The National Emergency Department Safety Study: study rationale and design.

The significance of medical errors is widely appreciated. Given the frequency and significance of errors in medicine, it is important to learn how to reduce their frequency; however, the identification of factors that increase the likelihood of errors poses a considerable challenge. The National Emergency Department Safety Study (NEDSS) sought to characterize organizational- and clinician-associated factors related to the likelihood of errors occurring in emergency departments (EDs).

Cellular and morphological changes during neointimal hyperplasia development in a porcine arteriovenous graft model.

Background: Implantation of a haemodialysis arteriovenous graft is often followed by the development of neointimal hyperplasia (NH) at the venous anastomosis. The nature of the proliferating cells in these lesions is not well understood. A better understanding of the cells contributing to NH is important to the development of preventive strategies.

Surgical therapies in brain metastasis.

Brain metastases are the most common intracranial tumors in adults and source of the most common neurological complications of systemic cancer. The treatment approach to brain metastases differs essentially from treatment of systemic metastases due to the unique anatomical and physiological characteristics of the brain. Surgery and radiosurgery are important components in the complex treatment of brain metastases and can prolong survival and improve the quality of life (QOL).

Barriers to the provision of smoking cessation services reported by clinicians in underserved communities.

Purpose: This qualitative study describes barriers to the provision of smoking cessation services among primary care providers serving medically underserved populations in the state of Georgia.

Methods: Eighty-two health care professionals, including clinicians, nurses, administrators, and support staff, participated in 10 focus groups. All sessions were audiotaped and transcribed.

A national survey of physician-industry relationships.

Background: Relationships between physicians and pharmaceutical, medical device, and other medically related industries have received considerable attention in recent years. We surveyed physicians to collect information about their financial associations with industry and the factors that predict those associations.

Methods: We conducted a national survey of 3167 physicians in six specialties (anesthesiology, cardiology, family practice, general surgery, internal medicine, and pediatrics) in late 2003 and early 2004.

Transient postictal MRI changes in patients with brain tumors may mimic disease progression.

Background: Transient postictal imaging abnormalities in patients with non-tumor-related seizures are well documented and include fluid-attenuated inversion recovery/T2 hyperintensity and parenchymal and meningeal contrast enhancement. In contrast, transient postictal imaging abnormalities in patients with tumor-related seizures have been poorly described. Fifty percent of patients with brain tumors have a seizure during the course of their illness and are often imaged after a seizure or after a change in seizure character or frequency.

Increased rate of major birth malformations in infants with neonatal "asymmetric crying face": a hospital-based cohort study.

Asymmetric crying face (ACF) is a minor anomaly found in 3-8 per 1,000 births, which may be associated with other anomalies. Previous studies on this topic included small groups of selected subjects, resulting in large variations in findings. The aim of this study was to examine the characteristics and associated anomalies of newborn infants with ACF compared with the general population of newborn infants.

Mechanism of dipyridamole's action in inhibition of venous and arterial smooth muscle cell proliferation.

Dipyridamole is a potential pharmacological agent to prevent vascular stenosis because of its antiproliferative properties. The mechanisms by which dipyridamole inhibits the growth of vascular smooth muscle cells, especially venous smooth muscle cells, are unclear. In the present study, dipyridamole transiently but significantly increased cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) levels in human venous and arterial smooth muscle cells in a time- and dose-dependent manner.

Public roles of US physicians: community participation, political involvement, and collective advocacy.

Context: Whether physicians have a professional responsibility to address health-related issues beyond providing care to individual patients has been vigorously debated. Yet little is known about practicing physicians' attitudes about or the extent to which they participate in public roles, which we defined as community participation, political involvement, and collective advocacy.

Objectives: To determine the importance physicians assign to public roles, their participation in related activities, and sociodemographic and practice factors related to physicians' rated levels of importance and activity.

Extinction ratio regeneration, signal re-amplification (2R), and broadband wavelength switching using a monolithically integrated photocurrent driven wavelength converter.

