, Deng X, Li WY, Wen B, Robinson N, Liu JP, Sung HK, Yang N, Go HY, Shin SM, Jung H, Kim YJ, Jung WS, Park TY, Suzuki K, Ito T, Uchida S, Kamohara S, Ono N, Takamura M, Yokochi A, Maruyama K, Tapia P, Thabaut K, Brinkhaus B, Stöckigt B, Thronicke A, Kröz M, Steele M, Matthes H, Herbstreit C, Schad F, Tian J, Lian F, Yang L, Tong X, Tian T, Zhang H, Tian X, Wang C, Chai QY, Zhang L, Xia R, Huang N, Fei Y, Liu J, Trent N, Miraglia M, Dusek J, Pasalis E, Khalsa SB, Trifunovic-König M, Klose P, Cramer H, Lauche R, Koch A, Dobos G, Langhorst J, Uebelacker L, Tremont G, Gillette L, Epstein-Lubow G, Strong D, Abrantes A, Tyrka A, Tran T, Gaudiano B, Miller I, Ullmann G, Ullmann G, Li Y, Vaidya S, Marathe V, Vale AC, Motta J, Donadão F, Valente AC, Valente LCC, Ghelman R, Vesovic D, Jevdic D, Jevdic A, Jevdic K, Djacic M, Letic D, Bozic D, Markovic M, Dunjic S, Vesovic D, Jevdic D, Jevdic A, Jevdic K, Djacic M, Letic D, Bozic D, Markovic M, Ruscuklic G, Baksa D, Dunjic S, Vesovic D, Jevdic D, Jevdic A, Jevdic K, Djacic M, Letic D, Bozic D, Markovic M, Ruscuklic G, Baksa D, Dunjic S, Vesovic D, Jevdic D, Jevdic A, Jevdic K, Djacic M, Letic D, Bozic D, Markovic M, Ruscuklic G, Baksa D, Dunjic S, Vesovic D, Jevdic D, Jevdic A, Jevdic K, Djacic M, Letic D, Bozic D, Markovic M, Vrca K, Dunjic S, Vincent A, Wahner-Roedler D, Whipple M, Vogelius MM, Vollbracht C, Friesecke I, Gündling PW, Wahner-Roedler D, Mahapatra S, Hynes R, Van Rooy K, Looker S, Ghosh A, Bauer B, Cutshall S, Walach H, Flores AB, Walach H, Ofner M, Kastner A, Schwarzl G, Schwameder H, Alexander N, Strutzenberger G, Wang J, Lu Y, Gu W, Zhang C, Bu X, Zhang H, Zhang J, He Y, Zhang X, Meng F, Wang S, Yu H, Shi J, Hao Y, Liu T, Wu J, Qiu Z, Gu X, Wang YH, Lou CJ, Watts S, Wayne P, Osypiuk K, Vergara-Diaz G, Bonato P, Gow B, Hausdorff J, Miranda J, Sudarsky L, Tarsy D, Fox M, Macklin E, Wode K, Bergqvist J, Bernhardsson BM, Nordberg JH, Kienle G, Sharp L, Henriksson R, Woo Y, Hyun MK, Wu H, Wang TF, Zhao Y, Wei Y, Tian L, He L, Wang X, Wu R, Feng S, Han M, Caldwell PHY, Liu S, Zhang J, Liu J, Xia R, Chai Q, Fei Y, Guo Z, Wang C, Liu Z, Li X, Zhang Y, Liu J, Yang IJ, Lincha VR, Ahn SH, Lee DU, Shin HM, Yang L, Sibbritt D, Peng W, Adams J, Yang N, Sung H, Shin SM, Go HY, Jung H, Kim Y, Park TY, Yap A, Kwan YH, Tan CS, Ibrahim S, Ang SB, Yayi A, Han D, Im HB, Hwang JH, Choi SJ, Yoo JE, Yoo HR, Jang SB, Lee HL, Youssef A, Ezzat S, Motaal AA, El-Askary H, Yu X, Cui Y, Zhang Y, Lian F, Yun Y, Ko Y, Ahn JH, Jang BH, Kim KS, Ko SG, Choi I, Zerm R, Glinz A, Pranga D, Berger B, ten Brink F, Reif M, Büssing A, Gutenbrunner C, Kröz M, Zerm R, Helbrecht B, Pranga D, Brinkhaus B, Michalsen A, Kröz M, Zhang H, Fang T, Wang J, Zhang C, He Y, Zhang X, Zhang Z, Wang D, Meng F, Zhang J, Zhang C, Bai H, Shen Z, Ma W, Liu H, Bai Y, Shang X, Meng F, Zhang R, Wu F, Li M, Xuan X, Shen X, Ren K, Berman B, Zhen J, Li X, Gu X, Yu H, Zheng Z, Wan Y, Wang Y, Ma X, Dong F, Liu T, Zhen J, Li X, Gu X, Yu H, Zheng Z, Wan Y, Wang Y, Ma X, Dong F, Liu T, Zick S, Harris R, Bae GE, Kwon JN, Lee HY, Nam JK, Lee SD, Lee DH, Han JY, Yun YJ, Lee JH, Park HL, Park SH, Bocci C, Ivaldi GB, Vietti I, Meaglia I, Guffi M, Ruggiero R, Gualea M, Longa E, Bonucci