Paraneoplastische dermatomyositis bij rectumcarcinoom: belang van snelle diagnose en therapie, maar onduidelijkheid over de beste aanpak

Paraneoplastic dermatomyositis in rectal cancer: importance of rapid diagnosis and therapy, but uncertainty about the best approach A 55-year-old woman, recently diagnosed with peritoneal metastasized rectal adenocarcinoma, developed a rash on her face, hands and torso, shortly after starting chemotherapy, as well as progressive proximal myalgia. Based on the typical symptoms, the increased creatine kinases (CK) levels after a biochemistry test and the characteristic abnormalities after an EMG, the diagnosis of dermatomyositis was made. Dermatomyositis (DM) is a rare autoimmune disease characterized by inflammation of the skin and muscles, which may also be accompanied by systemic manifestations. The etiology of dermatomyositis is still not fully understood. When dermatomyositis develops at older age, however, it is often a paraneoplastic syndrome. DM is a disease that can have a rapid and severe course. Thereby, fast recognition and adequate treatment are extremely important. The symptoms, diagnosis and treatment options are discussed in the article on the basis of the current literature.

Comparison of a 5 F Microtube-Irrigated Ablation Catheter and a General Ablation Catheter in the Treatment of Resistant Hypertension with Renal Denervation

Objective: To assess the effectiveness of catheter-based renal denervation for reducing blood pressure in patients withresistant hypertension using a 5 F microtube-irrigated ablation catheter.Methods: Sixty patients with resistant hypertension were divided into two groups: a microtube-irrigated ablation catheter group and a general ablation catheter group. We conducted 12-month follow-up of all patients and recorded clinical blood pressure, ambulatory blood pressure, medication use, and biochemistry test results in both groups at the baseline and at the 12-month follow-up.Results: All patients underwent renal denervation. At the 6-month follow-up, ambulatory blood pressure in the microtube-irrigated ablation catheter group was significantly lower than in the general ablation catheter group (systolic blood pressure 142.0 ± 14.4 mmHg vs. 150.8 ± 17.9 mmHg, P = 0.04; diastolic blood pressure 81.2 ± 7.0 mmHg vs. 87.6 ± 8.0 mmHg, P = 0.002). At the 12-month follow-up, the between-group difference in ambulatory blood pressure was not statistically significant. At the 12-month follow-up, the number of antihypertensive drugs and diuretics used in the microtube-irrigated ablation catheter group was less than in the general ablation catheter group (P = 0.043). There was no statistical difference between the two groups in the results of biochemistry tests and echocardiography.Conclusion: The microtube-irrigated ablation catheter is more effective in treating hypertension than the generalablation catheter at the 6-month follow up and thus fewer antihypertensive drugs were used in the microtube-irrigatedablation catheter group than in the general ablation catheter group.

COVID-19 Pandemic Planning: Simulation models to predict biochemistry test capacity for patient surges

Background Patient surges beyond hospital capacity during the initial phase of the COVID-19 pandemic emphasized a need for clinical laboratories to prepare test processes to support future patient care. The objective of this study was to determine if current instrumentation in local hospital laboratories can accommodate the anticipated workload from COVID-19 infected patients in hospitals and a proposed field hospital in addition to testing for non-infected patients. Methods Simulation models predicted instrument throughput and turn-around-time for chemistry, ion-selective-electrode and immunoassay tests using vendor-developed software with different workload scenarios. The expanded workload included tests from anticipated COVID patients in two local hospitals and a proposed field hospital with a COVID-specific test menu in addition to the pre-pandemic workload. Results Instrumentation throughput and turn-around time at each site was predicted. With additional COVID-patient beds in each hospital the maximum throughput was approached with no impact on turnaround time. Addition of the field hospital workload led to significantly increased test turnaround times at each site. Conclusions Simulation models depicted the analytic capacity and turn-around times for laboratory tests at each site and identified the laboratory best suited for field hospital laboratory support during the pandemic.

Aromatherapy for test anxiety in chiropractic students:

Objective Up to 85% of college students experience test anxiety, which may contribute to decreased academic performance. The purpose of this study was to assess the feasibility of recruiting chiropractic students for a randomized trial involving aromatherapy for anxiety reduction. Methods This study enrolled chiropractic students who were randomly assigned to separate rooms during a biochemistry test. Waterless diffusers dispersed a lemon and rosemary blend of essential oils in the experimental room and water in the control room. Students completed pretest surveys rating current and general anxiety. Posttest surveys included rating current anxiety. Analysis of covariance (ANCOVA) was preformed to determine within- and between-group differences for current anxiety. Feasibility was the primary aim, and the statistical significance of anxiety test scores between rooms was the secondary aim. Results Sixty-four students were included in the study. The feasibility of research methods was noted for adherence to the study protocol (informed consent, randomization, and survey distribution and completion) and resource allocation. Design improvements are required in recruitment methods, follow-up surveys, and intervention blinding. ANCOVA for between-group comparisons showed no statistically significant difference between groups' pre- and posttest anxiety scores (p = .22). Two reported side effects, eye and sinus irritation, could not be attributed to treatment group. Most students were willing to use aromatherapy for test anxiety in the future. Conclusion We demonstrated feasibility in conducting a randomized study to measure the influence of aromatherapy on test anxiety in chiropractic students. A powered, randomized study is needed to determine if aromatherapy may be effective in reducing test anxiety.

Application Research and Practice of TBL Innovative Teaching Method in the Course of Clinical Biochemical Testing Technology

The purpose of this study is to explore the practical application effect of TBL innovative teaching method in the course of clinical biochemistry test technology. The research object is all undergraduate students in the laboratory major of 2018 medical school of our university. The research method is comparative experiment method, the teaching method of LBL teaching is set as control group, while the experimental group adopts TBL teaching method. By the final teaching evaluation and the data collected in the process, the influence of TBL teaching methods on the teaching effect of the course is compared and analyzed. The evaluation methods are combined with subjective and objective evaluation. The evaluation methods include questionnaire, student mutual evaluation, final test and other multiple ways. And the results of this study showed that the average score of the experimental group using TBL teaching method was significantly higher than that of the control group using traditional teaching method. In addition, through the process evaluation, it was found that the students in the experimental group were superior to the students in the control group in terms of learning interest, communication ability and learning methods. As a result, the application of TBL teaching method in the teaching of clinical biochemistry test obviously promotes the teaching quality and effect of this course.