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The article announces the recipients of the 2007 Ralph R. Tompsett Writing Award including surgery resident Tuoc N. Dao and doctor Meera Shreedhara.

The article offers news briefs related to medical personnel in Texas. Paul Convery, chief medical officer at Baylor Health Care System (BHCS), has been appointed as chair for the Provider Organizations Council of the National Quality Forum. Melinda Gregory, a registered nurse of Baylor Medical Center at Garland, has received the Helen Henry Award. William Stephen Boyd has been named as senior vice president and general counsel of BHCS.

People the authors would like to thank for their assistance in the creation of the journal is mentioned.

Hypothermia is a significant contributor to mortality in severely injured patients. Rewarming is an enormous challenge, especially in those who require operative or angiographic intervention. In this patient population, external warming methods are only capable of reducing further heat loss, whereas active rewarming adds heat to the body's core but is invasive. This article analyzes our initial experience with a minimally invasive, continuous, automated, and easily portable intravascular rewarming technique using the Alsius Corporation's CoolGard system. The records of 11 hypothermic critically injured patients presenting to our level 1 trauma center over a 6-month period were reviewed. The patients' mean age was 39 ± 22 years, 7 (64%) were male, and 7 (64%) had blunt mechanisms of injury. The mean injury severity score was 40 ± 16, and the mean initial systolic blood pressure was 91 ± 60 mm Hg. The mean core temperature at the initiation of rewarming was 33.6 ± 1.0°C, and the mean rewarming rate was 1.5 ± 1.0°C/h. Six patients died (55%), two of acute exsanguination and four of unsurvivable traumatic brain injuries. One patient developed a deep vein thrombosis at the femoral catheter site and experienced a nonfatal pulmonary embolus. Our experience demonstrates that active intravascular balloon-catheter rewarming represents a practical, automated technique for the immediate and continuous treatment of hypothermia in all phases of the acute care of trauma patients.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article presents a study that aims to understand the patient's perspective on activity restrictions and recovery after an open chest surgery (OCS). The authors imply that their experience with patients has suggested that inadequate or badly targeted postsurgical guidance can have negative psychological effects that can lead to suboptimal outcomes. It is proposed by the authors that after OCS, patients need written information and consistent advice and a way to ask questions.

Acute gastric dilation leading to ischemia of the stomach is an underdiagnosed and potentially fatal event. Multiple etiologies can lead to this condition, and all physicians should be aware of it. Without proper and timely diagnosis and treatment, gastric perforation, hemorrhage, and other serious complications can occur. We report a case of acute gastric dilation and ischemia secondary to small bowel obstruction. We also review the world literature and discuss the etiology, diagnosis, and management of this condition.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

Information about the topics discussed during the meeting titled "Advances in Surgery and Surgical Education: The Past 20 Years" of the Society of Baylor Surgeons at Baylor University Medical Center (BUMC) in Dallas, Texas on August 10-11, 2007 is presented. The meeting was in honor of Dr. Ronald C. Jones who served as chairman of BUMC's Department of Surgery for 20 years. The event featured several physicians as guest speakers including Edward M. Copeland, Kirby I. Bland and R. Scott Jones.

The article offers information concerning a 35-year-old man presented with a 4-week history of an asymptomatic golden-brown macule on his right lateral ankle. The man said that he has no past medical history and took no medications. Here, the medical personnel diagnosed the macule as lichen aureus, a rare and chronic localized variant of pigmented purpuric dermatoses. It outlines several therapies for lichen aureus including topical steroids, phototherapy and systemic calcium dobesilate.

The article presents a dermatology report of a 44-year-old woman with an asymptomatic painless papule on the finger. It stated that it was diagnosed as digital mucous cyst, a lesion that are commonly found on the distal phalanx. Furthermore, two entities have been described, one involves the base of the nail and the other which overlies the distal interphalangeal joint.

A chart is presented that records the ventricular rhythm of a 40-year-old man who died of cardiac failure.

The article reviews the book "Autoimmune Diseases in Endocrinology," edited by Anthony P. Weetman .

This study evaluated 1) the efficacy of packing autologous fat grafts around temporomandibular joint (TMJ) total joint prosthetic reconstructions to prevent fibrosis and heterotopic bone formation and 2) the effects on postsurgical joint mobility and jaw function. One hundred fifteen patients (5 males and 110 females) underwent TMJ reconstruction with total joint prostheses and simultaneous fat grafts (88 bilateral and 27 unilateral) for a total of 203 joints. The abdominal fat grafts were packed around the articulating portion of the joint prostheses after the fossa and mandibular components were stabilized. Patients were divided into two groups: group 1 (n = 76 joints) received Christensen total joint prostheses, and group 2 (n = 127 joints) received TMJ Concepts total joint prostheses. Clinical and radiographic assessments were performed before surgery, immediately after surgery, and at long-term follow-up. In group 1, maximal incisal opening (MIO) increased 3.5 mm, lateral excursions (LE) decreased 0.2 mm, and jaw function improved 1.9 levels. In group 2, MIO increased 6.8 mm, LE decreased 1.4 mm, and jaw function improved 2.4 levels. The improvement for MIO and patient perception of jaw function in both groups was statistically significant; no significant difference was found for LE. There was no radiographic or clinical evidence of heterotopic calcifications or limitation of mobility secondary to fibrosis in either group. Twenty-five Christensen prostheses (33%) were removed because of device failure and/or metal hypersensitivity; no fibrosis or heterotopic bone formation was seen at surgical removal. Four TMJ Concepts prostheses (3%) were removed because of metal hypersensitivity. In all instances, removal of the prostheses was unrelated to the autologous fat grafting. Ten patients (8.7%) developed complications involving the fat donor site: two patients (1.8%) developed abdominal cysts requiring surgery, and eight patients (6.9%) developed seroma formation requiring aspiration. Autologous fat transplantation is a useful adjunct to prosthetic TMJ reconstruction to minimize the occurrence of excessive joint fibrosis and heterotopic calcification, consequently providing improved range of motion and jaw function.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article reports that Baylor All Saints Medical Center has performed a laparoscopic vaginal hysterectomy and pelvic lymphadenectomy using Intuitive Surgical's da Vinci S HD System in Texas. The system integrates three-dimensional high-definition endoscopy and advanced robotic technology for treating uterine cancer. According to Kenneth Hancock, gynecologist/oncologist on the medical staff, the da Vinci S model provides with more than twice the viewing resolution and more viewing area.

