Clinical resources to teach components of a new Family Medicine Clerkship Curriculum.

BACKGROUND AND OBJECTIVES: This retrospective study was designed to determine the capacity of a 6-week distributed Family Medicine Clerkship to provide student documented patient encounters that could facilitate instructions on the acute illness and chronic disease components of the new Family Medicine Clerkship Curriculum (FMCC). The FMCC was developed to standardize core clinical education experiences in Family Medicine Clerkships in US medical schools. METHODS: Three years (FY06--FY08) of patient encounters documented by students and compiled in a Family Medicine Clerkship patient encounter database at the Medical College of Georgia were examined to determine the presence of patient experiences consistent with the acute illness and chronic disease presentations objectives of the new FMCC. The study cohort consisted of 537 students encountering 78,770 patients in 21 learning sites. RESULTS: Fifty-five percent of the FMCC acute illness presentations objectives (n=20) were encountered at least once by >90% of the students while 81% of the chronic disease presentations objectives (n=16) were encountered at least once by >90% of the students. All students encountered patients with multiple chronic diseases, with an average of 32.29 and 13.6 student patient encounters containing two and three chronic diseases respectively. Patient volumes for the FMCC acute illness and chronic disease objectives ranged from means of 0.37 to 10.37 and 2.24 to 57.47 per student respectively. CONCLUSIONS: The study suggests that a 6-week Family Medicine Clerkship could provide patient experiences to facilitate student instructions on most of the acute illness and chronic disease presentations objectives of the new FMCC.

Further studies on the adjuvanticity of stearyl tyrosine and amide analogues.

Stearly tyrosine has been described in the literature as a candidate adjuvant for human vaccines. More recently, other stearyl esters have been reported to be adjuvant-active. This preliminary study assesses the adjuvanticity of stearyl amides, including the amide analogue of stearyl tyrosine: tyrosyl stearylamine. This study indicates that phenylalanylethanolamine O-stearate induces a significant antibody response and a favourable isotype distribution.

Further studies on the adjuvanticity of stearyl tyrosine and ester analogues.

A new family of immunoadjuvants, long-chain stearyl esters of amino acids and peptides, are described and examined with bacterial and viral vaccines. The parent compound, stearyl tyrosine, displayed significant adjuvant activity with these vaccines. Stearyl glycyl glycine displayed superior activity with viral vaccines. A number of analogues of stearyl tyrosine were adjuvant-active. Further, these adjuvants were able to elicit a neutralizing antibody response. Stearyl tyrosine and stearyl ester analogues represent promising adjuvants for human vaccines.

The adjuvant effect of stearyl tyrosine on a recombinant subunit hepatitis B surface antigen.

We describe the enhancement of the antibody response against hepatitis B surface Ag by octadecyl L-tyrosine, a synthetic adjuvant designed to exert its adjuvant effect in a manner similar to that of alum because it binds soluble Ag and releases it slowly from the site of injection. Our data demonstrate that octadecyl L-tyrosine showed a significant enhancement of the antihepatitis B surface Ag response compared to that of alum in the secondary response. The most striking difference between octadecyl L-tyrosine and alum in the antihepatitis B surface Ag antibody response was the absence of IgE-specific antibodies subsequent to immunization of the Ag in octadecyl L-tyrosine. Both the optical isomers of the octadecyl esters of tyrosine were adjuvant active, however, the racemic mixture showed a significantly lowe adjuvant activity. This adjuvant has great potential to be used in humans because it is devoid of side effects as assessed by the lack of acute and chronic toxicity in mice and rats, pyrogenicity in rabbits, formation of granuloma in cats, and adjuvant arthritis in rats.