Médecine interne générale en pratique hospitalière: l'année 2011 mise en perspective par les chefs de clinique [Hospital-based internal medicine: year 2011 in chief resident's perspective].

The year 2011 was full of significant advances in all areas of medicine. Whether small or large issues, they all have an impact on daily practice in general internal medicine. For example, intravenous administration of diuretics in heart failure shows no benefit. But double dose may improve symptoms faster. Direct Xa inhibitors are emerging as alternative to anti-vitamin K. beta-blockers reduce overall mortality in COPD and do not worsen lung function significantly. Each year, the chief residents from the Department of internal medicine at the University hospital of Lausanne meet to share their readings. Twelve new therapeutic considerations of 2011 are reviewed here.

Audit report on internal control over financial reporting and on compliance and other matters of the State of Iowa for the year ended June 30, 2012

Audit report on internal control over financial reporting and on compliance and other matters of the State of Iowa for the year ended June 30, 2012

European integration, FDI and the internal geography of trade : evidence from Western European border regions

In this paper we use a gravity model to study the trade performance of French and Spanishborder regions relatively to non-border regions, over the past two decades. We find that,controlling for their size, proximity and location characteristics, border regions trade onaverage between 62% and 193% more with their neighbouring country than other regions,and twice as much if they are endowed with good cross border transport infrastructures.Despite European integration, however, this trade outperformance has fallen for the mostperipheral regions within the EU. We show that this trend was linked in part to a shift in the propensity of foreign investors to move their affiliates from the regions near their home market to the regions bordering the EU core.

Ultrastructural changes of the internal limiting membrane removed during indocyanine green assisted peeling versus conventional surgery for idiopathic macular epiretinal membrane.

PURPOSE: To evaluate the histologic features of cellular retinal fragments on the internal limiting membrane (ILM) removed during idiopathic macular epiretinal membrane (MEM) peeling surgery with and without the aid of indocyanine green (ICG) diluted in 5% glucose. METHODS: ILM specimens removed from 88 eyes during idiopathic MEM surgery between 1995 and 2003 were reviewed retrospectively. Histologic analysis focused on the presence and characteristics of retinal fragments on the retinal surface of the ILM. Statistical analysis compared the results between group I (conventional surgery) and group II (ICG-assisted peeling). RESULTS: Seventy-one eyes underwent MEM surgery without the aid of ICG (group I) and seventeen underwent MEM ICG-assisted surgery (group II). The amount of Müller cell debris on the retinal surface of the ILM was more significant in the group I than in the group II (40.8 vs. 11.8; P = 0.024). Large fragments of Müller cells were more frequently observed in the group I (no ICG) than in the group II (ICG) (63.4 vs. 23.5%; P = 0.003). CONCLUSIONS: The use of ICG diluted with 5% glucose in ILM removal during MEM surgery was associated with less retinal debris attached to the retinal face of the ILM compared with surgery in which ICG was not used.

Integrated Risk Management for Improving Internal Traffic Control, Work-Zone Safety, and Mobility during Major Construction, TPF-5(081), 2012

Highway construction is among the most dangerous industries in the US. Internal traffic control design, along with how construction equipment and vehicles interact with the traveling public, have a significant effect on how safe a highway construction work zone can be. An integrated approach was taken to research work-zone safety issues and mobility, including input from many personnel, ranging from roadway designers to construction laborers and equipment operators. The research team analyzed crash data from Iowa work-zone incident reports and Occupational Safety and Health Administration data for the industry in conjunction with the results of personal interviews, a targeted work-zone ingress and egress survey, and a work-zone pilot project.

