A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

- Top 30 Publications

Young people, HIV, and life goals.

Environmental Pollutants and Neurodevelopment: Review of Benefits From Closure of a Coal-Burning Power Plant in Tongliang, China.

Background. Understanding preventable causes of neurodevelopmental disorders is a public health priority. Polycyclic aromatic hydrocarbons (PAH) from combustion of fossil fuel, lead, and mercury are among known neurodevelopmental toxicants. Method. For the first time, we comprehensively review the findings from a study by the Columbia Center for Children's Environmental Health and Chinese partners that followed 2 groups of mother-child pairs, one from 2002 and another from 2005, in Tongliang County, China. Pregnant mothers in the 2 cohorts experienced different exposure to PAH because a local coal-burning power plant was shut down in 2004. Investigators assessed change in prenatal PAH exposure, measured using a biomarker (benzo[a]pyrene [BaP]-DNA adducts in cord blood). Developmental quotients were measured using the Gesell Developmental Scales at age 2 and IQ was assessed using the Wechsler Intelligence Scale for Children at age 5. Biologic markers of preclinical response were measured in cord blood: methylation status of long interspersed nuclear elements (LINE1), an indicator of genomic stability, and brain-derived neurotrophic factor (BDNF), a neuronal growth promoter. Analyses accounted for co-exposure to lead and mercury. Results. BaP-DNA adducts were significantly inversely associated with Gesell Developmental Scales scores in the first cohort but not in the second cohort; and levels of BDNF and LINE1 methylation were higher in the second cohort. Conclusion. In this study, reduced exposure to PAH was associated with beneficial effects on neurodevelopment as well as molecular changes related to improved brain development and health. These benefits should encourage further efforts to limit exposure to these toxic pollutants.

Screening for Syphilis in Cases of Suspected Gonorrhea and Chlamydia Infections.

Background. In all cases of suspected sexually transmitted infections (STIs), it has been routine practice to screen for syphilis with a blood sample. The incidence of syphilis seems to be lower than that of commonly screened STIs. Objective. The objective of our study was to determine whether it is cost-effective to screen for syphilis with serological testing in cases of suspected gonorrhea and chlamydia infections. Hypothesis. Our hypothesis is that it is not cost-effective to screen for syphilis in cases of presumed gonorrhea and chlamydia infections. Methods. Our study is a New York Medical College institutional review board-approved retrospective study. During the period January 2004 to August 12, 2006, the laboratory work of all patients tested for gonorrhea and chlamydia in our emergency department was reviewed. The charts were reviewed for the following tests: gonorrhea DNA probe, chlamydia DNA probe, and syphilis IgG (immunoglobulin G)/RPR (rapid plasma reagin). The results of these tests were obtained and analyzed. Results. The total number of patients screened for gonorrhea and chlamydia during this period was 196. Seventy-eight patients tested positive for gonorrhea and chlamydia. All these 78 patients, tested negative for syphilis. The overall prevalence of positivity for STIs was 39.8% (78/196). The prevalence of chlamydia alone was 85.9% (67/78) and gonorrhea alone was 7.69% (6/78). The prevalence of combined both chlamydia and gonorrhea was 6.4% (5/78). Statistics. We used online SILICO 2 × 4 Fisher exact test. By comparing positive and negative results of serology RPR, GC, and chlamydia trap, the resultant 2-tailed P value is <.0001, which is statistically significant. Conclusions. Per our study, the yield of syphilis testing was negligible. It may not be cost-effective to screen for syphilis in cases of STIs such as gonorrhea and chlamydia.

Initiating a Standardized Regional Referral and Counter-Referral System in Guatemala: A Mixed-Methods Study.

