What is the current state of patient education after Clostridioides difficile infection?

In a survey of hospitals and of patients with Clostridioides difficile infection (CDI), we found that most facilities had educational materials or protocols for education of CDI patients. However, approximately half of CDI patients did not recall receiving education during their admission, and knowledge deficits regarding CDI prevention were common.

Effect of a Medical Student-Led Curriculum on Teen Health Knowledge and Intentions: An Evaluation of the MiHealth Pilot Program.

INTRODUCTION: Adolescents are often thought of as a healthy population, however, they routinely engage in high-risk behaviors that can lead to health problems. Medical students designed MiHealth, a program in which medical students teach health lessons in the high school classroom to help address these behaviors. METHODS: A series of six lessons were created and implemented in the classroom for this pilot study focused on sexual health, intimate partner violence, mental health, smoking and marijuana, nutrition, and physical fitness. High school students in grades nine through twelve at a public high school in southeast Michigan receiving the MiHealth curriculum (N=52) or the standard health education curriculum (N=61) were surveyed on health knowledge, attitudes, and intentions before and after the program. RESULTS: Six weeks after program completion, high school students who received the MiHealth curriculum scored significantly higher on health knowledge ( P=0.007), and expressed significantly healthier attitudes and intentions toward risk behavior compared to controls (P=0.025). Among individual themes, MiHealth resulted in significant knowledge gains in sexual health ( P=0.001) and mental health (P<0.025), and significantly healthier attitudes regarding sexual health (P=0.047), nutrition (P=0.040), and smoking and marijuana (P=0.012). CONCLUSIONS: MiHealth demonstrated promising improvements in health knowledge retention and attitude changes in adolescents 6 weeks after program completion. An interactive curriculum targeting key adolescent health topics given by near-peer medical student educators may provide benefits beyond traditional high school health curricula.

Epidermal growth factor receptor (EGFR) contributes to fetal lung fibroblast injury induced by mechanical stretch.

CONTEXT: Epidermal growth factor receptor (EGFR) is critical for normal fetal lung development. However, the role of this receptor in lung injury induced by mechanical ventilation is controversial. OBJECTIVE: To investigate in vitro whether EGFR plays a protective role or contributes to stretch-induced lung injury. METHODS: Fetal lung fibroblasts were isolated from wild-type and EGFR knockout mice and exposed to physiologic stretch (2.5% elongation) or injurious stretch (20% distention). Cells were evaluated for necrosis, apoptosis, proliferation and inflammation. RESULTS: Injurious stretch increased lactate dehydrogenase (LDH) release to similar degree in wild-type and knockout cells. In contrast, 20% stretch increased cleaved caspase-3 and decreased proliferating cell nuclear antigen (PCNA) only in wild-type cells. Furthermore, 20% stretch increased macrophage inflammatory protein-2 (MIP-2) and monocyte chemotactic protein-1 (MCP-1) by 3-5 fold in wild-type cells. In contrast, in knockout cells MIP-2 decreased by 50% and MCP-1 only increased by 60% when compared to physiologic stretch. CONCLUSION: Our data show a decrease of apoptosis and inflammation and absence of decreased proliferation after injurious stretch of fetal fibroblasts lacking EGFR. These data suggest that EGFR contributes to lung injury mediated by stretch. We speculate that EGFR may contribute to the arrest of lung development observed after mechanical ventilation by decreasing the population of lung fibroblasts.