The American journal of medicine
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Clinical academic medicine desperately needs the continued infusion of talented young academicians, but many young faculty are not pursuing strategies that optimize their chances for academic survival. Many junior faculty are overburdened with clinical demands and do not have a well-focused research agenda. Such situations will hinder the full development of many talented young persons. In order to optimize chances for success, young faculty should clearly define their goals, carefully negotiate the terms of their employment, practice sound principles of time management, identify a mentor, and develop a focused research agenda.
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Controlled Clinical Trial
Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission.
Despite recognition that Clostridium difficile diarrhea/colitis is a nosocomial infection, the manner in which this organism is transmitted is still not clear. Hands of health care workers have been shown to be contaminated with C. difficile and suggested as a vehicle of transmission. Therefore, we conducted a controlled trial of the use of disposable vinyl gloves by hospital personnel for all body substance contact (prior to the institution of universal body substance precautions) to study its effect on the incidence of C. difficile disease. ⋯ Vinyl glove use was associated with a reduced incidence of C. difficile diarrhea and is indirect evidence for hand carriage as a means of nosocomial C. difficile spread.
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Major cardiac and pulmonary complications associated with abdominal and noncardiac thoracic surgery are a common cause of mortality and serious morbidity in elderly patients. We postulated that a simple, inexpensive bicycle exercise test could provide objective documentation of cardiopulmonary reserve and, therefore, predict perioperative pulmonary as well as cardiac complications. ⋯ Objective measurement of exercise capacity by supine bicycle ergometry appears to be of clinical value for preoperative risk stratification for both pulmonary and cardiac complications prior to major elective abdominal or noncardiac thoracic surgery in elderly patients.