Improving the Understanding and the Reliability of the Concept of "Sufficiency" in Friction Ridge Examination

The National Academies has stressed the need to develop quantifiable measures for methods that are currently qualitative in nature, such as the examination of fingerprints. Current protocols and procedures to perform these examinations rely heavily on a succession of subjective decisions, from the initial acceptance of evidence for probative value to the final assessment of forensic results. This project studied the concept of sufficiency associated with the decisions made by latent print examiners at the end of the various phases of the examination process. During this 2-year effort, a web‐based interface was designed to capture the observations of 146 latent print examiners and trainees on 15 pairs of latent/control prints. Two main findings resulted from the study: The concept of sufficiency is driven mainly by the number and spatial relationships between the minutiae observed on the latent and control prints. Data indicate that demographics (training, certification, years of experience) or non‐minutiae based features (such as level 3 features) do not play a major role in examiners' decisions; Significant variability was observed between detecting and interpreting friction ridge features and at all levels of details, as well as for factors that have the potential to influence the examination process, such as degradation, distortion, or influence of the background and the development technique.

Acquisitions thérapeutiques en médecine ambulatoire en 2011 [2011 findings from literature on general internal ambulatory medicine].

In 2011 several articles seemed significant for the practice of general medicine. Diagnosis of hypertension needs several measurements and may need 24-hour ambulatory blood pressure monitoring. Glycosylated hemoglobin is a reliable tool to diagnose diabetes mellitus. The ABCD2 score with neurological imaging help the triage of transient ischemic attacks. Pulmonary embolism can be treated as outpatient for low risk patients. Gluten-free diet may be tried in irritable bowel syndrome. Nitrofurantoin is a reasonable alternative for simple urinary tract infection in women, but antibiotics are not needed after drainage of an uncomplicated skin abscess. Subclinical thyroid dysfunction is a risk factor of osteoporosis in older men. Sequential use of MMSE and ACE scores is a promising approach to assess medical decision-making capacity.

Construct validity and internal reliability of a French version of FACES III in adolescents and adults

Family cohesion and adaptability, as operationalised in the Family Adaptability and Cohesion Scales III (FACES III), are two hypothesised dimensions of family functioning. We tested the properties of a French version of FACES III in school-children (mean age: 13 years; S.D:0.85) recruited from the general population and their parents. Separate confirmatory factor analyses were performed for adolescents and adults. The results of both analyses were compatible with a two-factor structure similar to that proposed by the authors of the original instrument. However, orthogonality between the two factors was only supported in the adult data. Internal reliability estimates were 0.78 and 0.68 in adolescents and 0.82 and 0.65 in adults, for cohesion and adaptability respectively.

The Potential of Friction as a Tool for Winter Maintenance, TR-400, 1998

It is intuitively obvious that snow or ice on a road surface will make that surface more slippery and thus more hazardous. However, quantifying this slipperiness by measuring the friction between the road surface and a vehicle is rather difficult. If such friction readings could be easily made, they might provide a means to control winter maintenance activities more efficiently than at present. This study is a preliminary examination of the possibility of using friction as an operational tool in winter maintenance. In particular, the relationship of friction to traffic volume and speed, and accident rates is examined, and the current lack of knowledge in this area is outlined. The state of the art of friction measuring techniques is reviewed. A series of experiments whereby greater knowledge of how friction deteriorates during a storm and is restored by treatment is proposed. The relationship between plowing forces and the ice-pavement bond strength is discussed. The challenge of integrating all these potential sources of information into a useful final product is presented together with a potential approach. A preliminary cost-benefit analysis of friction measuring devices is performed and suggests that considerable savings might be realized if certain assumptions should hold true. The steps required to bring friction from its current state as a research tool to full deployment as an operational tool are presented and discussed. While much remains to be done in this regard, it is apparent that friction could be an extremely effective operational tool in winter maintenance activities of the future.

Défis et opportunités liés a la création d'une société unique de spécialistes en médecine interne générale en 2015 [Challenges and opportunities related to the creation of a unique society of specialists in general internal medicine in 2015].

A common training plan in general internal medicine was a brave enterprise started in 2011 in accordance with the common objectives of the Swiss Society of General Medicine and the Swiss Society of Internal Medicine. The next challenge will be the dissolution of the two Societies and therefore the creation of an unique new association in 2015. This is an extraordinary opportunity to bring together the specific qualities of each association and to create a new society. Issues, objectives and secondary benefits expected from the creation of the largest national society of a medical discipline are explored as a joint discussion in this article.