The article reports that Baylor Health Care System has established the Baylor Distinguished Professorship for Nursing Research at the University of Texas at Arlington's School of Nursing. The professorship program will allow the nursing school to reward and recognize a distinguished faculty member who conducts research relevant to the field of nursing.

The article highlights the 10th anniversary of Baylor Institute for Immunology Research (BIIR) in 2007. BIIR was established in 1996 as the immunology research component of Baylor Research Institute. BIIR celebrates a decade of advances in understanding the immune system and developing new treatments for cancer, autoimmune diseases, and infectious diseases, as well as reducing organ transplant rejection.

he article presents news briefs about the Baylor University Medical Center, including its receipt the Leapfrog Patient-Centered Care Award in January 2008 and 2008 National Quality Healthcare Award.

The article reports on the two grants for health care improvement research received by Baylor Health Care System. The first grant was a $150,000 from the U.S. National Cancer Institute to research patient-centered communication in cancer care. The second was award from Agency for Healthcare Research and Quality worth $200,000 to study adverse event-directed risk analysis in ambulatory primary care.

The article reports on the designation given to the Baylor Regional Medical Center at Plano, Texas by the Texas Nurses Association. Baylor was recognized as Nurse-Friendly for its practices, policies, and procedures that allow nurses to practice safe, quality patient care and to pursue a level of professional development and career satisfaction that retains them in the profession.

The article reports that Baylor Research Institute (BRI) in Dallas, Texas has received a $300,000 grant from Susan G. Komen to develop a novel vaccine to treat breast cancer. The vaccine is developed by integrating antibodies from the patient's own immune system with portions of antigens from the infected breast. Dr. Karolina Palucka, a cancer immunologist at Baylor Institute for Immunology Research (BIIR), will be the lead investigator of the study.

The article reports that the Baylor Regional Transplant Institute has performed its 3000th adult liver transplant in Dallas, Texas. It was the third liver transplant program in the nation to reach the said milestone. According to Göran Klintmalm, chairman of the Baylor Regional Institute, their patients are approaching 10-, 15- and 20- year survival milestones with an excellent quality of life.

The article focuses on the contribution of Ronald C. Jones thoracic surgery and cardiac stem cell therapy for heart failure. It discusses the history of thoracic and cardiovascular surgery at Baylor University Medical Center (BUMC). Detailed information about CyberKnife radiosurgery technology and cardiac stem cell research is elaborated.

The article reports on the selection of Baylor Health Care System (BHCS) as the number one user of business technology in the health care industry in the U.S. based on the ranking of the journal "InformationWeek." BHCS earns top marks for its physician portal upgrade, which helps improve the quality of care by aiding patients get procedures scheduled faster. It also allows physicians to access critical information for more informed and timely decisions.

The article announces that Baylor Health Care System (BHCS) has received the Best Practices in Seasonal Influenza Immunization award from the American Nurses Association.

The article presents a case report in diagnosing a 20-year-old woman, who has a bilateral tender neck masses that had been increasing in size for two months. Accordingly, physical examination revealed a healthy appearing young woman with significant bilateral cervical lymphadenopathy that was tender to palpation. It is concluded that understanding the spectrum of imaging features associated with scrofula is important make an early diagnosis and begin proper treatment.

The article reviews the book "Acute Myelogenous Leukemia," edited by Judith Karp.

The article lists several books received from September 2007-August 2008 including "Sports Injuries Information for Teens," edited by K. Bellenir, "Environmental Genomics," edited by CC. Martin, and "The Illusion of Certainty," by E. Rifkin and E. Bouwer.

The article discusses the diagnostic findings for a premature infant boy who was found to have bilateral supraclavicular masses at 13 days of age. The infant had persistent pulmonary hypertension and thrombocytopenia. Subsequent magnetic resonance imaging (MRI) of his chest demonstrated symmetric and confluent soft tissue extending from the neck inferiorly to the chest. These findings indicated that he has a brown adipose tissue (BAT).

The article discusses cancer-related depression and its potential pharmacologic medication. As noted, the depressive symptoms naturally develop from the stress and anticipation of cancer diagnosis, treatment, and remission that can introduce significant morbidity and health care costs for patients , family members, and caregivers. However, patients are being recommended to place careful attention on identification and treatment strategies to prevent unnecessary roadblocks to recovery.