M, Croke S, Rodriguez LD, Caracuel-Martínez JC, Fajardo-Rodríguez MF, Ariza-García A, la Fuente FGD, Arroyo-Morales M, Estrems MS, Gómez VG, Estrems MS, Sabater MV, Ferreri R, Bernardini S, Pulcri R, Cracolici F, Rinaldi M, Porciani C, Firenzuoli F, Baccetti S, Di Stefano M, Monechi MV, Gallo E, Maggini V, Gori L, Rossi E, Fisher P, Hughes J, Mendoza A, MacPherson H, Witt C, Filshie J, Lewith G, Di Francesco A, Bernardini A, Messe M, Primitivo V, Iasella PA, Ghelman R, Taminato M, Alcantara JDC, De Oliveira KR, Rodrigues DCDA, Mumme JRC, Sunakozawa OKM, Filho VO, Seifert G, Goldenberg J, Day A, Sasagawa M, Ward L, Cooley K, Gunnarsdottir T, Hjaltadottir I. World Congress Integrative Medicine & Health 2017: part two. BMC Complement Altern Med 2017. [PMCID: PMC5498867 DOI: 10.1186/s12906-017-1783-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Rakowsky A, Mahan J, Donthi R, Backes C. The Doctors Hospital and Nationwide Children's Hospital Dually Accredited Pediatric Residency Program: A Potential Best Model for Pediatric Osteopathic GME Training. J Osteopath Med 2015; 115:390-3. [PMID: 26024333 DOI: 10.7556/jaoa.2015.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
With the commitment on the part of the American Osteopathic Association, the American Association of Colleges of Osteopathic Medicine, and the Accreditation Council for Graduate Medical Education to transition to a single graduate medical education accreditation system by 2020, a legitimate concern exists about the future of pediatric residency training that maintains an osteopathic focus. The authors describe a dually accredited pediatric residency program at one of the nation's largest children's hospitals, which may serve as a potential model of how to integrate a robust osteopathic-based education into a general pediatric residency program.
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Ferris M, Iglesia E, Ko Z, Amamoo A, Mahan J, Desai T, Gibson K, Jhaveri K, Primack W. Wanted: pediatric nephrologists! — why trainees are not choosing pediatric nephrology. Ren Fail 2014; 36:1340-4. [DOI: 10.3109/0886022x.2014.937671] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ingram M, Mahan J. Return to contingency: developing a coherent strategy for future R2E/R3 land medical capabilities. J ROY ARMY MED CORPS 2014; 161:5-8. [DOI: 10.1136/jramc-2014-000255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
While video is a powerful teaching and learning tool because it can influence knowledge, skills, and attitude formation effectively and reach learners with various learning and communication styles, there are pedagogical, technical, and copyright considerations. Instructors must know sources of appropriate videos, select effective video segments, apply various strategies for incorporating video triggers into the overall educational process, refine the message, overcome technological obstacles, and comply with copyright laws. One might ask, "Is using video triggers to improve your teaching worth it?" "Yes!" Numerous studies demonstrate that using video in many medical education settings supports and enhances learning and offers a bigger advantage in contrast with traditional methods.
