Prostate Cancer Support Groups: The Unadvertised Camaraderie

Prostate cancer (PCa), in particular, is known to cause significant psychosocial distress during the duration of a patient’s treatment due to its uncertainty and demasculinizing side effects. Prostate cancer support groups (PCSGs) have been proven to be beneficial, yet are underutilized by the majority of PCa patients and physicians. A thorough review of the literature was performed for articles pertaining to prostate cancer support groups. We sought to identify factors contributing to the psychological burden of the disease, factors that influenced patients to join, and barriers to participation in a PCSG. Additionally, the characteristics and format of PCSGs, as well as outcomes (i.e. quality of life), were evaluated.

Factors Influencing Fluoroscopy Use During Ureteroscopy at a Residency Training Program

Introduction: Ionizing radiation is used throughout urologic surgery and is known to cause a greater cancer risk with increasing exposure. The International Commission on Radiological Protection states that "it is the control of radiation dose that is important, no matter the source." However, there are few reports on the amount of radiation used by urology residents during ureteroscopy (URS). We present the largest database evaluating fluoroscopy (fluoro) use during URS at a resident training program. Our objective is to assess the amount of fluoro use at varying levels of experience and to identify factors that lead to increased fluoro use. Methods: Retrospective data from 242 URSs performed at two resident training sites were collected. In total, 105 surgeries were done by two attending physicians without and 137 surgeries with residents (Uro1-Uro3). Patient data were collected from the electronic medical record. Statistical analyses included analysis of variance, Spearman correlations, and multiple linear regression (MLR). Results: Comparisons between years 1 and 2 revealed significantly (p < 0.05) decreased fluoro time (20.0 seconds) and operative time (OT) (12.2 minutes) for the year 2 resident. Total OT was significantly (p < 0.05) decreased (11.1 minutes) for attending physicians operating on their own compared with a year 1 resident. Significant (p < 0.05) correlations with fluoro time were demonstrated for OT, stone size, ureteral dilation, ureteral access sheath use, presence of a preoperative stent, resident year, and resident month. OT, ureteral dilation, and a preoperative stent placement were significant predictors of fluoro time on MLR (p < 0.05). Conclusion: Fluoro time during retrograde URS was significantly reduced as residents gained more experience in the operating room. An increase in fluoro time was also associated with ureteral dilation, access sheath use, increasing stone size, and lack of prestenting. With knowledge of these factors, emphasis can be placed on using and teaching techniques that limit radiation exposure.

Incorporating the plasmidome into antibiotic resistance surveillance in animal agriculture

Mobile genetic elements (MGE) carrying resistance genes represent a unique challenge to risk assessment and surveillance of antimicrobial resistance (AMR). Yet determining the mobility of resistance genes within animal microbiomes is essential to evaluating the potential dissemination from livestock to potential human pathogens, as well as evaluating co-selection mechanisms that may impact persistence of resistance genes with changing antibiotic use patterns. Current surveillance efforts utilize phenotypic testing and sequencing of individual isolates for tracking of AMR in livestock. In this work, we investigated the utility of using long-read sequencing of the plasmids from mixed Enterobacterales enrichments of swine fecal samples as a surveillance strategy for AMR plasmids. Enrichments were performed in either MacConkey broth without selection or with selection by addition of tetracycline or ceftriaxone, and plasmids were extracted and sequenced in order to evaluate the diversity of plasmids enriched by each method. Intact resistance plasmids were successfully assembled, as well as complex resistance transposons carrying multiple repeated elements that would interfere with assembly by short read sequencing technologies. Comparison of the assembled plasmids with representatives from public databases confirmed the quality of the assemblies and also revealed the occurrence of IncI2 plasmids carrying bla_CMY-2 in Ontario swine samples, which have not been found in previous studies.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Die Struktur von SrCuSn2 und BaCuSn2 und ihre Verwandtschaft zum BiOCl-Gitter / The Structure of SrCuSn2 and BaCuSn2 and its Relationship to the BiOCl-Structure

The compounds SrCuSn2 and BaCuSn2 have been prepared and their crystal structures have been determined. They crystallize in a lattice (space-group Cmcm-D17 2h) related to that of the BiOCl-type.

Neue Vertreter des ThCr2Si2-Typs und dessen Verwandtschaft zum Anti-PbFCl-Gitter

Der von SILLEN am BiOCl-Gitter beobachtete Übergang von der Stöchiometrie ABX zur AB2X2 wurde nunmehr auch bei intermetallischen Phasen gefunden. In diesem Zusammenhang gelang es, eine Reihe neuer Vertreter des ThCr2Si2-Typs darzustellen und strukturell zu charakterisieren

Eine neue strukturelle Variante des BaAl4-Typs: Der CaBe2Ge2-Typ / A New Structural Variant of the BaAl4-Type: The CaBe2Ge2-Type

The ternary intermetallic compounds CaBe2Ge2, BaMg2Pb2 and BaZn2Sn2 have been prepared. Their crystal-structures have been determined. They are isotypic and crystallize in a new variant of the BaAl4-type (Space group: P4/nmm — D4h 7, lattice parameters:

CaBe2Ge2: a = 4,02 ± 0,02 Å

c = 9,92 ± 0,02 Å

BaMg2Pb2: a = 5,00 ± 0,02 Å

c = 12,11 ± 0,02 Å

BaZn2Sn2: a = 4,69 ± 0,02 Å

c = 11,33 ± 0,02 Å).

