bluuebunny/crossref_metadata_2025 huggingface dataset:
Qualidade de vida de puérperas que vivenciaram near miss materno
Authors: Colombo Natália Carolina Rodrigues , Aggio Cristiane de Melo , Rodrigues Renne , Medeiros Fabiana Fontana , Ruiz Lailla Ketly Ferreira Tiradentes , Curan Franciane Maria da Silva , Santos Izabel Dayana de Lemos , Cardelli Alexandrina Aparecida Maciel
Published: February 2021

Objetivo: Avaliar a qualidade de vida de mulheres que vivenciaram o near miss no período pós-parto. Métodos: Estudo transversal, aninhado a uma coorte prospectiva, entre outubro de 2016 e agosto de 2017. Participaram 262 puérperas de alto risco de uma maternidade pública, sem comprometimento cognitivo, com algum critério de near miss materno, não submetidas ao abortamento ou tratamento gestacional. Utilizou-se formulário estruturado para a caracterização delas e o Short Form Survey, cujas medianas e testes de Mann-Whitney, Kruskal-Wallis e de Dunn foram calculados. Resultados: Dor e limitações por aspectos físicos e emocionais foram os domínios da qualidade de vida com piores escores e o near miss cardiovascular prevaleceu. Adolescentes tiveram pior escore de limitação física (p =0,035), puérperas com 36 anos ou mais apresentaram melhor escore de saúde mental (p =0,042), as brancas apresentaram escore pior de dor (p =0,04) e melhor de estado geral de saúde (p =0,04) e quem realizou cesárea teve pior escore de limitação física, aspectos emocionais, saúde mental e aspectos globais físicos e mentais. Conclusão: A qualidade de vida das participantes foi prejudicada pela dor e limitações físicas e emocionais, que definem o diagnóstico de conforto prejudicado e exigem qualidade na atenção à saúde materna.
Vulnerabilidade e fatores de risco associados para Covid-19 em idosos institucionalizados
Authors: De Souza Talita Araujo , Nunes Vilani Medeiros de Araújo , Do Nascimento Izabel Cristina Santos , Delmiro Luylla Astéria Maia , De Morais Miria Mendonça , Nobre Thaiza Teixeira Xavier , Dos Reis Luciana Araújo , De Mendonça Ana Elza Oliveira , Torres Gilson de Vasconcelos
Published: February 2021

Objetivo: Identificar a associação de fatores de risco para COVID-19 com a vulnerabilidade em pessoas idosas residentes em instituições de longa permanência. Métodos: Trata-se de um estudo descritivo, exploratório, com abordagem quantitativa, realizado em oito Instituições de Longa Permanência para Idosos (ILPI) na região metropolitana de Natal, Rio Grande do Norte, Brasil. Foram incluídos idosos com idade igual ou superior a 60 anos, que estivessem presentes na instituição durante a coleta das informações. Na obtenção dos dados foi utilizado o protocolo de identificação do idoso vulnerável inserido na Caderneta de Saúde da Pessoa Idosa. Para análise utilizou-se o software SPSS versão 21.0 e aplicados testes Qui-quadrado de Pearson e Razão de Chance. Resultados: Verificou-se que houve associação do número de itens de vulnerabilidade (até 3 itens) nos idosos que apresentaram até 3 fatores de risco para COVID-19 (p=0,008), com razão de chance de 2,2. Conclusão: A predominância de fatores de risco para COVID-19 indica maior vulnerabilidade à evolução da forma grave da COVID-19, associada ao maior risco de mortalidade, o que evidencia necessidade do monitoramento da saúde dos idosos.
Paracoccidiomicose juvenil: um relato de caso
Authors: Bernardino Patrícia Macedo , Azarias Ana Cláudia Fernandes , Dos Santos Fernanda Gomes Junqueira , Braga Adriano , Junior Wilson Cunha
Published: February 2021

Objetivo: Descrever um caso de paracoccidioidomicose em um paciente previamente hígido, pois se trata de uma patologia ainda subnotificada. Detalhamento do caso: Paciente jovem do sexo masculino iniciou com quadro de lesões de pele e linfonodomegalia generalizada além de febre diária e perda de peso durante duas semanas. Ao exame físico foi evidenciado além das lesões de pele e aumento dos linfonodos uma hepatoesplenomegalia. Iniciado tratamento para PBmicose e paciente entrou em remissão das lesões recebendo alta para acompanhamento ambulatorial. Considerações finais: PBmicose é uma micose profunda de grande importância epidemiológica ainda nos dias de hoje. No entanto a mesma por não ser de notificação compulsória é ainda subdiagnosticada. É uma patologia que deve ser sempre lembrada em casos de linfonodomegalia generalizada e hepatoesplenomegalia. Seu diagnóstico envolve fatores clínicos, laboratoriais e biopsia. Seu tratamento envolve drogas de acesso amplo como o sulfametoxazol + trimetoprim e pode ser realizado em ambiente ambulatorial.
Influence of selective laser trabeculoplasty on the result of subsequent glaucoma surgery
Authors:   IRTC Eye Microsurgery Ekaterinburg Center, Ekaterinburg, Pasenova I.G. , Alekseeva K.V. ,   IRTC Eye Microsurgery Ekaterinburg Center, Ekaterinburg
Published: February 2021

