NIH disease funding levels and burden of disease.

Background: An analysis of NIH funding in 1996 found that the strongest predictor of funding, disability-adjusted life-years (DALYs), explained only 39% of the variance in funding. In 1998, Congress requested that the Institute of Medicine (IOM) evaluate priority-setting criteria for NIH funding; the IOM recommended greater consideration of disease burden. We examined whether the association between current burden and funding has changed since that time.

Heterogeneous patterns of tissue injury in NARP syndrome.

Point mutations at m.8993T>C and m.8993T>G of the mtDNA ATPase 6 gene cause the neurogenic weakness, ataxia and retinitis pigmentosa (NARP) syndrome, a mitochondrial disorder characterized by retinal, central and peripheral neurodegeneration.

An intervention to teach medical students ankle reflex examination skills.

Background: Methods of teaching neurologic examination skills are understudied compared with general physical examination skills. Eliciting an ankle reflex is an important element of a screening neurologic examination and directly drives further patient evaluation, but many students and physicians perceive this skill to be difficult; as a result, ankle reflex testing is frequently incorrectly performed or omitted entirely.

Methods: Twenty-two medical student volunteers of various levels of training took part in a blinded, randomized study of a brief intervention used to teach how best to elicit ankle reflexes.

Influence of physician specialty on outcomes after acute ischemic stroke.

Background: Specialist care has been shown to improve outcomes for several complex medical conditions. For patients with ischemic stroke, prior studies have suggested that admission to the care of neurologists is associated with better outcomes, but these studies may have incompletely controlled for confounding prognostic differences.

Objective: The objective of this study was to evaluate whether admission to the care of a neurologist is associated with improvement in outcomes of stroke patients after controlling for initial prognostic differences.

Preparing fourth-year medical students to teach during internship.

Interns are expected to teach medical students, yet there is little formal training in medical school to prepare them for this role. To enhance the teaching skills of our graduating students we initiated a 4-hour "teaching to teach" course as part of the end of the fourth-year curriculum. Course evaluations demonstrate that students strongly support this program (overall ratings 2000 to 2005: mean=4.