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Schwarze U, Cundy T, Pyott SM, Christiansen HE, Hegde MR, Bank RA, Pals G, Ankala A, Conneely K, Seaver L, Yandow SM, Raney E, Babovic-Vuksanovic D, Stoler J, Ben-Neriah Z, Segel R, Lieberman S, Siderius L, Al-Aqeel A, Hannibal M, Hudgins L, McPherson E, Clemens M, Sussman MD, Steiner RD, Mahan J, Smith R, Anyane-Yeboa K, Wynn J, Chong K, Uster T, Aftimos S, Sutton VR, Davis EC, Kim LS, Weis MA, Eyre D, Byers PH. Mutations in FKBP10, which result in Bruck syndrome and recessive forms of osteogenesis imperfecta, inhibit the hydroxylation of telopeptide lysines in bone collagen. Hum Mol Genet 2013; 22:1-17. [PMID: 22949511 PMCID: PMC3606010 DOI: 10.1093/hmg/dds371] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 08/17/2012] [Accepted: 08/30/2012] [Indexed: 01/21/2023] Open
Abstract
Although biallelic mutations in non-collagen genes account for <10% of individuals with osteogenesis imperfecta, the characterization of these genes has identified new pathways and potential interventions that could benefit even those with mutations in type I collagen genes. We identified mutations in FKBP10, which encodes the 65 kDa prolyl cis-trans isomerase, FKBP65, in 38 members of 21 families with OI. These include 10 families from the Samoan Islands who share a founder mutation. Of the mutations, three are missense; the remainder either introduce premature termination codons or create frameshifts both of which result in mRNA instability. In four families missense mutations result in loss of most of the protein. The clinical effects of these mutations are short stature, a high incidence of joint contractures at birth and progressive scoliosis and fractures, but there is remarkable variability in phenotype even within families. The loss of the activity of FKBP65 has several effects: type I procollagen secretion is slightly delayed, the stabilization of the intact trimer is incomplete and there is diminished hydroxylation of the telopeptide lysyl residues involved in intermolecular cross-link formation in bone. The phenotype overlaps with that seen with mutations in PLOD2 (Bruck syndrome II), which encodes LH2, the enzyme that hydroxylates the telopeptide lysyl residues. These findings define a set of genes, FKBP10, PLOD2 and SERPINH1, that act during procollagen maturation to contribute to molecular stability and post-translational modification of type I procollagen, without which bone mass and quality are abnormal and fractures and contractures result.
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Affiliation(s)
| | - Tim Cundy
- Department of Medicine, University of Auckland, Auckland, NZ, USA
| | | | | | - Madhuri R. Hegde
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Ruud A. Bank
- Department of Medical Biology, University Medical Center Groningen, Groningen, Netherlands
| | - Gerard Pals
- Department of Clinical Genetics, VU Medical Center, Amsterdam, Netherlands
| | - Arunkanth Ankala
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Karen Conneely
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Laurie Seaver
- Kapi'olani Medical Specialists and Department of Pediatrics, John A. Burns School of Medicine, Honolulu, HI, USA
| | - Suzanne M. Yandow
- Kapi'olani Medical Specialists and Department of Pediatrics, John A. Burns School of Medicine, Honolulu, HI, USA
| | - Ellen Raney
- Kapi'olani Medical Specialists and Department of Pediatrics, John A. Burns School of Medicine, Honolulu, HI, USA
| | | | - Joan Stoler
- Division of Genetics, Children's Hospital, Boston, MA, USA
| | | | - Reeval Segel
- Medical Genetics Institute, Shaare Zedek Medical Center and Hebrew University, Jerusalem, Israel
| | - Sari Lieberman
- Medical Genetics Institute, Shaare Zedek Medical Center and Hebrew University, Jerusalem, Israel
| | | | - Aida Al-Aqeel
- Department of Pediatrics, Riyadh Armed Forces Hospital, Riyadh, Saudi Arabia
| | - Mark Hannibal
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Louanne Hudgins
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | | | | | | | - Robert D. Steiner
- Department of Pediatrics, Oregon Health and Sciences University, Portland, OR, USA
| | - John Mahan
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Rosemarie Smith
- Division of Genetics, Department of Pediatrics, Maine Medical Center, Portland, ME, USA
| | - Kwame Anyane-Yeboa
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Julia Wynn
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Karen Chong
- Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Tami Uster
- Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Salim Aftimos
- Northern Regional Genetics Services, Auckland, New Zealand
| | - V. Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA and
| | - Elaine C. Davis
- Department of Cell Biology, McGill University, Montreal, Quebec, Canada
| | | | | | - David Eyre
- Department of Orthopaedics and Sports Medicine
- Department of Biochemistry, and
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Sternfeld B, Liu K, Quesenberry CP, Wang H, Jiang SF, Daviglus M, Fornage M, Lewis CE, Mahan J, Schreiner PJ, Schwartz SM, Sidney S, Williams OD, Siscovick DS. Changes over 14 years in androgenicity and body mass index in a biracial cohort of reproductive-age women. J Clin Endocrinol Metab 2008; 93:2158-65. [PMID: 18334590 PMCID: PMC2435637 DOI: 10.1210/jc.2007-2203] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Body mass index (BMI) is directly related to testosterone (total T and free T) and inversely to SHBG cross-sectionally, but little is known about how changes in body fat and androgen markers affect each other over time. METHODS Participants included 969 White and Black women from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, who were ages 18-30 at entry into the study and were pre- or perimenopausal 16 yr later at the time of the CARDIA Women's Study (CWS). Total T and SHBG were assayed from specimens drawn at the CWS examination and stored serum from the yr 2 and 10 CARDIA exams. Free T was calculated based on total T and SHBG. BMI and waist circumference were measured at yr 2, 10, and 16. RESULTS Despite clinically significant increases in BMI and waist circumference, total T and free T tended to decline, whereas SHBG remained relatively constant. BMI and waist circumference were directly correlated with free T and inversely correlated with SHBG in cross-sectional analyses. In longitudinal, multivariable analyses, an annualized increase in BMI was inversely related to a concurrent annualized decrease in SHBG (beta = -0.79 ng/dl, and se = 0.22 in Blacks; beta = -1.07 ng/dl; and se = 0.31 in Whites). However, early increases in BMI were not related to later decreases in SHBG. CONCLUSION Increases in adiposity are closely tied to decreases in SHBG, but changes in BMI and SHBG may occur concurrently rather than sequentially.