Treatment efficacy analysis was performed on 111 eyes of 100 patients. The effect of non-penetrating deep sclerectomy (NPDS), phaco+IOL+ab interno trabeculotomy with or without preceding selective laser trabeculoplasty (SLT) was estimated by IOP level at the moment of decompensation and by the duration of hypotensive effect after surgery. IOP decompensation after NPDS occurred in 8.09 ± 1.3 months with SLT and in 5.72 ± 0.59 months without SLT. After laser goniopuncture (LGP) the duration of hypotensive effect before hypotensive treatment was 8.83 ± 0.7 months in the first group and 10.76 ± 1.18 months in the second grouP. The duration of hypotensive effect after combined surery of glaucoma and cataract was 25.11 ± 2.82 months after SLT and 18.26 ± 1.79 months without SLT. At the moment of decompensation IOP level was almost equal in both groups: 24.57 ± 0.51 and 25.10 ± 0.59 mm Hg, respectively. The results of glaucoma surgery after SLT and without preceding laser treatment are comparable; moreover, preceding SLT may prolong hypotensive effect of glaucoma surgery. Key words: selective laser trabeculoplasty; non-penetrating deep sclerectomy; laser goniopuncture; trabeculotomy.
Excimer Laser Use in Percutaneous Coronary Intervention
Authors: Karácsonyi Judit , Martínez-Parachini J. Roberto , Ungi Imre , Katona András , Sasi Viktor , Nagy Ferenc T. , Vemmou Evangelia , Nikolakopoulos Ilias D. , Rangan Bavana V. , Brilakis Emmanouil S.
Published: February 2021

Excimer laser coronary atherectomy (ELCA) can be used during complex percutaneous coronary interventions (PCIs) to debulk and modify the tissue with photochemical, photothermal, and photokinetic mechanisms without causing significant vessel injury. ELCA can facilitate treatment of balloon uncrossable, balloon undilatable, in-stent restenotic, saphenous vein graft and thrombotic lesions. Potential complications include perforation and dissection. Judicious use of ELCA can improve the outcomes of complex PCI.
Theoretical Atomic Radii of Elements (H-Cm): A Non-Relativistic Study with Gaussian Basis Set Using HF, Post-HF and DFT Methods
Authors: Prasanna Krishnamohan , Sunil Sooraj , Kumar Ajith , Joseph Jamesh
Published: February 2021

We calculated the most probable radius of an atom for elements from H to Cm. The calculations were carried out by using non-relativistic, spin polarized, HF, MP2 and DFT methods with all electron Gaussian basis set. Periodicity of atomic radii was correlated with the experimental first ionization energies. This non-relativistic atomic radii were also compared with other theoretical atomic radii. With respect to the Dirac-Slater data, our values were in good agreement with the elements up to Sn. Relationship with van der Waals radii of noble gases was discussed. Anomalous properties of Gd and Pd were examined. Linearity of lanthanide contraction of elements with 4f electrons is illustrated. This linearity is found independent of the extent of electron correlation. S.I. give data of calculated radii and other correlated studies (with ionization energies, another theoretical radii etc.)
Interrogation of O-ATRP Activation Conducted by Singlet and Triplet Excited States of Phenoxazine Photocatalysts
Authors: Lattke Yisrael M. , Corbin Daniel , Sartor Steven M. , G. McCarthy Blaine , Miyake Garret , Damrauer Niels
Published: February 2021

Organocatalyzed ATRP (O-ATRP) is a growing field exploiting organic chromophores as photoredox catalysts (PCs) that engage in dissociative electron transfer (DET) activation of alkyl halide initiators following absorption of light. Characterizing DET rate coefficients (kact) and photochemical yields across various reaction conditions and PC photophysical properties will inform catalyst design and efficient use during polymerization. The studies described herein consider a class of phenoxazine PCs where synthetic handles of core-substitution and N-aryl substitution enable tunability of the electronic and spin character of the catalyst excited state as well as DET reaction driving force ( ). Using Stern-Volmer quenching experiments through variation of diethyl 2-bromo-2-methylmalonate (DBMM) initiator concentration, collisional quenching is observed. Eight independent measurements of kact are reported as a function of for four PCs: four triplet reactants and four singlets with kact values ranging from 1.1´108 M-1s-1 where DET itself controls the rate to 4.8´109 M-1s-1 where diffusion is rate limiting. This overall data set, as well as a second one inclusive of five literature values from related systems, is readily modeled with only a single parameter of reorganization energy under the frameworks of adiabatic Marcus electron transfer theory and Marcus-Savéant theory of DET. The results provide a predictive map where kact can be estimated if is known and highlight that DET in these systems appears insensitive to PC reactant electronic and spin properties outside of their impact on driving force. Next, on the basis of measured kact values in selected PC systems and knowledge of their photophysics, we also consider activation yields specific to the reactant spin states as the DBMM initiator concentration is varied. In N-naphthyl-containing PCs characterized by near-unity intersystem crossing, the T1 is certainly an important driver for efficient DET. However, at DBMM concentrations common to polymer synthesis, the S1 is also active and drives 33% of DET reaction events. Even in systems with low yields of ISC, such as in N-phenyl-containing PCs, reaction yields can be driven to useful values by exploiting the S1 under high DBMM concentration conditions. Finally, we have quantified photochemical reaction quantum yields, which take into account potential product loss processes after electron-transfer quenching events. Both S1 and T1 reactant states produce the PC·+ radical cation with a common yield of 71%, thus offering no evidence for spin selectivity in deleterious back electron transfer. The sub-unity PC·+ yields suggest that some combination of solvent (DMAc) oxidation and energy-wasting back electron transfer is likely at play and these pathways should be factored in subsequent mechanistic considerations.
Embryonal Rhabdomyosarcoma in a Young Boy
Authors: Ng Wendy Kar Yee
Published: February 2021

