Faculty Bibliography

With former President George W. Bush having decided to stay largely silent during Mr. [Barack Obama]'s tenure, Mr. Cheney had embraced the role of public critic, accusing the new, young president of rolling back Bush-era policies and undermining the security of the United States. In 2009, Mr. Cheney and Mr. Obama gave dueling speeches on the same day. Mr. Cheney's friends and family say that he is making plans to get out in 2011 and do more speeches. On Jan. 20, he is to fly to Texas for the 20th anniversary of the Gulf War with former President George H.W. Bush, the emir of Kuwait, and a host of alumni of that administration, including the former national security adviser Brent Scowcroft and Colin L. Powell, who was the chairman of the Joint Chiefs of Staff at the time, when Mr. Cheney was defense secretary. Mr. Cheney, who is spending the holidays at his ranch in Wyoming, recently had a class of U.S. Military Academy cadets over to his house in McLean, Virginia, to talk about his experiences working for four of the last five Republican presidents. In Wyoming, he has been seen in local stores, stocking up to make chili and spaghetti sauce, 'as well as walking me through how to cook Christmas dinner,' his daughter Liz Cheney said in an e-mail. But most of all, Ms. Cheney said, her father has been working on his book, which is due out this autumn

Mr. Cheney, as he did at several holiday receptions in Washington, chatted about his new pump. At one cocktail party, he even opened his coat jacket to show off the pump. While Mr. Cheney is noticeably thinner -- his stiff, one-sided grin now shows up on a markedly leaner face -- he is returning, associates say, to his old life, including hunting and socializing. With former President George W. Bush having decided to stay largely silent during Mr. [Barack Obama]'s tenure, Mr. Cheney had embraced the role of public critic, accusing the new, young president of rolling back Bush-era policies and undermining the security of the United States. In 2009, Mr. Cheney and Mr. Obama gave dueling speeches on the same day. Mr. Cheney's friends and family say that he is making plans to get out in 2011 and do more speeches. On Jan. 20, he is to fly to Texas for the 20th anniversary of the Gulf War with former President George H.W. Bush, the emir of Kuwait, and a host of alumni of that administration, including the former national security adviser Brent Scowcroft and Colin L. Powell, who was the chairman of the Joint Chiefs of Staff at the time, when Mr. Cheney was defense secretary

[...] Mr. Cheney has begun resuming his old activities. Besides the Cino fund-raiser, he attended a round of holiday parties in Washington -- leaving whispers in his trail about his weight loss.

The fundraiser for [Maria Cino], held at the Alexandria, Va., home of [Dick Cheney]'s former aide Mary Matalin, was his first major foray into partisan Washington political theater since receiving a mechanical heart pump in July that has, most doctors say, saved Cheney's life by taking on the task of helping to push blood through his arteries. With George W. Bush having decided to stay largely silent during [Barack Obama]'s tenure, Cheney embraced the role of public critic, accusing the new, young president of rolling back Bush-era policies and undermining the nation's security. In 2009, Cheney and Obama gave dueling speeches on the same day. At 69, Cheney's heart will never beat at full strength again, doctors say. His new mechanical pump, a partial artificial heart known as a ventricular assist device, leaves patients without a pulse because it pushes blood continuously instead of mimicking the heart's own beat. Most pulseless patients feel nothing unusual, but the devices do pose significant risks of infection. They are implanted as a last resort either for permanent use or as a bridge to transplant until a donor heart can be found. Cheney, who has participated in some of the nation's toughest decisions for decades, now faces a crucial one of his own: whether to seek a full heart transplant

PURPOSE: This study investigates the impact of a multilingual, multidisciplinary team targeting social and economic determinants of cancer treatment adherence among at-risk Hispanic immigrants. METHODS: Patients were recruited at 10 hospital-based cancer clinics in New York City between December 2008 and November 2009. This is a nested cohort study of Hispanic patients and their sociodemographic characteristics, areas of needed assistance, and reported impact of meeting service needs on keeping appointments. At the core of the intervention is the trained, bilingual Portal Access Facilitator, who assesses needs and synchronizes an individualized set of transdisciplinary services for each patient. RESULTS: A total of 328 Hispanic patients participated in the study. Of these, 89% preferred to speak Spanish in the health care setting, and 17% had no health insurance. The most common cancer diagnosis among participants was breast cancer (35%) followed by GI (17%) and gynecologic (16%) cancers. Patients most commonly requested financial support (59%), food support (37%), transportation assistance (21%), social work services (14%), psychosocial support (6%), help with health insurance issues (5%), and legal services (5%). In a follow-up assessment of high-need patients in urgent need of financial support, 86% reported that portal services helped them attend cancer care and treatment appointments, and 72% reported that portal services decreased worry about their care. CONCLUSION: Most patients reported that financial, social, and logistical support would help them attend their appointments for cancer care and treatment. Further multidisciplinary interventions should be implemented and evaluated to address social and economic determinants in cancer care for this population

