The clinical task force: Improving quality of medical students' internship.

Background: Up to 40% of young medical doctors feel that the internships prepared them insufficiently for the clinical work. This study investigated whether a Clinical Task Force (CTF) could improve internship quality. Methods: The CTF visited internship departments with a triple-targeted approach: first, departments pre-filled a self-evaluating questionnaire; secondly, CTF visited departments to discuss the self-evaluation and previous student evaluations; and thirdly, CTF and departments agreed on several quality-improving focus points to work on after the meeting. Focus points were followed-up after three and 12 months. The impact on internship quality was assessed with departments' student evaluation scores, number of completed focus points, and the effect of completed focus points on a range of learning parameters. The CTF learned several things along the way, that potentially could affect the quality of internships. A shortlist of these was provided to illustrate unmeasurable benefits. Results: The CTF met with 53 out of 60 eligible departments. The CTF and departments agreed upon 197 focus points of which 64% were completed. The three most frequent categories of focus points were Introduction of the students, The departments' evaluation percentage, and The departments' function as an educational site. The mean student evaluation scores did not change significantly, but the individual evaluation parameters changed significantly in two categories. It decreased in the category regarding the students' satisfaction with the clinical lecturers and the scheduled teaching and increased in the category regarding the percentage of students evaluating the department. Conclusion: The CTF's triple-targeted approach did not increase the mean student evaluation score significantly. For departments that completed the agreed focus points, one category increased and another decreased. However, the unmeasurable benefits illustrated that CTF was a good viable linking element between the faculty, departments, and students with the potential of improving other aspects of the quality of internships.

High incidence of candidaemia in a nationwide cohort: Underlying diseases, risk factors and mortality.

BACKGROUND: Denmark has a high incidence rate of candidaemia. A Nordic study suggested a higher Danish prevalence of haematological malignancies as an underlying reason. This nationwide study ascertained clinical characteristics of Danish candidaemia patients and investigated potential factors contributing to the high incidence and mortality. METHODS: Microbiological and clinical data for candidaemia patients in 2010-2011 were retrieved. 30-day mortality was estimated by hazard ratios (HR) with 95% confidence intervals (CI, Cox regression). RESULTS: Data were available for 912/973 candidaemia episodes (93.7%). Intensive care unit (ICU) held the largest share of patients (43.2%). Prevalent host factors were multi-morbidity (≥2 underlying diseases, 74.2%) and gastrointestinal disease (52.5%). Haematological disease was infrequent (7.8%). Risk factors included antibiotic exposure (90.5%), CVC (71.9%) and Candida colonisation (66.7%). 30-day mortality was 43.4%, and 53.6% in ICU. Mortality was lower for patients with recent abdominal surgery (HR 0.70, 95% CI: 0.54-0.92). CONCLUSION: A substantial prevalence of multi-morbidity and a high 30-day mortality was found. We hypothesise, that an increasing population of severely ill patients with prolonged supportive treatment and microbiological testing may in part explain the high candidaemia incidence in Denmark. Nationwide studies are warranted to clarify this issue.

Evidence for additional functional genetic variation within the porcine IGF2 gene affecting body composition traits in an experimental Piétrain × Large White/Landrace cross.

The aim of this study was to test for the existence of causative genetic variation affecting body composition traits within or adjacent to the porcine insulin-like growth factor 2 (IGF2) gene beyond the known IGF2-intron3-G3072A mutation. A focussed quantitative trait loci analysis using four microsatellite markers within the telomeric region of porcine chromosome 2p was conducted in a large resource population comprising 2741 F2 offspring. The analysis of two subsets of animals that were alternatively homozygous for the in3G3072A mutation provides evidence for additional genetic variation significantly contributing to the overall quantitative trait nucleotide variance within our population.

Detection of a quantitative trait locus for ham weight with polar overdominance near the ortholog of the callipyge locus in an experimental pig F2 population.

The distal part of SSC7, which contains the ortholog to the ovine region encompassing the callipyge locus, was analyzed in a Piétrain F(2) resource population comprising more than 2,700 offspring. The aim of the study was to map QTL affecting carcass traits comparable with the callipyge phenotype in sheep. We applied an interval mapping approach using 14 microsatellite markers and detected 3 QTL with small effects. The first QTL affects fat thickness on the middle of the back, with no detectable impact on fat sizes at other places on the back, whereas the second QTL affects side fat thickness. The third QTL influences the ham weight and shows a clear parent-of-origin-dependent effect in the form of maternal polar overdominance. It is not located at the position of the imprinting cluster including the callipyge locus, but 7 cM proximal.

EBV-associated gastric carcinoma in high- and low-incidence areas for nasopharyngeal carcinoma.

BACKGROUND: Approximately 10% of gastric carcinomas are associated with Epstein-Barr virus (EBV). The Inuit in Greenland have a high incidence of EBV-associated nasopharyngeal carcinoma. METHODS: We conducted a population-based case-control study comparing gastric carcinomas in Greenland and in Denmark. RESULTS: The prevalence rate of EBV-associated gastric carcinomas was 8.5% in both populations. CONCLUSION: The findings of this study argue against a general susceptibility to EBV-associated carcinomas among the Inuit.

Considerations for the Lapidus operation.

The Lapidus operation for correction of severe hallux valgus with metatarsus primus varus has never been well accepted by foot surgeons. The main reason for this has been the poor results obtained from its misuse. Lapidus strongly advocated the operation as a virtual panacea for correction of all degrees of severity of these deformities in both young and old patients. The technique, however, is appropriate for severe metatarsus primus varus with hallux valgus, in the foot with marked first ray hypermobility and collapsed distal-medial arch. The purpose and proper indications for the Lapidus operation are discussed, and the technique is illustrated.

Surgery for tophaceous gout.

Cases of tophaceous gout amenable to surgical management may be encountered in a podiatric practice. This paper reviews the indications for surgery, the pathology, the principles of surgical technique, the preoperative and postoperative management, and presents a case report.

A modified anaerobic method of sweat collection.

In an attempt to devise a method for collecting large volumes of thermally induced sweat with less epidermal contamination and evaporative water loss, we developed an anaerobic sweat collector by using a sheet of polyethylene film placed over a thin layer of Vaseline and paraffin oil on the skin. To test the validity of the new method, sweat samples collected every 5 min from the new collector (sweat A) were compared with those obtained from a second collector using no oil (sweat B) and scraped sweat for concentrations of adenosine 3',5'-cyclic monophosphate (cAMP), protein, glucose, urea, lactic acid, calcium, sodium, potassium, and cholesterol. The concentration of sweat ingredients in scraped sweat was often far greater than could be expected from evaporative water loss alone. When compared with sweat A, sweat B also had higher concentrations of these ingredients in the initial samples, indicating epidermal contamination, which was especially marked in cAMP, protein, urea, cholesterol, and calcium. Concomitant with a rise in plasma glucose following the administration of a glucose bolus, the sweat glucose significantly increased, indicating the plasma as a major source of sweat glucose. We conclude that the new sweat collector is instrumental in collecting large volumes of the cleanest possible human sweat.