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Personalized Medicine Some Thoughts
Authors: Kalow Werner
Published: February 2021

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Asbestos: mining exposure, health effects and policy implications
Authors: Luus Kristina
Published: February 2021

The purpose of this paper is to review research in the health effects and risks associated with exposure to asbestos and then to use this scientific evidence to analyze the implications of Canada's current policy on the use, manufacturing and export of asbestos. The review begins with a brief historical introduction to asbestos, and then moves on to look at the risks associated with asbestos exposure. Epidemiological and in vitro studies are then analyzed to determine the health risks of asbestos, with a specific focus on the different effects of serpentine and amphibole asbestos fibres. The paper then concludes with an analysis of Canadian policy in light of established scientific evidence and with a discussion of the possible implications of a gap between scientific knowledge and public policy.
Interventional Radiology: From Idea to Device to Patient
Authors: Ciarallo Anthony , Nguyen Cam-Tu Emilie , Stein Lawrence
Published: February 2021

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Surgery through the keyhole: a new view of an old art
Authors: Fried Gerald M. , Gill Heather
Published: February 2021

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Dientes ChiquiTICOS: an analysis of juvenile dentition and dental health in Costa Rican indigenous communities
Authors: García Alfredo , Guzzo Christina M.
Published: February 2021

This study surveyed the dental health of three Costa Rican indigenous populations and two rural, non-indigenous communities. Sixty-six individuals, both children and adults, were interviewed regarding dental hygiene practices and the dentition of eighty-eight children from the ages of two to thirteen was examined. The indigenous populations, on average, showed a more important number of anterior dental pathologies as compared to a non-indigenous group (42% vs 20%). Collectively, both access to and utilization of dental healthcare were worse within the indigenous communities; however, there was still great variation amongst all five sites.
Elective advice
Authors: O'Hanlon Shane
Published: February 2021

Going on a medical elective is an exciting opportunity. No matter where the destination, for most people it is an intensely rewarding experience, and the memories last a lifetime. However poor preparation can impinge on an otherwise productive elective, leading to lost opportunities. A little time spent considering your options will be time well spent.
A case of postictal psychosis
Authors: Musaib-Ali Lisette
Published: February 2021

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Hepatic Fibrosis: Novel Strategies in Detection and Therapy
Authors: Bhat Venkataramana , Bhat Mamatha
Published: February 2021

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How many will it take?
Authors: Mercier Eric , O’Reilly-Fromentin Marie-Éve
Published: February 2021

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A case of Sinus Histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Syndrome) from Western India
Authors: Jani Priyanka A. , Banjan Deepa
Published: February 2021

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Challenging Received Wisdom: Antidepressants and the Placebo Effect
Authors: Kirsch Irving
Published: February 2021

This article explores the reaction when an article challenging received wisdom is published and covered extensively by the media (1). The article in question was a meta-analysis of antidepressant clinical trials indicating that for most patients, difference between drug and placebo was not clinically significant. Reactions ranged from denial that the effects of antidepressants are so small to criticisms of the clinical trials that were analyzed. Each of these reactions is explored and countered.
Book Review by Chenjie Xia, McGill University, by Dr. Jerome Groopman
Authors: Xia Chenjie
Published: February 2021

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An Unidentified Monster in the Bed – Assessing Nocturnal Asthma in Children
Authors: Ginsberg Darrell
Published: February 2021

Nocturnal asthma (NA) is increasing in prevalence, affecting millions of people worldwide. In addition to being associated with increased mortality, NA is associated with a decreased quality of life. NA associated sleep disturbances and increased daytime sleepiness are especially important in children due to the accompanying behavioral and developmental difficulties. As diurnal spirometry is not a practical tool for the diagnosis and monitoring of NA, self or parental reports are used. Children underreport and underestimate their NA symptoms and parents are not fully aware of their child’s NA indicators. In addition, there is the lack of physician familiarity regarding the assessment and treatment of NA. Therefore, NA is chronically underreported. The development of a non-invasive, objective, home-based diagnostic tool is crucial in diagnosing and monitoring children with NA. The presence of wheeze during sleep has been successfully employed as a tool to measure NA in children. This review discusses the increasing prevalence of NA, current diagnostic tools and the consequences of undiagnosed NA in children. In conclusion, this paper suggests that an automated wheeze detective device is an objective and practical tool to aid the diagnosis and monitoring of NA.
Retrospective review of two-port thoracoscopic (VATS) wedge bullectomy and lung wedge biopsy
Authors: Bejjani Jimmy , Couture Guillaume , Asenjo Juan-Francisco , Sirois Marco , Sirois Chantal , Sirois Christian
Published: February 2021