PURPOSE: To prepare to develop a medical school curriculum on substance abuse disorders (SADs), the authors conducted a review of the quality of the sparse published literature. METHOD: The authors searched MEDLINE (1950 through December 2008) using OVID, PsycINFO, and PubMed to identify all studies of SAD interventions targeted toward undergraduate medical students. Of the 1,084 studies identified initially, 31 reported sufficient data to allow the authors to evaluate quality using Medical Education Research Study Quality Instrument (MERSQI) scores. The authors also determined the impact of the studies by considering three-year citation rate and journal impact factor. A detailed review of the literature provided data on contact hours and intervention content. RESULTS: The three-rater intraclass correlation coefficient for total MERSQI score was 0.82 (95% confidence interval: 0.70-0.90). The mean MERSQI score was 10.42 of a possible 18 (SD 2.59; range: 6.33-14.83). MERSQI scores were higher for more recently published studies and correlated with three-year citation rate but not impact factor. The mean contact time for 26 studies was 29.25 hours (range: 0.83-200 hours). CONCLUSIONS: The literature provides a variety of educational methods to train medical students in SAD detection and intervention skills. This literature is of variable quality and provides limited guidance for development of curricula and medical education policy. Better methods of curriculum evaluation and publication guidelines would help ensure that this literature has a positive impact on educational practice and public health

Plasma cell neoplasms result from the clonal expansion of terminally differentiated, immunoglobulin heavy-chain class switched B cells that typically secrete a monoclonal immunoglobulin. The 2008 World Health Organization (WHO) classification of plasma cell neoplasms encompasses a broad spectrum of disorders, from the precursor disorder monoclonal gammopathy of undetermined significance (MGUS) to plasma cell leukemia. The classification includes, in addition to precursor lesion MGUS, plasma cell myeloma, plasmacytoma, immunoglobulin deposition diseases, and osteosclerotic myeloma. Plasma cell myeloma is further divided into symptomatic plasma cell myeloma or multiple myeloma (MM), asymptomatic smoldering myeloma (SMM), non-secretory myeloma, and plasma cell leukemia. Although histopathologic cut-off criteria are incorporated into the classification schema, distinction between MGUS, SMM, and MM depends primarily on the presence or absence of end-organ damage, as defined by "CRAB" criteria (hypercalcemia, renal insufficiency, anemia, lytic bone lesions, or a combination of these). Systematic evaluation of pathogenetic differences between MGUS and MM should offer invaluable insights into early myelomagenesis. Given the complex, intertwined nature of the malignant plasma cell and its surroundings, multiple pathogenetic mechanisms play a critical role in interactions between neoplastic cells and their microenvironment. Understanding the events leading to end-organ damage, like anemia and bone remodeling, is a critical part of investigating early myelomagenesis and should provide us with better tools for early identification and treatment of these patients.

OBJECTIVE: To report the first case of severe osteoporosis associated with a vertebral pathologic fracture and osteonecrosis of femoral heads in an HIV-infected man receiving inhaled corticosteroids and ritonavir-boosted antiretroviral therapy. METHODS: We describe an HIV-infected man with severe osteoporosis, bilateral hip osteonecrosis, and secondary adrenal suppression, including detailed clinical, laboratory, and radiographic data, and review the related literature. RESULTS: A 60-year-old man with a 15-year history of HIV infection and a medical history of long-standing bronchiectasis treated with inhaled corticosteroids and hypogonadism treated with testosterone was referred to the endocrinology clinic after experiencing an osteoporotic vertebral fracture. He was taking ritonavir-boosted antiretroviral therapy. Osteonecrosis of both hips was also diagnosed, which required total hip replacement therapy. Laboratory evaluation revealed adrenal insufficiency due to increased effect of exogenous inhaled steroids and no other secondary causes of osteoporosis. A bone densitometry study showed osteoporosis of both hips and the lumbar spine. He was treated with intravenous pamidronate. During treatment, he developed bilateral femoral fractures after minor trauma. CONCLUSIONS: Given the potential for increased serum levels of inhaled corticosteroids in patients taking ritonavir-boosted highly active antiretroviral therapy, attention must be paid to the risk of bone loss in HIV-infected patients taking inhaled corticosteroids. Prescribing calcium and vitamin D supplementation and considering early osteoporosis screening are reasonable measures for this patient population. Interaction between inhaled corticosteroids and ritonavir may increase risk of hypothalamus-pituitary-adrenal axis suppression