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Article ; Online: The 3rd year Radiology Medical Student Clerkship Objective Structured Clinical Examination (OSCE)

Jeffrey Brooks / Christina Lebedis / Kitt Shaffer / Stephanie Coleman

MedEdPORTAL, Vol

2014 Volume 10

Abstract: Abstract Introduction These objective structured clinical examination (OSCE) cases were developed because we were unhappy with the current state of traditional radiology clerkship multiple-choice exams. The goal was to be able to use a more objective ... ...

Abstract	Abstract Introduction These objective structured clinical examination (OSCE) cases were developed because we were unhappy with the current state of traditional radiology clerkship multiple-choice exams. The goal was to be able to use a more objective measure for evaluation of students on the radiology rotation. One of the critical educational objectives is for students in the radiology clerkship to become more familiar with radiology reports. As most students will not become radiologists, this experience will allow future ease of incorporating information from radiology reports into their patient's care. These cases have been developed with joint involvement of multiple members of the radiology faculty including the current clerkship coordinator, as well as the vice chair of education in radiology who has over 25 years of experience in medical student and resident education. Methods These nine OSCE cases each involve a short clinical scenario and a radiologic exam with an associated grading sheet. Each OSCE case has five open-ended questions designed to simulate a radiologic report. Each case also has a specific checklist for which points can be assigned to each correct answer. Each case attempts to assess whether students can understand straightforward radiology cases and essentially answer questions analogous to the different sections of the radiology report, including pertinent history, positive and negative findings, differential diagnosis, and recommendations. Results These OSCE cases have been used at the Boston University School of Medicine for research purposes and will now be part of the formal evaluation system Discussion These cases improved medical student evaluation in the radiology clerkship so that we could rely less on multiple-choice exams. These OSCE cases not only allowed us to test basic radiologic knowledge, but allowed us to give more specific formative feedback for students. This is important because the radiology clerkship tends to be more of a combination of didactic lectures and an ...
Keywords	OSCE ; Assessment ; Clinical Clerkship ; Radiology ; Medical Student ; Exam ; Medicine (General) ; R5-920 ; Education ; L
Subject code	370
Language	English
Publishing date	2014-02-01T00:00:00Z
Publisher	Association of American Medical Colleges
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Investigating the Range of Symptom Endorsement at Initiation of a Graduated Return-to-Play Protocol After Concussion and Duration of the Protocol: A Study From the National Collegiate Athletic Association-Department of Defense Concussion, Assessment, Research, and Education (CARE) Consortium.

Brett, Benjamin L / Breedlove, Katherine / McAllister, Thomas W / Broglio, Steven P / McCrea, Michael A / Hoy, April Marie Reed / Hazzard, Joseph B / Kelly, Louise A / Port, Nicholas / Putukian, Margot / Pasquina, Paul / Jackson, Jonathan / McGinty, Gerald / O'Donnell, Patrick / Cameron, Kenneth L / Houston, Megan N / Giza, Christopher / Benjamin, Holly J / Buckley, Thomas /

Clugston, James R / Schmidt, Julianne D / Feigenbaum, Luis A / Mihalik, Jason P / Guskiewicz, Kevin / Anderson, Scott / Master, Christina L / Collins, Michael W / Kontos, Anthony P / Chrisman, Sara P D / Brooks, M Alison / Rowson, Steven / Miles, Christopher M / Susmarski, Adam

The American journal of sports medicine

2020 Volume 48, Issue 6, Page(s) 1476–1484

Abstract: ... Concussion Assessment Tool-3rd Edition. Nonparametric comparisons were used to examine the effect of medical ... influence symptom severity scores at the commencement of the GRTP protocol. (3) Greater symptom severity ... initiated were as follows: 0 to 5 (n = 1378; 90.0%), 6 to 10 (n = 76; 5.0%), 11 to 20 (n = 42; 3.0%), and ...