Background: Video-assisted thoracoscopic surgery (VATS) involving wedge resection of bulla and lung biopsy can be done by two or three-port incisions. Controversy exists as to which approach is superior. We communicate our experience with two-port VATS for these procedures. Methods: We retrospectively analyzed the charts of all patients who underwent a VATS procedure by two-port incisions from July 2001 to July 2007 by two thoracic surgeons (S.C., S.C.) We included in the study all patients who underwent wedge resections for primary or secondary spontaneous pneumothorax and biopsies for pulmonary infiltrates and small nodules. Results: A total of 319 patients’ charts were examined, and 217 of whom had undergone two-port incisions fitted in the inclusion criteria. There were 136 (65.7%) males and 81 (37.3%) females with a mean age of 47 years. Pneumothorax was the main diagnosis for 98 (45%) patients, followed by pulmonary infiltrates for 69 (32%) patients and lung nodules for 50 (23%) patients. The mean operative time and the number of post-op days for chest tube removal and to discharge home in each group have also been recorded. There were few post-operative complications, such as 11 (5%) cases of persistent air leak, 11 (5%) cases of transient fever of unknown origin, 3 (1.4%) cases of pneumonia, 3 (1.4%) cases of bleeding within, one reoperated, and 1 (0.46%) case of C. difficile colitis. The 30-day mortality was 0%. Conclusion: The thoracoscopic (VATS) wedge biopsy via two-port incisions is a safe operation for patients presenting with pneumothorax or requiring a lung biopsy. A two-port approach seems to be a reasonable alternative to three-port incision procedures for these types of diagnosis, regarding post-operative pain and cosmetic benefits particularly for young patients.
Medical Leadership: Doctors at the Helm of Change
Authors: Chadi Nicholas
Published: February 2021

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Beyond the News: Health Risks of Climate Change
Authors: Ebi Kristie L
Published: February 2021

Climate change is affecting the health of millions of people through altering the geographic distribution and incidence of climate-sensitive health outcomes, including through injuries, illnesses, and deaths due to extreme weather events, food-, water-, and vectorborne diseases, air pollution, aeroallergens, and malnutrition (1). The magnitude of impacts is projected to increase as the climate continues to change. The scope and scale of projected impacts mean that climate change will touch the professional and personal lives of many public health and health care professionals. Avoiding, preparing for, and effectively responding to the health risks of climate change will require broad engagement of scientists, decision-makers, and the public. Achieving this engagement means that increased scientific literacy is needed of the causes and implications of climate change for human health.

There are growing numbers of assessments of the potential health impacts of climate change (1-4) and summaries for various audiences (5). Instead of summarizing current knowledge of the causes and consequences for human health of anthropogenic climate change, this paper will highlight a few issues that may help with understanding the human health impacts of climate change.
The Importance of Remaining Empathic
Authors: Filip Constantin
Published: February 2021

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Anatomical Course Demarcating the Safe Area for the Superior Gluteal Nerve
Authors: Lammy Simon
Published: February 2021

Iatrogenic injury to the superior gluteal nerve (SGN) persists despite a safe area being defined. Current descriptions of the course of the SGN are conflicting and do not provide agreeable distances to surface landmarks that are useful for most health care professionals. This study aimed to suggest a more conservative and gender-dependent estimate of the safe area between each buttock and genitals as defined by four bony surface landmarks. The posterior and lateral surfaces of each buttock in eight cadavers, four male and four female, were dissected. The surface anatomy of sixteen SGNs was defined in relation to the quadrate tubercle of the intertronchanteric crest of the femur (QTIF), the most cranial ridge of the iliac crest (IC), the anterior superior iliac spine (ASIS) and the posterior superior iliac spine (PSIS). Between the sexes, no significant difference existed concerning average SGN lengths across each buttock pair, (i.e. SGN length male/female difference df=3 (p=0.273); Pearson = - 0.76). There was no significant difference between both buttock sides concerning the SGN distances from each of the four bony surface landmarks across either sex (e.g. male QTIF df=3 (p=0.284); Pearson correlation = -0.31.) From our measurements we conclude that the standard safe area is too generous and should be half the size immediately adjacent to the tip of the greater trochanter.
Effects of Maternal Plasmodium falciparum Malaria and HIV infection on Birth Weight in Southeastern Nigeria
Authors: Uneke Chigozie J , Duhlinska Dochka D , Ujam Treasure N
Published: February 2021

The effects of malaria and HIV infection on birth weight were assessed among 300 women in childbirth in Southeastern Nigeria using standard techniques. Prevalence of maternal Plasmodium falciparum malaria infection was 16.0%. Individuals of younger age, primigravidae, anemic (with Hgb <11.0g/dl) and those who had never attended antenatal clinic (ANC) were more likely to have malaria infection. Prevalence of HIV infection was 3.6% and malaria prevalence was significantly higher among HIV-positive than HIV-negative women (37.5%, 95% CI, 4.0-71.0% versus 14.3%, 95% CI., 9.6-19.0%), (χ2 =13.3, P<0.05). Malaria-infected women had a significantly higher proportion of lBW babies than the uninfected (F-ratio=15.05, P<0.05). A higher proportion of low birth weight (lBW) was recorded among anemic women, primigravidae and those who never attended ANC. lBW babies were significantly higher among HIV-positive than HIV-negative women (25.0% vs 16.6%), (F-ratio=130.8, P<0.05). Malaria and HIV interventions via ANC are crucial for reduction of their adverse effects on pregnancy outcome.
Tracheal agenesis: A rare but fatal congenital anomaly
Authors: Ergun Suzan , Tewfik Ted , Daniel Sam
Published: February 2021

