Achieving informed consent when patients appear to lack capacity and surrogates.

Obtaining informed consent is a frequent and important part of the practice of orthopaedic surgery. However, the process can be complicated, especially when there are impediments to communication and unusual decisions. An approach that considers each of the elements of informed consent permits the clinician to enhance the role of autonomy in patient decisions while maximizing the probability of achieving successful informed consent.

The orthopaedic surgeon and industry. Ethics and industry incentives.

Physicians may receive various gifts and incentives from companies that make pharmaceuticals and medical devices. Although such incentives may benefit patients and physicians, they often pose serious conflicts of interest that violate a physician's professional responsibility. The physician-patient relationship is predicated on the physician acting in the best interest of the patient.

Racial and ethnic disparities in the use of cardiovascular procedures: associations with type of health insurance.

Objectives: This study examined whether disparities in the use of cardiovascular procedures exist among African Americans, Latinos, and Asians relative to White patients, within health insurance categories.

Methods: Hospital discharge records (n = 104,952) of Los Angeles Country, California, residents with possible coronary artery disease were analyzed.

Results: After adjustment for confounders, lower odds of procedure use were found for African American and Latino patients for most types of insurance.

Antimicrobial peptides of leukocytes.

Leukocytes use an array of antimicrobial peptides and proteins to help them destroy invading microorganisms. These endogenous antibiotic molecules are remarkable for their structural variety, rapid evolutionary divergence, intraspecies variation, and complex yet subtle interactions with their targets. This arsenal has been studied most extensively in neutrophils, where its members include lactoferrin, secretory phospholipase A2, lysozyme, and the cathelicidins in the secretory granule compartment; defensins, bactericidal permeability inducing protein, serprocidins, and (again) lysozyme in the azurophil granule compartment; and calprotectin in the cytosolic compartment.