Faculty Bibliography

BACKGROUND: Sexual history taking is a core clinical skill for all physicians, yet many medical schools do not adequately address this important topic within the curriculum. This article describes a sexual-history-taking module that was initiated, designed, and presented by 2nd-year medical students for their peers as part of the required Introduction to Clinical Medicine (ICM) course. DESCRIPTION: As part of this module, a group of 2nd-year medical students developed a large-group presentation and small-group role play cases to enhance students' basic sexual-history-taking skills in challenging situations, teach ways to ask nonjudgmental questions, and introduce legal issues that may arise. Under faculty supervision, the students recruited and trained peer and faculty facilitators and designed, developed, and analyzed the survey evaluation tools. EVALUATION: Both the students and facilitators completed an anonymous questionnaire within 1 to 4 weeks of completing the activity. Of the 92 students completing an online survey, 92% rated the large group presentation good or excellent, and 89% rated the small-group role playing activities as good or excellent, as compared to overall ICM course ratings of 68% good or excellent. Facilitators were well prepared for their roles and reported that the students responded to them positively. Participating students reported that having students as teachers positively enhanced their small group learning experience. Students performed better on the sexual-history-taking questions on the final examination (97.5%) than on the final examination overall (89%). CONCLUSIONS: Medical students can successfully create and implement a curriculum module for their peers in a sensitive area such as sexual history taking. Due to changing responsibilities for students as they progress through medical school, sustainability may be challenging.

Mutant alleles of MYH9 encoding a class II non-muscle myosin heavy chain-A (NMMHC-IIA) have been linked to hereditary megathrombocytopenia with or without additional clinical features that include sensorineural deafness, cataracts, and nephritis. To assess its biological role in the affected targets, particularly the inner ear, we have generated and characterized mice with Myh9 deficiency. These mice were generated using the XA136 ES cell line (BayGenomics, http://baygenomics.ucsf.edu/) carrying gene trap insertion in Myh9, within the intron flanking exons 4 and 5. Mice heterozygous for the Myh9 null allele, Myh9 +/- were expanded on C57BL/6J background. Intercross of the Myh9 +/- mice did not yield Myh9 -/- pups, indicating embryonic lethality, subsequently determined to occur at or before E7.5, thus precluding a post-natal analysis of the effects of complete Myh9 deficiency. The heterozygous mice were normal for their hearing, parameters of platelet integrity and renal function despite their Myh9 haplo-insufficiency. In addition, the age-dependent auditory threshold of the Myh9 +/- mice and their wild type littermates, spanning from 3 to 12 months of age, were similar indicating that Myh9 haplo-insufficiency does not contribute towards accelerated age-related hearing loss (AHL). The embryonic lethality associated with the complete Myh9 deficiency establishes a critical role for this non-muscle myosin in fetal development. The results of these studies do not support the Myh9 haploinsufficiency as a pathogenic factor in the etiology of auditory dysfunction

Segmental mandibulectomy leads to a great deficit in the form and function of the patient. Vascularised bone flaps have become the choice of the method of reconstruction of the mandible in an oncologic setting. Fibula osseous or oseteocutaneous flaps have become the favored method in centers across the world. This article reviews certain pertinent and practical points with regards to fibula flap reconstruction of the mandible. Methods of osteosynthesis, merits of inclusion of the FHL muscle in the flap and use of osteointegrated implants are discussed in detail. The reader will also be able at the end to understand the role of pre operative vascular imaging, steps taken when there is an irreversible flap failure and steps to maintain and rehabilitate occlusion as practiced in the author's service