Faculty Bibliography

The recipient of the transplant was a 38-year-old woman who was severely disfigured after being attacked by a dog, said the surgeon, Dr. Jean-Michel Dubernard of Lyons. The operation was carried out in Amiens on Sunday. In a brief telephone interview, Dubernard said the two surgical teams grafted a nose, lips and chin from a donor who had been declared brain dead onto the woman's face

The woman who received the transplant Sunday had been attacked by a dog in May. [Jean-Michel Dubernard] said she was transferred Tuesday from Amiens to the Edouard-Herriot Hospital in Lyon, where Dubernard works, for long-term monitoring of the immunosuppressive therapy that she will need to prevent rejection of the new partial face. The relatively short interval of about six months between the dog bite and the surgery also raised questions in the minds of some experts about what, if any, efforts had been made to perform reconstructive surgery before the transplant. 'The major question is: What were the indications' for the transplant, said Dr. Maria Siemionow, a surgeon at the Cleveland Clinic who plans to perform a full face transplant. Photo: A FIRST: Dr. Jean-Michel Dubernard of Lyon, France, collaborated on the first partial face transplant, performed Sunday in Amiens. Dubernard performed the first hand-forearm transplant in 1998

The trapping included 679 bats. The scientists found either evidence of the immune globulin (G) protein specific to Ebola virus in the blood, or fragments of the virus in the liver or spleen, of three species of bats -- Hypsignathus monstrosus, Epomops franqueti and Myonycteris torquata

The woman who received the transplant Sunday had been attacked by a dog in May. [Jean-Michel Dubernard] said she was transferred Tuesday from Amiens to the Edouard-Herriot Hospital in Lyon, where Dubernard works, for long-term monitoring of the immunosuppressive therapy that she will need to prevent rejection of the new partial face

The woman who received the transplant on Sunday had been attacked by a dog in May. Dr. [Jean-Michel Dubernard] said she was transferred Tuesday from Amiens to the Edouard-Herriot Hospital in Lyons, where he works, for long-term monitoring of the immunosuppressive therapy that she will need to prevent rejection of the new partial face. The relatively short interval of about six months between the dog bite and the surgery also raised questions in the minds of some experts about what, if any, efforts had been made to perform reconstructive surgery before the transplant. 'The major question is: what were the indications' for the transplant, said Dr. Maria Siemionow, a surgeon at the Cleveland Clinic who plans to perform a full face transplant. PHOTO; Associated Press: French surgeon Jean-Michel Dubernard, who performed the face transplant, is famous in his field. In 1976, he performed Europe's first pancreas transplant. He also led teams that performed a hand transplant in September 1998 and the world's first double forearm transplant in January 2000

Because of the public fear of bird flu, there has been a lot of pressure on Roche to produce more supply -- even political pressure to break the patent on Tamiflu and allow the drug to be sold generically before the patent expires. Tamiflu is the newest of the neuramidase inhibitors, drugs that work by blocking the transmission of the influenza virus from cell to cell. As a drug to treat the fear of, rather than the effect of bird flu, Tamiflu can easily be misused

BACKGROUND: Physician communication skills, linked to important patient outcomes, are rarely formally addressed after the pre-clinical years of medical school. We implemented a new communication skills curriculum during the third year Surgery Clerkship which was part of a larger curriculum revision found in a controlled trial to significantly improve students' overall communication competence. DESCRIPTION: In three 2 hour workshops students, learned to address common communication challenges in surgery: patient education, shared decision-making, and delivering bad news. Each 2 hour, surgeon facilitated session was comprised of a 30 minute introductory lecture, a 15 minute checklist driven video critique, a 15 minute group discussion, a 45 minute standardized patient (SP) exercise with feedback from the SP, peers, and faculty member, and a 15 minute closing summary. To date, over 25 surgery faculty have been trained to conduct these sessions. In an end-of-clerkship survey, students reported on skill changes and assessed the curriculum's educational effectiveness. EVALUATION: A survey was completed by 120 of the 160 (76%) third year students who participated in the curriculum. Fifty-five percent of students reported improvement in their communication skills and ability to address specific communication challenges. Students were satisfied with the amount and quality of teaching. CONCLUSIONS: Communication skills teaching can be implemented in the surgery clerkship, and surgeons are particularly well suited to teach about patient education, discussing informed consent and shared decision making, and delivering bad news. Structured case-based sessions are acceptable to, and improve the self-assessed skills of, surgery clerkship students. Faculty development geared toward such sessions has added benefits to educational activities in a clinical department overall.

OBJECTIVES: The authors examined whether African Americans, compared with whites, received guideline-concordant care for bipolar I disorder. METHODS: A retrospective analysis was conducted of data for patients who received a diagnosis of bipolar I disorder in fiscal year 2001 and received care in facilities in the Department of Veterans Affairs (VA) mid-Atlantic region. Indicators of guideline-concordant care were based on prescription data and data on utilization of inpatient and outpatient services from VA databases. RESULTS: A total of 2,316 patients with a diagnosis of bipolar I disorder were identified. Their mean age was 52 years; 9.4 percent (N=218) were women, and 13.1 percent (N=303) were African American. Overall, mood stabilizers were prescribed for 74.6 percent (N=1,728) of the patients; 67.1 percent (N=1,554) had an outpatient mental health visit within 90 days after the index diagnosis, and 54.3 percent (N=1,258) had an outpatient visit within 30 days after discharge from a psychiatric hospitalization. Multivariate logistic regression analyses with adjustment for sociodemographic and facility factors revealed that African Americans were less likely than whites to have an outpatient follow-up visit within 90 days after the index diagnosis. Race was not associated with receipt of mood stabilizers or use of outpatient services after a hospital discharge. CONCLUSIONS: Although a majority of patients received guideline-concordant care for bipolar disorder, potential gaps in continuity of outpatient care may exist for African-American patients

The purpose of this study was to identify potential barriers and facilitators to Chinese immigrant participation in cancer screening and clinical trials. A series of focus groups, in English, Cantonese, and Mandarin, were conducted with physicians, community leaders, and first generation members of the Manhattan Chinatown community. Participants were asked to discuss their beliefs about cancer, cancer screening, clinical trials, and cancer health education materials. Focus group data were stratified by respondent group and analyzed for thematic content. Eleven physicians, 15 community leaders, and 38 community members participated. Some community members were not familiar with cancer screening as a preventive measure and had not received common screens such as PAP smears or mammograms. They described widespread misconceptions about cancer that act as screening deterrents, e.g. testing for cancer can cause cancer. Community members were unfamiliar with clinical trials and would not participate in a clinical trial unless 'sick,' and only on the recommendation of their physicians. Physicians did not see the relevance or value of clinical trials for their patients. Among first generation Chinese immigrants, there are many perceptual barriers to cancer screening and clinical trials recruitment. There is a need for effective culturally tailored health education on these health topics to address persistent misconceptions about cancer and to increase knowledge about cancer screening and clinical trials. Health education efforts and clinical trial recruitment in this community must involve community physicians