Background:Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods: PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system. Referred patient records were reviewed to evaluate system effectiveness. Results: A total of 111 initial focus group participants included 96 (86.5%) from PHCs and 15 from the hospital. Of these participants, 53 PHC physicians and nurses and 15 hospital physicians initially completed written surveys. Convenience samples participated in follow-up. Eighteen focus groups achieved thematic saturation. Four themes emerged: effective communication; provision of timely, quality patient care with adequate resources; educational opportunities; and development of empowerment and relationships. Pre- and post-implementation surveys demonstrated significant improvement at the PHCs (P < .001) and the hospital (P = .02). Chart review included 435 referrals, 98 (22.5%) pre-implementation and 337 (77.5%) post-implementation. There was a trend toward an increased percentage of appropriately referred patients requiring medical intervention (30% vs 40%, P = .08) and of patients requiring intervention who received it prior to transport (55% vs 73%, P = .06). Conclusions: Standardizing a referral/counter-referral system improved communication, education, and trust across different levels of pediatric health care delivery. This model may be used for extension throughout Guatemala or be modified for use in other countries. Mixed-methods research design can evaluate complex systems in resource-limited settings.

Clinical Versus Objective Assessment of Overweight and Obese Children Among Primary Care Physicians.

Influenza A Virus Infection and Nucleotide Sequencing in HIV-Infected Children: A Case Report and Review of Literature.

Emergency Medical Service Personnel Recognize Pediatric Concussions.

Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed. This first of its kind pilot study was designed to assess EMS personnel's ability to recognize and triage pediatric concussions. Our findings show EMS providers are statistically identical in their ability to recognize and triage concussions to physicians. The performance of our MD participants was lower than expected. Larger studies are needed to further investigate EMS providers' ability to recognize a concussion.

The Superior Labial Frenulum in Newborns: What Is Normal?

Introduction and Objectives: There has been an emergence of procedures to release the superior labial frenula in infants, yet little is known about the normal appearance or incidence of severe attachment, or "lip-tie." The objective of this article was to develop a classification system for superior labial frenula and to estimate the incidence of different degrees of attachment. Methods: A prospective cross-sectional study. Newborns were examined and had photographs taken of their upper frenula. Relevant medical professionals rated the appearance of the labial frenula using a previously described Kotlow classification system. The raters assessed each photograph twice and were blinded to their previous rating and to other raters' scores. Results: All newborns have a labial frenula, with most attached at the gingival margins (83%). Raters had poor intra- and interrater reliability (64% to 74% and 8%, respectively), using the Kotlow classification system, which improved when the classification system was simplified. Conclusions: The Kotlow classification of lip-tie fails to be reproducible by relevant experts. The majority of infants had a significant level of attachment of the labial frenulum. As more procedures are done to release the upper lip frenulum, it is important to understand what degree of attachment is normal, or more common.

Posterolateral Fusion Versus Interbody Fusion for Degenerative Spondylolisthesis: Systematic Review and Meta-Analysis.

Systematic review and meta-analysis.

Analysis of the Literature on Cervical Spine Fractures in Ankylosing Spinal Disorders.

Narrative literature review.

Systematic Review of the Outcomes of Surgical Treatment of Prostate Metastases to the Spine.

Systematic review.

Clinical Outcomes of Total Disc Replacement Versus Anterior Lumbar Interbody Fusion for Surgical Treatment of Lumbar Degenerative Disc Disease.

The authors performed a retrospective controlled study of patients diagnosed with lumbar degenerative disc disease who received surgical intervention (either total disc replacement [TDR]/Activ-L or anterior lumbar interbody fusion [ALIF]) at a single tertiary-care hospital from 2007-2010.

Postoperative Kinetics of C-Reactive Protein and Erythrocyte Sediment Rate in One-, Two-, and Multilevel Posterior Spinal Decompressions and Instrumentations.

Prospective study.

Effect of Preoperative Anemia on the Outcomes of Anterior Cervical Discectomy and Fusion.

Retrospective cohort study.

Early Complications and Outcomes in Adult Spinal Deformity Surgery: An NSQIP Study Based on 5803 Patients.

