Faculty Bibliography

To assess the degree of house officers' concerns about acquiring AIDS (acquired immunodeficiency syndrome) from their patients, we surveyed 263 medical and pediatric interns and residents in four housestaff training programs affiliated with seven New York City hospitals with large AIDS patient populations; 258 questionnaires (98 per cent) were returned. Thirty-six per cent of medical and 17 per cent of pediatric house officers reported percutaneous exposures to needles contaminated with blood of AIDS patients. Forty-eight per cent of medical and 30 per cent of pediatric house officers reported a moderate to major concern about acquiring AIDS from their patients. Greater concern about personal risk was noted in those house officers who were earlier in their residency training, who reported having treated a greater number of AIDS patients, and who were in medicine rather than pediatrics programs. Twenty-five per cent of all respondents reported that they would not continue to care for AIDS patients if given a choice. The results demonstrate a substantial degree of concern about acquiring AIDS among house officers caring for AIDS patients and suggest the need for housestaff program administrators for formally address these concerns

Uncertainty about optimal treatment for many diseases results in heterogeneous management by definition. It was hypothesized that identifiable characteristics in a physician's background would influence the management of any such condition and thereby explain some of this heterogeneity. A vignette describing a patient with new-onset angina and a questionnaire ascertaining individual physician characteristics and management preferences were sent to attending physicians and house staff in the Department of Medicine at New York University School of Medicine. Although physicians believed very strongly that the patient had angina on the basis of the history, there was no consensus about managing the hypothetic patient. The age of the physician was the single most important predictor of management, with the younger half of the sample more likely to hospitalize (p less than 0.001), less likely to prescribe nitroglycerin as a sole therapy (p less than 0.005), and more likely to prescribe beta blockers (p less than 0.005). The era in which a physician trains may determine practices that persist for a lifetime. These findings may have important implications for medical education and the quality and cost of medical care

A case of antibiotic-associated pseudomembranous colitis is presented in which the Gallium scan was the first diagnostic modality to alert the clinicians to the existence of an inflammatory bowel process. The mechanism of localization of the radiopharmaceutical in inflammatory bowel disease is discussed. Although colonoscopy is far more specific and should be the first-line diagnostic tool used in assessing the presence of pseudomembranous colitis, Gallium scanning may have a role in the follow-up of treatment and in cases of relapse