Abstract	Background: Organizations recommend that athletes should be asymptomatic or symptom-limited before initiating a graduated return-to-play (GRTP) protocol after sports-related concussion, although asymptomatic or symptom-limited is not well-defined. Hypotheses: (1) There will be a range (ie, beyond zero as indicator of "symptom-free") in symptom severity endorsement when athletes are deemed ready to initiate a GRTP protocol. (2) Baseline symptom severity scores and demographic/preinjury medical history factors influence symptom severity scores at the commencement of the GRTP protocol. (3) Greater symptom severity scores at GRTP protocol initiation will result in longer protocol duration. (4) Symptom severity scores will not differ between those who did and did not sustain a repeat injury within 90 days of their initial injury. Study design: Cohort study; Level of evidence, 2. Methods: Across 30 universities, athletes (N = 1531) completed assessments at baseline and before beginning the GRTP protocol, as determined by local medical staff. Symptom severity scores were recorded with the symptom checklist of the Sport Concussion Assessment Tool-3rd Edition. Nonparametric comparisons were used to examine the effect of medical, demographic, and injury factors on symptom endorsement at GRTP protocol initiation, as well as differences in symptom severity scores between those who did and did not sustain a repeat injury within 90 days. A Cox regression was used to examine the association between symptom severity scores at GRTP protocol initiation and protocol duration. Results: Symptom severity scores at the time when the GRTP protocol was initiated were as follows: 0 to 5 (n = 1378; 90.0%), 6 to 10 (n = 76; 5.0%), 11 to 20 (n = 42; 3.0%), and ≥21 (n = 35; 2.0%). Demographic (sex and age), medical (psychiatric disorders, attention-deficit/hyperactivity disorder, learning disorder), and other factors (baseline symptom endorsement and sleep) were significantly associated with higher symptom severity scores at the GRTP initiation ( Conclusion: A range of symptom severity endorsement was observed at GRTP protocol initiation, with higher endorsement among those with higher baseline symptom endorsement and select demographic and medical history factors. Findings suggest that initiation of a GRTP protocol before an absolute absence of all symptoms is not associated with longer progression of the GRTP protocol, although symptom severity scores >10 were associated with longer duration of a GRTP protocol. Results can be utilized to guide clinicians toward optimal GRTP initiation (ie, balancing active recovery with avoidance of premature return to activity).
MeSH term(s)	Athletes/psychology ; Athletic Injuries/diagnosis ; Athletic Injuries/psychology ; Athletic Injuries/rehabilitation ; Brain Concussion/diagnosis ; Brain Concussion/psychology ; Brain Concussion/rehabilitation ; Cohort Studies ; Humans ; Neuropsychological Tests ; Post-Concussion Syndrome/psychology ; Quality of Life ; Return to Sport ; Sports ; Universities
Language	English
Publishing date	2020-04-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/0363546520913252
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Article: Sustained effects of high participation in an early intervention for low-birth-weight premature infants.

Hill, Jennifer L / Brooks-Gunn, Jeanne / Waldfogel, Jane

Developmental psychology

2002 Volume 39, Issue 4, Page(s) 730–744

Abstract: ... in the treatment group were offered high-quality center-based care in their 2nd and 3rd years of life (full ...