Retrospective analysis.

Elderly Age as a Risk Factor for 30-Day Postoperative Outcomes Following Elective Anterior Cervical Discectomy and Fusion.

Retrospective analysis of prospectively collected data.

Incidence, Impact, and Risk Factors for 30-Day Wound Complications Following Elective Adult Spinal Deformity Surgery.

Case-control study.

ACDF Graft Selection by Surgeons: Survey of AOSpine Members.

Cross-sectional survey study.

A Novel Spinal Implant for Fusionless Scoliosis Correction: A Biomechanical Analysis of the Motion Preserving Properties of a Posterior Periapical Concave Distraction Device.

Biomechanical study.

A Matched Cohort Analysis Comparing Stand-Alone Cages and Anterior Cervical Plates Used for Anterior Cervical Discectomy and Fusion.

Retrospective cohort study.

An interview with Samuel Shem, author of 'The House of God'.

Dr Stephen Bergman, Professor of medical humanities at New York University, writes under the name Samuel Shem. He is an acclaimed author of several novels, plays and textbooks, and his work has been translated into several languages -'The House of God' his first novel has sold over 3 million copies. His work exposes the potential moral challenges of the medical workplace and the connection between values, good relationships and healing. In 2015 he visited the UK for medical humanities academic tour which included keynote talks at the RCGP 2015 Annual Conference and at the Royal Society of Medicine. Claire Brash interviewed him at the Royal Society of Medicine.

Pakistan Journal of Medical Sciences: A bibliometric assessment 2001-2010.

The aim of this study was to measure the growth of scientific research, authors' productivity, affiliation with the institute and geographic locations published in the Pakistan Journal of Medical Sciences during the period of 2001 - 2010.

Oral Care and Prevention of Pneumonia in Hospitalized Patients With Psychiatric Disorders in Japan.

Oral care in hospitalized patients with psychiatric disorders is important. However, some patients with psychiatric disorders cannot undergo oral care because of psychiatric symptoms and cognitive decline. The effect of a standardized oral hygiene intervention on the prevention of pneumonia in hospitalized patients with psychiatric disorders was investigated.

Inhibition of Inflammation Mediated Through the Tumor Necrosis Factor α Biochemical Pathway Can Lead to Favorable Outcomes in Alzheimer Disease.

Tumor necrosis factor α (TNF-α) inhibitors have long been used as disease-modifying agents in immune disorders. Recently, research has shown a role of chronic neuroinflammation in the pathophysiology of neurodegenerative diseases such as Alzheimer disease, and interest has been generated in the use of anti-TNF agents and TNF-modulating agents for prevention and treatment. This article extensively reviewed literature on animal studies testing these agents. The results showed a role for direct and indirect TNF-α inhibition through agents such as thalidomide, 3,6-dithiothalidomide, etanercept, infliximab, exendin-4, sodium hydrosulfide, minocycline, imipramine, and atorvastatin. Studies were performed on mice, rats, and monkeys, with induction of neurodegenerative physiology either through the use of chemical agents or through the use of transgenic animals. Most of these agents showed an improvement in cognitive function as tested with the Morris water maze, and immunohistochemical and histopathological staining studies consistently showed better outcomes with these agents. Brains of treated animals showed significant reduction in pro-inflammatory TNF-α and reduced the burden of neurofibrillary tangles, amyloid precursor protein, and β-amyloid plaques. Also, recruitment of microglial cells in the central nervous system was significantly reduced through these drugs. These studies provide a clearer mechanistic understanding of the role of TNF-α modulation in Alzheimer disease. All studies in this review explored the use of these drugs as prophylactic agents to prevent Alzheimer disease through immune modulation of the TNF inflammatory pathway, and their success highlights the need for further research of these drugs as therapeutic agents.

Cytogenetic Profile and FLT3 Gene Mutations of Childhood Acute Lymphoblastic Leukemia.

