User login
Interactive online module improved detection of Barrett’s esophagus neoplasia
An online educational tool for endoscopists helped improve their detection of Barrett’s esophagus–related neoplasia (BORN), researchers reported in the April issue of Gastroenterology.
In tests administered before and after training, endoscopists increased their rates of BORN detection by a median of 30% (P less than .001), reported J.J. Bergman, MD, PhD, of the University of Amsterdam, together with his associates. “To our knowledge, this is the first validated online, interactive endoscopic training program in our field,” they wrote. “Widespread use of this tool might improve management of Barrett’s esophagus by general endoscopists.”
To develop the program, the investigators recorded high-definition videos of upper endoscopies of patients with either BORN or nondysplastic Barrett’s esophagus. They sent these videos to three experts, who used special tools to superimpose their delineations of lesions.
Next, 68 general endoscopists (fellows, early-career general gastroenterologists, and senior general gastroenterologists) watched four batches of 20 videos each. The researchers compared the assessors’ interpretations with the experts’ to identify the 25 videos with the most educational impact. These were then shown in four batches of five to 121 new assessors (five videos were reserved for pre- and post testing).
From the first to the fourth batch of training videos, assessors sequentially improved their scores for detection, delineation, agreement delineation, and relative delineation of BORN, the researchers said. Among the 121 assessors in the second phase of development, median rates of detection of BORN rose by 30% after training. Furthermore, from baseline to the end of the study, scores rose by 46% for detection, 129% for delineation, 105% for agreement delineation, and 106% for relative delineation (all P less than .001). These improvements did not depend on the country of origin of the assessors or their level of endoscopic experience.
This module requires the use of high-definition videos whose resolution is not lost during replay or when viewed on the web, the researchers emphasized. They noted that the module is active, not passive – learners select the video frame to position a biopsy mark and delineate the lesion, and the software then gives them tailored feedback on their choice. Learners also can add and remove the experts’ delineations as well as their own during feedback sessions at the end of each batch of videos. This enables them to “fully appreciate the subtle appearance of the lesion on the selected time frame,” the investigators wrote.
By completing the training module, “general endoscopists with a wide range of experience and from different countries of origin can substantially and conveniently increase their skills for detection and delineation of early BORN lesions,” they concluded. “Therefore, the module could provide training in an essential upper gastrointestinal endoscopic skill that is not otherwise readily available.”
The investigators disclosed no external funding sources. They reported having no conflicts of interest.
SOURCE: Bergman JJ et al. Gastroenterology. 2019 Jan 2. doi: 10.1053/j.gastro.2018.12.021.
Endoscopic mucosal resection and ablation strategies offer the potential for minimally invasive, curative treatment for patients with Barrett’s esophagus–associated intramucosal neoplasia. For the gastroenterologist interested in endoscopic prevention and management of esophageal cancer, however, achieving proficiency in performance of these endoscopic techniques represents only part of the requisite preparatory experience. Acquisition of cognitive skills in lesion recognition is a fundamental and underappreciated component to a successful endoscopic treatment paradigm.
General endoscopist assessors were grouped into three groups based on level of experience. Following completion of the training module, scores in lesion detection and delineation increased irrespective of level of endoscopist experience.
The module is free, CME-accredited, and available for online use. Any endoscopist who performs Barrett’s screening, surveillance, and therapy should be motivated and incentivized to engage with this important educational tool.
Patrick Yachimski, MD, MPH, AGAF, is associate professor of medicine, director of pancreatobiliary endoscopy, division of gastroenterology, hepatology & nutrition, Vanderbilt University Medical Center, Nashville, Tenn. He has no conflicts.
Endoscopic mucosal resection and ablation strategies offer the potential for minimally invasive, curative treatment for patients with Barrett’s esophagus–associated intramucosal neoplasia. For the gastroenterologist interested in endoscopic prevention and management of esophageal cancer, however, achieving proficiency in performance of these endoscopic techniques represents only part of the requisite preparatory experience. Acquisition of cognitive skills in lesion recognition is a fundamental and underappreciated component to a successful endoscopic treatment paradigm.
General endoscopist assessors were grouped into three groups based on level of experience. Following completion of the training module, scores in lesion detection and delineation increased irrespective of level of endoscopist experience.
The module is free, CME-accredited, and available for online use. Any endoscopist who performs Barrett’s screening, surveillance, and therapy should be motivated and incentivized to engage with this important educational tool.
Patrick Yachimski, MD, MPH, AGAF, is associate professor of medicine, director of pancreatobiliary endoscopy, division of gastroenterology, hepatology & nutrition, Vanderbilt University Medical Center, Nashville, Tenn. He has no conflicts.
Endoscopic mucosal resection and ablation strategies offer the potential for minimally invasive, curative treatment for patients with Barrett’s esophagus–associated intramucosal neoplasia. For the gastroenterologist interested in endoscopic prevention and management of esophageal cancer, however, achieving proficiency in performance of these endoscopic techniques represents only part of the requisite preparatory experience. Acquisition of cognitive skills in lesion recognition is a fundamental and underappreciated component to a successful endoscopic treatment paradigm.
General endoscopist assessors were grouped into three groups based on level of experience. Following completion of the training module, scores in lesion detection and delineation increased irrespective of level of endoscopist experience.
The module is free, CME-accredited, and available for online use. Any endoscopist who performs Barrett’s screening, surveillance, and therapy should be motivated and incentivized to engage with this important educational tool.
Patrick Yachimski, MD, MPH, AGAF, is associate professor of medicine, director of pancreatobiliary endoscopy, division of gastroenterology, hepatology & nutrition, Vanderbilt University Medical Center, Nashville, Tenn. He has no conflicts.
An online educational tool for endoscopists helped improve their detection of Barrett’s esophagus–related neoplasia (BORN), researchers reported in the April issue of Gastroenterology.
In tests administered before and after training, endoscopists increased their rates of BORN detection by a median of 30% (P less than .001), reported J.J. Bergman, MD, PhD, of the University of Amsterdam, together with his associates. “To our knowledge, this is the first validated online, interactive endoscopic training program in our field,” they wrote. “Widespread use of this tool might improve management of Barrett’s esophagus by general endoscopists.”
To develop the program, the investigators recorded high-definition videos of upper endoscopies of patients with either BORN or nondysplastic Barrett’s esophagus. They sent these videos to three experts, who used special tools to superimpose their delineations of lesions.
Next, 68 general endoscopists (fellows, early-career general gastroenterologists, and senior general gastroenterologists) watched four batches of 20 videos each. The researchers compared the assessors’ interpretations with the experts’ to identify the 25 videos with the most educational impact. These were then shown in four batches of five to 121 new assessors (five videos were reserved for pre- and post testing).
From the first to the fourth batch of training videos, assessors sequentially improved their scores for detection, delineation, agreement delineation, and relative delineation of BORN, the researchers said. Among the 121 assessors in the second phase of development, median rates of detection of BORN rose by 30% after training. Furthermore, from baseline to the end of the study, scores rose by 46% for detection, 129% for delineation, 105% for agreement delineation, and 106% for relative delineation (all P less than .001). These improvements did not depend on the country of origin of the assessors or their level of endoscopic experience.