Abstract	Effects of high participation in the Infant Health and Development Program (IHDP), an 8-site randomized trial that targeted low-birth-weight (LBW) premature infants (N=1,082), were estimated. Children in the treatment group were offered high-quality center-based care in their 2nd and 3rd years of life (full-day care, 50 weeks per year). High-dosage effects were estimated with a new methodology that found a matched comparison group within the follow-up group for those with high participation rates; these estimates were compared with traditional intention-to-treat (ITT) estimates. At age 8, effects on the Wechsler Intelligence Scale for Children Full and Verbal scales for children who attended > 400 days ranged from 7 to 10 points. For the heavier LBW infants (2,001-2,500 g), the effects were about 14 points for > 400 days; for the lighter LBW infants (< or = 2,000 g), the effects were about 8 points. These effects were all substantially higher than corresponding ITT effects. Similar but smaller effects were found for children who attended > 350 days.
MeSH term(s)	Birth Weight ; Child ; Child, Preschool ; Data Interpretation, Statistical ; Early Intervention (Education)/statistics & numerical data ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight/psychology ; Infant, Newborn ; Infant, Premature/psychology ; Intelligence/classification ; Language Development ; Male ; Outcome and Process Assessment (Health Care)/statistics & numerical data ; Socioeconomic Factors
Language	English
Publishing date	2002-07-25
Publishing country	United States
Document type	Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2066223-3
ISSN	1939-0599 ; 0012-1649
ISSN (online)	1939-0599
ISSN	0012-1649
DOI	10.1037/0012-1649.39.4.730
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Article ; Online: Psychogenic non-epileptic seizures--definition, etiology, treatment and prognostic issues: a critical review.

Bodde, N M G / Brooks, J L / Baker, G A / Boon, P A J M / Hendriksen, J G M / Mulder, O G / Aldenkamp, A P

Seizure

2009 Volume 18, Issue 8, Page(s) 543–553

Abstract: ... for the patient. Prognosis is unclear but studies consistently report that 1/3rd to 1/4th of the patients become ...

Abstract	In this review we systematically assess our currently available knowledge about psychogenic non-epileptic seizures (PNES) with an emphasis on the psychological mechanisms that underlie PNES, possibilities for psychological treatment as well as prognosis. Relevant studies were identified by searching the electronic databases. Case reports were not considered. 93 papers were identified; 65 of which were studies. An open non-randomized design, comparing patients with PNES to patients with epilepsy is the dominant design. A working definition for PNES is proposed. With respect to psychological etiology, a heterogeneous set of factors have been identified. Not all factors have a similar impact, though. On the basis of this review we propose a model with several factors that may interact in both the development and prolongation of PNES. These factors involve psychological etiology, vulnerability, shaping, as well as triggering and prolongation factors. A necessary first step of intervention in patients with PNES seems to be explaining the diagnosis with care. Although the evidence for the efficacy of additional treatment strategies is limited, variants of cognitive (behavioural) therapy showed to be the preferred type of treatment for most patients. The exact choice of treatment should be based on individual differences in the underlying factors. Outcome can be measured in terms of seizure occurrence (frequency, severity), but other measures might be of greater importance for the patient. Prognosis is unclear but studies consistently report that 1/3rd to 1/4th of the patients become chronic.
MeSH term(s)	Databases, Bibliographic/statistics & numerical data ; Diagnosis, Differential ; Electroencephalography/methods ; Epilepsy/diagnosis ; Epilepsy/etiology ; Epilepsy/therapy ; Humans ; Neuropsychological Tests ; Prognosis ; Psychophysiologic Disorders/diagnosis ; Psychophysiologic Disorders/etiology ; Psychophysiologic Disorders/therapy ; Seizures/diagnosis ; Seizures/etiology ; Seizures/therapy ; Video Recording/methods
Language	English
Publishing date	2009-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1137610-7
ISSN	1532-2688 ; 1059-1311
ISSN (online)	1532-2688
ISSN	1059-1311
DOI	10.1016/j.seizure.2009.06.006
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Article: Pregnancy impairs the counterregulatory response to insulin-induced hypoglycemia in the dog.

Connolly, Cynthia C / Aglione, Lisa N / Smith, Marta S / Lacy, D Brooks / Moore, Mary Courtney

American journal of physiology. Endocrinology and metabolism

2004 Volume 287, Issue 3, Page(s) E480–8

Abstract: ... pmol/l in the 3rd h in NP and P, respectively. Arterial glucose fell from 5.9 +/- 0.2 to 2.3 +/- 0.2 ... 10 ng/l (basal and 1st and 3rd h) in NP, but the response was attenuated in P (34 +/- 5, 46 +/- 6, 41 ... kg(-1).min(-1)) increased from 10.6 +/- 1.8 to 21.2 +/- 3.3 in NP (3rd h) but did not increase in P ...