In this report we describe a newborn with a rare case of Type II tracheal  agenesis and bronchoesophageal fstula. Polyhydramnios and suspected esoph- ageal atresia were identifed during routine pre-natal ultrasound screening. Upon  delivery, rigid bronchoscopy, esophagoscopy, and intraoperative fuoroscopy were  performed, where both bronchi and the carina showed unusual horizontal orienta- tion making it diffcult to identify the fstula. However, a post mortem CT confrmed  the diagnosis of an isolated Type II tracheal agenesis with bronchoesophageal fs- tula.
Quantifying the increasing use of anti-vascular endothelial growth factor therapy in ophthalmology
Authors: Micieli Jonathan , Micieli Andrew
Published: February 2021

Introduction: Bevacizumab (Avastin; genetech Inc., South San fran- cisco, CA) and ranibizumab (Lucentis, genetech Inc.) are two anti-Vascular Endo- thelial growth factor (VEgf) agents used in increasing amounts off-label to treat  ocular conditions. To date, no study has quantifed how far reaching these therapies have been in treating eye disease and compared their off-label use to the number of clinical trials performed. Method: A systematic search of Ovid MEdLINE using the keywords bevacizumab and ranibizumab limited to “Case Reports” was used as an index of the number of diseases treated. Each keyword was also limited to “Clinical Trials, All” and “Phase III Clinical Trials” to discern the quality of evidence for these uses.Results: Bevacizumab has been utilized for the treatment of 58 different ocular conditions, but only 14 conditions were studied in a trial, and none were part of a phase III clinical trial. Ranibizumab has been used for 17 different eye conditions,  with only 6 studied in a trial and only 1 disease, “wet” age-related macular degenera- tion reported in 4 phase III trials. In the case reports, there were 21 different adverse  events ascribed to bevacizumab and 2 to ranibizumab with retinal pigment epithelial tears being the most common. Conclusion: Bevacizumab is one of the most far reaching drugs in ophthalmology and even medicine, but it is not yet supported by high quality evidence. The much higher cost of ranibizumab may be responsible for bevacizumab’s popularity among eye specialists. Patients should be fully informed about the off-label use of bevacizumab and the associated risks with its use.
The Effects of Cognitive Therapy on Hallucinations in Patients with Schizophrenia
Authors: Propst Alanna
Published: February 2021

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Use of fresh osteochondral allograft in repair of distal femur after trauma
Authors: Taylor Drew , Bohm Kyle C , Taylor Jennifer E , Gross Allan E
Published: February 2021

Preserving the ability to maintain an active lifestyle is a major concern in the reconstruction of the knee in young patients. for the healthy individual who desires to maintain a relatively active lifestyle, fresh osteochondral allografts may serve as an alternative to total joint reconstruction. The use of fresh allografts is  primarily indicated in the patient suffering from a traumatic loss of articular seg- ments, who is too young or active for arthroplasty. In addition, fresh osteochon- dral allografts have a number of advantages over arthroplasty such as providing  surgeons with a source of large grafts that can be ftted to replace osteochondral defects and cover the majority or entirety of articular surfaces without any donor site morbidity. In this case, a young, active patient lost a 7 x 8 cm portion of their  distal femur, including a large portion of the articulating surface. Using a fresh os- teochondral allograft, harvested within 24 hours of donor death, a segment was  ftted to match bony apposition, articular congruity, and congruity with the femoral notch and affxed with four partially threaded cancellous screws. Joint function was restored with the allograft in place, allowing the patient to delay the need for a total joint replacement.
Poverty Reduction Strategy Papers and their contribution to health: An Analysis of Three Countries
Authors: Bartlett Sam
Published: February 2021

Poverty Reduction Strategy Papers (PRSPs) represent the World Bank and the International Monetary Fund’s (IMF) most recent initiative for reducing the plight of the poor. This paper examines whether the PRSPs for Liberia, Afghanistan and Haiti follow World Bank guidance on health. The health data, analysis and strategy content of the three PRSPs are assessed with respect to the ‘Health, Nutrition and Population’ chapter of the World Bank’s PRSP Sourcebook. This guidance states that PRSPs should include: health data on the poor and a clear analysis showing the determinants of ill health and pro-poor health strategies. Unfortunately, none of the PRSPs analysed comply with the guidance and, consequently, do not adequately portray the health situation within their countries. Thus health is not given a high priority in the PRSP process and is seemingly low on the agenda of both poor country governments and the International Financial Institutions (IFIs). If the situation for the world’s poorest people is to improve, health and the right to health need to be promoted within PRSPs.
Breaking the Scope-of-Practice Taboo: Where Multidisciplinary Rhymes with Cost-Efficiency
Authors: Chadi Nicholas
Published: February 2021

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Ultrasound: From Earth to Space
Authors: Law Jennifer , Macbeth Paul B
Published: February 2021

Ultrasonography is a versatile imaging modality that offers many ad- vantages over radiography, computed tomography, and magnetic resonance imag- ing. on Earth, the use of ultrasound has become standard in many areas of medi- cine including diagnosis of medical and surgical diseases, management of obstetric  and gynecologic conditions, assessment of critically ill patients, and procedural  guidance. Advances in telecommunications have enabled remotely-guided ultraso- nography for both geographically isolated populations and astronauts aboard the  International Space Station. while ultrasound has traditionally been used in space- fight to study anatomical and physiological adaptations to microgravity and evalu- ate countermeasures, recent years have seen a growth of applications adapted from  terrestrial techniques. Terrestrial, remote, and space applications for ultrasound are reviewed in this paper.
Email in Medical Practice: A Critical Review
Authors: Nensi Alysha , Chandok Natasha
Published: February 2021