This module requires the use of high-definition videos whose resolution is not lost during replay or when viewed on the web, the researchers emphasized. They noted that the module is active, not passive – learners select the video frame to position a biopsy mark and delineate the lesion, and the software then gives them tailored feedback on their choice. Learners also can add and remove the experts’ delineations as well as their own during feedback sessions at the end of each batch of videos. This enables them to “fully appreciate the subtle appearance of the lesion on the selected time frame,” the investigators wrote.
By completing the training module, “general endoscopists with a wide range of experience and from different countries of origin can substantially and conveniently increase their skills for detection and delineation of early BORN lesions,” they concluded. “Therefore, the module could provide training in an essential upper gastrointestinal endoscopic skill that is not otherwise readily available.”
The investigators disclosed no external funding sources. They reported having no conflicts of interest.
SOURCE: Bergman JJ et al. Gastroenterology. 2019 Jan 2. doi: 10.1053/j.gastro.2018.12.021.
An online educational tool for endoscopists helped improve their detection of Barrett’s esophagus–related neoplasia (BORN), researchers reported in the April issue of Gastroenterology.
In tests administered before and after training, endoscopists increased their rates of BORN detection by a median of 30% (P less than .001), reported J.J. Bergman, MD, PhD, of the University of Amsterdam, together with his associates. “To our knowledge, this is the first validated online, interactive endoscopic training program in our field,” they wrote. “Widespread use of this tool might improve management of Barrett’s esophagus by general endoscopists.”
To develop the program, the investigators recorded high-definition videos of upper endoscopies of patients with either BORN or nondysplastic Barrett’s esophagus. They sent these videos to three experts, who used special tools to superimpose their delineations of lesions.
Next, 68 general endoscopists (fellows, early-career general gastroenterologists, and senior general gastroenterologists) watched four batches of 20 videos each. The researchers compared the assessors’ interpretations with the experts’ to identify the 25 videos with the most educational impact. These were then shown in four batches of five to 121 new assessors (five videos were reserved for pre- and post testing).
From the first to the fourth batch of training videos, assessors sequentially improved their scores for detection, delineation, agreement delineation, and relative delineation of BORN, the researchers said. Among the 121 assessors in the second phase of development, median rates of detection of BORN rose by 30% after training. Furthermore, from baseline to the end of the study, scores rose by 46% for detection, 129% for delineation, 105% for agreement delineation, and 106% for relative delineation (all P less than .001). These improvements did not depend on the country of origin of the assessors or their level of endoscopic experience.
This module requires the use of high-definition videos whose resolution is not lost during replay or when viewed on the web, the researchers emphasized. They noted that the module is active, not passive – learners select the video frame to position a biopsy mark and delineate the lesion, and the software then gives them tailored feedback on their choice. Learners also can add and remove the experts’ delineations as well as their own during feedback sessions at the end of each batch of videos. This enables them to “fully appreciate the subtle appearance of the lesion on the selected time frame,” the investigators wrote.
By completing the training module, “general endoscopists with a wide range of experience and from different countries of origin can substantially and conveniently increase their skills for detection and delineation of early BORN lesions,” they concluded. “Therefore, the module could provide training in an essential upper gastrointestinal endoscopic skill that is not otherwise readily available.”
The investigators disclosed no external funding sources. They reported having no conflicts of interest.
SOURCE: Bergman JJ et al. Gastroenterology. 2019 Jan 2. doi: 10.1053/j.gastro.2018.12.021.
FROM GASTROENTEROLOGY
Anthrax booster expanded to 3 years for moderate-risk groups
A booster dose for pre-exposure prophylaxis with an anthrax vaccine may be given at 3 years after an initial series for individuals not currently at risk who wish to maintain protection, according to the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
In a unanimous 15-0 vote at the February meeting, ACIP committee members agreed on the recommendation after adjusting the wording to reflect a permissive, rather than mandated, guidance.
William Bower, MD, of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), presented data on Anthrax Vaccine Adsorbed (AVA) to support its protective effects over a longer booster dose interval.
The recommendations apply to persons aged 18 years or older who are not currently at high risk of exposure to Bacillus anthracis, but who might need to deploy to a high-risk area quickly, such as military personnel, Dr. Bower said.
In addition, data suggest that adults who have started, but not completed the pre-exposure priming series, can transition to the postexposure schedule prior to entering a high-risk area, he noted.
The previous pre-exposure anthrax vaccination schedule was a three-dose priming series at 0, 1, and 3 months, followed by a booster at 12 months and 18 months, then annually.
with “sustained immunological memory to at least month 42,” and suggested that even longer intervals between boosters may be possible, Dr. Bower said.
A dosing schedule of intramuscular injections at 0 and at 1 month and 6 months, with a booster at 42 months yielded survival estimates of approximately 84%-93%.
Dr. Bower noted that a new vaccine, AV7909, has demonstrated safety and effectiveness similar to AVA and could be used for pre-exposure prophylaxis if AVA is not available. AVA remains the preferred option, but ultimately will be replaced by AV7909, when the current AVA stockpile is exhausted.
Additional safety data on AV7909 will be reviewed by ACIP as they become available, and future guidance from the CDC will include statements on dosing for special populations including pregnant and breastfeeding women, said Dr. Bower.
“We anticipate that this [anthrax vaccine] work group will reconvene in 2021 to review data from pending studies” of AV7909, he said.
The ACIP members had no financial conflicts to disclose.
A booster dose for pre-exposure prophylaxis with an anthrax vaccine may be given at 3 years after an initial series for individuals not currently at risk who wish to maintain protection, according to the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
In a unanimous 15-0 vote at the February meeting, ACIP committee members agreed on the recommendation after adjusting the wording to reflect a permissive, rather than mandated, guidance.
William Bower, MD, of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), presented data on Anthrax Vaccine Adsorbed (AVA) to support its protective effects over a longer booster dose interval.
The recommendations apply to persons aged 18 years or older who are not currently at high risk of exposure to Bacillus anthracis, but who might need to deploy to a high-risk area quickly, such as military personnel, Dr. Bower said.
In addition, data suggest that adults who have started, but not completed the pre-exposure priming series, can transition to the postexposure schedule prior to entering a high-risk area, he noted.
The previous pre-exposure anthrax vaccination schedule was a three-dose priming series at 0, 1, and 3 months, followed by a booster at 12 months and 18 months, then annually.
with “sustained immunological memory to at least month 42,” and suggested that even longer intervals between boosters may be possible, Dr. Bower said.
A dosing schedule of intramuscular injections at 0 and at 1 month and 6 months, with a booster at 42 months yielded survival estimates of approximately 84%-93%.
Dr. Bower noted that a new vaccine, AV7909, has demonstrated safety and effectiveness similar to AVA and could be used for pre-exposure prophylaxis if AVA is not available. AVA remains the preferred option, but ultimately will be replaced by AV7909, when the current AVA stockpile is exhausted.