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Affiliation(s)
- Barbara Sternfeld
- Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
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Symons JM, Chua AN, Somers MJG, Baum MA, Bunchman TE, Benfield MR, Brophy PD, Blowey D, Fortenberry JD, Chand D, Flores FX, Hackbarth R, Alexander SR, Mahan J, McBryde KD, Goldstein SL. Demographic Characteristics of Pediatric Continuous Renal Replacement Therapy: A Report of the Prospective Pediatric Continuous Renal Replacement Therapy Registry. Clin J Am Soc Nephrol 2007; 2:732-8. [PMID: 17699489 DOI: 10.2215/cjn.03200906] [Citation(s) in RCA: 177] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND This article reports demographic characteristics and intensive care unit survival for 344 patients from the Prospective Pediatric Continuous Renal Replacement Therapy (ppCRRT) Registry, a voluntary multicenter observational network. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS Ages were newborn to 25 yr, 58% were male, and weights were 1.3 to 160 kg. Patients spent a median of 2 d in the intensive care unit before CRRT (range 0 to 135). At CRRT initiation, 48% received diuretics and 66% received vasoactive drugs. Mean blood flow was 97.9 ml/min (range 10 to 350 ml/min; median 100 ml/min); mean blood flow per body weight was 5 ml/min per kg (range 0.6 to 53.6 ml/min per kg; median 4.1 ml/min per kg). Days on CRRT were <1 to 83 (mean 9.1; median 6). A total of 56% of circuits had citrate anticoagulation, 37% had heparin, and 7% had no anticoagulation. RESULTS Overall survival was 58%; survival differed across participating centers. Survival was lowest (51%) when CRRT was started for combined fluid overload and electrolyte imbalance. There was better survival in patients with principal diagnoses of drug intoxication (100%), renal disease (84%), tumor lysis syndrome (83%), and inborn errors of metabolism (73%); survival was lowest in liver disease/transplant (31%), pulmonary disease/transplant (45%), and bone marrow transplant (45%). Overall survival was better for children who weighed >10 kg (63 versus 43%; P = 0.001) and for those who were older than 1 yr (62 versus 44%; P = 0.007). CONCLUSIONS CRRT can be used successfully for a wide range of critically ill children. Survival is best for those who have acute, specific abnormalities and lack multiple organ involvement; sicker patients with selected diagnoses may have lower survival. Center differences might suggest opportunities to define best practices with future study.
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Affiliation(s)
- Jordan M Symons
- Department of Pediatrics, University of Washington School of Medicine and Children's Hospital & Regional Medical Center, Seattle, Washington 98105, USA.
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Mansbach CM, Siddiqi S, Mahan J. 181 VESICLE-ASSOCIATED MEMBRANE PROTEIN 7 IS CRUCIAL FOR LIPID ABSORPTION. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0008.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Robinson R, Nahata M, Mahan J, Casavant M. Potential heavy metal exposure from tiger tail cucumber (Holothuria thomas) envenomation. Vet Hum Toxicol 2004; 46:225. [PMID: 15303404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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22
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Webster A, Chapman JR, Craig JC, Mahan J, Orton L, Pankhurst T, Webb N. Polyclonal and monoclonal antibodies for treating acute rejection episodes in kidney transplant recipients. Hippokratia 2004. [DOI: 10.1002/14651858.cd004756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mansbach C, Mahan J, Gorelick F, Siddiqi S. 196 PRE-CHYLOMICRON TRANSPORT VESICLE (PCTV) UTILIZES A NOVEL SNARE-COMPLEX TO FUSE WITH INTESTINAL GOLGI. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hoyer PF, Ettenger R, Kovarik JM, Webb NJA, Lemire J, Mentser M, Mahan J, Loirat C, Niaudet P, VanDamme-Lombaerts R, Offner G, Wehr S, Moeller V, Mayer H. Everolimus in pediatric de nova renal transplant patients. Transplantation 2003; 75:2082-5. [PMID: 12829916 DOI: 10.1097/01.tp.0000070139.63068.54] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The steady-state pharmacokinetics of everolimus were longitudinally assessed in pediatric de novo kidney allograft recipients during a 6-month period. METHODS Nineteen patients received everolimus 0.8 mg/m2 (maximum 1.5 mg) twice daily as a dispersible tablet in water in addition to cyclosporine and corticosteroids. Everolimus and cyclosporine trough concentrations were obtained on days 3, 5, 6, and 7 and at months 1, 2, 3, and 6; an everolimus pharmacokinetic profile was obtained on day 7 and month 3. RESULTS There were 9 boys and 10 girls with a median age of 9.9 (range, 1-16) years. Steady-state pharmacokinetic parameters were as follows (median, range): C(min) (trough level), 4.7 (2.3- 9.5) ng/mL; peak concentration, 13.5 (5.9-22.2) ng/mL; area under the concentration-time curve (AUC), 77 (53-147) ng x hr/mL; and apparent oral clearance, 10.2 (5.5-15.6) L/hr/m2. Clearance (unadjusted for demographic