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department:Medicine. General Internal Medicine

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MEDICINE; THE UNREAL WORLD; Diagnosis rings true, but not the care [Newspaper Article]

Siegel, Marc
Mercy [Television Program] -- The reality Dr. William L. Risser, director of adolescent medicine at the University of Texas Medical School at Houston, says he would consider hepatitis, pancreatitis or pelvic inflammatory disease as the most likely causes of such pain and vomiting in an 11-year-old
PROQUEST:1989174361
ISSN: 0458-3035
CID: 108875

MEDICINE; THE UNREAL WORLD; A few more tests and some bedside reality are needed [Newspaper Article]

Siegel, Marc
Scrubs [Television Program] -- If so, how long would a doctor have to wait after stopping a patient's heparin before performing an invasive test such as a bronchoscopy, in which a tissue biopsy may be taken? (A biopsy could cause excessive bleeding if the platelets don't clot properly.) Would a bronchoscopy be a routine test to evaluate breathing problems?
PROQUEST:1936481941
ISSN: 0458-3035
CID: 108881

Dr. Barton Childs, 93, Dies; Studied Inherited Diseases [Newspaper Article]

Altman, Lawrence K
[...] Dr. Childs helped shape the understanding of inherited diseases as scientists learned more about so-called inborn errors of metabolism, biochemistry and molecular biology. If a mother's gene for the Factor VIII blood clotting agent is mutated, that could be harmful to a son, leading to hemophilia, because the gene is on the X that she has supplied to the boy (with the father having supplied the Y)
PROQUEST:1978624521
ISSN: 0362-4331
CID: 108895

Routine checkup finds Obama in excellent health [Newspaper Article]

Altman, Lawrence K; Zeleny, Jeff
President Barack Obama 'is in excellent health' and likely to remain able to carry out his duties for the rest of his term, his doctor said after completing Mr. Obama's first routine medical checkup since he took office last year. Mr. Obama, 48, continues to struggle to stop his 30-year smoking habit and needs to modify his diet, said Dr. [Jeffrey Kuhlman], a navy captain who led the medical team that performed Mr. Obama's physical Sunday. As for Mr. Obama's smoking, Mr. [Robert Gibbs] said the president had tried to quit but had 'admitted lapses.' It is not known how frequently Mr. Obama smokes, or what the figure is for his total 'pack years,' a standard measure of a smoker's risk for diseases like lung cancer
PROQUEST:1972840241
ISSN: 0294-8052
CID: 110417

Lautenberg's Cancer Is Curable, Doctor Says [Newspaper Article]

Halbfinger, David M; Altman, Lawrence K
[...] his advanced age and Mr. Christie's election had prompted an effort by Democrats to pass legislation that would have prevented the governor from appointing a Republican to the Senate -- whether by specifically requiring him to choose a Democrat or by keeping the seat vacant until a special election could be held
PROQUEST:1966850541
ISSN: 0362-4331
CID: 108896

Clement Finch, 94, Dies; A Pioneer in Hematology [Newspaper Article]

Altman, Lawrence K
Dr. Clement A. Finch, a pioneering hematologist whose research on iron helped improve nutrition and led to advances in diagnosing and treating anemia, died June 28 at his home in the La Jolla neighborhood of San Diego. Dr. Finch also played a crucial role in showing that hemochromatosis, a genetic disease that causes the body to absorb too much iron from food, could be treated through periodic bleeding
PROQUEST:2073201781
ISSN: 0362-4331
CID: 119191

Pioneering researcher into comatose state; Coined term for 'locked-in syndrome' [Newspaper Article]

Altman, Lawrence K
Plum's immensely influential research improved the diagnosis and treatment of patients who lose consciousness from head injuries, strokes, metabolic disorders and drug overdoses.
PROQUEST:2061150581
ISSN: 0384-1294
CID: 119192

Dr. Fred Plum, at 86; advanced study of consciousness [Newspaper Article]

Altman, Lawrence K
Without the benefit of now-standard technologies like CT and MRI scans and ultrasound, the medical field had only a rudimentary understanding of ailments like brain swelling, degenerative brain disease, impaired consciousness and brain death, and doctors could treat few of them.
PROQUEST:2057377851
ISSN: 0743-1791
CID: 119193