Additional safety data on AV7909 will be reviewed by ACIP as they become available, and future guidance from the CDC will include statements on dosing for special populations including pregnant and breastfeeding women, said Dr. Bower.
“We anticipate that this [anthrax vaccine] work group will reconvene in 2021 to review data from pending studies” of AV7909, he said.
The ACIP members had no financial conflicts to disclose.
A booster dose for pre-exposure prophylaxis with an anthrax vaccine may be given at 3 years after an initial series for individuals not currently at risk who wish to maintain protection, according to the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
In a unanimous 15-0 vote at the February meeting, ACIP committee members agreed on the recommendation after adjusting the wording to reflect a permissive, rather than mandated, guidance.
William Bower, MD, of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), presented data on Anthrax Vaccine Adsorbed (AVA) to support its protective effects over a longer booster dose interval.
The recommendations apply to persons aged 18 years or older who are not currently at high risk of exposure to Bacillus anthracis, but who might need to deploy to a high-risk area quickly, such as military personnel, Dr. Bower said.
In addition, data suggest that adults who have started, but not completed the pre-exposure priming series, can transition to the postexposure schedule prior to entering a high-risk area, he noted.
The previous pre-exposure anthrax vaccination schedule was a three-dose priming series at 0, 1, and 3 months, followed by a booster at 12 months and 18 months, then annually.
with “sustained immunological memory to at least month 42,” and suggested that even longer intervals between boosters may be possible, Dr. Bower said.
A dosing schedule of intramuscular injections at 0 and at 1 month and 6 months, with a booster at 42 months yielded survival estimates of approximately 84%-93%.
Dr. Bower noted that a new vaccine, AV7909, has demonstrated safety and effectiveness similar to AVA and could be used for pre-exposure prophylaxis if AVA is not available. AVA remains the preferred option, but ultimately will be replaced by AV7909, when the current AVA stockpile is exhausted.
Additional safety data on AV7909 will be reviewed by ACIP as they become available, and future guidance from the CDC will include statements on dosing for special populations including pregnant and breastfeeding women, said Dr. Bower.
“We anticipate that this [anthrax vaccine] work group will reconvene in 2021 to review data from pending studies” of AV7909, he said.
The ACIP members had no financial conflicts to disclose.
FROM AN ACIP MEETING
ACIP unanimously supports updates to Japanese encephalitis vaccination
according to a vote at a meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
Japanese encephalitis (JE) virus is a mosquito-borne flavivirus and those at risk for infection include travelers to countries where JE is endemic, as well as laboratory personnel who work with the virus.
The committee voted unanimously 15-0 in favor of the recommendations, which also advised vaccination for those whose travels in endemic areas are uncertain, but not for travelers with low-risk itineraries “such as shorter term travel limited to urban areas or travel that occurs outside of a well-defined JE virus transmission season.”
Susan Hills, MD, of the of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, presented data in support of the recommendations.
A second unanimous vote confirmed recommendations for a primary series schedule for JE vaccination for adults aged 18-65 years as “two doses of vaccine administered on days 0 and 7-28.”
The third vote, also a unanimous 15-0, updated recommendations for a JE booster dose. The new recommendation is that adults and children receive a booster dose (a third dose) at least a year after completion of the primary JE vaccine series “if ongoing exposure or re-exposure to JE virus is expected.”
The currently available Japanese encephalitis vaccine in the United States is an inactivated Vero cell culture-derived vaccine marketed as IXIARO that was approved in March 2009 for individuals aged 17 years and older and approved in May 2013 for children aged 2 months through 16 years.
The ACIP members had no financial conflicts to disclose.
according to a vote at a meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
Japanese encephalitis (JE) virus is a mosquito-borne flavivirus and those at risk for infection include travelers to countries where JE is endemic, as well as laboratory personnel who work with the virus.
The committee voted unanimously 15-0 in favor of the recommendations, which also advised vaccination for those whose travels in endemic areas are uncertain, but not for travelers with low-risk itineraries “such as shorter term travel limited to urban areas or travel that occurs outside of a well-defined JE virus transmission season.”
Susan Hills, MD, of the of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, presented data in support of the recommendations.
A second unanimous vote confirmed recommendations for a primary series schedule for JE vaccination for adults aged 18-65 years as “two doses of vaccine administered on days 0 and 7-28.”
The third vote, also a unanimous 15-0, updated recommendations for a JE booster dose. The new recommendation is that adults and children receive a booster dose (a third dose) at least a year after completion of the primary JE vaccine series “if ongoing exposure or re-exposure to JE virus is expected.”
The currently available Japanese encephalitis vaccine in the United States is an inactivated Vero cell culture-derived vaccine marketed as IXIARO that was approved in March 2009 for individuals aged 17 years and older and approved in May 2013 for children aged 2 months through 16 years.
The ACIP members had no financial conflicts to disclose.
according to a vote at a meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
Japanese encephalitis (JE) virus is a mosquito-borne flavivirus and those at risk for infection include travelers to countries where JE is endemic, as well as laboratory personnel who work with the virus.
The committee voted unanimously 15-0 in favor of the recommendations, which also advised vaccination for those whose travels in endemic areas are uncertain, but not for travelers with low-risk itineraries “such as shorter term travel limited to urban areas or travel that occurs outside of a well-defined JE virus transmission season.”
Susan Hills, MD, of the of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, presented data in support of the recommendations.
A second unanimous vote confirmed recommendations for a primary series schedule for JE vaccination for adults aged 18-65 years as “two doses of vaccine administered on days 0 and 7-28.”
The third vote, also a unanimous 15-0, updated recommendations for a JE booster dose. The new recommendation is that adults and children receive a booster dose (a third dose) at least a year after completion of the primary JE vaccine series “if ongoing exposure or re-exposure to JE virus is expected.”
The currently available Japanese encephalitis vaccine in the United States is an inactivated Vero cell culture-derived vaccine marketed as IXIARO that was approved in March 2009 for individuals aged 17 years and older and approved in May 2013 for children aged 2 months through 16 years.
The ACIP members had no financial conflicts to disclose.
FROM AN ACIP MEETING
App, role-playing used as interventions
Help for people with mental health and substance use issues has become more accessible now that the Georgia Crisis & Access Line launched a mobile app. The aim of the My GCAL app is to guide people to free and confidential access, and the targets are those who would rather send a text message than speak to someone over the phone. In Georgia and elsewhere, this tends to be younger people. “We are trying to be proactive,” said Georgia Gov. Brian Kemp. Atlanta Journal-Constitution.
Ninth-grade students at the Uplift Hampton Preparatory school in Dallas have been taking part in classroom sessions where role-playing activities are helping them spot the signs of depression in themselves and others. “It’s kind of like ‘Mental Health 101,’ ” said Tony Walker, senior director of student support services at Uplift Education, in an Associated Press article published in the National Post. “So they talk about depression and anxiety and just common mental health issues, and then I think the most important thing is they talk about what to do if you feel that way.” The Youth Aware of Mental Health (YAM) program, administered by Madhukar H. Trivedi, MD, of the University of Texas Southwestern Medical Center is offered to all 9th-graders in the 20-school Uplift Education network in the Dallas area. The program, consisting of five 45-minute sessions, originally was developed at the Karolinska Institute in Stockholm and Columbia University in New York. A similar initiative offered by the National Alliance on Mental Illness (NAMI) teaches students the warning signs of mental health problems. Since the NAMI program launched in 2014, it has reached almost 450,000 youth in 41 states. National Post.
