Faculty Bibliography

The US healthcare system has engendered many attempts at incremental fixes and largescale overhauls. Practitioners of evidence-based medicine have developed the tools that can measure the effects of these attempts on improvement in healthcare by dissecting the strengths and weaknesses of the different means of evidence generation, such as observational studies, randomized trials, and systematic reviews. Randomized clinical trials have emerged as the de facto gold standard for creating medical knowledge; they are used primarily to define whether a drug or intervention is beneficial in an artificially optimized clinical setting, not whether it makes sense for most patients or for a specific patient. Because of the limitations of clinical trials and their exclusionary patient-selection criteria, relying on a single study is likely to lead to an incomplete answer; using a range of randomized and observational studies, or aggregation of studies, is therefore recommended. This article reviews the historical development of evidence creation in medicine, including the strengths and weaknesses of the current state of the science, focusing on outcomes needed for decision-making relevant to the various stakeholders, as well as on the emerging field of comparative effectiveness research

A number of phylogenetic studies of Mycobacterium tuberculosis have suggested a highly clonal population structure. Despite the extreme homogeneity of M. tuberculosis strains, the genome is punctuated by a number of polymorphic regions that give rise to sufficient diversity, thus forming the basis for molecular epidemiologic studies of tuberculosis. As such, insertion sequence (IS) 6110, which is unique to members of the M. tuberculosis complex and is present in variable numbers and in discrete genomic locales among strains, has been extensively used in molecular epidemiologic studies. Genotyping, using IS6110-based restriction fragment length polymorphism (RFLP), was standardized by the international community, and this has facilitated inter- and intralaboratory comparison, thereby serving as a model system for subspeciation of M. tuberculosis. When IS6110-based RFLP was used in conjunction with conventional epidemiologic data, its utility was realized. In this chapter, we discuss the basic methodology for conducting IS6110-based RFLP and analyzing the resulting hybridization profiles

BACKGROUND: Research suggests that forgiveness is associated with better psychological and physical health and in particular cardiovascular functioning. Despite these findings, most forgiveness studies involve healthy participants. PURPOSE: The current study assessed the psychological and physiological correlates of forgiveness in individuals with coronary artery disease (CAD). METHOD: Self-reported forgiveness, perceived stress, anxiety, and depression, and physiological data, including triglycerides, total cholesterol, high- (HDL) and low-density lipoprotein (LDL) cholesterol, were obtained from 85 hospitalized CAD patients. RESULTS: Higher levels of forgiveness were associated with lower levels of anxiety (p < 0.05), depression (p < 0.01), and perceived stress (p < 0.005) as well as lower total cholesterol to HDL and LDL to HDL ratios (both at p < 0.05) after controlling for age and gender. The psychological indices did not mediate the relationship between forgiveness and cholesterol ratios. CONCLUSIONS: Results suggest that the psychological correlates of forgiveness are similar in cardiac patients and healthy individuals. Further, among cardiac patients, forgiveness may be associated with reduced risk for future cardiovascular events

In this paper, I argue that social science and genomics can be integrated; however, the way this marriage is currently occurring rests on spurious methods and assumptions and, as a result, will yield few lasting insights. However, recent advances in both econometrics and in developmental genomics provide scientists with a novel opportunity to understand how genes and environment interact to produce social outcomes. Key to any causal inference about the interplay between genes and social environment is that either genotype be exogenously manipulated (i.e. through sibling fixed effects) while environmental conditions are held constant, and/or that environmental variation is exogenous in nature, i.e. experimental or arising from a natural experiment of sorts. Further, initial allele selection should be motivated by findings from genetic experiments in model animal studies linked to orthologous human genes. Likewise, genetic associations found in human population studies should then be tested through knock-out and over-expression studies in model organisms

The blue rubber bleb nevus syndrome, a rare condition characterized by lesions of the skin, gastrointestinal tract, and other parts of the body, can result in serious gastrointestinal bleeding and other adverse results and be challenging to manage. The clinical features and treatment of this rare disorder are reviewed here