Melanoma is a prevalent and deadly disease with limited therapeutic options. Current prognostic factors are unable to adequately guide treatment. Circulating tumor cells are a disease-specific factor that can be used as a prognostic variable to guide therapy. Most research to date has focused on identification of circulating tumor cells using various methods, including polymerase chain reaction. These techniques, however, have poor sensitivity and variable specificity and predictive significance. A recently developed technology to identify circulating tumor cells is the CellSearch system. This system uses immunomagnetic cell labeling and digital microscopy. This technology may provide an alternative method to identify circulating tumor cells in patients with advanced-stage melanoma and function as a prognostic factor. We review the literature on circulating tumor cells in melanoma and present data collected at our institution using the CellSearch system in nine patients with stage III or IV melanoma.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article offers information on the significance of Baylor Health Care System (BHCS) design teams for Baylor University Medical Center's computerized physician order entry (CPOE). The design teams are developed to create the principles of ease of use and time savings for physician using Baylor's CPOE. Through the BHCS's design teams, records of electronic orders are clear, concise and ready for execution.

Myocardial perfusion imaging (MPI) is a highly sensitive and specific test for noninvasive detection of coronary artery disease. Therefore, in patients with negative MPI results, further noninvasive testing is usually not pursued. We report a series of patients with negative MPI results in whom 64-slice computed tomographic coronary angiography accurately predicted flow-limiting coronary lesions requiring subsequent revascularization.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article discusses a 3-day course on negotiation and conflict resolution offered by physicians F. David Winter and Marie Isabelle Chevrier at the King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. The course was designed for 90 members of the senior medical staff. It offered practical experience in negotiating and theoretical frameworks for organizing and understanding negotiation concepts. Teaching methods included targeted lectures and experiential learning.

A correction to the article "Imaging-related medications: A class overview" that was published in the October 2007 issue is presented.

As a significant known risk factor for the development of ischemic stroke, carotid atherosclerosis is a potentially preventable and treatable disease process. The progression of improved diagnostic modalities, including magnetic resonance and computed tomography angiography, has provided enhanced plaque detection and characterization. The management of carotid artery stenosis has also continued to evolve from an aggressive, early surgical approach with the advent of the carotid endarterectomy to the initiation of progressive medical management options and the development of advanced percutaneous intervention. Carotid endarterectomy continues to be the clear treatment of choice in symptomatic patients with &rt;70% carotid stenosis. However, strict risk factor modification, including improved antihypertensive therapy, lipid management, smoking cessation, and antiplatelet therapy, have led to less-compelling indications for immediate surgery in asymptomatic populations. In recent years, the evolution of improved percutaneous techniques and the development and approval of carotid stents have expanded the role of intervention. Several randomized trials have studied the efficacy of carotid artery stenting versus carotid endarterectomy in asymptomatic and symptomatic patients to help define the role of invasive therapy. The primary objective of this review is to summarize the current evidence and standards for the advanced diagnostic and management strategies used in asymptomatic and symptomatic patients with carotid artery stenosisABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article presents a study on treating soft tissue sarcoma (STS) using magnetic resonance imaging, surgery and chemotherapy. Study shows that radiation-associated wound complications were more common in the preoperative radiation group, which is a 33% wound complication rate versus 16% in the postoperative radiation arm. The authors conclude that while advances have been made, the treatment of STS still has much room for improvement.

The article offers information on the biology of dendritic cells. Dendritic cells have been described to have several innate features that make them logical targets in dissecting disease and developing new therapies. Moreover, their interaction with T cells is more developed, while they interact with all classes of lymphocytes. Detailed information on various approaches for the harnessing of dendritic cells is elaborated.

The article presents a 28 year old man who complained of dyspnea everytime he smokes and chew tobacco or when he exerts an effort more than his normal activity. According to the patient the discomfort was gradually relieved when he used an albuterol inhaler ≥ ten times a day. It stated that transthoracic echocardiogram revealed left ventricular thickening with normal systolic and diastolic function. Furthermore, valve morphology was not clearly seen, but a unicuspid valve was suspected.

Carbapenems are a class of antimicrobials structurally related to penicillin. Doripenem, the newest agent in this class, was recently approved by the Food and Drug Administration for the treatment of complicated intra-abdominal infections and complicated urinary tract infections. Its spectrum of activity is similar to that of meropenem and imipenem/cilastatin. Some studies indicate that approximately 29% of carbapenem-resistant Pseudomonas aeruginosa isolates may remain sensitive to doripenem, although the clinical relevance of that finding has not been determined. Clinical studies, which have been published only in abstract form to date, have found doripenem to be similar to comparator agents. The most common adverse effects related to doripenem therapy were headache, nausea, diarrhea, rash, and phlebitis. Doripenem, like the other carbapenems, may also cause seizures. Because of the lack of published data, the lack of clear advantages over meropenem, and the increased cost compared with meropenem, doripenem will not be available for use at Baylor University Medical Center except by infectious diseases specialists.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article focuses on the published case reports of drug-induced acute pancreatitis (AP), particularly in the U.S. It outlines the etiological risk factors for AP including a history of alcohol abuse, trauma and medical complications. It highlights drugs and medications associated with AP such as hormone replacement therapy (HRT), angiotensin-converting enzyme (ACE) inhibitors and oral contraceptives.

The article presents an electrocardiographic report of a 20-year-old pregnant women with electrocardiographic right ventricular enlargement. It stated that the patient complained of exertional dyspnea of 6-months duration and upon assessment the doctors found out that the chest was clear to auscultation, the second heart sound was single and loud and there is no cyanosis or clubbing. Furthermore, the diagnosis was confirmed through echocardiography that revealed ventriculoarterial discordance.