Identifying the source of students’ frustration and anger can prevent them from lashing out, according to a National Public Radio report. But responses rooted in compassion can help diffuse potentially tragic outcomes. The report describes the story of a young man whose struggles started in middle school. An encounter with bullies left him with severe damage in his right eye, and he spent his high school years getting into fights. After school officials stepped in, acknowledged that he had reasons to be angry, and connected him with a mentor who was able to talk and reason with him, the young man graduated on time. He’s now 25 and works full time for a security firm. “Moving kids from despair to hope. That’s the bumper sticker for what we do,” said school psychologist John Van Dreal. The approach “really works,” he added. NPR.
An exhibition now running at the Science Center of Iowa in Des Moines is helping patrons explore the reality of mental illness. The Mental Health: Mind Matters exhibition is intended to show the real lives of people with mental illness, with the hope of inspiring better appreciation and empathy. It features audio renderings of what the world can sound like to someone with psychosis, walk-through rooms that take patrons inside the homes of people with depression, and exercises that inspire worry or fear, as well as photography. The aim is to take the patron inside the heads of those with mental illnesses. “A possibility now exists to utilize a constellation of exhibits like Mind Matters to revolutionize understanding, prevention, and wellness nationally, all while unlocking economic benefits and advancing human dignity,” wrote Paul Piwko, the author of an article describing the exhibit. Des Moines Register.
Students are creating a dialogue about suicide awareness and prevention at Gardner (Kansas) Edgerton High School. At a recent basketball game with Shawnee Mission West High School, Gardner Edgerton team members, students, cheerleaders, and fans donned T-shirts emblazoned with “#ZeroReasonsWhy.” The student-led campaign is aimed at encouraging students to seek help rather than consider suicide. At the game, T-shirts and bracelets also were handed out to Shawnee Mission West players in an effort to spread the message. The Kansas City Star.
Help for people with mental health and substance use issues has become more accessible now that the Georgia Crisis & Access Line launched a mobile app. The aim of the My GCAL app is to guide people to free and confidential access, and the targets are those who would rather send a text message than speak to someone over the phone. In Georgia and elsewhere, this tends to be younger people. “We are trying to be proactive,” said Georgia Gov. Brian Kemp. Atlanta Journal-Constitution.
Ninth-grade students at the Uplift Hampton Preparatory school in Dallas have been taking part in classroom sessions where role-playing activities are helping them spot the signs of depression in themselves and others. “It’s kind of like ‘Mental Health 101,’ ” said Tony Walker, senior director of student support services at Uplift Education, in an Associated Press article published in the National Post. “So they talk about depression and anxiety and just common mental health issues, and then I think the most important thing is they talk about what to do if you feel that way.” The Youth Aware of Mental Health (YAM) program, administered by Madhukar H. Trivedi, MD, of the University of Texas Southwestern Medical Center is offered to all 9th-graders in the 20-school Uplift Education network in the Dallas area. The program, consisting of five 45-minute sessions, originally was developed at the Karolinska Institute in Stockholm and Columbia University in New York. A similar initiative offered by the National Alliance on Mental Illness (NAMI) teaches students the warning signs of mental health problems. Since the NAMI program launched in 2014, it has reached almost 450,000 youth in 41 states. National Post.
Identifying the source of students’ frustration and anger can prevent them from lashing out, according to a National Public Radio report. But responses rooted in compassion can help diffuse potentially tragic outcomes. The report describes the story of a young man whose struggles started in middle school. An encounter with bullies left him with severe damage in his right eye, and he spent his high school years getting into fights. After school officials stepped in, acknowledged that he had reasons to be angry, and connected him with a mentor who was able to talk and reason with him, the young man graduated on time. He’s now 25 and works full time for a security firm. “Moving kids from despair to hope. That’s the bumper sticker for what we do,” said school psychologist John Van Dreal. The approach “really works,” he added. NPR.
An exhibition now running at the Science Center of Iowa in Des Moines is helping patrons explore the reality of mental illness. The Mental Health: Mind Matters exhibition is intended to show the real lives of people with mental illness, with the hope of inspiring better appreciation and empathy. It features audio renderings of what the world can sound like to someone with psychosis, walk-through rooms that take patrons inside the homes of people with depression, and exercises that inspire worry or fear, as well as photography. The aim is to take the patron inside the heads of those with mental illnesses. “A possibility now exists to utilize a constellation of exhibits like Mind Matters to revolutionize understanding, prevention, and wellness nationally, all while unlocking economic benefits and advancing human dignity,” wrote Paul Piwko, the author of an article describing the exhibit. Des Moines Register.
Students are creating a dialogue about suicide awareness and prevention at Gardner (Kansas) Edgerton High School. At a recent basketball game with Shawnee Mission West High School, Gardner Edgerton team members, students, cheerleaders, and fans donned T-shirts emblazoned with “#ZeroReasonsWhy.” The student-led campaign is aimed at encouraging students to seek help rather than consider suicide. At the game, T-shirts and bracelets also were handed out to Shawnee Mission West players in an effort to spread the message. The Kansas City Star.
Help for people with mental health and substance use issues has become more accessible now that the Georgia Crisis & Access Line launched a mobile app. The aim of the My GCAL app is to guide people to free and confidential access, and the targets are those who would rather send a text message than speak to someone over the phone. In Georgia and elsewhere, this tends to be younger people. “We are trying to be proactive,” said Georgia Gov. Brian Kemp. Atlanta Journal-Constitution.
Ninth-grade students at the Uplift Hampton Preparatory school in Dallas have been taking part in classroom sessions where role-playing activities are helping them spot the signs of depression in themselves and others. “It’s kind of like ‘Mental Health 101,’ ” said Tony Walker, senior director of student support services at Uplift Education, in an Associated Press article published in the National Post. “So they talk about depression and anxiety and just common mental health issues, and then I think the most important thing is they talk about what to do if you feel that way.” The Youth Aware of Mental Health (YAM) program, administered by Madhukar H. Trivedi, MD, of the University of Texas Southwestern Medical Center is offered to all 9th-graders in the 20-school Uplift Education network in the Dallas area. The program, consisting of five 45-minute sessions, originally was developed at the Karolinska Institute in Stockholm and Columbia University in New York. A similar initiative offered by the National Alliance on Mental Illness (NAMI) teaches students the warning signs of mental health problems. Since the NAMI program launched in 2014, it has reached almost 450,000 youth in 41 states. National Post.