Abstract	The impact of pregnancy on the counterregulatory response to insulin-induced hypoglycemia was examined in six nonpregnant (NP) and six pregnant (P; 3rd trimester) conscious dogs by tracer and arteriovenous difference techniques. After basal sampling, insulin was infused intraportally at 30 pmol.kg(-1).min(-1) for 180 min. Insulin rose from 70 +/- 15 to 1,586 +/- 221 pmol/l and 27 +/- 4 to 1,247 +/- 61 pmol/l in the 3rd h in NP and P, respectively. Arterial glucose fell from 5.9 +/- 0.2 to 2.3 +/- 0.2 mmol/l in P. Glucose was infused in NP to equate the rate of fall of glucose and the steady-state concentrations in the groups (5.9 +/- 0.2 to 2.3 +/- 0.1 mmol/l in NP). Glucagon was 32 +/- 6, 69 +/- 11, and 48 +/- 10 ng/l (basal and 1st and 3rd h) in NP, but the response was attenuated in P (34 +/- 5, 46 +/- 6, 41 +/- 9 ng/l). Cortisol and epinephrine rose similarly in both groups, but norepinephrine rose more in NP (Delta3.01 +/- 0.46 and Delta1.31 +/- 0.13 nmol/l, P < 0.05). Net hepatic glucose output (NHGO; micromol.kg(-1).min(-1)) increased from 10.6 +/- 1.8 to 21.2 +/- 3.3 in NP (3rd h) but did not increase in P (15.1 +/- 1.5 to 15.3 +/- 2.8 micromol.kg(-1).min(-1), P < 0.05 between groups). The glycogenolytic contribution to NHGO in NP increased from 5.8 +/- 0.7 to 10.4 +/- 2.5 micromol.kg(-1).min(-1) by 90 min but steadily declined in P. The increase in glycerol levels and the gluconeogenic contribution to NHGO were 50% less in P than in NP, but ketogenesis did not differ. The glucagon and norepinephrine responses to insulin-induced hypoglycemia are blunted in late pregnancy in the dog, impacting on the magnitude of the metabolic responses to the fall in glucose.
MeSH term(s)	Animals ; Blood Glucose/analysis ; Dogs ; Fatty Acids, Nonesterified/metabolism ; Female ; Gluconeogenesis ; Glucose/metabolism ; Glycogen/metabolism ; Hormones/blood ; Hypoglycemia/blood ; Hypoglycemia/chemically induced ; Hypoglycemia/physiopathology ; Insulin/blood ; Ketone Bodies/metabolism ; Kinetics ; Liver Circulation ; Osmolar Concentration ; Pregnancy ; Pregnancy Complications/blood ; Pregnancy Complications/physiopathology ; Pregnancy, Animal ; Progesterone/blood ; Protein Precursors/metabolism
Chemical Substances	Blood Glucose ; Fatty Acids, Nonesterified ; Hormones ; Insulin ; Ketone Bodies ; Protein Precursors ; Progesterone (4G7DS2Q64Y) ; Glycogen (9005-79-2) ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2004-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	603841-4
ISSN	1522-1555 ; 0193-1849
ISSN (online)	1522-1555
ISSN	0193-1849
DOI	10.1152/ajpendo.00529.2003
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Article: Chronic estradiol and progesterone treatment in conscious dogs: effects on insulin sensitivity and response to hypoglycemia.

Batista, Marcia R / Smith, Marta S / Snead, Wanda L / Connolly, Cynthia C / Lacy, D Brooks / Moore, Mary Courtney

American journal of physiology. Regulatory, integrative and comparative physiology

2005 Volume 289, Issue 4, Page(s) R1064–73

Abstract: ... PE; producing serum levels observed in the 3rd trimester of pregnancy) or placebo (C) on hepatic and ... We evaluated the effect of chronic (3 wk) subcutaneous treatment with progesterone and estradiol ... female dogs, using tracer and arteriovenous difference techniques. Insulin was infused peripherally for 3 ...

