28 results on '"William A. McDade"'
Search Results
2. COVID-19 Has Exacerbated Inequities That Hamper Physician Workforce Diversification
- Author
-
James N. Woodruff, William A. McDade, Sunny Nakae, and Monica B. Vela
- Subjects
Physicians ,Workforce ,Humans ,COVID-19 ,General Medicine - Published
- 2022
3. Rates of Medical Student Placement Into Graduate Medical Education by Sex, Race and Ethnicity, and Socioeconomic Status, 2018-2021
- Author
-
Mytien Nguyen, Sarwat I. Chaudhry, Mayur M. Desai, Alexandra M. Hajduk, William A. McDade, Tonya L. Fancher, and Dowin Boatright
- Subjects
Students, Medical ,Social Class ,Socioeconomic Factors ,Education, Medical, Graduate ,Ethnicity ,Humans ,General Medicine - Abstract
This cohort study investigates whether different rates of medical student placement into graduate medical education exist by sex, race and ethnicity, and socioeconomic status from 2018 to 2021.
- Published
- 2022
4. Association of Mistreatment and Discrimination With Medical School Attrition
- Author
-
Mytien Nguyen, Sarwat I. Chaudhry, Mayur M. Desai, Candice Chen, William A. McDade, Tonya L. Fancher, and Dowin Boatright
- Subjects
Students, Medical ,Interprofessional Relations ,Pediatrics, Perinatology and Child Health ,Research Letter ,Humans ,Schools, Medical - Abstract
This cross-sectional study assesses the association of mistreatment and discrimination among medical students with attrition from medical school.
- Published
- 2022
5. Anticipating the Impact of the USMLE Step 1 Pass/Fail Scoring Decision on Underrepresented-in-Medicine Students
- Author
-
Monica B. Vela, William A. McDade, and J P Sánchez
- Subjects
Students, Medical ,020205 medical informatics ,education ,Specialty ,02 engineering and technology ,Subspecialty ,Patient advocacy ,Education ,Formative assessment ,03 medical and health sciences ,0302 clinical medicine ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,030212 general & internal medicine ,Curriculum ,Licensure ,Medical education ,Internship and Residency ,Cultural Diversity ,General Medicine ,Licensure, Medical ,United States Medical Licensing Examination ,United States ,Test (assessment) ,Educational Measurement ,Psychology ,Education, Medical, Undergraduate - Abstract
Three-digit United States Medical Licensing Examination (USMLE) Step 1 scores have assumed an outsized role in residency selection decisions, creating intense pressure for medical students to obtain a high score on this exam. In February 2020, the Federation of State Medical Boards and the National Board of Medical Examiners announced that Step 1 would transition to pass/fail scoring beginning in 2022.The authors discuss the potential advantages and disadvantages of the pass/fail scoring change for underrepresented-in-medicine (UiM) trainees. UiM students may benefit from this change because it reduces the effect of an inequitable exam; helps correct for students who attend medical schools with a curriculum heavier on nontested formative elements; and decreases stress, improves quality of life, and undermines imposter syndrome. However, this change may also precipitate unforeseen challenges, such as increased discrimination toward UiM trainees, an increase in high-stakes test failures due to a reduced focus on preparing for standardized exams, or the development of new (e.g., subject exams) or overreliance on existing (e.g., school ranking) metrics that would make UiM residency candidates less competitive.To enhance UiM representation in the future health care workforce, it is imperative that national organizations (e.g., accrediting, licensing, regulatory, professional, honor, student, and faculty), hospitals, residency programs, and patient advocacy groups undertake a shared, rigorous approach in assessing the impact of the pass/fail scoring change on UiM applicants' selection to specialty and subspecialty residencies.