factors) was positively correlated with age (r=0.66), body surface area (r=0.68), and weight (r=0.67). There were no trends in C(min) or AUC versus patient age when everolimus was dosed on a mg/m2 basis. Everolimus C(min) were stable over time with median values of 3.9, 3.4, and 3.1 ng/mL at months 1, 3, and 6, respectively. Intra- and interpatient variability in AUC was 29% and 35%, similar to that in adults. During the observation period, eight patients maintained stable AUCs and nine patients had increases or decreases, generally between 30% and 50% compared with the AUC at week 1. The concurrent median cyclosporine C(min) were generally at the lower end of conventional target ranges: 156, 83, and 69 ng/mL at months 1, 3, and 6, respectively. There were no graft losses and only three mild or moderate, reversible rejection episodes occurred. Everolimus was generally safe and well tolerated. CONCLUSIONS These data support the use of body surface area-adjusted dosing for everolimus in pediatric patients. Although exposure is generally stable over time with moderate variability in AUC, therapeutic monitoring would be a helpful adjunct for individualizing everolimus exposure, assessing regimen adherence, and adjusting doses as the child matures.
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Affiliation(s)
- Peter F Hoyer
- Department of Pediatric Nephrology, Universitätsklinik Essen, Hufelandstr. 55, D-45122 Essen, Germany.
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Wolfrom M, Harris W, Johnson G, Mahan J, Moffett S, Wildi B. Additions and Corrections - Osage Orange Pigments. XI. Complete Structures of Osagin and Pomiferin. J Am Chem Soc 2002. [DOI: 10.1021/ja01204a605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Van Damme-Lombaerts R, Webb NAY, Hoyer PF, Mahan J, Lemire J, Ettenger R, McMahon L, Cambon N, Boger R, Kovarik JM. Single-dose pharmacokinetics and tolerability of everolimus in stable pediatric renal transplant patients. Pediatr Transplant 2002; 6:147-52. [PMID: 12000472 DOI: 10.1034/j.1399-3046.2002.01070.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Everolimus (Certican; RAD), a novel macrolide with potent immunosuppressive and anti-proliferative activities, prevents acute rejection in adult recipients of renal transplantation. This phase I trial conducted in stable pediatric renal transplant patients examined the single-dose pharmacokinetics, safety, and tolerability of everolimus in combination with cyclosporin A (CsA; Neoral) and corticosteroids, with or without azathioprine. Nineteen pediatric patients were enrolled and received a single 1.2 mg/m2 dose of everolimus. Everolimus was safe and well tolerated, with a low incidence of adverse events reported and none judged to be related to the study medication. Everolimus administration did not increase infection rates or produce clinically significant changes in vital signs or changes in electrocardiograms. Apparent clearance and volume of distribution of everolimus increased with age, weight, and body surface area in a generally linear manner across the pediatric demographic ranges. Compared with adults from a previous study, apparent clearance (L/h) and distribution volume (L) were lower in pediatric patients, whereas the elimination half-life was similar. Single-dose everolimus co-administration did not affect the steady-state pharmacokinetics of CsA. Based on this information, pediatric patients will need a dose scaled down for body size, but can probably maintain the same twice-daily dosing schedule used in adults.
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Allen VG, Pond KR, Saker KE, Fontenot JP, Bagley CP, Ivy RL, Evans RR, Schmidt RE, Fike JH, Zhang X, Ayad JY, Brown CP, Miller MF, Montgomery JL, Mahan J, Wester DB, Melton C. Tasco: Influence of a brown seaweed on antioxidants in forages and livestock—A review. J Anim Sci 2001. [DOI: 10.2527/jas2001.79e-supple21x] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Voor MJ, Mehta S, Wang M, Zhang YM, Mahan J, Johnson JR. Biomechanical evaluation of posterior and anterior lumbar interbody fusion techniques. J Spinal Disord 1998; 11:328-334. [PMID: 9726303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study determined the biomechanical differences between anterior and posterior lumbar interbody fusion (ALIF and PLIF). Ten cadaveric spines were tested. Five specimens had ALIF and five had PLIF at L4-L5. Stabilization was performed with pedicle screws and rods (Cotrel-Dubboset, Sofamor-Danek, Memphis, TN, U.S.A.). Angular motion was measured in flexion, extension, bending, and torsion on the intact, instrumented, and "fused" specimens. Instrumentation alone caused a significant decrease in segmental motion in all loading modes (p < 0.01). After the simulated fusion procedures, all specimens were most stable in flexion, and significantly less stable in extension (p = 0.04). Comparing directly, ALIF was significant more stable in left torsion (p = 0.03) with trends in left bending (p = 0.08) and right torsion (p = 0.07). Thus, from a purely biomechanical perspective, ALIF appears to be slightly superior to PLIF.
