Faculty Bibliography

Modern anesthesia evolved from frolics that drew large audiences. In one such show in 1844, a Connecticut dentist, Horace Wells, observed a volunteer breathe nitrous oxide, gash his leg, and not note any pain until the effects wore off. The next day, Dr. Wells asked another dentist to administer the ''laughing gas'' to him and extract a tooth. When the gas wore off, Dr. Wells exclaimed: ''It is the greatest discovery ever made. I didn't feel as much as the prick of a pin.'' He began using it on his patients. Ether, chloroform and other anesthetics followed, in part from additional self-experimenting. One medical myth is that Walter Reed experimented on himself in Cuba in discovering that mosquitoes transmit yellow fever. But after pledging to be a guinea pig for the mosquito theory, Dr. Reed returned to the United States while two of the three other members of his team experimented on themselves. One died. Another barely survived. After Dr. Reed's teammates made the crucial breakthrough, he returned to Cuba but never took his turn with a yellow-fever-carrying mosquito

In the wake of Hurricane Katrina, the [Bush] administration's efforts to plan for a possible pandemic flu have become controversial, with many Democrats in Congress charging that the administration has not done enough. Many have pointed to the lengthy writing process of the flu plan as evidence of this. Mr. [Michael O. Leavitt] is leaving Saturday for a 10-day trip to at least four Asian nations, where he will meet with health and agriculture officials to discuss planning for a pandemic flu. He said at a briefing on Friday that the administration's flu plan would be officially released soon. He was not aware at the briefing that The Times had a copy of the plan. And he emphasized that the chances that the virus now killing birds in Asia would become a human pandemic were unknown but probably low. A pandemic is global epidemic of disease. Note: The projections are based in part on past flu pandemics. The moderate case approximates the virulence of the 1958 or 1968 flus, which killed 70,000 and 34,000 in the United States, respectively. The severe case approximates the 1918 flu, which killed about 500,000

After Dr. Marshall and Dr. [J. Robin Warren] discovered the role of the spiral-shaped H. pylori bacterium, they and others conducted trials showing that antibiotics and drugs inhibiting the production of stomach acid could cure gastritis and most stomach and duodenal ulcers. Dr. [Barry J. Marshall] joined Dr. Warren in studying biopsies from a series of patients. After several attempts, Dr. Marshall succeeded in growing a bacterium that was unknown then; he named it Campylobacter pyloridis, believing that it was a member of the Campylobacter family. (It was later found to be a member of the Helicobacter family and renamed H. pylori.) In earlier interviews, Dr. Marshall described how at age 32, he swallowed a gastroscope tube to allow another doctor to look at his stomach and take several biopsies. These procedures and examinations were needed to document that Dr. Marshall had no H. pylori in his stomach and did not suffer from gastritis or another abnormality

One member of [Lin-Fa Wang]'s team, Dr. Jonathan Epstein, a veterinary epidemiologist, led the scientists in gathering different species of bats. After obtaining samples of feces and blood, the scientists released the bats into the wild or returned them to markets. The specimens were tested at both the Wuhan Institute of Virology in China and the Australian laboratory in Geelong for a variety of viruses. Laboratory analyses of the coronaviruses' molecular makeup provided strong evidence of the close genetic relationship between the viruses found in bats and the SARS virus

BACKGROUND: Medical students have unique information about peers' professionalism but are reluctant to share it through peer assessment. METHOD: Students (231 of 375; 62%) in one school replied to a survey about whether various characteristics of peer assessment (e.g., who receives the assessment, its anonymity, implications for the classmate) would prevent or encourage their participation. RESULTS: Sixty-six percent of the students agreed that there should be peer assessment of professionalism as long as the assessment reflected their preferences for how the assessment should take place. Some of their preferences included reporting unprofessional behavior to an impartial counselor, a 100% anonymous process, and having the classmate receive corrective instruction. Students across year levels generally agreed about the characteristics of peer assessment. Men and women disagreed about some characteristics. CONCLUSION: Most students are willing to participate in peer assessment as long as their preferences are taken into consideration.

BACKGROUND AND OBJECTIVES: Clinical trials increasingly use results of diagnostic tests as surrogate outcomes. Our objective was to answer the following questions: (1) is the parameter measured by the reference standard a valid surrogate? (2) How does the tests accuracy influence the estimate of the treatment benefit on surrogate? (3) Is it possible to correct the measured treatment effect given by results of inaccurate tests? METHODS AND SETTING: We reviewed the literature on asymptomatic deep venous thrombosis (DVT), detected by the reference standard and other imaging techniques, as surrogate for venous thromboembolism. The influence of test inaccuracy on the measurement of treatment benefit was calculated as a function of the patient baseline risk, the treatment effect model, and test performances. RESULTS: We show that: (1) asymptomatic DVT is correlated with clinical outcomes but is yet to be established as a surrogate; (2) inaccurate diagnostic test underestimates the treatment effect on surrogate; (3) the prevalence of the disease, the treatment effect model, and the accuracy of the test and the reference standard used to evaluate it need to be known to correct this underestimation. CONCLUSION: Even when the surrogate end point is valid, without a reliable study of the diagnostic test we cannot quantify the true treatment effect