RESUMO
ABSTRACT: Despite the growing popularity of physical medicine and rehabilitation as a specialty among medical students, meaningful experiences and mentorship can be challenging to obtain and may significantly vary depending on opportunities available to interact with physiatrists. This study explores the association between the geographic proximity of physical medicine and rehabilitation residency programs to medical schools and the match rate of medical students into physical medicine and rehabilitation from 2019 to 2021. Data on US medical schools, graduates, and physical medicine and rehabilitation residency programs were collected from publicly available sources, and a sample of 1193 physical medicine and rehabilitation residents from US medical schools was analyzed using a one-sample proportion test. The proportion of physical medicine and rehabilitation residents originating from medical schools with physical medicine and rehabilitation residency programs in the same metropolitan area was significantly greater than the corresponding proportion of expected residents based on medical school graduates, even when controlling for medical school affiliations with physical medicine and rehabilitation residency programs. These findings suggest that exposure and opportunities provided by physical medicine and rehabilitation residency programs may influence nearby medical students and that expanding residency programs into geographic regions without existing physical medicine and rehabilitation programs may foster interest and promote growth in the field of physiatry.
Assuntos
Internato e Residência , Medicina Física e Reabilitação , Estudantes de Medicina , Humanos , Internato e Residência/estatística & dados numéricos , Medicina Física e Reabilitação/educação , Estudantes de Medicina/estatística & dados numéricos , Estados Unidos , Escolha da Profissão , Faculdades de Medicina/estatística & dados numéricos , Masculino , FemininoRESUMO
Carbapenem-resistant Enterobacterales (CRE) are an urgent public health threat. Genomic sequencing is an important tool for investigating CRE. Through the Division of Healthcare Quality Promotion Sentinel Surveillance system, we collected CRE and carbapenem-susceptible Enterobacterales (CSE) from nine clinical laboratories in the USA from 2013 to 2016 and analysed both phenotypic and genomic sequencing data for 680 isolates. We describe the molecular epidemiology and antimicrobial susceptibility testing (AST) data of this collection of isolates. We also performed a phenotype-genotype correlation for the carbapenems and evaluated the presence of virulence genes in Klebsiella pneumoniae complex isolates. These AST and genomic sequencing data can be used to compare and contrast CRE and CSE at these sites and serve as a resource for the antimicrobial resistance research community.
Assuntos
Antibacterianos , Gammaproteobacteria , Estados Unidos/epidemiologia , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Mapeamento Cromossômico , Carbapenêmicos/farmacologiaRESUMO
The Onchocerca lupi nematode infects dogs, cats, and humans, but whether it can be spread by coyotes has been unknown. We conducted surveillance for O. lupi nematode infection in coyotes in the southwestern United States. We identified multiple coyote populations in Arizona and New Mexico as probable reservoirs for this species.
Assuntos
Coiotes , Doenças do Cão , Oncocercose , Animais , Arizona/epidemiologia , Reservatórios de Doenças , Doenças do Cão/epidemiologia , Cães , New Mexico , Onchocerca/genética , Oncocercose/epidemiologia , Oncocercose/veterinária , Sudoeste dos Estados Unidos , Estados Unidos/epidemiologia , ZoonosesRESUMO
Altered intestinal microbiota is associated with systemic and intestinal diseases, such as inflammatory bowel disease (IBD). Dysbiotic microbiota with enhanced proinflammatory capacity is characterized by depletion of anaerobic commensals, increased proportion of facultatively anaerobic bacteria, as well as reduced diversity and stability. In this study, we developed a high-throughput in vitro screening assay to isolate intestinal commensal bacteria with anti-inflammatory capacity from a healthy fecal microbiota transplantation donor. Freshly isolated gut bacteria were screened for their capacity to attenuate Escherichia coli lipopolysaccharide (LPS)-induced interleukin 8 (IL-8) release from HT-29 cells. The screen yielded a number of Bacteroides and Parabacteroides isolates, which were identified as P. distasonis, B. caccae, B. intestinalis, B. uniformis, B. fragilis, B. vulgatus and B. ovatus using whole genome sequencing. We observed that a cell-cell contact with the epithelium was not necessary to alleviate in vitro inflammation as spent culture media from the isolates were also effective and the anti-inflammatory action did not correlate with the enterocyte adherence capacity of the isolates. The anti-inflammatory isolates also exerted enterocyte monolayer reinforcing action and lacked essential genes to synthetize hexa-acylated, proinflammatory lipid A, part of LPS. Yet, the anti-inflammatory effector molecules remain to be identified. The Bacteroides strains isolated and characterized in this study have potential to be used as so-called next-generation probiotics.
Assuntos
Anti-Inflamatórios/metabolismo , Bacteroides , Microbioma Gastrointestinal/imunologia , Adulto , Bacteroides/classificação , Bacteroides/imunologia , Bacteroides/isolamento & purificação , Bacteroides/metabolismo , Bacteroidetes/classificação , Bacteroidetes/imunologia , Bacteroidetes/isolamento & purificação , Bacteroidetes/metabolismo , Células CACO-2 , Fezes/microbiologia , Feminino , Ensaios de Triagem em Larga Escala , Homeostase/imunologia , Humanos , Interleucina-8/análise , Interleucina-8/metabolismo , Lipopolissacarídeos/metabolismo , ProbióticosRESUMO
The full geographic range of coccidioidomycosis is unknown, although it is most likely expanding with environmental change. We report an apparently autochthonous coccidioidomycosis patient from Spokane, Washington, USA, a location to which Coccidioides spp. are not known to be endemic.