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Affiliation(s)
- M J Voor
- Department of Orthopaedic Surgery, University of Louisville School of Medicine, Kentucky 40292, USA
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Affiliation(s)
- M Mentser
- Department of Pediatrics, Ohio State University Medical Center, Columbus, USA
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Mungall DR, Anbe D, Forrester PL, Luoma T, Genovese R, Mahan J, LeBlanc S, Penney JB. A prospective randomized comparison of the accuracy of computer-assisted versus GUSTO nomogram--directed heparin therapy. Clin Pharmacol Ther 1994; 55:591-6. [PMID: 8181203 DOI: 10.1038/clpt.1994.73] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Failure to adequately anticoagulate the blood of patients receiving recombinant tissue plasminogen activator (TPA) leads to greater rates of rethrombosis. In a multicentered, randomized trial in 51 patients we compared the ability to achieve and maintain therapeutic anticoagulation by use of computer-assisted heparin therapy or the GUSTO (Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries) heparin nomogram guidelines in patients with myocardial infarction treated with recombinant TPA. Heparin therapy was initiated with either computer-generated starting doses or GUSTO guideline starting doses. Activated partial thromboplastin times were measured every 6 to 8 hours for the first 24 hours. The therapeutic range used in this trial was 1.5 to 2.5 times the patient's baseline activated partial thromboplastin time (APTT). Ninety-four percent of the APTT ratios in the computer group were equal to or greater than 1.5 in the first 24 hours compared with 78% in the GUSTO group (p < 0.009). No significant difference in bleeding was found (7.7% for GUSTO; 4.2% for computer). Incremental time-dependent changes in heparin dose were found (day 1, 1110 +/- 243 units/hr, APTT ratio = 2.5 +/- 1.4; day 3, 1380 +/- 374 units/hr, APTT ratio, 1.9 +/- 0.4). Computer-assisted heparin therapy TPA results in superior anticoagulation accuracy compared with the GUSTO guidelines. In addition, the pharmacodynamic response to heparin changes in the 2 to 3 days after administration of TPA, leading to greater heparin requirements.
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Abstract
The contemporary literature helps us to analyze and assess the various clinical risks associated with MCDK. Clearly, MCDK is not an isolated developmental anomaly, and the child born with MCDK is at increased risk, but these risks are primarily directed towards: (1) the opposite kidney and lower urinary tract, where there is a significant likelihood of coexisting obstructive disease and reflux, and (2) the patient's family (current and future). In contrast, the risks to the patient caused by the MCDK (hypertension, infection, or malignant degeneration) actually appear to be quite low. Consequently, it no longer seems advisable to routinely remove MCDK in young patients for either diagnostic or prophylactic reasons. Nor is it obvious to what degree the MCDK itself requires long-term surveillance, although associated urological abnormalities will need follow-up and the patient requires periodic blood pressure screening. Hopefully, by careful analysis of the risks to the patient and family, the results of non-operative management, and the long-term results of the Multicystic Kidney Registry, contemporary pediatric nephrologists, urologists and surgeons will be able to reassess their approach to the evaluation and clinical management of the patient with this condition.
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Affiliation(s)
- M Menster
- Department of Pediatrics, Ohio State University College of Medicine, Columbus
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Sentipal JM, Wardlaw GM, Mahan J, Matkovic V. Influence of calcium intake and growth indexes on vertebral bone mineral density in young females. Am J Clin Nutr 1991; 54:425-8. [PMID: 1858707 DOI: 10.1093/ajcn/54.2.425] [Citation(s) in RCA: 113] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This cross-sectional study examined the relationship between current calcium intake and vertebral bone mineral density (V-BMD) in 49 healthy Caucasian adolescent females aged 8-18 y. The ability of current calcium intake to account for the variance in V-BMD in this population was compared with that seen with weight, height, maturational age (determined by the Tanner Sexual Maturity Rating), chronological age, and total energy expenditure. Calcium intake was determined from the mean of 4-d, food-intake records. Average vertebral bone mineral density from L1-L4 was measured by dual x-ray absorptiometry. A multiple-regression model revealed that 81% of the variance in V-BMD was described by maturational age, chronological age, and calcium intake, with all representing significant predictors of bone mineral density (P less than 0.0001, 0.005, 0.04, respectively). This study supports the hypothesis that better calcium nutrition during adolescence may optimize, within genetic boundaries, peak bone mass.