Email between patients and physicians can be an effective means of communication and health care delivery, but concerns over security, privacy, fea- sibility, and legality prevail. This paper reviews the limited literature in this area, highlighting our current understanding of the prevalence of email in clinical prac- tice, patient attitudes toward email communication, and the impact of email communication on patient outcomes. While there is a paucity of data on the role, benefts, and risks of email communication, patients and physicians alike should consider secure email as a convenient tool for communication. Physicians require further guidelines on appropriate uses of email in clinical practice to best enhance patient autonomy, preserve patient confdentiality, and comply with current medico-legal standards.
The Role of Nurses in Primary Care Reform: “The Wheel and Hub of Health Care System”
Authors: Mamishi Nina
Published: February 2021

The current focus in Canadian healthcare system is on improving efficiencies and quality of care. Therefore, primary healthcare is receiving further attention. It is the right moment to highlight the value that registered nurses can bring to collaborative practice in primary care settings. Since nurses are the largest group of healthcare providers in Canada being present throughout the system, thy are ideally positioned to effect change at the national level. The purpose of this paper is to highlight the value that nurses bring to primary healthcare system to discuss how integrating registered nurses into family practice will optimize primary healthcare.
Québec’s emergency room overcrowding and long wait times: don’t apply “Band-Aids”, treat the underlying disease!
Authors: Puzhko Svetlana
Published: February 2021

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Radiation Safety Awareness Amongst Medical Students
Authors: Mengnjo Leinjo , Noureldin Yasser , Andonian Sero
Published: February 2021

ABSTRACT

Objectives: To assess awareness of radiation safety amongst medical and dental students and determine how their knowledge could be improved.

Methods: An anonymous electronic survey of medical and dental students at a Canadian university was conducted between February and April 2016. It was made up of 15 close-ended questions assessing knowledge and practice of radiation safety measures. Participants were also questioned about their willingness to learn more about radiation safety measures and the type of educational intervention.

Results: They were 87 responses, of which 39.1% (n=34) were males and 60.9 % (n=53) were female. Most students (83%, n=39) indicated that they had never practiced radiation safety measures. While most students (81.7%, n=67) had an idea or good idea about radiation safety measures, 45.4% (n=25) had never used them. Most students (77.1%, n=64) wanted to learn more about radiation safety in the form of workshops, seminars, and online modules. Students were divided as to when radiation safety education was appropriate. While 47.6% (n=40) thought that it would be most appropriate to have them during undergraduate degree, 48.8% (n=41) thought that it would be more appropriate during clinical rotations. Most students (75%, n=63) had never completed an educational course on radiation safety and only 9.5% (n=8) knew the annual permissible occupational radiation dose. Most students (76.9%, n=30) did not track their annual occupational radiation exposures.

Conclusions: Radiation safety awareness among medical and dental students needs to be improved. Students are willing to learn and improve their knowledge about radiation safety awareness especially during clinical training or college/undergraduate studies
The family medicine based virtual ward: Qualitative description of the implementation process
Authors: Gagnon Justin , Kremer Bernardo , Arsenault-Lapierre Geneviève , Gonzalez-Reyes Araceli , Ladores Mina , Vedel Isabelle
Published: February 2021

Purpose: Chronically ill older patients transitioning from hospital to home are at increased risk of readmission and complications. Numerous transitional care interventions have been proposed to improve communication and continuity of care throughout the transition. Evidence suggests that the risk of readmission and complications is reduced when interventions provide closer follow-up and multidisciplinary care. Informed by this evidence, the family medicine based virtual ward was developed by a Montreal family medicine group (FMG) to provide home-based care for patients with an elevated risk of emergency department (ED) visit or hospital readmission. The virtual ward team provides comprehensive, multidisciplinary post-discharge care at patients’ homes, combining the systems and staffing of the FMG’s home care program with a nurse case manager. Research was conducted to inform the implementation of similar transitional care programs in other Quebec health care settings. Methods: This research consists of a retrospective qualitative descriptive study of the implementation of the family medicine based virtual ward. Data was obtained from a semi-structured group interview with the team and informal interviews with individual members. Inductive thematic content analysis was used. Results: The following were identified as conditions for its successful implementation: 1) funding, 2) home care, 3) communication, 4) protocol standardization, and 5) continuous quality improvement. Conclusions: This intervention addresses the care of frequent health system users and compensates for gaps in communication and coordination. It was well-received by patients, healthcare providers and health system administrators and has the potential to reduce readmissions and reduce health system costs.
Forget two-faced, we're infinitely-faced: on facial plastic and reconstructive surgery
Authors: Curry Dennis E
Published: February 2021

Facial anatomy is wildly impressive and quite consequential to our everyday life. A third year medical student reflects on encounters with surgeons and patients intimately familiar with facial plastic surgery and how these experiences highlighted the importance of support following facial trauma and surgical reconstruction.
Women in Medicine: Dr. Louise Pilote
Authors: Munden Julia
Published: February 2021

Always driven by a desire to understand, Dr. Louise Pilote (MDCM, MPH, PhD, FRCPC) can accurately be described as a lifelong learner. As the former Director of the Division of General Internal Medicine at McGill University, this clinician scientist is a Professor of Medicine at McGill and holds a James McGill chair. Her research interests include cardiovascular disease, specifically in women, as well as health service outcomes. Pilote’s most recent endeavor focuses on the impact of gender on health outcomes, on a globalized scale. Now a mother of five, Pilote shares her experience with infertility and how to integrate professional and personal life. She also discusses the intersection of medicine and feminism, while providing advice for the next wave of clinician researchers.
Smize: A Mid-Pandemic Guide to Non-Verbal Communication
Authors: Bernstein Allison Jill
Published: February 2021

