Summary:With a growing elderly population, the incidence ol' isolated systolic hypertension (ISH) has increased. This study characterizes dynamic vascular changes that occur with achnnced age and with ISH. Fifty-the healthy individuals and seven with ISH were distributed in seven age groups from the second to the seventh decade. An index of aortic stiffness (AWAV) was derived using a mercury sphygmomanometer to oht;lin pulse pressure, and ultrasonographic measurements were iiaed to estimate aortic volumes applying the "cylinder formula." The mathematic derivation of this formula is explairied in detail. Pulse pressure showed no significant change with age, but showed a significant increase with ISH. A decretisc in volume change from systole to diastole was found with advanced age. Norinotensive subjects aged 6.5 -t 2 years hut1 ;I %-fold increase in aortic stiffness compared with young individuals. Elderly patients with ISH had a 7-fold increase in aoilic stiffness compared with Group 1 (15 -t 2 years) (p <: 0.001 ) rind a 2.7-fold increase compared with Group 6 (normotensive subjects aged 65 -t 2 years). A strong correlation between systolic pressure and arterial stiffness was observed (r = 0.953) (p < 0.001 ). The proposed stiffness index was compared with the one described by Hirai, obtaining a high correlation, that is. r = 0.989 (p < 0.001 ). When compared with Stefanadis's index of distensibility, our index showed a coi-rclation ofr = 0.932 (p < 0,003). It is concluded that while systolic pressure is a main detenninant of arterial stiffness, the AWAV is a more sensitive method to estimate dynamic chnnges in elastic arteries such as the aorta.
BACKGROUNDChanges in medical anatomy teaching have resulted from the application of modern learning theory, transitions to integrated curricula, decreased instructional hours, and a desire for distributed learning across the medEd continuum. In response, anatomists have tried to refine and reduce content, but this change raises the question: What anatomy is essential and for which stage of learning (for USMLE Step 1, clerkships, residency)? Often, anatomy curricula may be based on “what all medical students need,” asked to meet the needs of a “generalist,” or to provide the anatomical foundations for physical and neurological examinations. Recent studies based on the expertise of both clinical and anatomy faculty have offered proposals for curricula at different stages in the learning continuum (Lisk et al., 2013; Lazerus et al., 2014; Tubbs et al., 2014; Smith et al., 2016). Comprehensive clinical anatomy curricula for gross and developmental anatomy were also previously proposed by the AACA (1996, 2000). The present study, which expands on preliminary data presented in 2016, is the first broad assessment of the clinical importance of anatomy by residents in specific fields of medical practice. This presentation will discuss the clinical importance of a comprehensive list of anatomical structures and concepts across all anatomical regions to provide a better understanding of anatomy as applied in a clinical context.METHODSThis study reports survey data regarding the clinical importance of anatomy as assessed by 109 residents: anesthesiology (n=7), emergency medicine (n=14), family medicine (n=12), internal medicine (n=35), med‐peds (n=7), obstetrics & gynecology (n=13), and orthopedics (n=21).RESULTS & CONCLUSIONSThe rankings of the clinical importance of specific anatomy by residents in different fields of practice often conformed to preconceived notions of the field of practice (e.g., ObGyn residents ranked anatomy of the pelvis and perineum in the female as essential, but not the male). In some areas, however, the rankings surprised (e.g., low assessment of back surface anatomy by orthopaedics residents). Further stratification of the data based on variables such as postgraduate year and area of specialization may better define the anatomy considered essential by different groups of residents, especially in fields such as internal medicine and family medicine that encompass a broad range of subfields. The outcome of this study and the high level of specificity provided by respondents provides a database that may be used to for course planning for residency training. Moreover, this data will be useful in undergraduate medical education to inform the development anatomy learning experiences that both fit within curricular parameters and meet the needs of medical student learners.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
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