Identifying the source of students’ frustration and anger can prevent them from lashing out, according to a National Public Radio report. But responses rooted in compassion can help diffuse potentially tragic outcomes. The report describes the story of a young man whose struggles started in middle school. An encounter with bullies left him with severe damage in his right eye, and he spent his high school years getting into fights. After school officials stepped in, acknowledged that he had reasons to be angry, and connected him with a mentor who was able to talk and reason with him, the young man graduated on time. He’s now 25 and works full time for a security firm. “Moving kids from despair to hope. That’s the bumper sticker for what we do,” said school psychologist John Van Dreal. The approach “really works,” he added. NPR.
An exhibition now running at the Science Center of Iowa in Des Moines is helping patrons explore the reality of mental illness. The Mental Health: Mind Matters exhibition is intended to show the real lives of people with mental illness, with the hope of inspiring better appreciation and empathy. It features audio renderings of what the world can sound like to someone with psychosis, walk-through rooms that take patrons inside the homes of people with depression, and exercises that inspire worry or fear, as well as photography. The aim is to take the patron inside the heads of those with mental illnesses. “A possibility now exists to utilize a constellation of exhibits like Mind Matters to revolutionize understanding, prevention, and wellness nationally, all while unlocking economic benefits and advancing human dignity,” wrote Paul Piwko, the author of an article describing the exhibit. Des Moines Register.
Students are creating a dialogue about suicide awareness and prevention at Gardner (Kansas) Edgerton High School. At a recent basketball game with Shawnee Mission West High School, Gardner Edgerton team members, students, cheerleaders, and fans donned T-shirts emblazoned with “#ZeroReasonsWhy.” The student-led campaign is aimed at encouraging students to seek help rather than consider suicide. At the game, T-shirts and bracelets also were handed out to Shawnee Mission West players in an effort to spread the message. The Kansas City Star.
Researchers characterize novel subtype of endocervical adenocarcinoma
, including reduced survival and resistance to therapy, according to a retrospective histopathological study.
“[Gastric-type mucinous carcinoma] constitutes a unique tumor type with distinct etiologic, morphologic, and clinical features that set it apart from other mucinous carcinomas,” Shin Nishio, MD, PhD, of Kurume (Japan) University and his colleagues wrote in Gynecologic Oncology.
The researchers retrospectively analyzed 393 women with stage I or II endocervical adenocarcinoma who received surgical treatment without concomitant chemotherapy. Sample slides were collected from of all patients with endocervical adenocarcinoma and were compared for variations in clinicopathological features between disease subtypes.
Dr. Nishio and his colleagues performed histopathological analysis on both usual-type endocervical adenocarcinoma and gastric-type mucinous carcinoma.
“The outcomes in patients with each type of disease were statistically compared,” they wrote.
Multivariable analysis showed that, compared with usual-type endocervical adenocarcinoma, gastric-type mucinous carcinoma was associated with worse clinical outcomes, including more aggressive tumor behavior, resistance to radio- and chemotherapy, and reduced progression-free and overall survival.
“Our study clearly shows that recurrence was more common among patients with GAS [gastric-type endocervical adenocarcinoma],” they added.
The authors acknowledged that further research is needed to fully understand the molecular mechanisms of various forms of endocervical adenocarcinoma.
“The profiles of the genomic signatures of unusual cervical cancers are still limited, and definitive treatment guidelines for such cancers remain to be established,” they concluded.
The study was funded by the National Cancer Center Research and Development Fund of Japan. The authors reported no conflicts of interest.
SOURCE: Nishio S et al. Gynecol Oncol. 2019 Jan 29. doi: 10.1016/j.ygyno.2019.01.022.
, including reduced survival and resistance to therapy, according to a retrospective histopathological study.
“[Gastric-type mucinous carcinoma] constitutes a unique tumor type with distinct etiologic, morphologic, and clinical features that set it apart from other mucinous carcinomas,” Shin Nishio, MD, PhD, of Kurume (Japan) University and his colleagues wrote in Gynecologic Oncology.
The researchers retrospectively analyzed 393 women with stage I or II endocervical adenocarcinoma who received surgical treatment without concomitant chemotherapy. Sample slides were collected from of all patients with endocervical adenocarcinoma and were compared for variations in clinicopathological features between disease subtypes.
Dr. Nishio and his colleagues performed histopathological analysis on both usual-type endocervical adenocarcinoma and gastric-type mucinous carcinoma.
“The outcomes in patients with each type of disease were statistically compared,” they wrote.
Multivariable analysis showed that, compared with usual-type endocervical adenocarcinoma, gastric-type mucinous carcinoma was associated with worse clinical outcomes, including more aggressive tumor behavior, resistance to radio- and chemotherapy, and reduced progression-free and overall survival.
“Our study clearly shows that recurrence was more common among patients with GAS [gastric-type endocervical adenocarcinoma],” they added.
The authors acknowledged that further research is needed to fully understand the molecular mechanisms of various forms of endocervical adenocarcinoma.
“The profiles of the genomic signatures of unusual cervical cancers are still limited, and definitive treatment guidelines for such cancers remain to be established,” they concluded.
The study was funded by the National Cancer Center Research and Development Fund of Japan. The authors reported no conflicts of interest.
SOURCE: Nishio S et al. Gynecol Oncol. 2019 Jan 29. doi: 10.1016/j.ygyno.2019.01.022.
, including reduced survival and resistance to therapy, according to a retrospective histopathological study.
“[Gastric-type mucinous carcinoma] constitutes a unique tumor type with distinct etiologic, morphologic, and clinical features that set it apart from other mucinous carcinomas,” Shin Nishio, MD, PhD, of Kurume (Japan) University and his colleagues wrote in Gynecologic Oncology.
The researchers retrospectively analyzed 393 women with stage I or II endocervical adenocarcinoma who received surgical treatment without concomitant chemotherapy. Sample slides were collected from of all patients with endocervical adenocarcinoma and were compared for variations in clinicopathological features between disease subtypes.
Dr. Nishio and his colleagues performed histopathological analysis on both usual-type endocervical adenocarcinoma and gastric-type mucinous carcinoma.
“The outcomes in patients with each type of disease were statistically compared,” they wrote.
Multivariable analysis showed that, compared with usual-type endocervical adenocarcinoma, gastric-type mucinous carcinoma was associated with worse clinical outcomes, including more aggressive tumor behavior, resistance to radio- and chemotherapy, and reduced progression-free and overall survival.
“Our study clearly shows that recurrence was more common among patients with GAS [gastric-type endocervical adenocarcinoma],” they added.
The authors acknowledged that further research is needed to fully understand the molecular mechanisms of various forms of endocervical adenocarcinoma.
“The profiles of the genomic signatures of unusual cervical cancers are still limited, and definitive treatment guidelines for such cancers remain to be established,” they concluded.
The study was funded by the National Cancer Center Research and Development Fund of Japan. The authors reported no conflicts of interest.
SOURCE: Nishio S et al. Gynecol Oncol. 2019 Jan 29. doi: 10.1016/j.ygyno.2019.01.022.