Notizen:Neue Verbindungen im ThCr2Si2-Typ / New Compounds in the ThCr2Si2-Type

Structural chemistry of intermetallic AB2X2-Compounds

Customizing a clinical data warehouse for housestaff education in practice-based learning and improvement

We developed Systems and Practice Analysis for Resident Competencies (SPARC), a Web-based tool to support teaching the practice-based learning and improvement (PBLI) ACGME competencies. SPARC allows Department of Medicine residents to explore de-identified, population-based data about their patient panels with peer comparisons. Data primarily comes from an existing data warehouse that has been customized for this application. Our preliminary evaluation suggests that it improves residents' abilities in PBLI, is easy to use, and perceived as important and useful by the housestaff.

Drosophila minichromosome maintenance 6 is required for chorion gene amplification and genomic replication

Duplication of the eukaryotic genome initiates from multiple origins of DNA replication whose activity is coordinated with the cell cycle. We have been studying the origins of DNA replication that control amplification of eggshell (chorion) genes during Drosophila oogenesis. Mutation of genes required for amplification results in a thin eggshell phenotype, allowing a genetic dissection of origin regulation. Herein, we show that one mutation corresponds to a subunit of the minichromosome maintenance (MCM) complex of proteins, MCM6. The binding of the MCM complex to origins in G1 as part of a prereplicative complex is critical for the cell cycle regulation of origin licensing. We find that MCM6 associates with other MCM subunits during amplification. These results suggest that chorion origins are bound by an amplification complex that contains MCM proteins and therefore resembles the prereplicative complex. Lethal alleles of MCM6 reveal it is essential for mitotic cycles and endocycles, and suggest that its function is mediated by ATP. We discuss the implications of these findings for the role of MCMs in the coordination of DNA replication during the cell cycle.

Selective COX-2 inhibitors: a review of their therapeutic potential and safety in dentistry

Anti-inflammatory analgesics are commonly used medications in dental and medical practice. Their uses in dentistry include use as analgesics and as anti-inflammatory agents. In addition, antipyretic action accompanies the medication. The action of these groups of drugs depends on the dose provided. Analgesic and antipyretic effects occur at low dose, whereas analgesic effects occur at high dose. Among the common side effects of this class of medications are gastrointestinal irritation with potential for ulceration, increased tendency for bleeding due to antiplatelet effects, and long-term chronic dosing effects on renal function may occur. Recent developments in the anti-inflammatory group of medications include the introduction of cyclooxygenase-II inhibitors. These agents offer potentially significant advantages because of their relative lack of gastrointestinal irritation. Because of this, it is likely that these medications will be frequently used in the management of dental and medical conditions. Patients will present while on these medications, and these agents may serve as medications for management of dental pain, postsurgical pain, and for anti-inflammatory effects. The current literature indicates that COX-2 inhibitors offer substantial benefits because of their favorable gastrointestinal profiles and because of their lack of effect on platelet function.

Working to learn and learning to work: placement experience of Project 2000 nursing students in Scotland

It is evident that the Scottish colleges have designed and provided very different curricular arrangements to support students' learning to practise in placements. Evaluation has demonstrated that some of these arrangements are of fundamental importance in facilitating or constraining the educational experience of students, including opportunities for reflection on experience, students' preparation for placements, the role of tutors in students' placement learning, the preparation of mentors and the utility of instruments for the assessment of students' practice-based learning. In addition to the formal provision in support of students' learning to work, students have developed their own informal strategies in order to meet their (sometimes conflicting) needs to maximize practical learning opportunities, ease entry into the nursing team and achieve favourable assessment of learning. Some of these involve working in order to learn. This paper is based on the work of the National Board-funded Evaluation of Project 2000 in Scotland (1992-96). The remit of the evaluation was to examine the teaching/learning processes of the Project 2000 nursing programmes and the new midwifery programmes, and their relationship to the educational outcomes for individual students, giving particular emphasis to the experience of students.

Evaluation of nurse and midwife education in Scotland

The authors of an evaluation of the new programmes of nurse and midwife education in Scotland summarise their findings and methods. Students were found to be enjoying rich educational experiences. However, they did identify a number of problems in initial programme development, achievement of student roles and in assessment of learning. The authors offer recommendations for continued curriculum development and for further research. The evaluation was commissioned by the National Board for Scotland.

The practice-based context of educational innovation: nurse and midwife preparation in Scotland

The use of an illuminative approach to the national evaluation of the first 18 months of Project 2000 nurse and pre-registration midwifery education in Scotland has facilitated the generation of data about the contexts in which the new programmes function. The aim of this paper is to present some of the data generated from programme participants about the conditions students experience in practice-based learning experiences. The reported issues are direct or indirect effects of policy initiatives and service reforms. The current climate of change in health care provision has fostered a limited number of developments which are consistent with the aspirations of the new programmes and which offer highly valued learning experiences to students. More often however the reforms have served to frustrate the intent of the programmes to offer students experiences which are patient-centred, holistic-care and health oriented.

Age differences in letter and color matching: selective attention or internal noise?

We tested healthy young and older adults on a letter-matching task that varied letter identity and letter color (Experiment 1) and on a color matching task that varied letter color and letter identity (Experiment 2). The goal of this investigation was to empirically disentangle the theoretical concepts of internal noise and selective attention. The results from Experiment 1 indicated that both young and older adults exhibited "fast-same" effects for reaction time and "false-different" effects for errors, and older adults exhibited a relatively larger "false-different" effect. However, letter color did not affect performance. The data from Experiment 2 indicated that older adults, compared with young adults, evidenced greater interference from "different-similar" letter pairs than "different-dissimilar" letter pairs even though the task was color matching. These data suggest that older adults evidenced greater levels of internal noise, and that this factor may modulate age differences in selective attention.