Educational benefits of diversity in medical school: a survey of students.

Purpose: Many U.S. medical schools have abandoned affirmative action, limiting the recruitment and reducing the admission of underrepresented minority (URM) students even though research supports the premise that the public benefits from an increase in URM physicians and that URM physicians are likely to serve minority, poor, and Medicaid populations.

Effect on diagnostic efficiency of analgesia for undifferentiated abdominal pain.

Background: The question of whether it is safe to provide analgesia for patients with undifferentiated acute abdominal pain is marked by longstanding controversy over the possible masking of physical findings. The goal of this review is to assess the pertinent studies.

Method: A Medline search was performed in April 2002, using the terms 'analgesia', 'abdominal pain', 'acute abdomen' and 'morphine'.

Effects of morphine analgesia on diagnostic accuracy in Emergency Department patients with abdominal pain: a prospective, randomized trial.

Background: Because of concerns about masking important physical findings, there is controversy surrounding whether it is safe to provide analgesia to patients with undifferentiated abdominal pain. The purpose of this study was to address the effects of analgesia on the physical examination and diagnostic accuracy for patients with abdominal pain.

Study Design: The study was a prospective, double-blind clinical trial in which adult Emergency Department (ED) patients with undifferentiated abdominal pain were randomized to receive placebo (control group, n = 36) or morphine sulphate (MS group, n = 38).

Interval appendectomy in the laparoscopic era.

In the acute setting, patients with periappendiceal masses generally improve with broad-spectrum antibiotics with or without percutaneous catheter drainage, but whether or not to perform an interval appendectomy remains controversial. We have analyzed our experience over the past decade, comparing results from interval laparoscopic appendectomy (ILA) and interval open appendectomy (IOA). Medical records were reviewed for 56 patients who initially presented with the diagnosis of periappendiceal mass or abscess and who subsequently underwent interval appendectomy.

Appendectomy in the pre- and postlaparoscopic eras.

The role of laparoscopic appendectomy remains controversial since many authors have suggested that overall morbidity is primarily a function of the degree of appendicitis rather than the operative approach. We have reviewed our appendectomy experience to determine the advantages and/or disadvantages of the laparoscopic technique in cases of acute appendicitis, and furthermore to ascertain whether the extent of disease should affect the surgical approach used. Data were accumulated for all 1158 patients who underwent appendectomy at a single institution during the following three time periods that span the pre- and postlaparoscopic eras: period I (1987 to 1990), period II (1991 to 1993), and period III (1994 to 1997).

HCO3-secretion by bullfrog duodenum: dependence on nutrient Na+ during secretory stimulation.

HCO3(-) secretion across in vitro duodenal mucosa of Rana catesbeiana was investigated under baseline conditions and during secretory stimulation. Baseline secretion was abolished by removal of CO2-HCO3(-)and reduced approximately 60% by removal of nutrient Na+, but was not sensitive to changes in Cl- or K+. Baseline secretion was not directly altered by exposure to 10(-3) M amiloride or 10(-3) M H2DIDS (dihydro-4,4'-diisothiocyanostilbene-2,2'-disulfonic acid) in the nutrient solution and only mildly reduced by acetazolamide.

The impact of Clostridium difficile on a surgical service: a prospective study of 374 patients.

Objective: To evaluate the epidemiology of Clostridium difficile colitis (CDC) in a subset of patients admitted specifically to a surgical service.

Summary Background Data: CDC is an increasingly prevalent nosocomial infection that can prolong hospitalization and adversely affect patient outcome. Although this disease has been investigated extensively in patients admitted to medical services, the incidence and risk factors for the development of this disease in patients admitted to a surgical service have not been studied.

Functional studies of in vitro rat distal colon before and after restitution.

Background: Epithelial injury occurs in many acute and chronic diseases of the colon and from simple mechanical and chemical injury in the normal colon. Because epithelial repair is so important, we developed a highly reproducible, entirely in vitro model of restitution in rat distal colon.

Methods: The muscosal surface of colon mounted in Ussing chambers was exposed to 1.

Detection and management of parathyroid tumors.

Hyperparathyroidism is due to enlargement of one or more parathyroid glands and is most often treated by surgical resection. Recent advances have taken place in regard to preoperative localization and refinement of surgical technique. The underlying mechanisms of parathyroid tumorigenesis are just beginning to be unraveled.

Quality. A tightrope for the '90s.

How accurately can you measure quality of care in health care? Recently, HMOs and other types of managed care organizations have been in the process of defining quality in quantitative terms. Physicians who utilize fewer resources and who care for more patients per-unit-of-time are valued as providing better care than colleagues who may work at a slower (more expensive?) pace. The pressure to evaluate or treat greater numbers of patients in shorter periods of time can produce adverse consequences.

Role of transforming growth factor-beta in the restitution of injured guinea pig gastric mucosa in vitro.

The role of transforming growth factor-beta (TGF-beta) in restitution was examined in intact sheets of injured guinea pig gastric mucosa in which the epithelial cell-collagen interaction can be quantitatively evaluated. The luminal surface of intact sheets of in vitro guinea pig gastric mucosa was injured by exposure to 1.25 mol/l NaCl for 10 min.