FROM GYNECOLOGIC ONCOLOGY
March 2019 - Question 2
Correct Answer: E
Rationale
This patient has slow-transit constipation without concomitant defecatory disorder, which is unresponsive to newer pharmacologic agents. According to the recently published AGA medical position paper on constipation, the next step in this patient's evaluation should be to repeat colon transit testing on medications. If abnormal, the next step would be evaluation for possible upper GI motility disorder including a gastric-emptying scan. There is no role for repeat anorectal manometry, balloon expulsion testing, or a trial of biofeedback therapy in this patient.
References
1. Wald A, Bharucha AE, Cosman BC, Whitehead WE. ACG clinical guideline: management of benign anorectal disorders. Am J Gastroenterol. 2014;109(8):1141-57.
2. Bharucha AE, Pemberton JH, Locke GR 3rd. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013;144:218.
ginews@gastro.org
Correct Answer: E
Rationale
This patient has slow-transit constipation without concomitant defecatory disorder, which is unresponsive to newer pharmacologic agents. According to the recently published AGA medical position paper on constipation, the next step in this patient's evaluation should be to repeat colon transit testing on medications. If abnormal, the next step would be evaluation for possible upper GI motility disorder including a gastric-emptying scan. There is no role for repeat anorectal manometry, balloon expulsion testing, or a trial of biofeedback therapy in this patient.
References
1. Wald A, Bharucha AE, Cosman BC, Whitehead WE. ACG clinical guideline: management of benign anorectal disorders. Am J Gastroenterol. 2014;109(8):1141-57.
2. Bharucha AE, Pemberton JH, Locke GR 3rd. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013;144:218.
ginews@gastro.org
Correct Answer: E
Rationale
This patient has slow-transit constipation without concomitant defecatory disorder, which is unresponsive to newer pharmacologic agents. According to the recently published AGA medical position paper on constipation, the next step in this patient's evaluation should be to repeat colon transit testing on medications. If abnormal, the next step would be evaluation for possible upper GI motility disorder including a gastric-emptying scan. There is no role for repeat anorectal manometry, balloon expulsion testing, or a trial of biofeedback therapy in this patient.
References
1. Wald A, Bharucha AE, Cosman BC, Whitehead WE. ACG clinical guideline: management of benign anorectal disorders. Am J Gastroenterol. 2014;109(8):1141-57.
2. Bharucha AE, Pemberton JH, Locke GR 3rd. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013;144:218.
ginews@gastro.org
A 66-year-old woman presents for an evaluation of a 3-year history of constipation. She reports some mild abdominal pain, which is related to constipation. She denies GI bleeding and any relevant family history of colorectal neoplasia or IBD. A previous trial of fiber and polyethylene glycol was unsuccessful. Physical examination is normal, including the rectal examination. Evaluation including routine blood work and thyroid evaluation is normal. Her last colonoscopy was 1 year ago and was normal. She undergoes anorectal manometry, balloon expulsion testing and defecography, which do not reveal any significant abnormalities. Sitz marker test reveals 14 markers remaining in the colon on day 5. She is started on intestinal secretagogue therapy with no significant improvement in symptoms.
What is the next best step in the evaluation of this patient?
March 2019 - Question 1
Correct Answer: B
Rationale
The ultrasound finding of a hyperechoic protrusion is suggestive of a gallbladder polyp. These polyps can have malignant potential and should be monitored or referred for surgical management depending on their size. There is consensus that polyps larger than 10 mm should be referred for cholecystectomy. There is some debate about whether polyps greater than 6 mm should also be referred for surgery or whether they can be surveyed. For gallbladder polyps less than 6 mm, surveillance with ultrasound in 6-12 months is the recommended surveillance strategy.
Reference
1. Gallahan WC, Conway JD. Diagnosis and management of gallbladder polyps. Gastroenterol Clin North Am. 2010;39(2):359-67.
Correct Answer: B
Rationale
The ultrasound finding of a hyperechoic protrusion is suggestive of a gallbladder polyp. These polyps can have malignant potential and should be monitored or referred for surgical management depending on their size. There is consensus that polyps larger than 10 mm should be referred for cholecystectomy. There is some debate about whether polyps greater than 6 mm should also be referred for surgery or whether they can be surveyed. For gallbladder polyps less than 6 mm, surveillance with ultrasound in 6-12 months is the recommended surveillance strategy.
Reference
1. Gallahan WC, Conway JD. Diagnosis and management of gallbladder polyps. Gastroenterol Clin North Am. 2010;39(2):359-67.
Correct Answer: B
Rationale
The ultrasound finding of a hyperechoic protrusion is suggestive of a gallbladder polyp. These polyps can have malignant potential and should be monitored or referred for surgical management depending on their size. There is consensus that polyps larger than 10 mm should be referred for cholecystectomy. There is some debate about whether polyps greater than 6 mm should also be referred for surgery or whether they can be surveyed. For gallbladder polyps less than 6 mm, surveillance with ultrasound in 6-12 months is the recommended surveillance strategy.
Reference
1. Gallahan WC, Conway JD. Diagnosis and management of gallbladder polyps. Gastroenterol Clin North Am. 2010;39(2):359-67.
A 63-year-old woman undergoes a right upper quadrant ultrasound for intermittent epigastric pain. A 5-mm fixed hyperechoic protrusion in the gallbladder is identified, but there are no gallstones or wall thickening. Upper endoscopy shows moderate gastritis. Biopsies reveal active H. pylori gastritis. She is treated with triple therapy and reports complete resolution of her symptoms.
What is the best next step in management?
Cancer-battling breath, Zombie Bambi, and hops as health food
Does my breath smell like reduced cancer risk?
Cancer prevention just got a whole lot more ... fragrant. Allium vegetables – garlic, onions, leeks, chives, and shallots – have been found to decrease the risk of colorectal cancer (CRC), according to a Chinese study published last year. Very good news for Italians, but it looks like the risk of CRC in the vampire population might continue to rise.
The study authors reported that high allium intake correlated with lower CRC risk in both men and women, in the northeast Chinese population sampled. Bioactive compounds in these vegetables have anticarcinogenic properties, and researchers found that eating at least 35 pounds of allium vegetables per year could reduce cancer risk.
Unclear if this study was secretly funded by Big Onion, but as fans of delicious and anticancer flavor, we here at LOTME support these findings. However, we strongly advise against going the Tony Abbott route of chomping into whole onions.
An IPA a day keeps the doctor away
After you’re finished eating your annual 35 pounds of garlic and onions (sure, do it all in 1 day if you want), you might be a little thirsty. And we’ve got good news for you – have a brewski, it’s good for ya! Turns out, hops might have some health benefits, so drink up.
Hops contain a class of compound called isohumulones, which gives them that bitter taste. There have been multiple studies showing the metabolic effects of isohumulones, including cell inflammation suppression, reduced weight gain, reduced hyperglycemia, and increased glucose tolerance.
These isohumulones (try typing that 10 times in a row) interact with the bitter taste receptors in the gut, and researchers are hopeful that this could lead to isohumulone-esque drugs to treat metabolic disorders. In the meantime, maybe just chug a few IPAs a day.
My kingdom for a helmet
Most people like to root for the underdog. You know, the whole David vs. Goliath thing, the little guy who goes against overwhelming odds to take on some form of the Big Establishment.
