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PubMed2002

US graduate medical education, 2001-2002: changing dynamics.

The National Graduate Medical Education (GME) Census, jointly administered by the American Medical Association and the Association of American Medical Colleges, completed its second year as an online survey of all GME programs accredited by the Accreditation Council for Graduate Medical Education as well as combined specialty programs approved by their corresponding medical specialty boards. Continuing trends include the growing number of subspecialty programs, which increased by 65 since last year to 3822, and a smaller number of specialty programs, which decreased by 25 to 4203. There were corresponding shifts in the number of residents training in them. The number of graduates from osteopathic medical schools in allopathic GME has increased from 3288 in 1996-1997 to 4658 in 2001-2002, an increase of 42%. Overall, the total number of residents in GME has declined slightly, to an estimated 96 410 this year. The number of residents in graduate year 1 (GY1) positions (entry positions in GME, for which prior training is not required) has also decreased, although the proportion of residents in GY1 positions who have not had prior GME has increased. The number of international medical graduates (IMGs) in GY1 positions has decreased from a high of 6727 in 1999-2000 to 5898 in 2001-2002, a decrease of 12.3%. However, the number who have entered GME immediately on graduation has grown from 310 in 1996-1997 to 936 in 2001-2002. Most of these IMGs were citizens or permanent residents of the United States and attended medical schools in the Caribbean. New race and ethnicity questions, which parallel those of the US Census, continue to reveal disparities in the racial/ethnic distribution of the training physician population relative to the US population. Despite continued interest in resident work hours, there was no decrease in reported hours worked between 2000-2001 and 2001-2002. Physicians training in surgical specialties are reported to work the most hours per week, while internal medicine and pediatrics allow for the most consecutive time on duty, at 30 hours or more. Specialties and subspecialties with limited on-call schedules, such as forensic psychiatry and pediatric pathology, have, on average, the lowest number of duty hours.

Curriculum↗
PubMed2005

Comparison of yield and genotyping performance of multiple displacement amplification and OmniPlex whole genome amplified DNA generated from multiple DNA sources.

The promise of whole genome amplification (WGA) is that genomic DNA (gDNA) quantity will not limit molecular genetic analyses. Multiple displacement amplification (MDA) and the OmniPlex PCR-based WGA protocols were evaluated using 4 and 5 ng of input gDNA from 60 gDNA samples from three tissue sources (mouthwash, buffy coat, and lymphoblast). WGA DNA (wgaDNA) yield and genotyping performance were evaluated using genotypes determined from gDNA and wgaDNA using the AmpFlSTR Identifiler assay and N = 49 TaqMan SNP assays. Short tandem repeat (STR) and SNP genotyping completion and concordance rates were significantly reduced with wgaDNA from all WGA methods compared with gDNA. OmniPlex wgaDNA exhibited a greater reduction in genotyping performance than MDA wgaDNA. Reduced wgaDNA genotyping performance was due to allelic (all protocols) and locus (OmniPlex) amplification bias leading to heterozygote and locus dropout, respectively, and %GC sequence content (%GC) was significantly correlated with TaqMan assay performance. Lymphoblast wgaDNA exhibited higher yield (OmniPlex), buffy coat wgaDNA exhibited higher STR genotyping completion (MDA), whereas mouthwash wgaDNA exhibited higher SNP genotyping discordance (MDA). Genotyping of wgaDNA generated from < or = 5 ng gDNA, e.g., from archaeological, forensic, prenatal diagnostic, or pathology samples, may require additional genotyping validation with gDNA and/or more sophisticated analysis of genotypes incorporating observed reductions in genotyping performance.

Adult↗
PubMed1990

Foot length growth related to crown-rump length, gestational age and weight in human staged fresh fetuses. An index for anatomical and medical use.

