Physician business deals: surveying the new landscape.

Strong hospitals and health systems should be on the lookout for opportunities today to acquire physician businesses at depressed fair market values. In some instances, an outright purchase of physicians' interest in a physician-hospital joint venture may be preferable; in others, the hospital may benefit more from simply increasing its interest in the venture. A critical part of the strategy should be taking steps to ensure the physicians remain engaged, including addressing physicians' income goals and need for control.

Analysis of spermatogenesis in non-obstructive azoospermic and virtually azoospermic men with known testicular pathology.

It is widely thought that human testicles affected by unilateral pathology will have greater impairment of spermatogenesis than the otherwise unaffected testis. This study reviewed records of non-obstructive azoospermic (NOA) and virtually azoospermic (NOVA) men with associated testicular pathology who underwent testicular fine needle aspiration (FNA) mapping. Concentration of spermatozoa found in each testis was analysed to discern sperm-lateralization patterns in affected and unaffected testes.

Medicolegal aspects of telepathology.

A pathologist may practice telepathology in another room from the original slide using the hospital intranet, he/she may practice it if a CD-ROM is reviewed with a "virtual histologic image" or digital slide. As pathology becomes increasingly subspecialized, and pathologists are progressively more engaged in practices situations where they may not be in a centralized laboratory location, use of telepathology technology may be increasingly common. We touch on select medicolegal and reimbursement issues in the practice of telepathology.

Hypersomnia across mood disorders: a review and synthesis.

Hypersomnia is prevalent and persistent across mood disorders. This review has two aims: (1) to synthesize the research that has accrued on hypersomnia in mood disorders and (2) to identify an agenda for future research that advances knowledge on this critical, but understudied, feature of mood disorders. We begin by reviewing the state-of-the-science on the diagnosis, epidemiology and course of hypersomnia in Major Depressive Disorder, Bipolar Disorder, Dysthymic Disorder, and Seasonal Affective Disorder.

Surgical management of hip fractures: an evidence-based review of the literature. II: intertrochanteric fractures.

Treatment of intertrochanteric hip fracture is based on patient medical condition, preexisting degenerative arthritis, bone quality, and the biomechanics of the fracture configuration. A critical review of the evidence-based literature demonstrates a preference for surgical fixation in patients who are medically stable. Stable fractures can be successfully treated with plate-and-screw implants and with intramedullary devices.

10 myths of healthcare business valuation.

*Acceptance of common myths regarding business valuations can undermine a hospital's efforts to successfully negotiate deals with physicians. *Hospitals need to clearly understand the nature of fair market value (FMV), the use of multiples, the "guideline company technique," whether the FMV can be based on acute care revenue stream, the physician compensation model used in the valuation, and the applicability of the physician's historical production level. *Other matters that warrant careful consideration include whether to tax effect, whether to pay for goodwill, and whether obsolescence can be accounted for in the valuation.

Surgical management of hip fractures: an evidence-based review of the literature. I: femoral neck fractures.

During the past 10 years, there has been a worldwide effort in all medical fields to base clinical health care decisions on available evidence as described by thorough reviews of the literature. Hip fractures pose a significant health care problem worldwide, with an annual incidence of approximately 1.7 million.

Thailand: government re-launches war on drugs and people who use drugs.

On 2 April 2008, Thailand Prime Minister Samak Sundarajev announced a new national drug strategy. Called "Thai Power, To Avoid the Danger of Drugs," the strategy is intended to run for six months (from April to September 2008) and includes a number of activities designed to reduce the number of people who use drugs in Thailand.

The prevalence of BK polyomavirus infection in outpatient kidney transplant recipients followed in a single center.

Background: BK polyomavirus (BKV) infection has emerged as an important cause of renal allograft loss. There is no proven therapy, and much basic clinical information is still lacking.

Methods: We serially enrolled 95 outpatient renal transplant recipients (43% of whom were African American) in a single center cross-sectional screening study to determine the prevalence of BKV infection by whole blood polymerase chain reaction, and the prevalence of decoy cells by urinalysis and cytology.

