Cactus spines can easily puncture the skin with only minor pressure. Removal of the offending cactus spine is the treatment of choice; however, it is very difficult, even with tweezers. A 17-year-old Korean girl presented for evaluation of multiple purple-colored macules and papules on the left cheek and left thumb. Two months earlier, she had pricked her finger and face on cactus spines while volunteering in Haiti. An ultrasound identified wedge-shaped echogenic materials suspected as cactus spines. We recommended surgical removal of the spines, but she vehemently refused. We then advised her to take amoxicillin/clavulanic acid and undergo regular follow-up. During the follow-up period, the spines dislodged spontaneously for easy removal and the patient removed them with tweezers. The lesions actually improved over the next several months. Here, we report this rare and interesting case for educational purposes because such a case has never been previously reported in Korea.
Adolescent ; Cactaceae ; Cheek ; Female ; Fingers ; Follow-Up Studies ; Haiti ; Humans ; Korea ; Punctures ; Skin ; Spine ; Thumb ; Ultrasonography ; Wounds and Injuries

PURPOSE: Neisseria meningitidis and Neisseria gonorrhoeae share between 80% and 90% of their genetic sequence. Meningococcal serogroup B vaccines based on outer membrane vesicles—such as VA-MENGOC-BC—could cross-protect against gonorrhea. The aim of this study was to analyze the incidence rates of gonorrhea and other sexually transmitted diseases with respect to the use of the VA-MENGOC-BC vaccine. MATERIALS AND METHODS: Health statistics between 1970 and 2017 were reviewed and the incidence of meningococcal disease and sexually transmitted diseases (gonorrhea, syphilis, condyloma acuminatum, hepatitis B and human immunodeficiency virus infection) were analyzed during the pre- and post-vaccination periods. Gonorrhea incidence was also analyzed by age groups. RESULTS: VA-MENGOC-BC was successfully used to control a meningococcal epidemic in Cuba. The strategy to combat the epidemic was carried out in two stages. The first one was a nationwide mass-vaccination campaign from 1989 to 1990, targeting the population at highest-risk aged 3 months to 24 years. During the second stage, begun in 1991, it was included in the Expanded Immunization Program. Gonorrhea incidence increased from 1970 to 1989. However, after the VA-MENGOC-BC massive vaccination campaign a sharp decrease of gonorrhea incidence was observed. It lasted between 1989 and 1993. A second incidence peak was detected in 1995, but it dropped again. Data clearly show a decline in the incidence of gonorrhea following massive vaccination, in contrast with other sexually transmitted diseases. Incidence rates in unvaccinated age groups also decreased, probably due to herd immunity. CONCLUSION: There is evidence that VA-MENGOC-BC could induce a moderate protection against gonorrhea.
Cuba ; Gonorrhea ; Hepatitis B ; HIV ; Humans ; Immunity, Herd ; Immunization Programs ; Incidence ; Membranes ; Neisseria gonorrhoeae ; Neisseria meningitidis ; Serogroup ; Sexually Transmitted Diseases ; Syphilis ; Vaccination ; Vaccines

PURPOSE: Different students may adopt different learning approaches: namely, deep and surface. This study aimed to characterize the learning strategies of medical students at Trinity School of Medicine and to explore potential correlations between deep learning approach and the students' academic scores. METHODS: The study was a questionnaire-based, cross-sectional, observational study. A total of 169 medical students in the basic science years of training were included in the study after giving informed consent. The Biggs's Revised Two-Factor Study Process Questionnaire in paper form was distributed to subjects from January to November 2017. For statistical analyses, the Student t-test, 1-way analysis of variance followed by the post-hoc t-test, and the Pearson correlation test were used. The Cronbach alpha was used to test the internal consistency of the questionnaire. RESULTS: Of the 169 subjects, 132 (response rate, 78.1%) completely filled out the questionnaires. The Cronbach alpha value for the items on the questionnaire was 0.8. The score for the deep learning approach was 29.4±4.6, whereas the score for the surface approach was 24.3±4.2, which was a significant difference (P<0.05). A positive correlation was found between the deep learning approach and students' academic performance (r= 0.197, P<0.05, df= 130). CONCLUSION: Medical students in the basic science years at Trinity School of Medicine adopted the deep learning approach more than the surface approach. Likewise, students who were more inclined towards the deep learning approach scored significantly higher on academic tests.
Humans ; Informed Consent ; Learning ; Observational Study ; Saint Vincent and the Grenadines ; Students, Medical