Several anatomical parameters are useful in the assessment of gestational age. This work studies the foot length growth analysed against age, crown-rump length (C-R) and body weight (W) in eighty human fresh fetuses (staging from 14 to 38 weeks post-conception). These data were correlated with the following statistical methods: simple regression, power formula (allometric method), exponential and reciprocal models. The foot length growth presents very high and statistically significant coefficients of correlations with fetal parameters (P less than 0.001); the allometric method was the best method for this analysis. Foot length grows with moderate (against the age and C-R) or slight (against the W) positive allometry. This study presents statistically significant curves of the foot length growth in relation to fetal parameters. These curves are useful in anatomy, forensic medicine, feto-pathology, medical imaging, obstetrics and pediatrics.

Body Height↗
PubMed1984

Identification of mechanical asphyxiation in cases of attempted masking of the homicide.

Five homicides are described that had remained unexplained as to the causes of death after gross pathology. Although general signs of asphyxiation were present, they were lacking injuries specific of strangulation or oro-nasal occlusion. The diagnoses of asphyxiation were established by microscopical investigation of the lung and confirmed by subsequent police inquiries. An oro-nasal occlusion was involved in three cases, a strangulation or an oro-nasal occlusion, in another case. The victims were young and healthy. Toxicological investigations remained negative in four cases; one victim was anaesthetized by bromazepam and ether and had a blood alcohol concentration of 80 mg/100 ml. Lung histology and electron microscopy revealed acute emphysema, the development of a haemorrhagic-dysoric syndrome and a microembolism syndrome. With regard to the haemorrhagic-dysoric syndrome, the development of alveolar-interstitial edema is particularly important. This finding may also be diagnosed by light microscopy in semi-thin sections. It is emphasized that the combined action of several pathomechanisms is responsible for the rapid manifestation of the pulmonary lesions. Especially, the haemorrhagic-dysoric syndrome is brought about by the combined action of inspiratory intrapulmonary vacuum and raised intracapillary pressure. The complex pattern allows to compile the diagnosis of mechanical asphyxia even if there is no corresponding injury.

Adolescent↗
PubMed1987

1H-NMR of human saliva. An application of NMR spectroscopy in forensic science.

1H-NMR was applied to the study of metabolites in human saliva specimens. Acetate, lactate, ethanol, glucose and some other substances were simultaneously identified and quantitated from the 1H-NMR spectra of saliva specimens treated with D2O. These experiments demonstrated the value of 1H-NMR as an analytical method in the field of forensic science and clinical pathology and toxicology.

Acetates↗
PubMed1998

Morphological changes in traumatized skeletal muscle: the appearance of 'opaque fibers' of cervical muscles as evidence of compression of the neck.

Cervical muscles of 15 cases of compression of the neck and the other traumatized skeletal muscles from 54 autopsy cases were examined histologically and immunohistochemically. Round and thick fibers, that is, opaque fibers were observed in the muscles beneath the compression marks on the neck, whereas in areas where no force had been applied, such fibers did not exist. Furthermore, opaque changes appeared around cavities, which formed within severely compressed injured muscle tissue. The pattern of appearance of opaque fibers in the cases of compression of the neck were mainly divided into two types, 'diffuse' pattern and 'focal' pattern. In both blunt and sharp force injuries, the production of opaque fibers were common in the area directly where damage had been inflicted. In stab wounds especially, the appearance of opaque fibers and wavelike fibers, which fanned out and showed a different color from the other areas, was limited to the marginal zone. These results suggest that there is a close relationship between opaque changes and force. Opaque fibers are probably produced by damage to muscles due to extremely applied force. The high incidence of opaque fibers beneath compression marks on the neck should be regarded as a useful indication of strangulation and/or hanging. Furthermore, the distribution and direction of force to the neck might be presumed by the pattern of opaque fibers in cervical muscles, to a certain extent.

Adolescent↗
PubMed1985

[Programming of pacemakers: a gain or a passtime?].