Peroneal nerve compression secondary to an anomalous biceps femoris muscle in an adolescent athlete.

Common peroneal nerve compression is a well-recognized entity that can cause severe debilitating clinical manifestations. The current literature describes numerous locations and mechanisms of compression, including both structural and systemic causes. Anatomical variants should be considered part of the differential diagnosis in peroneal nerve impingement.

Reduced cold pain tolerance in chronic pain patients following opioid detoxification.

Objective: One potential consequence of chronic opioid analgesic administration is a paradoxical increase of pain sensitivity over time. Little scientific attention has been given to how cessation of opioid medication affects the hyperalgesic state. In this study, we examined the effects of opioid tapering on pain sensitivity in chronic pain patients.

Roles and responsibilities of health care agents: views of patients and agents.

Two qualitative methods were used to explore, from the perspectives of both patients and agents, the roles and responsibilities of health care agents related to making end-of-life decisions. Results of the individual interviews revealed that both patients and agents did not have a clear understanding of the role, responsibility, and legal authority of health care agents. The results of the focus group of former agents indicated that when assuming the role, some agents had both knowledge and experience in making end-of-life decisions, whereas others had little understanding of their role.

Treatment of an open infected type IIB distal clavicle fracture: case report and review of the literature.

Clavicle fractures are common skeletal injuries that are typically managed nonoperatively, which results in a high rate of fracture union with few or no long-term sequelae. Type II distal clavicle fractures are an exception, with reported rates of nonunion ranging from 22% to 44%. This high rate of nonunion has led to controversy regarding the appropriate treatment of type II injuries.

Bilateral humerus and corner fractures in an 18-month-old infant: a case report and review of child abuse from the resident perspective.

Child abuse continues to be a serious problem that is likely to be encountered in all medical specialties, with orthopaedic surgeons commonly evaluating children having sustained musculoskeletal injuries. In busy emergency departments and clinics, junior residents shoulder much of the responsibility in identifying cases of abuse. We report the case of an otherwise healthy 18-month-old child, who presented to the emergency room with bilateral humeral shaft and corner fractures.

Rugby injuries: a review of concepts and current literature.

Rugby football continues to grow in popularity internation- ally and within the United States. In 1995, rugby union, one form of rugby, turned from amateur to professional through- out Europe, increasing the potential for monetary reward, which, in turn, secondary to higher levels of play, increased the risk of injury. With this increased higher interest and the increasing number of inexperienced and professional players in the U.

Thailand: report analyses barriers to ART for people who inject drugs.

The HIV epidemic among people who use drugs mars Thailand's reputation as a success story in the global fight against AIDS. A new report has revealed that people who use drugs still face serious obstacles in obtaining needed health care

Isolated trapezoid fractures: a case report with compilation of the literature.

Isolated fractures of the trapezoid bone have been rarely reported in the literature, the mechanism of injury being an axial or bending load transmitted through the second metacarpal. We report a case of an isolated, nondisplaced trapezoid fracture that was sustained by direct trauma and subsequently treated successfully in a short-arm cast. Diagnostic and treatment strategies for isolated fractures of the trapezoid bone are reviewed as well as the results of operative and nonoperative treatment.

Bone plug versus suture fixation of the posterior horn in medial meniscalallograft transplantation: a biomechanical study.

This study was performed to determine if a meniscal al- lograft with attached bone plug and suture offers superior ixation when compared to allograft afixed with suture alone through a bony tunnel. Seven pairs of human cadaver proximal tibia specimens were obtained. The specimens were then randomly assigned to either Group 1 (suture alone) or Group 2 (bone plug plus suture).

The relative accuracy of a questionnaire compared with pedigree analysis in genetic risk assessment for infertility.

Purpose: For infertile couples family history assessment can add valuable information about genetic infertility and possible risks for offspring. We created a genetic questionnaire for eliciting family history and asked whether it could capture information similar to a pedigree.

Materials And Methods: Infertile male patients completed a genetic questionnaire and had a pedigree obtained by a genetic counselor.