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department:Medicine. General Internal Medicine

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Medicine - The Unreal World: That's why they call it science fiction [Newspaper Article]

Siegel, Marc
THIS made-for-TV movie stars Scott Bairstow as Jute, one of the few humans left in a world run by androids. After killing an android in a bar fight, Jute is sentenced to a prison deep in the wasteland. Another android, DeeCee (played by Joseph Lawrence), is responsible for bringing him to the prison camp, but instead helps him escape. As they spend time together, DeeCee becomes more and more human- like, which is ultimately explained by the fact that android brains are made using human brain fluid. In his growing empathy, DeeCee even goes so far as to allow his hand to be amputated to free Jute from the shackle that binds them together
PROQUEST:1070631811
ISSN: 0458-3035
CID: 80692

After Yearly Physical, Cheney Said to Be in Good Health [Newspaper Article]

Stolberg, Sheryl Gay; Altman, Lawrence K
Tests at George Washington University Hospital found that Mr. Cheney's cardiac pacemaker was working properly and had not been activated due to arrhythmia, or irregular heartbeat, said Mr. Cheney's spokeswoman, Lea Anne McBride. Mr. Cheney, 65, has had four heart attacks, the first when he was 37 and the fourth on Nov. 22, 2000, in the thick of the dispute between former Vice President Al Gore and President Bush over the outcome of the 2000 presidential election. Mr. Cheney has also had quadruple heart bypass surgery and two angioplasties, procedures to clear blockages in the arteries
PROQUEST:1070419311
ISSN: 0362-4331
CID: 81227

Which patients' factors predict the rate of growth of Mycobacterium tuberculosis clusters in an urban community?

Driver, Cynthia R; Macaraig, Michelle; McElroy, Peter D; Clark, Carla; Munsiff, Sonal S; Kreiswirth, Barry; Driscoll, Jeffrey; Zhao, Benyang
Factors influencing tuberculosis cluster growth are poorly understood. The authors examined clusters of two or more culture-confirmed Mycobacterium tuberculosis cases between January 1, 2001, and December 31, 2003, that had insertion sequence 6110 (IS6110) restriction fragment length polymorphism and spoligotype patterns identical to those of another study case. Genotypes first seen in New York, New York, before or during 1993 were considered historical; recent strains were those first seen after 1993. The authors examined the effect of the combined characteristics of infectiousness of the first two cases in a cluster on the rate of cluster growth. Genotyping was performed for 2,408 (91.8%) of the 2,623 tuberculosis cases diagnosed; 873 cases were in 212 clusters. Thirty-one clusters had historical strains, 153 were recent, and 28 were of unknown period. Patients' infectiousness was not associated with the rate of cluster growth among historical strain clusters. Among recent strain clusters, infectiousness of both of the initial cases was associated with a higher rate of cluster growth compared with clusters in which neither initial case was infectious, upon adjustment for male sex (rate ratio = 2.62, 95% confidence interval: 1.19, 5.78). The rate of genotype cluster growth should be monitored regardless of how long the strain has been present in the community. However, infectiousness in the first two cases may be useful to prioritize genotype cluster investigations
PMID: 16641308
ISSN: 0002-9262
CID: 112856

Antidote

Siegel, Marc
Ketek is an antibiotic with a deserved reputation as an effective treatment for bacterial respiratory infections. But erythromycin and all its derivatives, including Ketek, have some degree of liver toxicity. Ketek is now being deemed as unusually toxic -- at least according to a recent safety review by FDA officials. These officials have suggested that the FDA either force Sanofi-Aventis to withdraw Ketek from the market, severely restrict it, or at least add a stern warning to its label. Whatever the outcome for Ketek, the decision should be based on facts and statistical risks compared with the potential gain of lives saved
PROQUEST:1083605321
ISSN: 0025-7354
CID: 86189

Evidence Based Approach to the Treatment and Care of the Older Adult with Cancer (Cope, D.G. and Reb, A.M., Eds. Oncology Nursing Society Press, Inc.) [Book Review]

Clark, Maya N
ORIGINAL:0012944
ISSN: 1064-3842
CID: 3314782

Comprehensive association testing of common mitochondrial DNA variation in metabolic disease