Lithium carbonate is a common treatment for mood disorders, but it has a very narrow therapeutic index and can be toxic to multiple organ systems. Unfortunately, many patients suffer toxic effects through the course of their therapy. We describe a patient with toxic effects from a high dose of lithium who was successfully treated with normal saline diuresis. We discuss the properties that make lithium susceptible to normal saline diuresis and explore alternative options for treatment of lithium toxicity.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The number of uninsured Texas residents who rely on the medical emergency department as their primary health care provider continues to increase. Unfortunately, little information about the characteristics of this group of emergency department users is available. Using an administrative billing database, we conducted a descriptive study to examine the demographic and clinical features of 17,110 consecutive patients without medical insurance who presented to the emergency department of the University of Texas Medical Branch in Galveston over a 12-month period. We also analyzed the risk of multiple emergency department visits or hospitalization according to demographic characteristics. Twenty percent of the study population made two or more emergency department visits during the study period; 19% of the population was admitted to the hospital via the emergency department. The risk of multiple emergency department visits was significantly elevated among African Americans and increased in a stepwise fashion according to age. The risk of being hospitalized was significantly reduced among females, African Americans, and Hispanics. There was an age-related monotonic increase in the risk of hospitalization. Abdominal pain, cellulitis, and spinal disorders were the most common primary diagnoses in patients who made multiple emergency department visits. Hospitalization occurred most frequently in patients with a primary diagnosis of chest pain, nonischemic heart disease, or an affective disorder. Additional studies of emergency department usage by uninsured patients from other regions of Texas are warranted. Such data may prove helpful in developing effective community-based alternatives to the emergency department for this growing segment of our population. Local policymakers who are responsible for the development of safety net programs throughout the state should find this information particularly useful.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article presents a 41-year-old woman with asymptomatic thyroid mass, which has been monitored for several years by an endocrinologist using serial sonography. It was mentioned that a fine-needle aspiration biopsy was ordered by an endocrinologist after noticing that it had enlarged in normal thyroid function test. It stated that thyroidectomy was performed in the patient, and 15 lymph nodes in her neck were dissected from the central compartment of the neck.

The article discusses several facts about oil consumption and public health in the world. The author states that about one of every nine barrels of oil produced in the world goes into American automobile gasoline tanks. It mentions that the massive demand for oil in India and China is driving up the cost of their food production and transportation. In addition, a study has determined that nearly 3 in 10 workers become very sleepy or even fall asleep at work.

The article presents several quotes related to personality, life, and health.

The article presents several facts and ideas from various journals which includes cholesterol attack, animal agriculture and global warming, and safety of imported goods. According to Thomas J. Moore, diet does not have much effect on the cholesterol level, however, the drugs that can lower it have serious or fatal side effects. It was also mentioned that animal agriculture has become one of the biggest perpetrators in global warming.

The article offers new briefs related to medicine. The American Institute for Cancer Research and the World Cancer Research Fund examined more than 7000 scientific studies and offered recommendations to lower the risk of developing cancer. Researchers from the University College London in England found that poor close relationships may be linked to the emergence of coronary heart disease. In 2005, the pharmaceutical industry lost an estimated $30 billion due to fake drugs.

The article provides an overview of the medical findings involving a 58-year-old man who complained of fatigue, shortness of breath and melena. Endoscopic findings indicated that he had a proximal bleed in the small bowel. An ultrasound examination showed a 6-millimeter (mm) common bile duct with cholethiasis, and an angiogram found a proximal jejunal blush, which was suggestive of bleeding. His medical history and physical examination are highlighted.

The article presents a case study of a 58-year-old Hispanic man admitted to the emergency department at Baylor University Medical Center in Dallas, Texas due to a 1-year history of intermittent abdominal pain associated with infrequent nausea and vomiting. After laboratory tests, the patient was diagnosed of having a giant colonic diverticulum (GCD), an occasional complication of diverticular disease. Several medications have been documented including antimicrobial therapy and pain management.

The article presents the history of health insurance. Henry I was credited for introducing health care reforms to the newly combined kingdoms of England and Normandy. In the early part of the 20th century, several U.S. states proposed to enact compulsory health insurance. Between the 1940s and 1960s, the world witnessed a slow, steady and reluctant growth in health insurance.

Hepatocellular carcinoma (HCC) is a common cancer that typically occurs in the setting of cirrhosis and chronic hepatitis virus infections. Hepatitis B and C account for approximately 80% of cases worldwide. HCC is currently the fifth most common malignancy in men and the eighth in women worldwide; its incidence is increasing dramatically in many parts of the world. Recognition of those at risk and early diagnosis by surveillance with imaging, with or without serologic testing, are extremely important. Many highly effective and even curative therapies are now available and include resection, liver transplantation, and local ablation. Appropriate application of these interventions offers hope of prolonged survival to many patients with this otherwise lethal complication of liver disease.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article profiles doctor William D. Hillis, professor of Biology at Baylor University (BU) in Texas. Hillis had accordingly, earned an undergraduate degree from BU and a medical degree from John Hopkins University. After his residency training in internal medicine as part of the Osler Medical Service, he joined the Air Force. The author says that Hillis hopes to work more closely with students and help them as they studied the science of evolution.