Detailed wavelength conversion, extinction ratio regeneration, and signal re-amplification experiments are performed using a monolithically integrated, widely tunable photocurrent driven wavelength converter. A -3.5 dB power penalty is observed in bit error rate measurements at 2.

How common are electronic health records in the United States? A summary of the evidence.

Electronic health records (EHRs) are promising tools to improve quality and efficiency in health care, but data on their adoption rate are limited. We identified surveys on EHR adoption and assessed their quality. Although surveys returned widely different estimates of EHR use, when available information is limited to studies of high or medium quality, national estimates are possible: Through 2005, approximately 23.

Evaluation of histological techniques for quantifying haemodialysis arteriovenous (AV) graft hyperplasia.

Background: Assessing treatment efficacies for preventing haemodialysis arteriovenous (AV) graft stenosis requires a reproducible method for quantifying intimal hyperplasia. We identified sources of variability in three histological methods for assessing hyperplasia in a porcine AV graft model.

Methods: Carotid-jugular synthetic grafts were placed in pigs.

Safety in the academic medical center: transforming challenges into ingredients for improvement.

Patient safety has emerged as an important challenge to the leadership of academic medical centers (i.e., teaching hospitals with significant research activity).

Prevalence of basic information technology use by U.S. physicians.

Background: Information technology (IT) has been advocated as an important means to improve the practice of clinical medicine.

Objectives: To determine current prevalence of non-electronic health record (EHR) IT use by a national sample of U.S.

Early pathologic findings and long-term improvement in anti-Ma2-associated encephalitis.

A 67-year-old man sequentially developed anti-Ma2-associated paraneoplastic encephalitis (PNE) and contralateral herpes simplex encephalitis (HSE). Brain biopsy 1 month before HSE revealed extensive infiltrates of T cells, B cells, and plasma cells. Most T cells expressed the cytotoxic granule-associated protein TIA-1 and the membranolytic protein granzyme-B.

Differential effects of imatinib on PDGF-induced proliferation and PDGF receptor signaling in human arterial and venous smooth muscle cells.

Platelet-derived growth factor (PDGF) has been implicated in smooth muscle cell (SMC) proliferation, a key event in the development of myointimal hyperplasia in vascular grafts. Recent evidence suggests that the PDGF receptor (PDGFR) tyrosine kinase inhibitor, imatinib, can prevent arterial proliferative diseases. Because hyperplasia is far more common at the venous anastomosis than the arterial anastomosis in vascular grafts, we investigated whether imatinib also inhibited venous SMC (VSMC) proliferation, and examined possible differences in its mechanism of action between VSMC and arterial SMC (ASMC).

CDC-funded intervention research aimed at promoting colorectal cancer screening in communities.

Background: Although strong scientific evidence has shown that screening for colorectal cancer saves lives, most U.S. adults who are at the recommended age are not being screened.

Interactions between resource availability and enemy release in plant invasion.

Understanding why some exotic species become invasive is essential to controlling their populations. This review discusses the possibility that two mechanisms of invasion, release from natural enemies and increased resource availability, may interact. When plants invade new continents, they leave many herbivores and pathogens behind.

Variations of disseminated choroid plexus papilloma: 2 case reports and a review of the literature.

Background: Choroid plexus papillomas are typically considered benign lesions, but histology is not always predictive of their behavior. These tumors can metastasize anywhere along the neuraxis and may be intraventricular, subarachnoid, or intraparenchymal. We present 2 cases that illustrate the wide diversity with which choroid plexus papillomas can disseminate.

Primary spinal yolk sac tumor with brain metastasis: case report and review of the literature.

Object: Central nervous system primary germ cell tumors are typically pineal or suprasellar. Primary germ cell tumors of the spinal axis are very rare, with only a few case reports of germinomas and teratomas described in the literature.

Methods: We present the unique case of a 25-year-old woman with an intradural, extramedullary primary yolk sac tumor (YST) at and below the level of the conus medullaris.