But what if the little guy happens to be a fairly normal-sized lacrosse player with a very large head?
Alex Chu, a freshman at Division III Wheaton College in Norton, Mass., is just such a guy. “My head is wide,” he told WJAR TV. He wants to play goalie for the school’s lacrosse team, but he can’t because no current helmet will fit on the 25-inch-circumference head that sits atop his 6-foot-tall, 265-pound body.
He’s up against Big Sports Equipment in the form of Cascade-Maverik and Warrior, the two major manufacturers of lacrosse helmets, which won’t build him a custom helmet. It would be too expensive, they say – but the Boston Globe reported that there is a lacrosse player at a Division I school who wears a very large helmet “that was produced after [his] coaches and Cascade ‘huddled up.’ ”
We wish Mr. Chu well, and perhaps one day he will be mentioned with such large-skulled high achievers as Jay Leno, LeBron James, Jennifer Garner, Tyrannosaurus rex, Rihanna, Napoleon Bonaparte, SpongeBob SquarePants, and Simon Cowell.
We’ll just have the salad
Zombies, beware: You might want to eat us, but now, we can eat you.
Okay, “zombie” deer aren’t actually zombies, but they are infected with something almost as terrifying. Chronic wasting disease is a prion disorder similar to bovine spongiform encephalopathy, or mad cow disease, and has been found in deer across 24 U.S. states as of January 2019.
While venison is less commonly eaten than beef, if mad cow disease can make the jump to humans, can people who eat meat infected with chronic wasting disease also become infected?
Thanks to an Oneida County, N.Y., fire company and a 2005 Sportsmen’s feast we’re sure someone’s never heard the end of, we know the answer to be “no.”
The fire company accidentally served meat from a deer that was infected with chronic wasting disease, and more than 200 people were exposed. A group of about 80 of these individuals have been monitored since then by a research team from the Oneida County Health Department and the State University of New York at Binghamton. At the most recent follow-up, no individual had developed the disease.
Experts do caution that it’s entirely possible chronic wasting disease will make the jump to humans eventually, despite the species gap. But for now, you can enjoy without fear your sweet ironic revenge on those zombies.
Does my breath smell like reduced cancer risk?
Cancer prevention just got a whole lot more ... fragrant. Allium vegetables – garlic, onions, leeks, chives, and shallots – have been found to decrease the risk of colorectal cancer (CRC), according to a Chinese study published last year. Very good news for Italians, but it looks like the risk of CRC in the vampire population might continue to rise.
The study authors reported that high allium intake correlated with lower CRC risk in both men and women, in the northeast Chinese population sampled. Bioactive compounds in these vegetables have anticarcinogenic properties, and researchers found that eating at least 35 pounds of allium vegetables per year could reduce cancer risk.
Unclear if this study was secretly funded by Big Onion, but as fans of delicious and anticancer flavor, we here at LOTME support these findings. However, we strongly advise against going the Tony Abbott route of chomping into whole onions.
An IPA a day keeps the doctor away
After you’re finished eating your annual 35 pounds of garlic and onions (sure, do it all in 1 day if you want), you might be a little thirsty. And we’ve got good news for you – have a brewski, it’s good for ya! Turns out, hops might have some health benefits, so drink up.
Hops contain a class of compound called isohumulones, which gives them that bitter taste. There have been multiple studies showing the metabolic effects of isohumulones, including cell inflammation suppression, reduced weight gain, reduced hyperglycemia, and increased glucose tolerance.
These isohumulones (try typing that 10 times in a row) interact with the bitter taste receptors in the gut, and researchers are hopeful that this could lead to isohumulone-esque drugs to treat metabolic disorders. In the meantime, maybe just chug a few IPAs a day.
My kingdom for a helmet
Most people like to root for the underdog. You know, the whole David vs. Goliath thing, the little guy who goes against overwhelming odds to take on some form of the Big Establishment.
But what if the little guy happens to be a fairly normal-sized lacrosse player with a very large head?
Alex Chu, a freshman at Division III Wheaton College in Norton, Mass., is just such a guy. “My head is wide,” he told WJAR TV. He wants to play goalie for the school’s lacrosse team, but he can’t because no current helmet will fit on the 25-inch-circumference head that sits atop his 6-foot-tall, 265-pound body.
He’s up against Big Sports Equipment in the form of Cascade-Maverik and Warrior, the two major manufacturers of lacrosse helmets, which won’t build him a custom helmet. It would be too expensive, they say – but the Boston Globe reported that there is a lacrosse player at a Division I school who wears a very large helmet “that was produced after [his] coaches and Cascade ‘huddled up.’ ”
We wish Mr. Chu well, and perhaps one day he will be mentioned with such large-skulled high achievers as Jay Leno, LeBron James, Jennifer Garner, Tyrannosaurus rex, Rihanna, Napoleon Bonaparte, SpongeBob SquarePants, and Simon Cowell.
We’ll just have the salad
Zombies, beware: You might want to eat us, but now, we can eat you.
Okay, “zombie” deer aren’t actually zombies, but they are infected with something almost as terrifying. Chronic wasting disease is a prion disorder similar to bovine spongiform encephalopathy, or mad cow disease, and has been found in deer across 24 U.S. states as of January 2019.
While venison is less commonly eaten than beef, if mad cow disease can make the jump to humans, can people who eat meat infected with chronic wasting disease also become infected?
Thanks to an Oneida County, N.Y., fire company and a 2005 Sportsmen’s feast we’re sure someone’s never heard the end of, we know the answer to be “no.”
The fire company accidentally served meat from a deer that was infected with chronic wasting disease, and more than 200 people were exposed. A group of about 80 of these individuals have been monitored since then by a research team from the Oneida County Health Department and the State University of New York at Binghamton. At the most recent follow-up, no individual had developed the disease.
Experts do caution that it’s entirely possible chronic wasting disease will make the jump to humans eventually, despite the species gap. But for now, you can enjoy without fear your sweet ironic revenge on those zombies.
Does my breath smell like reduced cancer risk?
Cancer prevention just got a whole lot more ... fragrant. Allium vegetables – garlic, onions, leeks, chives, and shallots – have been found to decrease the risk of colorectal cancer (CRC), according to a Chinese study published last year. Very good news for Italians, but it looks like the risk of CRC in the vampire population might continue to rise.
The study authors reported that high allium intake correlated with lower CRC risk in both men and women, in the northeast Chinese population sampled. Bioactive compounds in these vegetables have anticarcinogenic properties, and researchers found that eating at least 35 pounds of allium vegetables per year could reduce cancer risk.
Unclear if this study was secretly funded by Big Onion, but as fans of delicious and anticancer flavor, we here at LOTME support these findings. However, we strongly advise against going the Tony Abbott route of chomping into whole onions.
An IPA a day keeps the doctor away
After you’re finished eating your annual 35 pounds of garlic and onions (sure, do it all in 1 day if you want), you might be a little thirsty. And we’ve got good news for you – have a brewski, it’s good for ya! Turns out, hops might have some health benefits, so drink up.