Indicators of the performance of clinical preventive services (CPS) have been adopted in the ambulatory setting to improve quality of care. The impact of CPS was evaluated in a network of 49 primary care practices providing care to an estimated 245,000 adults in the Dallas-Fort Worth area through a sample chart review to determine delivery of recommended evidence-based CPS combined with medical literature estimates of the effectiveness of CPS. In this population in 2005, CPS were estimated to have prevented 36 deaths and 97 incident cases of cancer; 420 coronary heart disease events (including 66 sudden deaths) and 118 strokes; 816 cases of influenza and pneumonia (including 24 hospital admissions); and 87 osteoporosis-related fractures. Thus, CPS have substantial benefits in preventing deaths and illness episodes.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article presents obituaries for physicians from Baylor University Medical Center including John Thomas Mallas and Anne Race.

A retrospective review of 27 patients who underwent endovascular repair of thoracic aneurysms and of other thoracic aortic pathology with the thoracic aortic endograft (Gore Medical, Flagstaff, AZ) from June 2005 to July 2007 was performed. The mean follow-up period was 13.5 months (range, 2-25 months). Indications for thoracic endografting included descending thoracic aneurysms (n = 18), thoracoabdominal aneurysms (n = 3), traumatic aortic injuries (n = 3), penetrating aortic ulcers (n = 2), and contained rupture of a type B dissection (n = 1). One patient died during the procedure, for an overall mortality rate of 3.7%. The average length of stay was 8.1 days, with an average stay in the intensive care unit of 4.2 days. If patients with traumatic aortic injuries were excluded, the average overall and intensive care unit length of stay were 5.6 and 1.8 days, respectively. There was one incident of spinal cord ischemia (3.7%). There were five type I or type III endoleaks, three of which required revision (11.1%). In conclusion, thoracic endografting is a safe and viable option for the repair of descending thoracic aneurysms and other aortic pathologies. We have found it to be less invasive, even in conjunction with preoperative debranching procedures, with a shorter recovery time, decreased perioperative morbidity and blood loss, and decreased perioperative mortality compared with standard open repair.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article discusses the innovation and clinical changes in surgical oncology at Baylor University Medical Center (BUMC) in Dallas, Texas. It outlines the advancement in the management of cancer patient under the leadership of Dr. Ronald C. Jones as BUMC's chairman of the Department of Surgery. It highlights the techniques applied by surgeons at BUMC including the use of magnetic resonance imaging (MRI), biopsy and positron emission tomography (PET).

The article reports on the move of Baylor University Medical Center (BUMC) in Dallas, Texas to use a handheld device that enables the radiology department to send medical orders. The instant messaging technology is part of Nortel Communications Systems Inc.'s Healthcare Solutions portfolio in partnership with BUMC's information technology department to improve patient safety. Don Allen, director of radiology at BUMC, hopes to increase the availability of medical data with the said technology.

Vascular thrombosis is a cause of allograft loss after pancreas transplantation. We present the use of intraoperative fluorescence imaging with the SPY imaging device (Novadaq Technologies Inc, Toronto, Canada) in two pancreas transplants as a means to assess patency of the vascular anastomoses. Intravenous indocyanine green 2.5 mg/mL was fluoresced with the device to create the intraoperative video sequences, which were recorded. After 60-day follow-up, real-time SPY imaging on these two pancreas transplants did not demonstrate adverse effects on patients or the transplanted allografts. This method of vascular imaging could prove useful in improving short-term graft survival and possibly lowering the thrombosis rates seen with pancreas transplantation. Long-term correlation studies between intraoperative findings and graft survival must be performed to confirm the utility of this imaging method.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article presents a case report on the surgery with a 46-year-old Caucasian woman with mental retardation, who experienced discomfort and irregular menstrual bleeding. The findings at surgery were accordingly, a normal appearing uterus, ovaries and fallopian tubes, without evidence of obvious disease. It is concluded that attempts can be made to educate and counsel the patient and all involved and to use trials with therapy to see how well toleration can be done.

The article discusses several studies on left-handed people. Although they are considered to be more intellectual and artistic, studies have documented that they are more prone to unintentional injuries, head trauma, and vehicular and sports accidents. They also determined that left-handed workers are five times more prone to finger amputations than are right-handed workers. The survey demonstrated that most orthopaedic surgeons, librarians and mathematicians are right-handed.

An interview with physician Joseph Allen Kuhn is presented. When asked about his childhood, he relates that his parents were both from a small farm in northeast Iowa and was the youngest of the three children. He added that he entered medical school and heard about Baylor University Medical Center (BUMC) and its internal medicine and cardiology programs. Lastly, he states that a strength of the BUMC residency program has always been the amount of early hands-on experience.

It has been suggested that patients with insomnia who are lost to followup continue to experience symptoms. From winter 2006 to spring 2007, we contacted consecutive patients initially seen at a multidisciplinary sleep medicine clinic 3 to 5 years earlier and asked them about continuing symptoms. Among the 58 patients who agreed to participate, 43 (74%) reported that they still experienced difficulty initiating and/or maintaining sleep. Thirty-one of those patients had continued to receive treatment, 11 from a sleep medicine specialist and the remainder from other physicians. The majority listed zolpidem or eszopiclone as their primary medication, and many took multiple medications, including over-the-counter drugs and alternative medications. Most patients with insomnia were unaware of cognitive-behavioral therapy. These findings emphasize the need for primary care physicians to monitor symptoms of insomnia and to remain vigilant about potential treatment complications.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

An interview with Mahmoud Moawad, head of the Section of General Internal Medicine (GIM) at the King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia is presented. When asked how difficult it was to get accepted into medical school in Egypt, he answered that it was and is still the most difficult school to get into. During vacation, he usually spends time to Egypt or in the U.S., and added that Pittsburgh, Pennsylvania is considered as the family's second home.