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Affiliation(s)
- J M Sentipal
- Division of Medical Dietetics, Children's Hospital, Columbus, OH
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Abstract
To determine the factors pertinent to the etiology of pin tract infections, 214 pins in 42 patients were examined prospectively at the time of pin removal. Eighty-nine (41.6%) pin tracts were inflamed, 49 (22.9%) pins had loose anchorages, and 160 (74.8%) pin tips cultured positive for bacteria. The predominant organism cultured was Staphylococcus epidermidis (90.6%), considered nonvirulent, followed by virulent Staphylococcus aureus (37.5%), and Escherichia coli (9.4%). There were 32 loose, inflamed pin tracts. This correlation was statistically significant (P less than .005). There were 40 loose pins whose pin tips had positive cultures. Loose pins correlated for infection with virulent species of bacteria at a highly significant level (P less than .005). Results demonstrate that most pins possess bacterial colonization. Clinically, this means that either inflamed pin tracts or pins with cultures positive for invasive organisms are probably loose and should be removed. Also, mechanical factors are the critical variable in determining the flora of external fixation pins.
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Affiliation(s)
- J Mahan
- Department of Orthopedic Surgery, University of Louisville, KY 40292
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Wysocki T, Herr R, Fryar M, McGlone C, Smith B, Dyas M, Monda K, Coburn T, Mahan J, Mentser M. Behavior modification in pediatric hemodialysis. ANNA J 1990; 17:250-4. [PMID: 2357122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This article reports the results of a behavior modification approach for managing disruptive and noncompliant behaviors in four male hemodialysis patients ranging in age from 10 to 16 years. Each patient demonstrated some improvement in either behavior or health status during the intervention and 76.7% of available token reinforcers were earned. The intervention was inexpensive and well-accepted by the patients, families, and staff. Guidelines for the planning, implementation, and evaluation of such interventions are presented.
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Davies KE, Patterson MN, Kenwrick SJ, Bell MV, Sloan HR, Westman JA, Elsas LJ, Mahan J. Fine mapping of glycerol kinase deficiency and congenital adrenal hypoplasia within Xp21 on the short arm of the human X chromosome. Am J Med Genet 1988; 29:557-64. [PMID: 2837087 DOI: 10.1002/ajmg.1320290313] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We have studied patients with Duchenne muscular dystrophy (DMD), DMD together with glycerol kinase (GK) deficiency, or DMD together with both GK deficiency and congenital adrenal hypoplasia (AHC). Analysis of deletions in these patients allows the mapping of these mutations in Xp21. The following order is proposed: Xpter - L1 - AHC - GK - DMD - Xcen. One of the boys with DMD, GK, and AHC is shown by pulsed-field-gel electrophoresis to have a deletion which has a proximal endpoint at least 500 kb distal from the pERT87 (DXS164) locus.
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Affiliation(s)
- K E Davies
- Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, United Kingdom
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Chesney RW, Mehls O, Anast CS, Brown E, Hammerman MR, Portale A, Fallon MD, Mahan J, Alfrey AC. Renal osteodystrophy in children: the role of vitamin D, phosphorus, and parathyroid hormone. Am J Kidney Dis 1986; 7:275-84. [PMID: 3515907 DOI: 10.1016/s0272-6386(86)80068-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
Primary hyperoxaluria is a rare metabolic disorder characterized by excessive synthesis and urinary excretion of oxalate. Nephrocalcinosis with or without calcium oxalate nephrolithiasis leads to renal failure in infancy through young adulthood. Oxalosis is the condition in which the highly insoluble calcium oxalate crystals are deposited in extrarenal tissues including bone, blood vessels, heart, and the male urogenital system. The radiographic abnormalities in 14 patients with primary hyperoxaluria are described. These abnormalities include nephrolithiasis, nephrocalcinosis, dense vascular calcifications, abnormal bone density, and characteristic metaphyseal abnormalities. Changes of renal osteodystrophy and pathologic fractures are common. Radiographic bone abnormalities are dependent on the age of the patient when renal failure occurred and the degree of success of renal transplantation. Characteristic skeletal changes are present in six of seven patients who developed renal failure when less than 7 years of age.
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Nibhanupudy JR, Streeter OE, King GC, Mahan J, Talley G, Lander C, Ashayeri E. Treatment of a Down's syndrome patient for hyperthyroidism with radioactive iodine. J Natl Med Assoc 1986; 78:139, 142-3. [PMID: 2936892 PMCID: PMC2571236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A Down's syndrome patient was hospitalized for evaluation of vomiting, abdominal pain, and a history of weight loss. A subsequent workup revealed that she had hyperthyroidism. The treatment of choice was radioactive iodine therapy. The patient had a history of consistent nausea and incontinence for urine and feces. Special problems posed by the patient and radiation safety are discussed.