Saxena, Richa; de Bakker, Paul I W; Singer, Karyn; Mootha, Vamsi; Burtt, Noel; Hirschhorn, Joel N; Gaudet, Daniel; Isomaa, Bo; Daly, Mark J; Groop, Leif; Ardlie, Kristin G; Altshuler, David
Many lines of evidence implicate mitochondria in phenotypic variation: (a) rare mutations in mitochondrial proteins cause metabolic, neurological, and muscular disorders; (b) alterations in oxidative phosphorylation are characteristic of type 2 diabetes, Parkinson disease, Huntington disease, and other diseases; and (c) common missense variants in the mitochondrial genome (mtDNA) have been implicated as having been subject to natural selection for adaptation to cold climates and contributing to "energy deficiency" diseases today. To test the hypothesis that common mtDNA variation influences human physiology and disease, we identified all 144 variants with frequency >1% in Europeans from >900 publicly available European mtDNA sequences and selected 64 tagging single-nucleotide polymorphisms that efficiently capture all common variation (except the hypervariable D-loop). Next, we evaluated the complete set of common mtDNA variants for association with type 2 diabetes in a sample of 3,304 diabetics and 3,304 matched nondiabetic individuals. Association of mtDNA variants with other metabolic traits (body mass index, measures of insulin secretion and action, blood pressure, and cholesterol) was also tested in subsets of this sample. We did not find a significant association of common mtDNA variants with these metabolic phenotypes. Moreover, we failed to identify any physiological effect of alleles that were previously proposed to have been adaptive for energy metabolism in human evolution. More generally, this comprehensive association-testing framework can readily be applied to other diseases for which mitochondrial dysfunction has been implicated.
PMCID:1474138
PMID: 16773565
ISSN: 0002-9297
CID: 2689832

The management of chronic prostatitis in men with HIV

Santillo, Vincent M; Lowe, Franklin C
Prostatitis is a common urologic diagnosis. Although treatment algorithms are available for this poorly understood entity, several adaptations must be made in order to accommodate the therapeutic needs of HIV-positive patients. The most important consideration when treating HIV-infected patients for prostatitis is their current immune status, whether they are immunocompromised or not (non-progressive disease or reconstituted with highly active antiretroviral therapy). A treatment algorithm for those with chronic bacterial prostatitis (Category II), chronic nonbacterial prostatitis (Category IIIA), and prostatodynia (Category IIIB) is presented in this article. In the HIV-positive patient population, there is a greater likelihood for atypical pathogens including fungi, tuberculosis, anaerobes, and viruses. Because the HIV-infected patient is at increased risk for the development of prostatic abscess and urosepsis than the general population, increased monitoring and evaluation and longer-term appropriately directed antimicrobial therapy are required.
PMID: 16930503
ISSN: 1527-2737
CID: 685972

Influenzalike illness among homeless persons [Letter]

Bucher, Scott J; Brickner, Philip W; Vincent, Richard L
PMCID:3291066
PMID: 16845776
ISSN: 1080-6040
CID: 95218

Literature search parameters marginally improved the pooled estimate accuracy for ultrasound in detecting deep venous thrombosis

Kassai, Behrouz; Sonie, Sandrine; Shah, Nirav R; Boissel, Jean-Pierre
BACKGROUND AND OBJECTIVES: Data collection remains of utmost importance to avoid publication bias in systematic reviews. Our objectives were to compare search strategies with and without methodological terms in Medline, to find out how other databases complement Medline, and how these strategies affect the pooled estimates of the accuracy. STUDY DESIGN AND SETTING: A study was eligible if it prospectively compared ultrasound to venography for the diagnosis of deep venous thrombosis in the lower limbs. All relevant articles found with all databases, searched from 1966 through 2003, constitute the reference standard. Sensitivity was defined as the proportion of relevant studies found by Medline searches divided by the total number of articles in the reference standard. RESULTS: Of a total of 1,473 citations, 237 abstracts were included. The sensitivity of strategies without methodological terms was higher (96%) than those with (95%, 76%, and 95%). Searches of multiple databases found seven articles not found with Medline. Searches of congress proceedings (International Society of Thrombosis and Haemostasis) found three abstracts not published in full. The diagnostic odds ratio OR was 5.66 (95% confidence interval CI = 4.84-6.48) when multiple databases were searched and 5.57 (95% CI = 3.49-7.65) when only English-language articles in Medline were identified. CONCLUSION: Medline searches combining free text and MeSH terms were more sensitive. Single Medline search affects only marginally the pooled estimate accuracy
PMCID:2670362
PMID: 16765274
ISSN: 0895-4356
CID: 116483

Radio frequency ablation registration, segmentation, and fusion tool

McCreedy, Evan S; Cheng, Ruida; Hemler, Paul F; Viswanathan, Anand; Wood, Bradford J; McAuliffe, Matthew J
The radio frequency ablation segmentation tool (RFAST) is a software application developed using the National Institutes of Health's medical image processing analysis and visualization (MIPAV) API for the specific purpose of assisting physicians in the planning of radio frequency ablation (RFA) procedures. The RFAST application sequentially leads the physician through the steps necessary to register, fuse, segment, visualize, and plan the RFA treatment. Three-dimensional volume visualization of the CT dataset with segmented three dimensional (3-D) surface models enables the physician to interactively position the ablation probe to simulate burns and to semimanually simulate sphere packing in an attempt to optimize probe placement. This paper describes software systems contained in RFAST to address the needs of clinicians in planning, evaluating, and simulating RFA treatments of malignant hepatic tissue.
PMCID:2614074
PMID: 16871716
ISSN: 1089-7771
CID: 2131602