Abstract	We evaluated the effect of chronic (3 wk) subcutaneous treatment with progesterone and estradiol (PE; producing serum levels observed in the 3rd trimester of pregnancy) or placebo (C) on hepatic and whole body insulin sensitivity and response to hypoglycemia in conscious, overnight-fasted nonpregnant female dogs, using tracer and arteriovenous difference techniques. Insulin was infused peripherally for 3 h at 1.8 mU x kg(-1) x min(-1). Glucose was allowed to fall to 3 mM (Hypo) or maintained at 6 mM (Eugly) by peripheral glucose infusion. Insulin concentrations were significantly higher in Eugly-PE (n = 7) and Hypo-PE (n = 7) than in Eugly-C (n = 6) and Hypo-C groups (n = 7), but there were no significant differences in hepatic insulin extraction. Concentrations of glucagon, cortisol, epinephrine, and norepinephrine did not differ significantly between Eugly groups or between Hypo groups. Whole body glucose disposal, adjusted for the differences in insulin between groups, was 35% higher in Eugly-C vs. Eugly-PE groups (P < 0.05). Eugly-C and Eugly-PE groups exhibited similar rates of net hepatic glucose uptake, but the rate of glucose appearance was greater in Eugly-PE in the last hour (P < 0.05). Net hepatic glucose output was greater (P < 0.05) in Hypo-PE than in Hypo-C groups, and the glucose infusion rate required to maintain equivalent hypoglycemia was less (P < 0.05). The rate of gluconeogenic flux did not differ between Hypo groups. Chronic progesterone and estradiol exposure caused whole body (primarily skeletal muscle) insulin resistance and enhanced the liver's response to hypoglycemia without altering counterregulatory hormone concentrations.
MeSH term(s)	Animals ; Dogs ; Estradiol/administration & dosage ; Glucose/metabolism ; Hypoglycemia/metabolism ; Insulin/administration & dosage ; Insulin Resistance ; Liver/drug effects ; Liver/metabolism ; Metabolic Clearance Rate ; Progesterone/administration & dosage ; Sensitivity and Specificity ; Time Factors ; Women
Chemical Substances	Insulin ; Progesterone (4G7DS2Q64Y) ; Estradiol (4TI98Z838E) ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2005-06-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	603839-6
ISSN	1522-1490 ; 0363-6119
ISSN (online)	1522-1490
ISSN	0363-6119
DOI	10.1152/ajpregu.00311.2005
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Article: Microscopic appearance of the human fallopian tube following a reanastomosis procedure.

Kosasa, T S / Mulligan, W J / Ehrmann, R L / Brooks, D C

Fertility and sterility

1976 Volume 27, Issue 12, Page(s) 1422–1424

Abstract: ... a polyethylene stent was performed 10 days after the initial surgical procedure. The stent was removed on the 3rd ... to jeopardize the patency of the tube and may be preferable to removal after 3 to 4 months. ...

Abstract	Microscopic evaluation of a human fallopian tube following end-to-end anastomosis over a polyethylene stent was performed 10 days after the initial surgical procedure. The stent was removed on the 3rd postoperative day. Examination of the excised tube revealed a patent lumen without any evidence of mucosal compromise. The submucosa adjacent to the anastomotic site revealed a mild polymorphonuclear leukocytic infiltration, although a marked inflammatory response was observed around the 5-0 chromic sutures used in the reanastomosis. This case and recent animal studies suggest that early removal of the stent does not appear to jeopardize the patency of the tube and may be preferable to removal after 3 to 4 months.
MeSH term(s)	Adenocarcinoma, Papillary/surgery ; Adult ; Fallopian Tube Neoplasms/surgery ; Fallopian Tubes/pathology ; Fallopian Tubes/surgery ; Female ; Humans ; Polyethylenes/adverse effects ; Sutures
Chemical Substances	Polyethylenes
Language	English
Publishing date	1976-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80133-1
ISSN	1556-5653 ; 0015-0282
ISSN (online)	1556-5653
ISSN	0015-0282
DOI	10.1016/s0015-0282(16)42258-2
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Article: Mycoplasma infections--the cause of arthritis, mastitis and pneumonia of dairy goats in the United States