The article presents an obituary for Steve Bell, surgeon of the Dallas Medical and Surgical Clinic in Dallas, Texas.

Dural arteriovenous fistulae are rare lesions composed of abnormal connections between meningeal arteries and the dural sinuses or leptomeningeal veins. Treatment is challenging because of the small size and wide distribution of the myriad sites of fistulous connection. We present a case of a dural arteriovenous fistula presenting with visual deterioration, pulsatile tinnitus, and intracranial hypertension that was successfully treated with a multidisciplinary approach combining angiographic, surgical, and radiosurgical intervention. This is one of the largest of these formidable lesions treated in this fashion that has been reported.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article presents the new drug entities that were approved by the Food and Drug Administration in 2007 which includes Aliskiren, Ambrisentan and Armodafinil. It stated that Aliskiren is indicated for hypertension and it decreases plasma renin activity and inhibits the conversion of angiotensinogen to angiotensin I. Furthermore, ambrisentan is given to patients with pulmonary arterial hypertension and a starting dose of 5 mg once daily which may be increased to 10 mg as tolerated is given.

The first 25 consecutive patients with high occiusal plane angulation, dysfunction, and pain who were treated with temporomandibular joint (TMJ) total joint prostheses and simultaneous maxillomandibular counter-clockwise rotation were evaluated before surgery (T1), immediately after surgery (12), and at the longest follow-up (13) for surgical movements and long-term stability. Subjective ratings were used for patients' facial pain/headache, TMJ pain, jaw function, diet, and disability, and objective functional changes were determined by measuring maximum incisal opening and lateral excursive movements. Results showed that the areas of greatest surgical change included an average decrease in the occiusal plane of 13.3 degrees with advancement at point B of i 3.4 mm and at the genial tubercies of 16.3 mm. At longest follow-up, relapse was 0.7 degrees, 0.8 mm, and 1.2 mm, respectively, with no statistically significant changes. Significant subjective pain and dysfunction improvements were observed (P ≤ 0.001). Maximum incisal opening increased, but lateral excursion decreased. Those who had two or more previous TMJ surgeries showed greater levels of dysfunction at T1 and T3 than those who had one or no previous surgeries, but otherwise patients presented similar amounts of absolute changes. In conclusion, end-stage TMJ patients can achieve significant improvement in their pain, dysfunction, dentofacial deformity, and airway problems in one operation with TMJ reconstruction and mandibular advancement using TMJ custom-made total joint prostheses and simultaneous maxillary osteotomies for maxillomandibular counter-clockwise rotation.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article discusses the characteristics of patent ductus arteriosus (PDA), citing a report case of a 43-year-old woman, who has a mild systemic hypertension and was referred after a precordial murmur was detected by physician. It is accordingly, found out that the clinical presentation of PDA in adults is dependent on the degree of left-to-right shunting. The authors say that the closure of an isolated, clinically detectable PDA is indicated in all symptomatic patients.

The article presents an interview with Perry Edward Gross, an active physician in Texas. When asked how old he was when he entered the medical school, he replied that he was 21 years old. He claimed that his wife has supported him in all his endeavors. He noted that his personal one-on-one relationships with his patients, enduring love of his wife, and the challenge of children and grandchildren have made his life uniquely rewarding.

The article offers news briefs related to health facilities in Dallas, Texas. The Baylor Health Care System (BHCS) Foundation has announced the fund raising of $11 million to help fund the expansion of Baylor University Medical Center (BUMC) emergency department. The BHCS Foundation held its 2007 Celebrating Women Luncheon on October 16, 2007 at the Hilton Anatole Hotel in Texas. Dallas' women in imaging centers will be honored by Darlene G. Cass, community leader and beast cancer survivor.

The article provides information on medicolegal issues in the U.S. The pharmaceutical industry is pushing an agenda to essentially eliminate the ability of individuals to pursue failure-to-warn claims against manufacturers, regardless of the adequacy of the warning provided. On the other hand, criticisms that the Food and Drug Administration and the current American drug safety system are unable to adequately protect the public health has been common throughout the new millennium.

The article describes the effectiveness of the 64-slice coronary computed tomography (CT) for the preoperative visualization of a muscular ventricular septal defect (VSD). With this method, doctors are able to evaluate the patient's coronary anatomy without invasive catheterization. Doctors also can visualize the septal defect, definitively identify the location and course of the defect through the ventricular septum.

Mucormycosis (zygomycosis) is an acute and often fatal opportunistic fungal infection. Predisposing factors in the development of mucormycosis are nonspecific and include hyperglycemia, hematologic malignancies, neutropenia, pharmacologic immunosuppression, solid organ or bone marrow/stem cell transplantation, burns, trauma, malnutrition, and intravenous drug use. Mucormycosis has also been described in patients with iron and aluminum overload, patients on dialysis, and patients receiving iron chelating therapy. We describe a 75-year-old man with myelodysplastic syndrome and iron overload secondary to multiple red blood cell transfusions who had been treated with deferoxamine chelation therapy. He was admitted to the hospital for atrial fibrillation, developed multiple organ failure, and died. Pulmonary invasive mucormycosis was demonstrated at autopsy. This case further documents an association between invasive mucormycosis, iron overload, and deferoxamine therapy.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article announces awards from Baylor Health Care System including Baylor Medical Center at Waxahachie, Texas for its system to identify and treat patients at high risk of developing venous thromboembolic events and two projects from Baylor Medical Center at Garland, Texas.

