Faculty Bibliography

OBJECTIVES: A method for the induction of complete heart block (CHB) by ethanol injection and its success rate in a pig model of acute right ventricular failure is reported. Additionally, a review of the literature for the induction of CHB in laboratory animals is detailed. The literature review was undertaken to both compare our rate of success with other methods and provide insight into our technique and refine its implementation. BACKGROUND: Animal models of CHB have facilitated the understanding of therapeutics for various cardiac pathologies in humans. In our laboratory, CHB in pigs is used for complete control of heart rhythm in studies of biventricular pacing. MATERIALS AND METHODS: Experiments carried out on pigs in our laboratory that required the induction of CHB were reviewed retrospectively. In addition, review of the literature for creating CHB in animals was undertaken. Our success rate was compared to that of other groups. RESULTS: Our success rate (93%) is similar to other models of CHB, in general, and to those models that used the injection of caustic substances with thoracotomy. CONCLUSIONS: Review of the literature indicates that our success rate is comparable to other groups and that, although many approaches have been described in both open- and closed-chest models, success is likely dependent on the practice and skill of the experimenter. In addition, review of the literature has afforded us new perspectives on the experimental induction of CHB.

The media have begun beating the stuffing out of another drug, Ambien, as they show pictures of drowsy sleepwalkers cooking or stuffing themselves at the refrigerator in the middle of the night, or write stories about the risks to motor vehicle operators. The fact is, the vast majority of the author's patients experience no side effects whatsoever. In fact, Ambien is so well tolerated and effective that it has changed the way doctors treat insomnia. Medical misinformation of this kind helps neither doctors nor their patients

TALKING WITH DOCTORS By David Newman. 199 pp. Hillsdale, NJ., Analytic Press, 2006. $32.50. ISBN 0-88163-446-8

As the population increases, older people have the opportunity to travel for longer periods and to destinations that are quite different from what they are used to. Older people do indeed have more ongoing medical issues and some limitations due to the aging process. Most of the time these chronic conditions are not a contraindication to travel. Preparing for travel frequently involves starting an exercise program, updating routine immunizations such as tetanus, pneumonia, and influenza as well as getting destination specific immunizations such as hepatitis, yellow fever and typhoid. Medications should be reviewed as they relate to altitude, climate and concurrent travel medications including malaria prophylaxis. There are many organizations and foundations that deal with travel and specific medical problems such as diabetes, asthma, dialysis and for those with spinal cord injuries. The traveler would be wise to seek the advice of specialists related to their specific medical condition as well as a travel medical physician. One should also be sure that their medical insurance would cover them in a foreign country

Counselling pregnant women seeking advice about travel should begin with a frank, in-depth discussion about their contemplated trip. While most travel during pregnancy is relatively safe, some women should be urged not to go on their planned trip, or to change their itineraries. But some women are not receptive to such advice. Much of today's popular culture preaches that pregnancy is a normal phase of life, not a health issue, and that restrictions placed on women during pregnancy by the medical profession are largely unnecessary. The women must truly and totally understand potential risks and realise that medical science does not have all the answers, especially as far as risks to the foetus are concerned. The women should be aware that travel may remove them from access to medical care, require immunisations and prophylactic medications, involve long hours sitting in aircraft, necessitate dietary restrictions at the destination, and expose them to extremes of climate, to mention just a few

In 1947, he and Marcel Bessis developed exchange blood transfusion as a therapy for childhood leukemia. The transfusions induced what is believed to have been the first temporary remission of acute lymphoblastic leukemia in children, Professor Jacques- Louis Binet, a hematologist and secretary of the French Academy of Medicine, said last week. In 1948, Bernard and Dr. Jean-Pierre Soulier described a hereditary syndrome that does not allow platelets to stick to blood vessels and form clots. It leads to bleeding in children and is now known as the Bernard-Soulier syndrome. He did not know who the patient would be when a trainee of his, practicing in Iran, asked him to come to Tehran urgently in 1974. Bernard took another trainee, Georges Flandrin. The patient was Shah Mohammad Reza Pahlavi, who was bothered by an enlarged spleen

Since AIDS first made headlines 25 years ago, it killed 25 million people worldwide and infect 40 million more in one of the worst epidemics in history. Altman relates that in 1985 he was greeted with skepticism about AIDS in Africa, even though the disease had begun to take a devastating toll there. Here, he details the outbreak of AIDS and why many people, including doctors, did not recognize an epidemic in the making and take steps to try to contain it

There are increasing reports of methicillin-resistant Staphylococcus aureus (MRSA) infection and colonization in horses and evidence that MRSA can be transmitted between horses and humans. The objective of this study was to investigate reports of skin infection in personnel working with a foal with community-associated MRSA colonization and subsequent infection. Clinical diagnostic specimens were collected from individuals reporting skin lesions following contact with the affected foal. Nasal and groin screening swabs were collected from other veterinary personnel that attended a voluntary screening clinic. MRSA skin infections were identified in three neonatal intensive care unit personnel. Nasal colonization was subsequently identified in 10/103 (9.7%) other veterinary hospital personnel. Isolates were indistinguishable by pulsed field gel electrophoresis, classified as Canadian epidemic MRSA-5, possessed SCCmecIV, were negative for the Panton-Valentine leukocidin and were multidrug resistant. Transmission to veterinary personnel despite short-term contact with standard protective barriers highlights the potential importance of MRSA as an emerging zoonotic pathogen, and indicates that further evaluation of interspecies transmission of MRSA and means to prevent zoonotic infection are required

David Oshinsky reviews "Kingfish: The Reign of Huey P. Long," by Richard D. White Jr