Faculty Bibliography

The patient is at the center of clinical medicine. In order to effectively teach clinical skills a teacher must learn to involve patients in the educational process. It is through this process that learners acquire the skills of observation, communication, examination and professionalism. Despite the importance of teaching with the patient present, many clinical teachers are hesitant to teach at the bedside. This paper describes a workshop on bedside teaching. The authors present barriers and advantages discussed during the workshop as well as a 'Model of Best Bedside Teaching Practices', which emerged after conducting the workshop for over 135 medical educators. The model includes suggested skills for effective bedside teaching that are arranged into three domains: attending to patient comfort, focused teaching and group dynamics.

Bioterrorism is an area of increasing public health concern. The intent of this article is to review the air cleansing technologies available to protect building occupants from the intentional release of bioterror agents into congregate spaces (such as offices, schools, auditoriums, and transportation centers), as well as through outside air intakes and by way of recirculation air ducts. Current available technologies include increased ventilation, filtration, and ultraviolet germicidal irradiation (UVGI) UVGI is a common tool in laboratories and health care facilities, but is not familiar to the public, or to some heating, ventilation, and air conditioning engineers. Interest in UVGI is increasing as concern about a possible malicious release of bioterror agents mounts. Recent applications of UVGI have focused on control of tuberculosis transmission, but a wide range of airborne respiratory pathogens are susceptible to deactivation by UVGI. In this article, the authors provide an overview of air disinfection technologies, and an in-depth analysis of UVGI-its history, applications, and effectiveness

A probabilistic model of aging is considered. It is based on the assumption that a random resource, a stochastic process of aging (wear) and the corresponding anti-aging process are embedded at birth. A death occurs when the accumulated wear exceeds the initial random resource. It is assumed that the anti-aging process decreases wear in each increment. The impact of environment (lifestyle) is also taken into account. The corresponding relations for the observed and the conditional hazard rate (force of mortality) are obtained. Similar to some demographic models, the deceleration of mortality phenomenon is explained via the concept of frailty. Simple examples are considered

The new quinolone garenoxacin (BMS-284756), which lacks a C-6 fluorine, was examined for its ability to block the growth of Staphylococcus aureus. Measurement of the MIC and the mutant prevention concentration (MPC) revealed that garenoxacin was 20-fold more potent than ciprofloxacin for a variety of ciprofloxacin-susceptible isolates, some of which were resistant to methicillin. The MPC for 90% of the isolates (MPC(90)) was below published serum drug concentrations achieved with recommended doses of garenoxacin. These in vitro observations suggest that garenoxacin has a low propensity for selective enrichment of fluoroquinolone-resistant mutants among ciprofloxacin-susceptible isolates of S. aureus. For ciprofloxacin-resistant isolates, the MIC at which 90% of the isolates tested were inhibited was below serum drug concentrations while the MPC(90) was not. Thus, for these strains, garenoxacin concentrations are expected to fall inside the mutant selection window (between the MIC and the MPC) for much of the treatment time. As a result, garenoxacin is expected to selectively enrich mutants with even lower susceptibility

Cardiovascular disease, an equal opportunity killer that actually affects more women than men is a shock to many women who believe this disease does not affect them as much as men. A healthy heart can be achieved through diet, weight control, and exercise. Furthermore, using Pycnogenol, an antioxidant, is powerful in reducing inflammation in the body, strengthening the vascular system, lowering high blood pressure and cholesterol, and fighting the effects of smoking, stress and other environmental risk factors on the heart

