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A new teaching format, the LecturePlus, was formulated as a lecture followed by small-group learning activities. This study assessed the effectiveness of LecturePlus in medical education. An interventional study was conducted among final-year medical students, with 74 students in the experimental group and 96 students in the control group. Each LecturePlus lasted [tilde]1 h and was conducted with 12-18 students. A LecturePlus session comprised of a lecture followed by small-group problem-solving exercises. The exercises were clinical cases with open-ended short-answer questions. Students were divided into groups of three (triads) for these exercises. A faculty tutor assisted the small groups as needed. Closure was achieved through a discussion moderated by the tutor. Learning outcomes were assessed via the National Board of Medical Examiners (NBME) subject scores and compared with those of the preceding academic year. An additional multiple-choice question (MCQ) test was administered before and after the clerkship. The MCQ test showed improvement in knowledge application (P < 0.001, partial eta squared = 0.42). There was a statistically significant improvement in adjusted NBME scores among female students (74.8 vs. 71.8; P = 0.017) but not among male students. An anonymous written questionnaire survey showed high ratings for LecturePlus (95% selecting yes or partly yes to overall satisfaction). LecturePlus is an instructional strategy that integrates a lecture with learning activities. It can be scaled to large class sizes facilitated by one teacher. By combining didactic teaching with problem-solving, this new instructional strategy may foster application of knowledge.

Numerous biomarkers have been reported in cancer research studies. These biomarkers are used for cancer diagnosis, estimating survival (prognosis), and for guiding treatment selection (predictive). For example, CA19-9 is a biomarker that can help provide prognostic information for patients with pancreatic cancer. Protein markers (proteomics) can be single molecules or a combination of proteins such as OVA1. Proteomics can be combined with other biomarkers including metabolites and RNA sequences to construct biomarker panels. The metabolic by-products of cancer cells provide a unique signature that reflects their abnormal growth profile, angiogenesis, and apoptosis evasion. Metabolites such as polyunsaturated fatty acids (PUFAs) can be used for diagnostic purposes by comparing with noncancer samples (metabolomics). Genomic markers of malignant disease include (proto)oncogenes, tumor suppressor genes, and DNA repair genes. Integration of genomic biomarkers with proteins, metabolites, and circulating mRNA has led to commercially available kits. Isolating cell-free DNA, mRNA, and noncoding RNA, which are shed by cancer cells into the bloodstream allows 'liquid biopsy" using conveniently obtained blood samples. This proliferation of cancer biomarkers has led to information overload, confusion among clinicians, and clinical inertia. Thus, there is a need for a practical classification system. Such a system should serve the needs of clinicians as well as researchers. A new classification is proposed to organize cancer biomarkers (Figure). This classification includes 3 categories: Diagnostic, Prognostic, and Treatment. The term 'predictive" was avoided as it may be confused with prognostic. Each category has 5 levels. Levels range from 0 to 4, corresponding to increasing levels of accuracy. Level 0 (zero) corresponds to lack of association or no practical usefulness. Putative biomarkers that are currently under research are designated as Level X. For example, a metabolic marker that is being investigated for use in the diagnosis of colorectal carcinoma can be assigned the classification: DX. PD-L1 expression is a useful marker in triple- negative breast cancer (TNBC) for therapy with immune checkpoint inhibitors such as pembrolizumab and can be assigned the label: R3. Predictive molecular alterations that can guide treatment choices are the gold standard for cancer biomarkers. By providing a practical classification system for cancer biomarkers (Figure), it is hoped that clinical utilization and research development can be optimized. Clinicians can quickly review the utility and accuracy of biomarkers for each cancer based on this classification. [ABSTRACT FROM AUTHOR]

The outbreak of pandemic (H1N1) 2009 influenza virus was first noted in Mexico in March 2009 (1) but quickly spread worldwide. On June 11, 2009, the World Health Organization declared [...]

