ABSTRACT
INTRODUCTION: The Orthopaedic In-Training Examination (OITE) is a multiple-choice examination developed by the American Academy of Orthopaedic Surgeons annually since 1963 to assess orthopaedic residents' knowledge. This study's purpose is to analyze the 2017 to 2021 OITE trauma questions to aid orthopaedic residents preparing for the examination. METHODS: The 2017 to 2021 OITEs on American Academy of Orthopaedic Surgeons' ResStudy were retrospectively reviewed to identify trauma questions. Question topic, references, and images were analyzed. Two independent reviewers classified each question by taxonomy. RESULTS: Trauma represented 16.6% (204/1,229) of OITE questions. Forty-nine percent of trauma questions included images (100/204), 87.0% (87/100) of which contained radiographs. Each question averaged 2.4 references, of which 94.9% were peer-reviewed articles and 46.8% were published within 5 years of the respective OITE. The most common taxonomic classification was T1 (46.1%), followed by T3 (37.7%) and T2 (16.2%). DISCUSSION: Trauma represents a notable portion of the OITE. Prior OITE trauma analyses were published greater than 10 years ago. Since then, there has been an increase in questions with images and requiring higher cognitive processing. The Journal of Orthopaedic Trauma (24.7%), Journal of the American Academy of Orthopaedic Surgeons (10.1%), and Journal of Bone and Joint Surgery, American Volume (9.3%) remain the most cited sources.
Subject(s)
Internship and Residency , Orthopedics , Orthopedics/education , Education, Medical, Graduate/methods , Educational Measurement , Retrospective StudiesABSTRACT
OBJECTIVES: Ewing's sarcoma is an aggressive malignancy of bone and soft tissue in children and young adults. Despite advances in modern therapy, metastasis can occur and results in high mortality. The objective of this study was to identify whether the signaling transduction proteins, insulin growth factor receptor (IGF1R) and S6 kinase (S6K), can predict poor prognosis in Ewing's sarcoma. METHODS: After the Institutional Research Board approval, immunohistochemical experiments on tissue microarray slides containing 32 archived Ewing's sarcoma tumor samples were performed with antibodies against IGF1Rb and p-S6K. Immunohistochemical staining results were correlated with patients' clinical data including clinical stage and overall survival (OS). RESULTS: Patients had an age range of 12-72 years and 8 (25%) were ≤20 years. After a follow-up to 14 years, the OS ranged from 25 to 5065 days. High expression of IGF1Rb and p-S6K, defined as staining stronger than positive control, was identified in 25% and 68.75% of cases, respectively. Statistical analysis revealed that IGF1Rb high expression had a significant association with adverse outcome, shorter OS (P < 0.05), and near significant association with advanced stage tumors (P = 0.0534). Expression of S6K exhibited a trend toward shorter survival (P = 0.0934). CONCLUSION: High expression or strong staining of IGF1Rb in Ewing's sarcoma may be more important than overall positive staining in identifying poor prognosis and aggressive cases to be selected for IGF1R inhibitory therapy. More definitive studies are needed to confirm the role of S6K in the prognosis in Ewing's sarcoma tumors.
ABSTRACT
The intents of this article are to share our experiences during a medical mission in the Dominican Republic and to provide the reader with a cross-sectional view of conditions seen and an overview of interesting and challenging cases encountered. We also discuss treatments and techniques used and share lessons learned.
Subject(s)
Dermatology , Religious Missions , Cross-Sectional Studies , Dominican Republic , Humans , PhysiciansABSTRACT
INTRODUCTION: The Saudi population is renowned for their unhealthy diet and physical inactivity. OBJECTIVE:To investigate apolipoproteins B (apo B), A-I (apo A-I) and B/A-I as risk factors that might be associated with increased incidence of the coronary artery disease. METHODS: Two hundred and twenty subjects suspected of having the coronary artery disease underwent coronary angiography and blood draw following a 12-hour fast. Apolipoproteins B and A-I were both measured by turbidimetric methods. RESULTS: One hundred and forty subjects were positive and 80 subjects were negative for the coronary artery disease. Both apolipoproteins were found to be statistically significant as risk factors for the coronary artery disease: apolipoprotein B (105.33±29.22 versus 94.56±24.35 mg/dL, p<0.003), apolipoprotein A-I (123.98±25.6 versus 133.5±24.1 mg/dL, p<0.004) and apolipoproteins B/A-I (0.88±0.28 versus 0.72±0.2, p<0.0001). CONCLUSIONS:Measurements of apolipoproteins B, A-I and calculation of apolipoproteins B/A-I ratio either instead of or in addition to the customary measurements of lipoprotein cholesterol may significantly add to predicting and assessing the coronary risk factors in the Saudi population.
