How Physicians are Trained to Interact With the Dying: A Thematic Analysis of Medical Student Exposures to End-Of-Life Cases.

Physicians-in-training feel uncomfortable coping with the grief they experience while delivering end-of-life care, and medical schools offer minimal formal curricular offerings on end of life care. Few studies have identified what experiences medical students have with death while training or what lessons they are being taught by more senior physicians at bedside. This qualitative study conducted semi-structured interviews prior to and six months into the medical school clinical year.

Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal-Fetal Mortality.

Background: Appendicitis is the most common extra-uterine surgical emergency requiring immediate intervention during pregnancy. However, risks for mortality and morbidity among pregnant women with appendicitis remain poorly understood. This study was conducted to determine the temporal trends of appendicitis in pregnant women, and to calculate the risk of maternal-fetal mortality and near-miss marker (i.

Occurrence and mass flows of fluorochemicals in the Glatt Valley watershed, Switzerland.

Fluorochemicals are persistent contaminants that are globally distributed in air, water, sediments, and biota. Wastewater treatment plants (WWTPs) play an important role in mitigating pollutant releases from municipalities to aquatic and terrestrial environments. However, because WWTPs are point sources of fluorochemicals, it is important to understand their contribution to fluorochemical burdens in the greater context of watersheds.

Polylactide/polyglycolide antibiotic implants in the treatment of osteomyelitis. A canine model.

Osteomyelitis with Staphylococcus aureus was established in the tibiae of twenty-six adult mongrel dogs. After confirmation of infection at four weeks, all animals had operative débridement and were then divided into three treatment groups. Group 1 (eight animals [sixteen tibiae]) was treated with parenteral administration of gentamicin (three milligrams per kilogram of body weight per day) every eight hours for four weeks.

Failure of the Vitek AutoMicrobic system to detect beta-lactam resistance in Aeromonas species.

The ability of the Vitek AutoMicrobic system (AMS; Vitek, Inc., Hazelwood, MO) and disk-diffusion method to detect beta-lactam resistance was assessed with 25 strains from four species of Aeromonas. A very major error was indicated when a strain was shown to be susceptible by the AMS or disk-diffusion method but resistant by the agar dilution method.

Morphologic and nutritional responses to intestinal patching following intestinal resection.

Growth of neomucosa has been investigated as a means to increase intestinal surface area in the short-bowel syndrome. Functional neomucosa grows over patched intestinal defects, but the effect of the patching procedure on absorption is unknown. The purpose of this study was to determine morphologic and nutritional responses to intestinal patching after resection.

Comparison of moxalactam and gentamicin in the treatment of complicated urinary tract infections.

Moxalactam and gentamicin were compared in a prospective, randomized study of 49 hospitalized patients with complicated urinary tract infections. Patients received parenteral moxalactam, 250 mg every 12 h, or gentamicin, 1 mg/kg every 8 h. The average duration of therapy (moxalactam, 7.

Emergence of resistance to beta-lactam and aminoglycoside antibiotics during moxalactam therapy of Pseudomonas aeruginosa infections.

In four patients with Pseudomonas aeruginosa infections, the infecting strain developed resistance to moxalactam during therapy with this drug. In addition, P. aeruginosa isolates from two of these four patients showed increased resistance to aminoglycosides.

Plesiomonas shigelloides overgrowth in the small intestine.

An 83-year-old male presented with chronic diarrhea and protein malnutrition associated with Plesiomonas shigelloides overgrowth in the small intestine. This overgrowth was related to achlorhydria and small-bowel diverticula. Tests for heat-labile and heat-stable enterotoxin were negative on the P.

The changing spectrum of disease, etiology, and diagnosis of mucormycosis.

During the 20 year interval from 1958 to 1978 a change in the spectrum of disease, etiology, and diagnosis of mucormycosis was observed at The Mount Sinai Hospital. Although the rhinocerebral and pulmonary forms of mucormycosis were still the most frequent forms of disease, hospital acquired cutaneous and subcutaneous infections emerged. Since 1974, 14 of 15 cases of mucormycosis were diagnosed during life.

Experimental murine candidiasis: pathological and immune responses in T-lymphocyte-depleted mice.

Mice depleted of T-lymphocytes by thymectomy and irradiation (TXB) and immunologically competent mice were compared for gross and histological pathology as well as immune responses after cutaneous and/or intravenous challenge with Candida albicans. In response to a first cutaneous inoculation with viable Candida, TXB, sham-operated (SXB), and unmanipulated (normal) mice, all developed lesions of comparable size, duration, and histopathology. When challenged a second time cutaneously, normal and SXB mice developed lesions which were greatly increased in size when compared with those produced by a first cutaneous infection, whereas TXB mice developed lesions comparable in size to those initiated by the first infection.

Experimental murine candidiasis: pathological and immune responses to cutaneous inoculation with Candida albicans.

Cutaneous infection of mice with Candida albicans elicited a predominantly acute inflammatory response, stimulated the production of precipitating antibodies, and conferred protection against subsequent intravenous challenge with the same organism. The acute inflammatory skin reaction seen after cutaneous infection suggested a predominantly humoral response to Candida. Animals infected cutaneously a second time with viable C.