Through the Declaration of Montevideo in 2011, the World Medical Association suggested that doctors worldwide should be trained in basic disaster response regardless of their specialty. The Haiti earthquake in 2010, which had the highest number of foreign medical team dispatched from all over the world, proved that untrained and disorganized team only brought confusion. This event led the World Health Organization to develop the ‘Classification and Minimum Standards for Foreign Medical Teams in Sudden Onset Disasters ’ in 2013. This guideline will become the standard for organizing an international emergency medical team. We should be able to provide high standard of care through field hospital set up and continuous training of disaster medicine specialists.
Disaster Medicine* ; Disasters* ; Earthquakes ; Emergencies* ; Haiti ; Mobile Health Units ; Specialization ; Standard of Care ; World Health Organization

This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain) and are available on YouTube, on the following topics: the head and neck (7:30), the cardiovascular system (7:38), the respiratory system (13:54), and the abdomen (11:10). We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015) to July 28, 2017 (2 years, 5 months, and 11 days). The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views), 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes), and 2:56 minutes (range, 1:49 to 4:03 minutes). Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico.
Abdomen ; Cardiovascular System ; Colombia ; Ecuador ; Education, Medical ; Head ; Humans ; Mexico ; Neck ; Physical Examination* ; Puerto Rico ; Respiratory System ; Spain ; Students, Medical* ; Uruguay ; Venezuela ; Video Recording

Currently, the importance of human anatomical dissection have come under debate in many countries but there are not references in Venezuela on this concern. This survey's aim is to assess the insights of Venezuelan surgeons and their outlines of usage of human anatomical dissection in teaching and learning human anatomy. Sixty-five Venezuelan surgeons at the Centro Médico Docente La Trinidad completed an anonymous survey on current and future teaching practices in human anatomy. Eighty-nine point two three percent of surveyed (n=58) conferred importance to human anatomical dissection despite the arrival of new innovations in learning human anatomy. The group surveyed view human anatomical dissection-based teaching as the most beneficial method of teaching human anatomy and it should be bolstered in human anatomical education with matching use of three-dimensional computerized tomography imaging as a complementary form for teaching and learning.
Anonyms and Pseudonyms ; Education ; Humans* ; Learning ; Methods ; Surgeons* ; Trinidad and Tobago ; Venezuela

The importance of understanding all gender facial differences is critical in providing a successful cosmetic outcome. Men are a growing segment of the cosmetic industry. Understanding of the male face and its appropriate treatment with minimally invasive cosmetic procedures are essential. The aim was to investigate various facial ratios in Indian American men and to compare them with the Indian and Caucasian norms. Additionally, we wanted to evaluate whether these values satisfy golden and silver ratios. Direct facial anthropometric measurements were made using a digital caliper in 100 Indian American men students (18-30 years) at the American University of Antigua (AUA), Antigua. A set of facial ratios were calculated and compared with coefficients of variation (CV). Most of the facial ratios had small CV thus making them highly reliable due to reduced intra-sample variability. The upper face to face height and mandibulo upper face height indices were close to golden ratios whereas mandibulo lower face height, upper face height biocular width, and nasal indices were close to silver ratios. There was significant difference in most of the values when compared with previous studies. The present facial ratios data can be used as a reference value for Indian American men.
Antigua and Barbuda ; Humans ; Male ; Reference Values ; Silver