Hops contain a class of compound called isohumulones, which gives them that bitter taste. There have been multiple studies showing the metabolic effects of isohumulones, including cell inflammation suppression, reduced weight gain, reduced hyperglycemia, and increased glucose tolerance.
These isohumulones (try typing that 10 times in a row) interact with the bitter taste receptors in the gut, and researchers are hopeful that this could lead to isohumulone-esque drugs to treat metabolic disorders. In the meantime, maybe just chug a few IPAs a day.
My kingdom for a helmet
Most people like to root for the underdog. You know, the whole David vs. Goliath thing, the little guy who goes against overwhelming odds to take on some form of the Big Establishment.
But what if the little guy happens to be a fairly normal-sized lacrosse player with a very large head?
Alex Chu, a freshman at Division III Wheaton College in Norton, Mass., is just such a guy. “My head is wide,” he told WJAR TV. He wants to play goalie for the school’s lacrosse team, but he can’t because no current helmet will fit on the 25-inch-circumference head that sits atop his 6-foot-tall, 265-pound body.
He’s up against Big Sports Equipment in the form of Cascade-Maverik and Warrior, the two major manufacturers of lacrosse helmets, which won’t build him a custom helmet. It would be too expensive, they say – but the Boston Globe reported that there is a lacrosse player at a Division I school who wears a very large helmet “that was produced after [his] coaches and Cascade ‘huddled up.’ ”
We wish Mr. Chu well, and perhaps one day he will be mentioned with such large-skulled high achievers as Jay Leno, LeBron James, Jennifer Garner, Tyrannosaurus rex, Rihanna, Napoleon Bonaparte, SpongeBob SquarePants, and Simon Cowell.
We’ll just have the salad
Zombies, beware: You might want to eat us, but now, we can eat you.
Okay, “zombie” deer aren’t actually zombies, but they are infected with something almost as terrifying. Chronic wasting disease is a prion disorder similar to bovine spongiform encephalopathy, or mad cow disease, and has been found in deer across 24 U.S. states as of January 2019.
While venison is less commonly eaten than beef, if mad cow disease can make the jump to humans, can people who eat meat infected with chronic wasting disease also become infected?
Thanks to an Oneida County, N.Y., fire company and a 2005 Sportsmen’s feast we’re sure someone’s never heard the end of, we know the answer to be “no.”
The fire company accidentally served meat from a deer that was infected with chronic wasting disease, and more than 200 people were exposed. A group of about 80 of these individuals have been monitored since then by a research team from the Oneida County Health Department and the State University of New York at Binghamton. At the most recent follow-up, no individual had developed the disease.
Experts do caution that it’s entirely possible chronic wasting disease will make the jump to humans eventually, despite the species gap. But for now, you can enjoy without fear your sweet ironic revenge on those zombies.
New BinaxNOW influenza test gets CLIA waiver
The Food and Drug Administration has granted the reformulated BinaxNOW Influenza A & B Card 2 waived status under the Clinical Laboratory Improvements Amendments for use with Abbott’s DIGIVAL reader, which means the system is relatively simple and has a low risk of erroneous results.
According to Abbott’s press release, the DIGIVAL reader (formerly known as the Alere Reader) automatically interprets this rapid influenza diagnostic test’s results in seconds and is intended to remove subjectivity from the diagnostic process. The BinaxNOW Influenza Card A & B Card 2 is a Class II assay and complies with the FDA’s new reclassification requirements for rapid influenza diagnostic tests.
The Food and Drug Administration has granted the reformulated BinaxNOW Influenza A & B Card 2 waived status under the Clinical Laboratory Improvements Amendments for use with Abbott’s DIGIVAL reader, which means the system is relatively simple and has a low risk of erroneous results.
According to Abbott’s press release, the DIGIVAL reader (formerly known as the Alere Reader) automatically interprets this rapid influenza diagnostic test’s results in seconds and is intended to remove subjectivity from the diagnostic process. The BinaxNOW Influenza Card A & B Card 2 is a Class II assay and complies with the FDA’s new reclassification requirements for rapid influenza diagnostic tests.
The Food and Drug Administration has granted the reformulated BinaxNOW Influenza A & B Card 2 waived status under the Clinical Laboratory Improvements Amendments for use with Abbott’s DIGIVAL reader, which means the system is relatively simple and has a low risk of erroneous results.
According to Abbott’s press release, the DIGIVAL reader (formerly known as the Alere Reader) automatically interprets this rapid influenza diagnostic test’s results in seconds and is intended to remove subjectivity from the diagnostic process. The BinaxNOW Influenza Card A & B Card 2 is a Class II assay and complies with the FDA’s new reclassification requirements for rapid influenza diagnostic tests.
Joseph R. Berger, MD
Introducing the Multiple Sclerosis Resource Center Editor-in-Chief, Joseph R. Berger, M.D., FACP, FAAN, FANA.
Dr. Berger is Professor of Neurology and Associate Chief of the Multiple Sclerosis Division of the Department of Neurology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. He is a fellow of the American College of Physicians, American Academy of Neurology and the American Neurological Association. He has published more than 240 refereed papers, more than 100 chapters, and has co-edited three textbooks. Dr. Berger co-founded and chaired the first international conference on the neurological complications of HIV, the Neuroscience of HIV meeting. He also established the Commonwealth Neurological Society for neurologists in the state of Kentucky. Dr. Berger has a longstanding interest in international health and was one of the founding members of People-to-People, an organization for HIV/AIDS care and education in East Africa.
Introducing the Multiple Sclerosis Resource Center Editor-in-Chief, Joseph R. Berger, M.D., FACP, FAAN, FANA.
Dr. Berger is Professor of Neurology and Associate Chief of the Multiple Sclerosis Division of the Department of Neurology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. He is a fellow of the American College of Physicians, American Academy of Neurology and the American Neurological Association. He has published more than 240 refereed papers, more than 100 chapters, and has co-edited three textbooks. Dr. Berger co-founded and chaired the first international conference on the neurological complications of HIV, the Neuroscience of HIV meeting. He also established the Commonwealth Neurological Society for neurologists in the state of Kentucky. Dr. Berger has a longstanding interest in international health and was one of the founding members of People-to-People, an organization for HIV/AIDS care and education in East Africa.
Introducing the Multiple Sclerosis Resource Center Editor-in-Chief, Joseph R. Berger, M.D., FACP, FAAN, FANA.
Dr. Berger is Professor of Neurology and Associate Chief of the Multiple Sclerosis Division of the Department of Neurology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. He is a fellow of the American College of Physicians, American Academy of Neurology and the American Neurological Association. He has published more than 240 refereed papers, more than 100 chapters, and has co-edited three textbooks. Dr. Berger co-founded and chaired the first international conference on the neurological complications of HIV, the Neuroscience of HIV meeting. He also established the Commonwealth Neurological Society for neurologists in the state of Kentucky. Dr. Berger has a longstanding interest in international health and was one of the founding members of People-to-People, an organization for HIV/AIDS care and education in East Africa.