The findings suggest in effect that the vaccine failed in its prime objective. The vaccine showed virtually no effectiveness overall, making it extremely unlikely that it could be approved for use without further trials. But the data offers intriguing clues to possibly productive avenues of research. Dr. Jose Esparza, the leading vaccine expert at the UN AIDS agency in Geneva, said he was very encouraged by the results. This is the first demonstration of protection in humans, and one of the most significant findings in HIV vaccine research in many years, he said. Though the vaccine is not the final product that we need for public health use and is not ready to be licensed for sale, he said, it should give encouragement to all vaccine developers. Esparza said it was imperative to conduct more vaccine trials, especially in Africa. VaxGen was formed to carry the vaccine forward after the U.S. National Institutes of Health, and the company that invented the vaccine, Genentech, decided it was not worthy of clinical trials. The fact that the vaccine advanced to such large trials was largely the result of the doggedness of the company co-founder and president, Dr. Donald Francis, a former epidemiologist and virologist at the Centers for Disease Control and Prevention who was one of the first medical experts to see the dangers of AIDS when the disease became known more than 20 years ago. The vaccine, known as Aidsvax, is made from a protein called gp120, the same protein that protrudes from the surface of HIV and helps the virus dock with cells of the body's immune system. The protein in the vaccine is made in genetically engineered hamster ovary cells

In 1999, the U.S. Institute of Medicine of the National Academy of Sciences reported that medical errors kill 44,000 to 98,000 people a year in the United States and that many of these deaths could be prevented by improving safety measures. Most medical errors do not result from individual recklessness, but from basic flaws in the way hospitals and clinics operate, the report said

This is the first demonstration of protection in humans, and one of the most significant findings in HIV vaccine research in many years, he said. Though the vaccine is not the final product that we need for public health use and is not ready to be licensed for sale, he said, it should give encouragement to all vaccine developers. [Jose Esparza] said it was imperative to conduct more trials, especially in Africa. VaxGen was formed to carry the vaccine forward after the U.S. National Institutes of Health, and the company that invented it, Genentech, decided it was not worthy of clinical trials. That the vaccine advanced to large trials is owed to the doggedness of VaxGen's co-founder and president, Dr. Donald Francis, a former epidemiologist and virologist at the Centers for Disease Control and Prevention, one of the first medical experts to see the dangers of AIDS when it became known more than 20 years ago. The vaccine, Aidsvax, is made from a protein called gp120, the same protein that protrudes from the surface of HIV and helps the virus dock with cells of the body's immune system. The protein in the vaccine is made in genetically engineered hamster ovary cells. Since the vaccine consists of only one protein and not the whole virus, it cannot give someone AIDS

It is good manners in a scientific paper to credit the work of others. Dr. Linus Pauling of the California Institute of Technology, who would win the Nobel Prize in 1954 for using quantum theory to understand how chemicals bond (above), was the lion of the field. A few months earlier, he and Dr. Robert Corey had deduced that some proteins were twisted in a shape known as an alpha-helix. Their new paper proposed that DNA was composed of three of these helixes (below) twisted together. When Dr. Pauling's son Peter visited their lab, Dr. [James D. Watson] and Mr. Crick saw the paper and concluded that Dr. Pauling had made a mistake. Photos by other researchers had shown hints of a helical structure in DNA, but Dr. [Rosalind Franklin]'s lab at King's College had performed the best X-ray measurements. Dr. Watson was shown an unpublished X-ray photograph (below) of Dr. Franklin's in which he saw the unmistakable signature of the helix structure. He later called it the key event in uncovering the structure of DNA, but an early draft of their paper sent to Dr. Pauling and now in the Pauling archive at Oregon State University did not mention her name at all

The trial grew out of a decision in 1994 by the allergy and disease institute not to support a big clinical trial of the vaccine, leaving the work to VaxGen. Yesterday, Dr. [Anthony S. Fauci] congratulated VaxGen for conducting a good study that would be ''a major contribution'' to the search for an effective AIDS vaccine. ''The possibility of a vaccine that works only for African-Americans should jump-start black America's involvement in the vaccine development and approval process,'' Mr. [Phill Wilson] said as he and 1,000 participants in the institute's fifth annual national conference on African-Americans and AIDS in Manhattan emphasized the need for more blacks to be informed, tested and, if found infected, treated. Dr. Nils Daulaire, president and chief executive of the Global Health Council, said that although the VaxGen findings were ''a blow to our hopes for turning the tide of AIDS in the near future, they will help researchers to identify more promising avenues toward a highly effective, globally available AIDS vaccine.''