Faculty Bibliography

Avastin, when added to chemotherapy, extended the median survival of people with advanced lung cancer by about two months. After two years, 22.1 percent of those who took Avastin were still alive, an improvement over the 16.9 percent who received only chemotherapy. Avastin can cause fatal bleeding in the lungs. About one-third of people with nonsmall-cell lung cancer would not be eligible for the drug based on criteria used in the clinical trial. But even though the trial excluded those patients to minimize bleeding risk, eight patients who took Avastin died from complications of the treatment itself, five from bleeding in the lungs. This compared with two deaths from chemotherapy alone. Some newer but still unapproved drugs, however, seek to improve on Avastin. They are pills, while Avastin requires an intravenous infusion. And they try to block not only VEGF but another protein, platelet-derived growth factor, that also spurs the formation of blood vessels. Some also try to block other proteins that spur tumor growth, so these newer drugs might best be called multitargeted therapies

The man did not have atherosclerosis, which accounts for about half of coronary aneurysms, or any of the rarer conditions associated with aneurysms, like syphilis, trauma and lupus and other connective tissue disorders. So Dr. [Timothy D. Henry] asked if the man had ever used cocaine. Three cardiologists examined the angiogram of each patient in the study to determine the presence or absence of coronary artery aneurysms. If all three doctors agreed that a coronary aneurysm was present, they classified it as definite. If two doctors concurred, they considered the aneurysm probable. In the cocaine user group, 24 patients had definite coronary artery aneurysms and 10 had probable ones. Aneurysms in the coronary arteries rarely burst and pose a less direct risk of death than do brain aneurysms or aortic aneurysms. But the study showed that coronary artery aneurysms might kill by setting up cocaine users for a heart attack

All test kits containing a deadly influenza virus that were sent to 4,614 laboratories in 18 countries last fall and winter have been identified and destroyed, the Centers..

More than four months after the Indian Ocean tsunami killed more than 200,000 people, tens of thousands of people are listed as missing and thousands of the bodies that have been recovered have not been identified, experts said at a meeting sponsored by the World Health Organization in Phuket, Thailand...

Gov. Mike Huckabee of Arkansas, who is serving as co-chairman of the effort with Mr. [Bill Clinton], said he ''got frightened to death'' after developing Type 2 diabetes. Mr. Huckabee, a Republican, told the students that he had lost 110 pounds in the past two years. Mr. Clinton said that while the national prevalence of childhood obesity was 16 percent, it was 20 percent in the Southeast and 25 percent in Alabama and Mississippi. One reason for the unfavorable statistics in the South, Mr. Huckabee said, was that ''we fry everything we eat and then smother it in gravy.'' Former President Bill Clinton and Gov. Mike Huckabee of Arkansas promoted their anti-obesity drive yesterday at a Manhattan school. (Photo by Peter Foley/European Pressphotos Agency)

Increasing physician and patient mobility has led to a move toward internationalization of standards for physician competence. The Institute for International Medical Education proposed a set of outcome-based standards for student performance, which were then measured using three assessment tools in eight leading schools in China: a 150-item multiple-choice examination, a 15-station OSCE and a 16-item faculty observation form. The purpose of this study was to empanel a group of experts to determine whether international student-level performance standards could be set. The IIME convened an international panel of experts in student education with specialty and geographic diversity. The group was split into two, with each sub-group establishing standards independently. After a discussion of the borderline student, the sub-groups established minimally acceptable cut-off scores for performance on the multiple-choice examination (Angoff and Hofstee methods), the OSCE station and global rating performance (modified Angoff method and holistic criterion reference), and faculty observation domains (holistic criterion reference). Panelists within each group set very similar standards for performance. In addition, the two independent parallel panels generated nearly identical performance standards. Cut-off scores changed little before and after being shown pilot data but standard deviations diminished. International experts agreed on a minimum set of competences for medical student performance. In addition, they were able to set consistent performance standards with multiple examination types. This provides an initial basis against which to compare physician performance internationally.

OBJECTIVES: To examine older persons' willingness to participate in exercise and relaxation programs for managing chronic pain, to identify characteristics associated with willingness to participate, and to ascertain their barriers to participation. DESIGN: Cross-sectional survey. SETTING: A geriatric ambulatory care practice located in New York, New York, and the General Clinical Research Center of Weill Cornell Medical College. PARTICIPANTS: Sixty-eight English-speaking patients aged 70 and older with chronic pain. MEASUREMENTS: Participants' level of willingness to participate in the programs was assessed using 5-point Likert scales, and information regarding their demographic, clinical, psychological, and pain status was obtained. Qualitative methods were used to ascertain participants' perceived barriers to participation. RESULTS: Participants had a mean age+/-standard deviation of 81.9+/-7.0 and were mostly white (85%) and female (68%). Although only 16% of participants reported current use of exercise as a pain-management strategy, 73% reported a willingness to try the exercise program. Four percent reported current use of relaxation methods; 70% reported an interest in learning these techniques. Moderate correlations were found between increasing days of restricted activity due to pain and greater willingness to participate. Seventeen unique barriers were identified; the mean number of barriers reported per person was 2.9+/-1.8 for exercise and 2.2+/-1.4 for relaxation. Commonly reported barriers to participating in either program included time conflicts, transportation, treatment efficacy concerns, and fear of pain or injury. CONCLUSION: Older primary care patients with chronic pain are willing to try exercise and relaxation therapies to help manage pain but report a substantial number of barriers to participating in these programs. Addressing patient-level barriers could improve engagement in and adherence to exercise and relaxation therapies for managing pain in older persons.