Adler, H.E / Brooks, D.L

Proceedings ... International Conference on Goat Production and Disease. 1982. (3rd)

1982

Title variant	Mycoplasma infections--the cause of arthritis, mastitis and pneumonia of dairy goats in the United States [Mycoplasma mycoides subsp capri]
Keywords	United States
Language	English
Size	p. 212-216.
Document type	Article
ISBN	0930848179 ; 9780930848170
Database	NAL-Catalogue (AGRICOLA)

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Article: Flutamide-associated liver toxicity during treatment with total androgen suppression and radiation therapy for prostate cancer.

Rosenthal, S A / Linstadt, D E / Leibenhaut, M H / Andras, E J / Brooks, C P / Stickney, D R / Chang, G C / Wolkov, H B / Gilbert, R M

Radiology

1996 Volume 199, Issue 2, Page(s) 451–455

Abstract: ... goserelin acetate for 4 months, with RT beginning at the 3rd month. Treatment records including liver function test ... aspartase aminotransferase increased from 23 (baseline) to 67 U/L (during flutamide treatment) (P<.02); mean ... alanine aminotransferase level increased from 26 (baseline) to 94 U/L (during flutamide treatment) (P<.005).: Conclusion ...

Abstract	Purpose: To examine the frequency and severity of toxicity associated with flutamide inpatients treated with total androgen suppression before and during pelvic radiation therapy (RT) for prostate cancer. Materials and methods: Sixty-five patients with T2b-T4 prostate cancer received flutamide and goserelin acetate for 4 months, with RT beginning at the 3rd month. Treatment records including liver function test (LFT) results at baseline and during treatment were reviewed and toxicities noted. Results: In 30 (46%) of 65 patients, flutamide was discontinued prematurely. Primary reasons included elevation in LFT levels (n=14); gastro-intestinal toxicity (n=9); decreased hemoglobin level (n=2); patient refusal (n=2); and arthralgia, rash, and malaise (n=1 each). Hepatotoxicity generally was manifest as asymptomatic transaminase level elevation. Grade 3-4 hepatotoxicity was noted in four of 65 patients. Mean aspartase aminotransferase increased from 23 (baseline) to 67 U/L (during flutamide treatment) (P<.02); mean alanine aminotransferase level increased from 26 (baseline) to 94 U/L (during flutamide treatment) (P<.005). Conclusion: Flutamide toxicity was common. LFTs should be monitored during flutamide therapy. The role of flutamide in this treatment regimen may need to be reevaluated.
MeSH term(s)	Aged ; Alanine Transaminase/blood ; Alkaline Phosphatase/blood ; Androgen Antagonists/adverse effects ; Androgen Antagonists/therapeutic use ; Antineoplastic Agents, Hormonal/therapeutic use ; Aspartate Aminotransferases/blood ; Chemical and Drug Induced Liver Injury/etiology ; Clinical Enzyme Tests ; Cohort Studies ; Combined Modality Therapy ; Flutamide/adverse effects ; Flutamide/therapeutic use ; Gastrointestinal Diseases/chemically induced ; Goserelin/therapeutic use ; Humans ; Liver Function Tests ; Male ; Prospective Studies ; Prostatic Neoplasms/therapy ; Radiotherapy Dosage
Chemical Substances	Androgen Antagonists ; Antineoplastic Agents, Hormonal ; Goserelin (0F65R8P09N) ; Flutamide (76W6J0943E) ; Aspartate Aminotransferases (EC 2.6.1.1) ; Alanine Transaminase (EC 2.6.1.2) ; Alkaline Phosphatase (EC 3.1.3.1)
Language	English
Publishing date	1996-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiology.199.2.8668793
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