Communication, whether it be verbal or non-verbal, is a key element in establishing trust and comfort in a physician-patient relationship. In the time of COVID-19, we have seen that non-verbal communication, which is conveyed through facial expression, gestures, and other signs that a person is engaged in the conversation, is lost, largely due to the use of Personal Protective Equipment (PPE). It has become important during these times to find ways to surmount this obstacle to keep providing professional and meaningful care to our patients. This article will discuss the definition and the importance of non-verbal communication in physician-patient care, as well as why effective communication is crucial to good patient outcomes. Finally, this article will present several strategies to overcome the communication obstacles we are currently facing, in order to continue offering elevated levels of care in this time when communication is most needed.
The virtualization of medical education in response to COVID-19: A Harvard and McGill pre-clerkship medical student perspective
Authors: Al-Zubi Sara , Coleman Julianna , Kordlouie Sarah , Lee Caroline , Nuechterlein Kaitlin , Rahmani Feriel , Shade Jamie E. , Talat Zahra , Teutenberg Michael , Wu Emily
Published: February 2021

In response to the spread of SARS-CoV-2 across North America in early March of 2020, Canadian and United States medical schools swiftly virtualized medical education for pre-clerkship students. With remote learning arrived novel challenges: barriers to students’ comprehension of course material, difficulties conveying the nuances of patient interaction, and social hardships hindering students’ continued progress. The 2020 Harvard-McGill Medical Student Exchange, a group of ten McGill University Faculty of Medicine and Harvard Medical School students, analyzed their institutions’ respective responses in the virtualization of medical education and their personal experiences with remote pre-clerkship education. The authors’ work provides insight into opportunities for mutual progress and cross-cultural exchange between Canadian and American medical schools, in the context of the COVID-19 pandemic. The authors detail potential changes to didactics, student research opportunities, support for students, and clerkship preparation that they expect would benefit pre-clerkship students in an ever-changing biomedical landscape. With gratitude toward their respective programs for their efforts in transitioning to virtual learning, the authors look toward a future of medical education increasingly interwoven with digital technology and responsive to social change.
Addressing COVID-19 vaccine hesitancy - healthcare workers and trainees must be equipped for discussions about vaccines
Authors: Moszczynski Alexander J , Hintermayer Matthew
Published: February 2021

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has challenged our world throughout the past year. As we end 2020 conversing with loved ones, the topic of COVID-19 vaccination is inevitable. Throughout the next year, our gradual return to a more familiar society will be influenced by vaccine compliance. It is therefore paramount that healthcare professionals and trainees are equipped with current knowledge to address the questions and concerns of our loved ones. The Holidays should be viewed as an opportunity to address misconceptions and questions. This brief review outlines some arguments for why a COVID-19 vaccine is necessary and clarifies some features of the current top vaccine candidates. By addressing the questions and concerns of our loved ones before they need to decide whether or not they will receive a COVID-19 vaccine, we lay the groundwork for them to make informed choices.
Retinopathy of Prematurity: A Clinical Approach
Authors: Chow Andrew , Weinstock David , Berger Alan
Published: February 2021

Retinopathy of prematurity (ROP), previously known as retrolental fibroplasia, was first described by Terry in 1942 (1). It is a vasoproliferative disorder that is a leading cause of childhood blindness in the United States, causing 550 new cases of infant blindness each year (2). It occurs principally in premature infants treated with high concentrations of oxygen. There are two phases of ROP: (i) an acute phase in which normal vasculogenesis is interrupted, and (ii) a chronic phase in which vascular membranes proliferate into thevitreous. This proliferation can lead to retinal detachment, scarring of the macula, and significant visual loss (3).This article summarizes the incidence, pathophysiology, and classification of ROP. Current protocols for evaluating and treating ROP, as well as long-term sequelae, are also described.
Role of Brain Science in the Evolution of Epilepsy Surgery
Authors: Feindel William
Published: February 2021

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New Perspectives in the Pharmacologic Treatment of Primary Open-Angle Glaucoma: Pathogenesis and Patient Factors
Authors: Waschke Kevin
Published: February 2021

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Alpha-Fetoprotein (AFP): Solved and Unsolved Problems
Authors: Abelev Garry , Lazarevich Natalia
Published: February 2021

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Prostate Specific Antigen (PSA): The Historical Perspective
Authors: Chu T. Ming
Published: February 2021

In 1970, shortly after joining Roswell Park Memorial Institute, the New York State institute for the study of malignant diseases, the author initiated investigations on the use of tumor cell products for diagnosis and therapy of cancer. Immunochemical approaches were used primarily to differentiate quantitatively or qualitatively normal cells from tumor cells. Prostate cancer was a major area of endeavor, with the goal to identify and characterize prostate tumor specific and associated antigens, and eventually to develop a simple but reliable blood test for prostate cancer. Prostate cancer research had not received much attention at the time this work was begun. The early studies focused upon, among others, prostatic acid phosphatase, alkaline phosphatase, and new prostate tumor markers. By the mid 1970s, three able investigators--Dr. Ching-Li Lee, Dr. Carl S. Killian, and Dr. Ming C. Wang--had joined the prostate cancer research team, and were invited to take charge of these three research projects, respectively.
Successful Resuscitation of the Longest Reported Case of Severe Hypothermia Complicated by Cardiac Arrest
Authors: Winegard Charles
Published: February 2021