PURPOSE: This study aimed to examine the modifiable programmatic characteristics reflected in the Commission on Accreditation in Physical Therapy Education (CAPTE) Annual Accreditation Report for all accredited programs that reported pass rates on the National Physical Therapist Examination, and to build a predictive model for first-time and three-year ultimate pass rates. METHODS: This observational study analyzed programmatic information from the 185 CAPTE-accredited physical therapy programs in the United States and Puerto Rico out of a total of 193 programs that provided the first-time and three-year ultimate pass rates in 2011. Fourteen predictive variables representing student selection and composition, clinical education length and design, and general program length and design were analyzed against first-time pass rates and ultimate pass rates on the NPTE. Univariate and multivariate multinomial regression analysis for first-time pass rates and logistic regression analysis for three-year ultimate pass rates were performed. RESULTS: The variables associated with the first-time pass rate in the multivariate analysis were the mean undergraduate grade point average (GPA) and the average age of the cohort. Multivariate analysis showed that mean undergraduate GPA was associated with the three-year ultimate pass rate. CONCLUSIONS: Mean undergraduate GPA was found to be the only modifiable predictor for both first-time and three-year pass rates among CAPTE-accredited physical therapy programs.
Accreditation ; Cohort Studies ; Education* ; Humans ; Logistic Models ; Multivariate Analysis ; Observational Study ; Physical Therapists ; Puerto Rico ; School Admission Criteria ; United States*

Translocation renal cell carcinoma (RCC) is a family of rare tumors recently identified in the pediatric and young adult population. We report the first case of a young woman from French West Indies with sickle cell anemia who developed a translocation RCC t(6;11)(p21;q12). Usually people with the sickle cell condition are known to develop renal medullary carcinoma (RMC). To our knowledge, this is the first case described in the literature of a translocation RCC associated with sickle cell disease. Here we discuss the relation between translocation RCC, RMC, and sickle cell disease.
Anemia, Sickle Cell* ; Carcinoma, Medullary ; Carcinoma, Renal Cell* ; Female ; Hemoglobin, Sickle ; Humans ; Kidney Neoplasms ; West Indies ; Young Adult

BACKGROUND/AIMS: Nonsteroidal anti-inflammatory drugs relieve osteoarthritis (OA) symptoms but cause adverse effects. D-002, a mixture of beeswax alcohols, is effective against experimental OA. A pilot study found that D-002 (50 mg/day) for 8 weeks improves OA symptoms. The aim of this study was to investigate the effects of D-002 (50 to 100 mg/day) administered for 6 weeks on OA symptoms. METHODS: Patients with OA symptoms were double-blindly randomized to D-002 (50 mg) or placebo for 6 weeks. Symptoms were assessed by the Western Ontario and McMaster Individual Osteoarthritis Index (WOMAC) and the visual analog scale (VAS) scores. Patients without symptom improvement at week 3 were titrated to two daily tablets. The primary outcome was the total WOMAC score. WOMAC pain, joint stiffness and physical function scores, VAS score, and use of rescue medications were secondary outcomes. RESULTS: All randomized patients (n = 60) completed the study, and 23 experienced dose titration (two in the D-002 and 21 in the placebo groups). At study completion, D-002 reduced total WOMAC (65.4%), pain (54.9%), joint stiffness (76.8%), and physical function (66.9%) WOMAC scores, and the VAS score (46.8%) versus placebo. These reductions were significant beginning in the second week, and became enhanced during the trial. The use of rescue medication by the D-002 (6/30) group was lower than that in the placebo (17/30) group. The treatment was well tolerated. Seven patients (two in the D-002 and five in the placebo group) reported adverse events. CONCLUSIONS: These results indicate that D-002 (50 to 100 mg/day) for 6 weeks ameliorated arthritic symptoms and was well tolerated.
Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Anti-Infective Agents/administration & dosage/adverse effects/*therapeutic use ; Cuba ; Double-Blind Method ; Drug Administration Schedule ; Fatty Alcohols/administration & dosage/adverse effects/*therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis/diagnosis/*drug therapy/physiopathology ; Pain Measurement ; Questionnaires ; Tablets ; Time Factors ; Treatment Outcome ; Young Adult