Radial artery conduits improve long-term survival after coronary artery bypass grafting

Tranbaugh, Robert F; Dimitrova, Kamellia R; Friedmann, Patricia; Geller, Charles M; Harris, Loren J; Stelzer, Paul; Cohen, Bertram; Hoffman, Darryl M
BACKGROUND: The second best conduit for coronary artery bypass graft surgery (CABG) is unclear. We sought to determine if the use of a second arterial conduit, the radial artery (RA), would improve long-term survival after CABG using the left internal thoracic artery (LITA) and saphenous vein (SV). METHODS: We compared the 14-year outcomes in propensity-matched patients undergoing isolated, primary CABG using the LITA, RA, and SV versus CABG using the LITA and only SV. In all, 826 patients from each group had similar propensity-matched demographics and multiple variables. The primary endpoint was all-cause mortality obtained using the Social Security Death Index. RESULTS: Perioperative outcomes including in hospital mortality (0.1% for the RA patients and 0.2% for the SV patients) were similar. Kaplan-Meier survival at 1, 5, and 10 years was 98.3%, 93.9%, and 83.1% for the RA group versus 97.2%, 88.7%, and 74.3% for the SV group (log rank, p = 0.0011). Cox proportional hazards models showed a lower all-cause mortality in the RA group (hazard ratio 0.72, confidence interval: 0.56 to 0.92, p = 0.0084). Ten-year survivals showed a 52% increased mortality for the SV patients (25.7%) versus the RA patients (16.9%; p = 0.0011). For symptomatic patients, RA patency was 80.7%, which was not different than the LITA patency rate of 86.4% but was superior to the SV patency rate of 46.7% (p < 0.001). CONCLUSIONS: Using the LITA, SV, and a RA conduit for CABG results in significantly improved long-term survival compared with using the LITA and SV. The use of two arterial conduits offers a clear and lasting survival advantage, likely due to the improved patency of RA grafts. We conclude that RA conduits should be more widely utilized during CABG
PMID: 20868808
ISSN: 1552-6259
CID: 137321

From the patient's perspective: the impact of training on resident physician's obesity counseling

Jay, Melanie; Schlair, Sheira; Caldwell, Rob; Kalet, Adina; Sherman, Scott; Gillespie, Colleen
BACKGROUND: It is uncertain whether training improves physicians' obesity counseling. OBJECTIVE: To assess the impact of an obesity counseling curriculum for residents. DESIGN: A non-randomized, wait-list/control design. PARTICIPANTS: Twenty-three primary care internal medicine residents; 12 were assigned to the curriculum group, and 11 were assigned to the no-curriculum group. Over a 7-month period (1-8 months post-intervention) 163 of the residents' obese patients were interviewed after their medical visits. INTERVENTION: A 5-hour, multi-modal obesity counseling curriculum based on the 5As (Assess, Advise, Agree, Assist, Arrange) using didactics, role-playing, and standardized patients. MAIN MEASURES: Patient-report of physicians' use of the 5As was assessed using a structured interview survey. Main outcomes were whether obese patients were counseled about diet, exercise, or weight loss (rate of counseling) and the quality of counseling provided (percentage of 5As skills performed during the visit). Univariate statistics (t-tests) were used to compare the rate and quality of counseling in the two resident groups. Logistic and linear regression was used to isolate the impact of the curriculum after controlling for patient, physician, and visit characteristics. KEY RESULTS: A large percentage of patients seen by both groups of residents received counseling about their weight, diet, and/or exercise (over 70%), but the quality of counseling was low in both the curriculum and no curriculum groups (mean 36.6% vs. 31.2% of 19 possible 5As counseling strategies, p = 0.21). This difference was not significant. However, after controlling for patient, physician and visit characteristics, residents in the curriculum group appeared to provide significantly higher quality counseling than those in the control group (std beta = 0.18; R(2) change = 2.9%, P < 0.05). CONCLUSIONS: Residents who received an obesity counseling curriculum were not more likely to counsel obese patients than residents who did not. Training, however, is associated with higher quality of counseling when patient, physician, and visit characteristics are taken into account
PMCID:2855014
PMID: 20217268
ISSN: 1525-1497
CID: 130962