A letter to the editor is presented commenting on the quality of articles published in the journal.

The article presents a case of a 64-year-old woman experiencing short episodes of rapid regular heart beating. Her condition became frequent and lengthy, resulting in a hospital admission a month earlier when intravenously administered adenosine terminated an episode. She was then discharged on diltiazem, but her condition of tachycardia continued and were accompanied by light-headedness and sometimes nausea.

The article reviews the book "Relevant Surgical Exposures," by Bernard F. Morrey and Matthew C. Morrey .

The objective of the study was to develop and validate predictors of 30- day hospital readmission using readily available administrative data and to compare prediction models that use alternate comorbidity classifications. A retrospective cohort study was designed; the models were developed in a two-thirds random sample and validated in the remaining one-third sample. The study cohort consisted of 29,292 adults aged 65 or older who were admitted from July 2002 to June 2004 to any of seven acute care hospitals in the Dallas-Fort Worth metropolitan area affiliated with the Baylor Health Care System. Demographic variables (age, sex, race), health system variables (insurance, discharge location, medical vs surgical service), comorbidity (classified by the Elixhauser classification or the High-Risk Diagnoses in the Elderly Scale), and geographic variables (distance from patient's residence to hospital and median income) were assessed by estimating relative risk and risk difference for 30-day readmission. Population-attributable risk was calculated. Results showed that age 75 or older, male sex, African American race, medical vs surgical service, Medicare with no other insurance, discharge to a skilled nursing facility, and specific comorbidities predicted 30-day readmission. Models with demographic, health system, and either comorbidity classification covariates performed similarly, with modest discrimination (C statistic, 0.65) and acceptable calibration (Hosmer-Lemeshow χかい<sup&rt;2</sup&rt; = 6.08; P &rt; 0.24). Models with demographic variables, health system variables, and number of comorbid conditions also performed adequately. Discharge to long-term care (relative risk, 1.94; 95% confidence interval, 1.80- 2.09) had the highest population-attributable risk of 30-day readmission (12.86%). A 25% threshold of predicted probability of 30-day readmission identified 4.1% of patients ⩾65 years old as priority patients for improved discharge planning. We conclude that elders with a high risk of 30-day hospital readmission can be identified early in their hospital course.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

he article presents abstracts of research conducted by researchers at the Baylor University Medical center including bilateral infiltrating renal inflammatory pseudotumor responsive to corticosteroid therapy, improving delivery of clinical preventive services: a multi-year journey, and neoadjuvant therapy followed by prostatectomy for clinically localized prostate cancer.

The article presents abstracts on medical topics which include a phase I trial of intravenous infusion of ONYX-015 and enbrel in solid tumor patients, the benefit-risk assessment of nesiritide in the treatment of acute decompensated heart failure and the safety and tolerability of sorafenib in clear-cell renal cell carcinoma.

This study evaluated serum nutrients in 23 patients who had previous Proplast/Teflon implants to their temporomandibular joints (TMJ) and continued to remain in chronic, severe, irresolvable pain despite subsequent surgical reconstruction. All of the patients were women, and their average age was 40.6 years (range, 28-55 years). Standard blood assays were performed for beta-carotene (vitamin A), folate, serum iron, ferritin, zinc, magnesium, and vitamins B1, B6, B12, and C. Each patient was deficient in at least one of these 10 elements, with an average of 3.3 elements. Some factors that may be responsible for the deficiency state include inadequate nutritional intake, malabsorption, utilization dysfunction, increased requirements, or drug interactions. In conclusion, the patient who has had multiple, complex TMJ operations with a history of TMJ Proplast/Teflon implants and poor treatment results may be suffering from an unrecognized malnutrition state, substantially adding to the patient's morbidity. Nutritional evaluations, dietary counseling, and appropriate medical management may improve the treatment outcomes for these patients.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article reviews the book "SLAM: Street Level Airway Management," by James Michael Rich.

The article discusses several observations on the occurrence of mitral and aortic valve diseases. In the 1950s and 1960s, most physicians attributed these diseases in adults to rheumatic heart disease. In 1970s, a congenitally malformed aortic valve was found to be frequent in adults with aortic stenosis (AS), and mitral valve prolapse (MVP) was recognized as a common cause of pure mitral regurgitation (MR). Their frequencies and causes in necropsy studies are highlighted.

The article presents a case report that aims to describe a patient who presented with minimal indicators of a difficult intubation and good bag-mask ventilation (BMV) after induction of anesthesia. It states that the digital intubation can be used as an acceptable alternative to direct laryngoscopy for tracheal intubation when there is a failure of the standard technique. It is concluded that persistent use of direct laryngoscopy during failed intubation may result in airway trauma.

