58 research outputs found

    Recent Legal Literature

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    Thorpe: The Constitutional History of the United States; The American State Reports, containing the Cases of General Value and Authority Subsequent to those Contained in the American Decisions and the American Reports, Decided in the Courts of Last Resort of the Several States. Selected, Reported, and Annotated by A. C. Freeman, and the Associate Editors of the American Decisions. Vol. 82-85; Sibbley: The Right to and the Cause for Action; Mack and Nash (eds.): Cyclopedia of Law and Procedure; Page: A concise treatise on the Law of Wills; May: The Law of Insurance as Applied to Fire, Life, Accident, Guaranty and other Non-Maritime Risks; Elliott: A Treatise on the Law of Insurance, including Fire, Life, Accident, Caualty, Title, Credit and Guaranty Insurance in Every Form; Chatterton: Probate Law; Abbott: Trial Evidence; Hammon: A Treatise on Chattel Mortgages for Michigan; Hammon: A Treatise on Chattel, Mortgages for Illinois; Freeman: Void Judicial Sales; Hirsch: Tabulated Digest of the Divorce Laws of the United State

    Ureteric complications in recipients of kidneys from donation after circulatory death donors.

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    A large increase in the use of kidneys from donation after circulatory death (DCD) donors prompted us to examine the impact of donor type on the incidence of ureteric complications (UCs; ureteric stenosis, urinary leak) after kidney transplantation. We studied 1072 consecutive kidney transplants (DCD n=494, live donor [LD] n=273, donation after brain death [DBD] n=305) performed during 2008-2014. Overall, there was a low incidence of UCs after kidney transplantation (3.5%). Despite a trend toward higher incidence of UCs in DCD (n=22, 4.5%) compared to LD (n=10, 3.7%) and DBD (n=5, 1.6%) kidney transplants, donor type was not a significant risk factor for UCs in multivariate analysis (DCD vs DBD HR: 2.33, 95% CI: 0.77-7.03, P=.13). There was no association between the incidence of UCs and donor, recipient, or transplant-related characteristics. Management involved surgical reconstruction in the majority of cases, with restenosis in 2.7% requiring re-operation. No grafts were lost secondary to UCs. Despite a significant increase in the number of kidney transplants from DCD donors, the incidence of UCs remains low. When ureteric complications do occur, they can be treated successfully with surgical reconstruction with no adverse effect on graft or patient survival.This study was supported by the Cambridge NIHR Biomedical Research Centre and the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation at the University of Cambridge in collaboration with Newcastle University and in partnership with NHS Blood and Transplant (NHSBT). VK was supported by an Academy of Medical Sciences Grant and an Evelyn Trust Grant. DHM was supported by a RCSEng Research Fellowship

    The relation between socioeconomic and demographic factors and tumour stage in women diagnosed with breast cancer in Denmark, 1983–1999

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    The authors investigated the association between socioeconomic position and stage of breast cancer at the time of diagnosis in a nationwide Danish study. All 28 765 women with a primary invasive breast cancer diagnosed between 1983 and 1999 were identified in a nationwide clinical database and information on socioeconomic variables was obtained from Statistics Denmark. The risk of being diagnosed with a high-risk breast cancer, that is size >20 mm, lymph-node positive, ductal histology/high histologic grade and hormone receptor negative, was analysed by multivariate logistic regression. The adjusted odds ratio (OR) for high-risk breast cancer was reduced with longer education with a 12% reduced risk (95% confidence interval (CI), 0.80,0.96) in women with higher education and increased with reduced disposable income (low income group: OR, 1.22; 95% CI, 1.10,1.34). There was an urban–rural gradient, with higher risk among rural women (OR 1.10; 95 % CI, 1.02, 1.18) and lower risk among women in the capital suburbs (OR, 0.85; 95% CI, 0.78, 0.93) and capital area (OR, 0.93; 95% CI, 0.84–1.02). These factors were significant only for postmenopausal women, although similar patterns were observed among the premenopausal women, suggesting a subgroup of aggressive premenopausal breast cancers less influenced by socioeconomic factors

    Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

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    BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

    Leadership development programs for physicians: a systematic review

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    Background: Physician leadership development programs typically aim to strengthen physicians’ leadership competencies and improve organizational performance. We conducted a systematic review of medical literature on physician leadership development programs in order to characterize the setting, educational content, teaching methods, and learning outcomes achieved. Methods: Articles were identified through a search in Ovid MEDLINE from 1950 through November 2013. We included articles that described programs designed to expose physicians to leadership concepts, outlined teaching methods, and reported evaluation outcomes. A thematic analysis was conducted using a structured data entry form with categories for setting/target group, educational content, format, type of evaluation and outcomes. Results: We identified 45 studies that met eligibility criteria, of which 35 reported on programs exclusively targeting physicians. The majority of programs focused on skills training and technical and conceptual knowledge, while fewer programs focused on personal growth and awareness. Half of the studies used pre/post intervention designs, and four studies used a comparison group. Positive outcomes were reported in all studies, although the majority of studies relied on learner satisfaction scores and self-assessed knowledge or behavioral change. Only six studies documented favorable organizational outcomes, such as improvement in quality indicators for disease management. The leadership programs examined in these studies were characterized by the use of multiple learning methods, including lectures, seminars, group work, and action learning projects in multidisciplinary teams. Discussion: Physician leadership development programs are associated with increased self-assessed knowledge and expertise; however, few studies have examined outcomes at a system level. Our synthesis of the literature suggests important gaps, including a lack of programs that integrate non-physician and physician professionals, limited use of more interactive learning and feedback to develop greater self-awareness, and an overly narrow focus on individual-level rather than system-level outcomes. This article is distributed under the terms of the Creative Commons Attribution License

    Recent Legal Literature

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    Hughes: Handbook of Admiralty Law; Wilgus: Cases on the General Principles of the Law of Private Corporations; Spelling: A Treatise on Injunctions and Other Extraordinary Remedies; Brannon: A Treatise on the Rights and Privileges Guaranteed by the Fourteenth Amendment to the Constitution of the United States; Boone: Real Property Law, 2nd ed.; Abbott and Abbott: The Clerks\u27 and Conveyancers\u27 Assistant; Rose: Notes on the United States Reports; Nichols: Britton: An English Translation and Note

    Recent Legal Literature

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    Thorpe: The Constitutional History of the United States; The American State Reports, containing the Cases of General Value and Authority Subsequent to those Contained in the American Decisions and the American Reports, Decided in the Courts of Last Resort of the Several States. Selected, Reported, and Annotated by A. C. Freeman, and the Associate Editors of the American Decisions. Vol. 82-85; Sibbley: The Right to and the Cause for Action; Mack and Nash (eds.): Cyclopedia of Law and Procedure; Page: A concise treatise on the Law of Wills; May: The Law of Insurance as Applied to Fire, Life, Accident, Guaranty and other Non-Maritime Risks; Elliott: A Treatise on the Law of Insurance, including Fire, Life, Accident, Caualty, Title, Credit and Guaranty Insurance in Every Form; Chatterton: Probate Law; Abbott: Trial Evidence; Hammon: A Treatise on Chattel Mortgages for Michigan; Hammon: A Treatise on Chattel, Mortgages for Illinois; Freeman: Void Judicial Sales; Hirsch: Tabulated Digest of the Divorce Laws of the United State
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