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Zager RA, Mahan J, Merola AJ. Effects of mannitol on the postischemic kidney. Biochemical, functional, and morphologic assessments. J Transl Med 1985; 53:433-42. [PMID: 3930877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
UNLABELLED To determine the effects of mannitol on the postischemic kidney rats were subjected to 25 minutes of renal artery occlusion and immediately after vascular clamp release they received a 2-ml intravenous mannitol bolus (20%). Equimolar urea-injected rats and sham-injected rats served as controls. Postischemic renal blood flow, tubular metabolic work (renal O2 consumption), adenine nucleotide pools, renal oxidant stress (tissue glutathione, malondialdehyde levels), and tubular cell/mitochondrial swelling (histomorphometry) were assessed at variable times during the early vascular reflow period (15 to 60 minutes). The severity of acute renal failure was determined by serial blood urea nitrogen and serum creatinine studies (24, 48 hours), and by renal histology (48 hours). Mannitol increased postischemic renal blood flow (2-fold), renal O2 consumptions (3-fold), and urine flow compared to urea-injected and sham-injected controls. Postischemic glutathione levels were equally depressed (reduced 33%) in all three treatment groups. Malondialdehyde did not rise. Mannitol significantly lowered total adenine nucleotide content without changing ATP at 15 minutes post renal artery occlusion. At 60 minutes post renal artery occlusion, mannitol- and urea-treated groups had comparable ATP levels, 25% higher than the noninjected controls. Mannitol and urea induced comparable decrements in proximal tubular cell swelling, returning cell volumes to normal values. However, mitochondrial swelling was unabated. Mannitol and urea caused significant and nearly identical degrees of functional and morphologic amelioration of renal injury. CONCLUSIONS Mannitol administered after renal ischemia ameliorates both functional and morphologic aspects of acute tubular injury despite dramatically increasing tubular aerobic work. This protection appears not to be due to early postischemic improvements in adenine nucleotide content, to increased renal blood flow, to increased urine flow, or to a lessening of oxidant stress. The data are consistent with the view that protection results from acute hypertonic solute loading which either directly or indirectly decreases tubular cell but not mitochondrial swelling.
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Abstract
The clinical and histopathologic features of 48 children presenting with the nephrotic syndrome during the first year of life were analyzed. Proteinuria was discovered soon after birth to 3 months of age in 39 infants (congenital nephrotic syndrome), and nine infants had an infantile onset presenting between 4 and 12 months of age. Neither histologic parameters--microglomeruli, epithelial, or mesangial proliferation, focal segmental or global sclerosis, fibrinoid necrosis, or tubular microcysts--nor histologic classification--microcystic disease, mesangial proliferative glomerulonephritis, focal segmental glomerular sclerosis/hyalinosis-predicted the outcome. Rather, age at presentation was found to predict outcome: One of 39 infants with a congenital onset and seven of nine infants with an infantile onset underwent a complete remission (P less than 0.0001).
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Mahan J. Is seeing, believing? Aust Nurses J 1983; 13:45-6. [PMID: 6559067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Perry MA, Brink PJ, Blackmon DN, Pilette WL, Bayer M, Hood D, Karstadt E, Mahan J, Hassels A, Brown PS, Bradshaw SM, Shaggs M, Faul R, Nygren DE, Park GD, Whalen F, Goudy FW, Bassett D, Rosenow AM, Kovacs EA, Iorio J, Smock M, Bernard M, Kahn EV. Letters. Am J Nurs 1976. [DOI: 10.2307/3423802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Mahan J. Nurses at work. A plunge at the deep end. Aust Nurses J 1976; 5:6-9. [PMID: 1045949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Wolfrum M, Harris W, Johnson G, Mahan J, Moffett S, Wildi B. Additions and Corrections-Osage Orange Pigments. XI. Complete Structures of Osajin and Pomiferin. J Am Chem Soc 1946. [DOI: 10.1021/ja01216a611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Adams R, Mahan J. Additions and Corrections - Basicity Studies of Tertiary Vinyl Amines. J Am Chem Soc 1942. [DOI: 10.1021/ja01264a634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wolfrom M, Mahan J. Additions and Corrections - Osage Orange Pigments. VII. Isoflavone Nature of Pomiferin. J Am Chem Soc 1941. [DOI: 10.1021/ja01857a628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wolfrom M, Mahan J, Morgan P, Johnson G. Additions and Corrections - Osage Orange Pigments. VI. Isoflavone Nature of Osajin. J Am Chem Soc 1941. [DOI: 10.1021/ja01857a627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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