Seventy-seven programmable pacemakers, selected at random from a reservoir of 1051 explanted pacemakers, made available by health-offices, institutes of pathology and institutes of forensic medicine, were examined for alterations made since the time of delivery. The results motivated our choice of title. In 41 of 74 (55.4%) no parameter was changed and in 36.5% the frequency was altered. Of the two- or multi-programmable pacemakers, the amplitude was altered in 13 of 61 (21.3%), the pulse duration in 9 out of 38 (23.7%), the sensitivity in 10 out of 32 (31.3%), hysteresis in one out of 31 (3.2%) and the refractory time in none of 30. None of the 10 pacemakers with programmable operation mode were reprogrammed although they included a DDD that was delivered, however, in the VVI state. Nine of 69 pacemakers (13%) were double- and 2 of 33 (6%) triple-programmed. The two physiological parameters (frequency and hysteresis) were clearly not utilised to the extent that would be desirable. All other programmable parameters serve exclusively for the technical adjustment to the heart.

Humans↗
PubMed1970

Forensic sciences.

Explore the source record for details and available documents.

Education, Medical↗
PubMed1990

Homicide by electrocution.

Two cases of homicidal electrocutions are reported. A woman and her young son were killed in 1980 by her ex-husband. The criminal used electrical force as a method of killing. He wound flexible conducting wires around the limbs of the victims and switched on the current. He deliberately deceived his ex-wife by telling her that the circuits were incomplete and hence harmless. Thus, he persuaded her to be part of the circuits, so that a bulb could be lit when placed on her bare skin. The circumstances associated with these cases are given and the scene of the crime is described. Some important pathological aspects of electrical injuries are reviewed. The significance of pathological findings in the forensic investigations of electrocution is discussed.

Adult↗
PubMed1999

Seroprevalence of IgG antibodies to Helicobacter pylori among gastrointestinal endoscopists, radiologists and paramedical personnel.

BACKGROUND: The route of transmission of Helicobacter pylori is unknown. Since the organism has been isolated from saliva, gastric juice and stool, medical personnel could be at high risk for acquiring the infection during procedures like gastrointestinal endoscopy. AIMS: To study whether endoscopy is a professional hazard for acquisition of H. pylori. METHODS: We studied the prevalence of IgG antibodies to H. pylori in endoscopists (n = 17), radiologists (n = 17) and personnel from paraclinical branches (n = 35); microbiology (n = 21), pathology (n = 7) and forensic medicine (n = 7); among the paraclinical personnel five were at high risk because they worked with cultures of H. pylori. Subjects answered a questionnaire regarding upper gastrointestinal symptoms, and precautions taken at the work place against infection. The serum was tested for IgG antibodies to H. pylori using a microwell ELISA and a rapid card test. RESULTS: H. pylori antibodies were present in five (29.4%) endoscopists, three (17.6%) radiologists and seven (20%) paraclinical personnel; only one of the 5 high risk para medical personnel was positive. There was no correlation between the duration of performing endoscopies and the H. pylori IgG status. CONCLUSION: Endoscopy is not a risk factor for acquiring H. pylori infection.

Adult↗
PubMed2000

Forensic biology: its past, present and future.

Forensic biology has reached an unprecedented prominence with the advent of DNA profiling, which allows the biologist to use microscopic evidence to match a person to a scene of crime. But there's a lot more in the forensic biologist's arsenal. Here we take a brief look at the who, when and how (and a little of the where to) of forensic biology.

Anthropometry↗
PubMed2003

Anal findings in sexual abuse of children (a descriptive study).

The aim of this study was to assess anal physical findings in children whose abuse was admitted by the perpetrator. Fifty children were studied in whom medical assessment took place remote in time from anal abuse which was admitted by the perpetrator. Medical assessment included examination to detect the presence of anal physical signs. Most frequent signs were anal scars and tags (either single or multiple) present, respectively, in 84 and 32% of cases. In some cases scars extended to the perianal region. Other signs included reflex anal dilatation (RAD) and venous congestion (VC) found, separately or associated with other signs, in over 33% of the cases. In 6% of the cases there were no abnormal anal findings. The results confirm earlier reports that physical signs, including scars, tags, RAD, funneled anus and extensive venous congestion, are often present in abused children, singly or in combination, and that anal examination should be undertaken even months after a known or suspected sexual assault. In the legal setting these physical signs are seen in association with anal abuse and support the child's statement. They do not per se provide proof of abuse.

Adolescent↗