INTRODUÇÃO: A população da Arábia Saudita é conhecida por sua dieta não-saudável e inatividade física. OBJETIVO: Investigar as apolipoproteínas B (apo B), AI (apo AI) e B/AI como fatores de risco que podem estar associados ao aumento da incidência da doença arterial coronariana. MÉTODOS: Duzentos e vinte pacientes com suspeita de doença art RESULTADOS: Cenerial coronariana foram submetidos à angiografia coronária e extração de sangue após jejum de 12 horas. As apolipoproteínas B e AI foram medidas por métodos turbidímetros.to e quarenta pacientes foram positivos e 80 foram negativos para a doença arterial coronariana. Ambas apolipoproteínas foram estatisticamente significativas como fatores de risco para doença arterial coronariana: apolipoproteínas B (105,33±29,22 versus 94,56±24,35 mg/dL, p<0,003), AI (123,98±25,6 versus 133,5±24,1, p<0,004) e B/A-I (0,88±0,28 versus 0,72±0,2, p<0,0001). CONCLUSÕES: As medidas das apolipoproteínas B, AI e o cálculo da relação B/AI tanto por ou em adição às medidas habituais de colesterol das lipoproteínas podem aumentar significativamente a previsão e avaliação dos fatores de risco coronariano na população saudita.
Subject(s)
Humans , Coronary Angiography/trends , Coronary Artery Disease/prevention & control , Hematologic Tests/methods , /classification , Risk FactorsABSTRACT
BACKGROUND: The Saudi population is known to have an unhealthy diet in addition to physical inactivity. OBJECTIVE: To investigate the lipid-mediated risk factors that might be associated with increased incidence of coronary heart diseasein the Saudi population as this was found in Western populations. MATERIALS AND METHODS: Two hundred and twenty subjects suspected of having coronary heart disease underwent coronary angiography and blood draw following a 12-hour fast. Total and HDL cholesterol, triglycerides, Lp(a) and lipoprotein lipase were measured by standard methods. Small, dense LDL was measured by the iodixanol method with an ultracentrifugation of only 2.5 hours. RESULTS: One hundred and forty subjects were found to be positive for coronary heart disease while 80 subjects were shown to be negative for this disease. Statistically significant risk factors for coronary heart disease in the Saudi population were hypertriglyceridemia (1.93±0.95 versus1.45±0.16 mmol/L;p<0.0001); low HDL cholesterol (1.09±0.55 vs 1.33±0.63 mmol/L, p=0.0001); high Lp(a) (46.8±45.58 versus 29.06±17.03 mg/dL;p=0.019); and the presence of small, dense LDL (1.0314±0.0028 versus 1.0300±0.0003 g/kg;p=0.0099). Total cholesterol (4.99±1.11 versus 4.75±1.11 mmol/L;p=0.099), LPL (35.56±26.6 versus 27.89±11.96 IU/L;p<0.059), and LDL cholesterol (3.06±1.12 versus 2.79±1.08 mmol/L;p=0.08) were not found to be statistically significant coronary heart disease risk factors. CONCLUSIONS: This study indicates that high TG, low HDL, high Lp(a) and the presence of small, dense LDL may contribute to the incidence of coronary heart disease and that TC was not significantly associated with incidence of coronary heart disease in the Saudi population.
CONTEXTO: A população saudita é conhecida por apresentar dietas não saudáveis, além de inatividade física. OBJETIVO: Investigar os lipídeos como fatores de risco que podem associar-se com o aumento da incidência de doença cardíaca coronariana na população saudita, uma vez que isso foi encontrado na população ocidental. MATERIAIS E MÉTODOS: Duzentos e vinte indivíduos com suspeita de doença cardíaca coronariana submeteram-se a angiografia coronária e coleta de sangue, após jejum de 12 horas. Colesterol total e HDL, triglicerídeos, Lp(a) e lipase lipoproteica foram calculados por métodos padrão. LDL pequena e densa foi medida pelo método do iodixanol com ultracentrifugação por apenas 2,5 horas. RESULTADOS: Cento e quarenta indivíduos apresentaram resultado positivo para doença cardíaca coronariana, enquanto 80 pacientes mostraram resultado negativo. Os fatores de risco estatisticamente significantes para doença cardíaca coronariana na população saudita foram hipertrigliceridemia (1,93±0,95 versus 1,45±0,16 mmol/L; p<0,0001); baixo colesterol HDL (1,09±0,55 versus 1,33±0,63 mmol/L; p=0,0001); Lp(a) elevada (46,8±45,58 versus 29,06±17,03 mg/dL; p=0,019) e a presença de LDL pequena e densa (1,0314±0,0028 versus 1,0300±0,0003 g/kg; p=0,0099). Colesterol total (4,99±1,11 versus 4,75±1,11 mmol/L; p=0,099), colesterol LPL (35,56±26,6 versus 27,89±11,96 IU/L; p<0,059) e LDL (3,06±1,12 versus 2,79±1,08 mmol/L; p=0,08) não foram fatores de risco estatisticamente significantes para doença cardíaca coronariana. CONCLUSÕES: Este estudo indica que elevados triglicerídeos, baixo HDL, elevada Lp(a) e a presença de LDL pequena e densa podem contribuir para a incidência de doença cardíaca coronariana. O colesterol total não foi significantemente associado à incidência de doença cardíaca coronariana na população saudita.