Childhood acute lymphoblastic leukemia (ALL) is characterized by recurrent genetic aberrations. The identification of those abnormalities is clinically important because they are considered significant risk-stratifying markers.

Retroperitoneal Bleeding: An Experience During Prophylactic Anticoagulation in a Patient With Nephrotic Syndrome.

The association between nephrotic syndrome (NS) and a hypercoagulable state has been demonstrated. Controlling the blood clotting activity may therefore be attractive for patients with nephrosis in terms of thromboembolism prophylaxis. We herein report a 75-year-old woman with minimal change disease who developed pains in the right back, groin, and thigh because of retroperitoneal bleeding during prophylactic anticoagulation with unfractionated heparin. Although this procedure has not been accepted as the standard of care for patients with nephrosis, pharmacologic prophylaxis may already be practiced empirically, as in the present patient. We believe that our experience highlights the pitfalls of such a management in patients with nephrosis, implying the need for a diagnostic strategy for identifying those patients with NS who can benefit from prophylactic anticoagulation. Several concerns that emerged in this case are also discussed.

Respiratory T-Wave Inversion in a Patient With Chest Pain.

T-wave inversion on electrocardiogram (ECG) is always a concerning finding as it is often associated with myocardial ischemia or ventricular strain. Respiratory variation in the T-wave morphology has been reported in the literature; however, the frequency of this observation remains unknown as this is not routinely evaluated. Although the exact physiological mechanisms underlying this ECG change are unclear, it is proposed to be due to the respiratory variation of the heart position resulting in an alteration in T-wave polarity. We describe a case of a patient who presented with chest pain with T-wave inversions in inferior and lateral ECG leads. On repeating ECG with breath held in end inspiration, the T waves became positive. The pain was found to be musculoskeletal in origin. This case is a reminder of an under-recognized physiological phenomenon involving the cardiac conduction. Variation of T-wave morphology with respiration may suggest a noncardiac cause of chest pain.

Consistency and Variability of DNA Methylation in Women During Puberty, Young Adulthood, and Pregnancy.

Prior DNA methylation (DNA-m) analyses have identified cytosine-phosphate-guanine (CpG) sites, which show either a significant change or consistency during lifetime. However, the proportion of CpGs that are neither significantly different nor consistent over time (indifferent CpGs) is unknown. We investigated the methylation dynamics, both longitudinal changes and consistency, in women from preadolescence to late pregnancy using DNA-m of peripheral blood cells. Consistency of cell type-adjusted DNA-m between paired individuals was assessed by regressing CpGs of subsequent age on the prior, stability by intraclass correlation coefficients (>0.5), and changes by linear mixed models. In the first 2 transitions (10-18 years and 18 years to early pregnancy), 19.5% and 20.9% CpGs were consistent, but only 0.35% in the third transition (from early to late pregnancy). Significant changes in methylation were found in 0.7%, 5.6%, and 0% CpGs, respectively. Functional enrichment analyses of genes with significant changes in DNA-m in early pregnancy (5.6%) showed that the maternal DNA-m seems to reflect signaling pathways between the uterus and the trophoblast. The transition from early to late pregnancy showed low consistency/stability and no changes, suggesting the presence of a large proportion of indifferent CpGs in late pregnancy.

Multiple Testing in the Context of Gene Discovery in Sickle Cell Disease Using Genome-Wide Association Studies.

The issue of multiple testing, also termed multiplicity, is ubiquitous in studies where multiple hypotheses are tested simultaneously. Genome-wide association study (GWAS), a type of genetic association study that has gained popularity in the past decade, is most susceptible to the issue of multiple testing. Different methodologies have been employed to address the issue of multiple testing in GWAS. The purpose of the review is to examine the methodologies employed in dealing with multiple testing in the context of gene discovery using GWAS in sickle cell disease complications.

Opinion: Climate policymakers and assessments must get serious about climate engineering.