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Case Report: ANNA and the Diagnosis of Lung Cancer
Authors: Wein Theodore , Chalk Colin
Published: February 2021

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ACE Genotype Distributions Differ between Sporadic and Familial Hypertrophic Cardiomyopathy
Authors: Kassarjian Ara , Elstein Eleanor
Published: February 2021

This study investigated the frequency of ACE genotypes in sporadic hypertrophic cardiomyopathy (HCM) and compared these frequencies to those found in the general population and in familial HCM. Delineation of the genotype of a 287 bp fragment in the ACE gene of 10 patients with confirmed sporadic HCM demonstrated that 2 (20%) were of the DD genotype, 5 (50%) of the ID genotype, and 3 (30%) of the II genotype. These genotype distributions did not differ significantly from controls (p < 0.57). Comparison of the present results with genotype frequencies in familial HCM reported in prior studies revealed a significant difference in genotype distribution between sporadic and familial HCM (p < 0.04). These findings indicate that the frequency of the ACE genotype does not appear to differ between patients with sporadic HCM and the general population. However, the results suggest that, with regard to the ACE polymorphism studied, genetic differences may exist between the sporadic and familial forms of HCM.
Letter from the President of the International Federation of Medical Student's Associations
Authors: Brumana Luisa
Published: February 2021

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Ethnopsychiatry and Theories of "the African Mind": A Historical and Comparative Study
Authors: Carson Nicholas J.
Published: February 2021

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Clinical Assessment of Alzheimer’s Disease and Response to Donepezil Treatment
Authors: Gauthier Serge
Published: February 2021

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Attention Deficit Hyperactivity Disorder and Methylphenidate: When Society Misunderstands Medicine
Authors: Kaminester David D.
Published: February 2021

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The Presenilins and Alzheimer Disease
Authors: Lévesque G. , St George-Hyslop P.
Published: February 2021

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Journal Review of the MJM by the Journal of the American Medical Association
Authors: Starich Gale H. , Zenan Joan S.
Published: February 2021

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Human Germline Gene Therapy
Authors: Nielsen Torsten O.
Published: February 2021

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Should Age Matter? One Possible Justification for Age-Influenced Medical Rationing
Authors: Agrawal Shantanu
Published: February 2021

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Public Attitudes Regarding the Community Canadian Mental Health Association Crisis Stabilization Unit in Swan River, Manitoba
Authors: Rapchuk Ivan
Published: February 2021

A door-to-door survey was conducted on households within a one square block of a Canadian Mental Health Association Crisis Stabilization Unit (Swan River, Manitoba, Canada). This was undertaken to examine the opinions and attitudes of the members of the surveyed households regarding the neighboring community mental health residence, as well as their general attitudes toward mentally ill individuals. The survey utilized preliminary questions to obtain personal characteristics of the respondents, which were followed by 11 short questions regarding attitudes towards mental illness and the neighborhood facility. The findings of this study agree with previous research suggesting a general receptiveness on the part of community residents to deinstitutionalization and to having community mental health residents as neighbors. The personal characteristic with the greatest positive influence on attitudes was previous personal contact with mentally ill individuals. However, it was found that a segment of the population holds negative attitudes towards the CSU. The author suggests that education of the community regarding the mental health facility and mentally ill persons may improve acceptance to a greater extent.
The Medial Temporal Lobe and Schizophrenia
Authors: Florencio Patrik , O'Driscoll Gillian
Published: February 2021

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Screening for Carotid Artery Stenosis and Performance of Carotid Endarterectomy in Select Asymptomatic Patients is Cost-effective
Authors: Rodriguez Filiberto
Published: February 2021

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Surviving the Rat Race: The Growing Presence of Marketing in Dental and Other Health Care Industries
Authors: Egert Shelley C. J.
Published: February 2021

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Towards an improved AIDS vaccine: Enhancing the MHC Class I and II Antigen presentation of SIV proteins using ubiquitin and HLA-Dm targeting sequences
Authors: Martinu Tereza , Hel Zdenek , Franchini Genoveffa
Published: February 2021

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Are Placebo-Controlled Studies Ethical in Psychiatric Research?
Authors: Cadesky Eric
Published: February 2021

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Observing objective, structure, clinical examinations (OSCE)
Authors: Adams Jean
Published: February 2021

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Postpartum Depression: Making the Case for Routine Screening
Authors: Keshen Aaron , MacDonald Joanne L.
Published: February 2021

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Advances in Tuberculosis Research in the Past 10 Years: Solutions for a Global Problem
Authors: Menzies Dick , Behr Marcel
Published: February 2021

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SUFFER THE LITTLE CHILDREN
Authors: Bird Garrett Reed , Hilton John
Published: February 2021

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Midwifery in Canada
Authors: Born Karen
Published: February 2021

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Host Genetics of Tuberculosis Susceptibility
Authors: Di Pietrantonio Tania , Gallant Caroline , Schurr Erwin
Published: February 2021

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TRANSIENT INHIBITION OF SMAD1/SMAD4 TRANSLATION USING ANTISENSE OLIGODEOXYNUCLEOTIDES IN VITRO
Authors: Hanna Waël C. , Gupta Indra R.
Published: February 2021

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Reinventing Medicine
Authors: Pfeffer Gerald
Published: February 2021

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