Faculty Bibliography

BACKGROUND: The University of Wisconsin (UW) solution is the gold standard for heart preservation but has limitations in terms of both duration and adequacy of protection. Our laboratory has been interested in a more physiologic approach to heart preservation by maintaining the heart at its resting membrane potential (hyperpolarized arrest) with the K(ATP) channel agonist pinacidil. This study compared our extracellular solution (WashU) with the UW intracellular depolarizing solution and quantified the protective effect of pinacidil in both solutions. METHODS: Thirty-two rabbit hearts received 1 of 4 solutions in a crystalloid-perfused Langendorff apparatus: (1) UW, (2) WashU containing 0.5 mmol/liter pinacidil, (3) UW with 0.5 mmol/liter pinacidil, or (4) WashU without pinacidil. Thirty minutes of perfusion was followed by data acquisition consisting of left ventricular pressure-volume curves generated by inflating an intraventricular balloon. All hearts were placed in cold storage for 8 hours, followed by 1 hour of reperfusion before data acquisition. RESULTS: Post-ischemic developed pressure (DP) was better preserved by WashU (76.8% +/- 3.8%) than by UW (48.3% +/- 2.5%). Diastolic compliance was better preserved by WashU (239.9% +/- 77.2%) compared with UW (711.1% +/- 193.1%). Removing pinacidil from our solution resulted in decreased DP (46.6% +/- 3.2%) and diastolic compliance (688.8% +/- 158.2%) Adding pinacidil to UW had a limited effect on DP and compliance. CONCLUSIONS: Our results support the superiority of the WashU hyperpolarizing solution for heart preservation over UW. Pinacidil was beneficial in maintaining cardiac function and compliance. This benefit was not observed when pinacidil was placed into the UW depolarizing solution

Prescription drugs have certainly been taking a hit lately in terms of public perception. Drug safety has become a popular topic, and many classes of drugs, from COX-2 inhibitors to psychiatric drugs like SSRIs and Adderall, for ADHD, have been repeatedly criticized. Any substance, whether in pill or herbal form, has an effect on the body and must be studied. It is wrong to assume that a prescription drug is automatically toxic, while untested alternative medicines are presumed safe

BACKGROUND: Although peer assessment holds promise for assessing professionalism, reluctance and refusal to participate have been noted among learners and practicing physicians. Understanding the perspectives of potential participants may therefore be important in designing and implementing effective peer assessment. OBJECTIVE: To identify factors that, according to students themselves, will encourage or discourage participation in peer assessment. DESIGN: A qualitative study using grounded theory to interpret views shared during 16 focus groups that were conducted by leaders using a semi-structured guide. PARTICIPANTS: Sixty-one students in Years 1, 3, and 4 in 2 mid-western public medical schools. RESULTS: Three themes students say would promote or discourage peer assessment emerged: personal struggles with peer assessment, characteristics of the assessment system itself, and the environment in which the system operates. Students struggle with reporting an unprofessional peer lest they bring harm to the peer, themselves, or their clinic team or work group. Who receives the assessment and gives the peer feedback and whether it is formative or summative and anonymous, signed, or confidential are important system characteristics. Students' views of characteristics promoting peer assessment were not unanimous. Receptivity to peer reports and close positive relationships among students and between students and faculty mark an environment conducive to peer assessment, students say. CONCLUSIONS: The study lays a foundation for creating acceptable peer assessment systems among students by soliciting their views. Merely introducing an assessment tool will not result in students' willingness to assess each other.

Drug resistance, particularly vancomycin and methicillin resistance, in Staphylococcus aureus continues to emerge as a significant public health threat in both the hospital and community settings. In addition to the limited treatment options, S. aureus strains acquire and express numerous virulence factors that continue to increase its ability to cause a wide spectrum of human disease. As a result, empirical treatment decisions are confounded and there is a heightened need for a diagnostic test (or assay) to rapidly identify antibiotic resistance and specific virulence determinants and indicate the appropriate treatment. To that end we developed a platform using multiplex molecular beacon probes with real-time PCR for the rapid detection of drug resistance-determining genes and virulence factors in S. aureus. In this study, we demonstrate the specificity and sensitivity of our platform for detection of the genes conferring methicillin (mecA) and vancomycin (vanA) resistance as well as a gene encoding the virulence factor Panton-Valentine leucocidin (lukF) in S. aureus isolates

This study examined the psychometric properties (specifically, the factorial invariance) of the Multidimensional Health Locus of Control scales in a multicultural sample of college students. The original 18-item MHLC was administered, along with measures of ethnicity-related variables, to 1845 college students from three ethnic groups (Caucasian Americans, Filipino Americans and Latino Americans). Confirmatory factor analysis failed to confirm a three-factor structure for any of the three groups. Subsequent exploratory principal components analysis supported a cross-ethnic-group three-factor structure that had reduced numbers of items loading adequately on each factor. Shortened scales were created, and internal consistency reliability for each scale was acceptable for each ethnic group. Filipino Americans scored higher on all three scales. Regression analyses predicting MHLC scales from demographic and sociocultural variables revealed few predictive relationships

Scores of people have already died by drowning or other causes, two by carbon monoxide poisoning from the use of gas-powered generators in poorly ventilated areas. An additional nine people are being treated for carbon monoxide poisoning, federal health officials said at a news conference in Atlanta, home of the Centers for Disease Control and Prevention. In New Orleans, Tulane University Hospital and Clinic, which was surrounded by about four feet of water, lost both of its backup generators to the flooding and began evacuating all its 200 patients, 30 requiring critical care. H.C.A., which manages the hospital, hired 20 helicopters to land in succession on its helipad, atop a parking garage, and ferry the patients to Women's and Children's Hospital in Lafayette, La., and elsewhere. In addition to the patients, more than 800 others were stranded at the Tulane hospital and also required evacuation: members of the staff as well as their families, families of patients and people who had simply sought shelter there. Dr. Irwin Redlener, who directs the National Center for Disaster Preparedness at the Columbia School of Public Health, said yet another concern was that people might have lost or become separated from the drugs they rely on daily for diabetes, heart disease and other chronic ailments. Pharmacies in the affected areas may have insufficient stocks of vital drugs like insulin for diabetics, a circumstance creating a need to import and distribute essential medicines in the area. The shortage could go on for months, Dr. Redlener said

Scores of people have already died by drowning or other causes, two by carbon monoxide poisoning from the use of gas-powered generators in poorly ventilated areas. Rescue workers searched for the injured and disabled on Tuesday in an effort to prevent additional fatalities and, trying to head off outbreaks of diarrheal disease, used helicopters to deliver food and safe drinking water. The Centers for Disease Control and Prevention has sent basic supplies like first-aid and suture kits, sterile gloves, bandages, blankets and portable oxygen tanks from the national stockpile