Suicide has reached epidemic proportions in the elderly, particularly in non-Hispanic white men. Unfortunately, the risk is underappreciated in this population. Known risk correlates for suicide in this population fall into three interrelated categories. Sociologic factors include such considerations as living alone and having few social interactions. Physical health factors include having more medical comorbidity and being a current smoker. The mental health risk factors include the presence of mood and anxiety disorders with a focus on the greater severity of symptoms, especially hypersomnia, hopelessness, and a history of suicide attempts. Suicide is a spectrum comprising ideation, intent, and plan. Clinical depression is never a normal part of aging and warrants aggressive treatment. Recent warnings linking antidepressants and suicide may have special relevance in the elderly. Based on preliminary studies with antipsychotic drugs, a subgroup of patients who experience akathisia may be particularly vulnerable to suicide. Upon initiation of antidepressants, it is recommended that adults be seen in follow-up three times within the first 12 weeks of treatment; if medically indicated, the first contact should be during the first week.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

Heat stroke is the end result of excess heat stress and results in multiorgan dysfunction with a propensity for central nervous system (CNS) injury. Damage to the CNS appears to be the result of multiple mechanisms, including direct heat damage and the initiation of a sepsis-type syndrome. Only a few scattered case reports exist in the literature that document CNS damage via imaging. We present a case with symmetric bilateral magnetic resonance findings in the caudate nuclei, subcortical white matter, hippocampi, and cerebellum. To our knowledge, this is the first case to report symmetric bilateral caudate abnormality and bilateral hippocampal enhancement.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

A personal narrative is presented which explores the author's experience when he interviewed the father of heart transplantation, Dr. Richard R. Lower in 1977.

The article discusses the characteristics of tennis elbow and aims to provide possible treatment. Also known as overuse injury, it is stated that tennis elbow usually presents as a small area of chronic pain on the lateral aspect of the elbow. It is accordingly, characterized by pain on wrist extension and most of the time, weakened grip. It is concluded that there is no one good and rapid treatment for tennis elbow and that the best treatment is permanent avoidance of whatever movements.

Ectopic production of adrenocorticotropic hormone by carcinoid tumors is relatively uncommon and may not be recognized by physicians. This report describes a woman who had Cushing syndrome from the ectopic secretion of adrenocorticotropic hormone by a carcinoid tumor. Her cause of death was a pneumonia that may have been secondary to her untreated hypercortisolism. There are three instructive elements of this case: 1) the recognition of Cushing syndrome, 2) the association of Cushing syndrome with low-grade (carcinoid tumors) as well as with high-grade (small cell carcinoma) neuroendocrine tumors, and 3) the need to treat the hypercortisolism as well as the tumor.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

Editor's note: On March 25, 2008, Zelig ("Zeck") Lieberman, MD, was recognized at a reception at the Crescent Club marking his 50th anniversary at Baylor University Medical Center. More than 115 friends, family members, and associates gathered to pay tribute to Dr. Lieberman for his commitment to the surgical oncology profession as well as his dedication to Baylor. Dr. Fordtran delivered the following tribute during the event. Culminating the evening's celebrations, Rowland K. Robinson, president of the Baylor Health Care System Foundation, and Joel Allison, president and chief executive officer of the Baylor Health Care System, presented Dr. Lieberman with a plaque for his extraordinary service.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article reviews the book "The Illusion of Certainty," by Erik Rifken and Edward Bouwer.

The article reviews the book "The Last Leaf Has Fallen," by J. Willis Hurst.

The article discusses the issues related to patient safety and medical errors in the U.S. It outlines the country's National Patient Safety Goals and explains the significance of the physicians' efforts in teamwork and communication to improve safety. It offers ways to improve patient safety such as the standardization of medical approach. Here, the author highlights the active patient safety program at Baylor University Medical Center in Dallas, Texas.

Amiodarone is a class III antiarrhythmic drug widely used for both ventricular and supraventricular tachyarrhythmias. Due to its high iodine content and structural similarity to thyroxine, abnormalities in thyroid function are common in patients taking amiodarone, especially with long-term use. Both hypo- and hyperthyroidism have been associated with amiodarone, with the former far more common in the United States. We present a patient with medically refractory amiodarone-induced thyrotoxicosis after a 2-year history of amiodarone use, resulting in cardiac arrest and encephalopathy. The patient ultimately required total thyroidectomy for symptomatic control.ABSTRACT FROM AUTHORCopyright of Baylor University Medical Center Proceedings is the property of Baylor University Medical Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.

The article provides information related to Mycobacterium tuberculosis. Mycobacterium tuberculosis remain the top-10 cause of death worldwide. Tuberculosis is spread primarily by inhalation of infected droplets, resulting in pulmonary disease. Tuberculous tenosynovitis is a rare complication of the disease, resulting from direct extension from adjacent bone or joint infection.

An interview with Dr. Virginia Pascual, full investigator at Baylor Institute of Immunology Research (BIIR) in Dallas, Texas, is presented. When asked about her work at BIIR, she denotes that Baylor has been very supportive and she has been experiencing great time with her colleagues. She states that she has been fortunate of having a number of grants from several institutions including the U.S. National Institutes of Health (NIH).

The article focuses on health care liability claims under Chapter 74 of the Texas Civil Practice and Remedies Code. Chapter 74 applies if the claim is against a health care provider; is based on treatment, deviates from common practice, and causes injury or death. Limitations of the law and test cases are discussed.

The article presents questions and answers related to the personal life of Mr. William Levin Sutker including the job of his father, if his father serve in World War II, and if he has a happy childhood and pleasant home.

The article presents questions and answers related to the personal life of William Levin Sutker including the job of his father, if his father serve in World War II, and if he have a happy childhood and pleasant home.

The article shows an electrocardiogram of a patient with Wolff-Parkinson-white-type ventricular preexcitation mimicking left ventricular and an inferoposte myocardial infarct. It indicated that the patient probably has a posteroseptal accessory pathway and nearly normal repolarization. It also showed a false-positive result for exercise tests. The electrocardiographic determined that the abnormality was an incidental finding.