Type 1 and type 2 diabetes can be renamed with more descriptive and clinically useful labels. Type 2 diabetes can be renamed as a Lifestyle Diabetes reflecting the renewed emphasis on healthy nutrition and a physically active lifestyle. As type 1 diabetes mostly affects children and imposes a unique set of requirements, it can be referred to as Special Diabetes. Children can connect with this name, while caregivers will be reminded of the quite different needs of these patients. Additionally, new simplified names are suggested for other diabetes subtypes and related endocrine disorders. Gestational diabetes mellitus can be renamed with a less stigmatizing label: pregnancy hyperglycemia, reflecting its transient nature as opposed to a lifelong diagnosis. Monogenic diabetes of the young can be renamed as monogenic diabetes and latent autoimmune diabetes of adults as special antibody diabetes. Diabetes insipidus, which does not share pathophysiology with diabetes mellitus, can be renamed as Renal Insipidus and Pituitary Insipidus, based on the etiology. Lastly, polycystic ovarian syndrome, which does not require polycystic ovaries for diagnosis, can be renamed as Androgenic Syndrome reflecting hyperandrogenism as its main clinical and diagnostic feature. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the features needed in electronic health record systems by supervising physicians for teaching medical students and residents. We conducted in-depth semistructured interviews with seven faculty members at a public-funded medical college. Emergent concepts were extracted in a qualitative thematic approach based on the realist paradigm. Thematic analysis revealed the need for clinical guidelines, medical calculators and research evidence. Documenting differential diagnoses for clinical reasoning and the use of medical images for pedagogical needs were requested as well. Clinical supervisors in this study suggested several features within electronic health records for teaching needs. The study findings provide a reference for developing teaching resources within electronic health records systems. [ABSTRACT FROM AUTHOR]

Background: Prematurity and glucose‑6‑phosphate dehydrogenase (G6PD) deficiency are considered important risk factors in neonatal hyperbilirubinemia. G6PD screening is performed by many neonatal units to identify this risk factor. Few studies evaluated the role of this screening on the management of hyperbilirubinemia in preterm infants during their neonatal hospitalization. This study aims to evaluate effects of G6PD screening on treatment of hyperbilirubinemia in infants <2000 g admitted to Neonatal Intensive Care Unit. Methods: All neonates <2000 g who were admitted to neonatal unit for 3 years (2013–2015) were retrospectively included in the study. Data related to risk factors and management of hyperbilirubinemia were collected and analyzed on these infants. A number of phototherapy units used for treatment, duration phototherapy, and level of bilirubin were compared between G6PD deficient and nondeficient infants and presented. Results: Included in this retrospective study were 621 infants. About half on included infants were < 1500 g. Gestational age groups as follow: ≤28 weeks, 23.3%; 29–32 weeks, 37.5%; 33–36 weeks, 33.6%; and ≥37 weeks, 5.6%. Prevalence of G6PD deficiency was 10.3%. The highest recorded serum bilirubin was significantly higher in G6PD deficient group compared with nondeficient one (161.6 μmol/l ± 57.5 vs. 145.4 μmol/l ± 46.4, P = 0.01). G6PD deficient infants were treated with more phototherapy than nondeficient group (85.9% vs. 64.5%, P < 0.001). G6PD deficient low birth weight neonates were more likely to receive intensive phototherapy. None of the G6PD deficient patients was treated with exchange transfusion. Conclusion: Prevalence of G6PD deficiency among low birth weight infant in the United Arab Emirates is similar to data reported in full‑term infants. Screening for G6PD in preterm infant is associated with more treatment using phototherapy and may contribute in preventing severe hyperbilirubinemia. [ABSTRACT FROM AUTHOR]

Provides information on caring for sick neonates. Reasons newborn infants may be transferred to a special care nursery (SCN); Causes of hypoxemia; Nutrition requirement for newborn infants; Reasons to withhold enteral feeding in neonates; Drugs used in the treatment of neonatal sepsis.