- Published
- 2020
6. Diversity, Equity, and Inclusion Officer Position Available: Proceed With Caution
- Author
-
Monica B. Vela, Monica Lypson, and William A McDade
- Subjects
Racism ,Diversity, Equity, Inclusion, and Justice ,Humans ,Internship and Residency ,General Medicine ,Cultural Diversity - Published
- 2022
7. Racial and Ethnic Differences in Internal Medicine Residency Assessments
- Author
-
Dowin, Boatright, Nientara, Anderson, Jung G, Kim, Eric S, Holmboe, William A, McDade, Tonya, Fancher, Cary P, Gross, Sarwat, Chaudhry, Mytien, Nguyen, Max Jordan, Nguemeni Tiako, Eve, Colson, Yunshan, Xu, Fangyong, Li, James D, Dziura, and Somnath, Saha
- Subjects
General Medicine - Abstract
ImportancePrevious studies have demonstrated racial and ethnic inequities in medical student assessments, awards, and faculty promotions at academic medical centers. Few data exist about similar racial and ethnic disparities at the level of graduate medical education.ObjectiveTo examine the association between race and ethnicity and performance assessments among a national cohort of internal medicine residents.Design, Setting, and ParticipantsThis retrospective cohort study evaluated assessments of performance for 9026 internal medicine residents from the graduating classes of 2016 and 2017 at Accreditation Council of Graduate Medical Education (ACGME)–accredited internal medicine residency programs in the US. Analyses were conducted between July 1, 2020, and June 31, 2022.Main Outcomes and MeasuresThe primary outcome was midyear and year-end total ACGME Milestone scores for underrepresented in medicine (URiM [Hispanic only; non-Hispanic American Indian, Alaska Native, or Native Hawaiian/Pacific Islander only; or non-Hispanic Black/African American]) and Asian residents compared with White residents as determined by their Clinical Competency Committees and residency program directors. Differences in scores between Asian and URiM residents compared with White residents were also compared for each of the 6 competency domains as supportive outcomes.ResultsThe study cohort included 9026 residents from 305 internal medicine residency programs. Of these residents, 3994 (44.2%) were female, 3258 (36.1%) were Asian, 1216 (13.5%) were URiM, and 4552 (50.4%) were White. In the fully adjusted model, no difference was found in the initial midyear total Milestone scores between URiM and White residents, but there was a difference between Asian and White residents, which favored White residents (mean [SD] difference in scores for Asian residents: −1.27 [0.38]; P P P Conclusions and RelevanceIn this cohort study, URiM and Asian internal medicine residents received lower ratings on performance assessments than their White peers during the first and second years of training, which may reflect racial bias in assessment. This disparity in assessment may limit opportunities for physicians from minoritized racial and ethnic groups and hinder physician workforce diversity.
- Published
- 2022
8. Association of Sociodemographic Characteristics With US Medical Student Attrition
- Author
-
Mytien, Nguyen, Sarwat I, Chaudhry, Mayur M, Desai, Candice, Chen, Hyacinth R C, Mason, William A, McDade, Tonya L, Fancher, and Dowin, Boatright
- Subjects
Male ,Students, Medical ,Racial Groups ,Ethnicity ,Internal Medicine ,Humans ,Female ,Schools, Medical ,United States ,Retrospective Studies - Abstract
Diversity in the medical workforce is critical to improve health care access and achieve equity for resource-limited communities. Despite increased efforts to recruit diverse medical trainees, there remains a large chasm between the racial and ethnic and socioeconomic composition of the patient population and that of the physician workforce.To analyze student attrition from medical school by sociodemographic identities.This retrospective cohort study included allopathic doctor of medicine (MD)-only US medical school matriculants in academic years 2014-2015 and 2015-2016. The analysis was performed from July to September 2021.The main outcome was attrition, defined as withdrawal or dismissal from medical school for any reason. Attrition rate was explored across 3 self-reported marginalized identities: underrepresented in medicine (URiM) race and ethnicity, low income, and underresourced neighborhood status. Logistic regression was assessed for each marginalized identity and intersections across the 3 identities.Among 33 389 allopathic MD-only medical school matriculants (51.8% male), 938 (2.8%) experienced attrition from medical school within 5 years. Compared with non-Hispanic White students (423 of 18 213 [2.3%]), those without low income (593 of 25 205 [2.3%]), and those who did not grow up in an underresourced neighborhood (661 of 27 487 [2.4%]), students who were URiM (Hispanic [110 of 2096 (5.2%); adjusted odds ratio (aOR), 1.41; 95% CI, 1.13-1.77], non-Hispanic American Indian/Alaska Native/Native Hawaiian/Pacific Islander [13 of 118 (11.0%); aOR, 3.20; 95% CI, 1.76-5.80], and non-Hispanic Black/African American [120 of 2104 (5.7%); aOR, 1.41; 95% CI, 1.13-1.77]), those who had low income (345 of 8184 [4.2%]; aOR, 1.33; 95% CI, 1.15-1.54), and those from an underresourced neighborhood (277 of 5902 [4.6%]; aOR, 1.35; 95% CI, 1.16-1.58) were more likely to experience attrition from medical school. The rate of attrition from medical school was greatest among students with all 3 marginalized identities (ie, URiM, low income, and from an underresourced neighborhood), with an attrition rate 3.7 times higher than that among students who were not URiM, did not have low income, and were not from an underresourced neighborhood (7.3% [79 of 1086] vs 1.9% [397 of 20 353]; P .001).This retrospective cohort study demonstrated a significant association of medical student attrition with individual (race and ethnicity and family income) and structural (growing up in an underresourced neighborhood) measures of marginalization. The findings highlight a need to retain students from marginalized groups in medical school.
- Published
- 2022
9. Association of Socioeconomic Status With Alpha Omega Alpha Honor Society Membership Among Medical Students
- Author
-
William A McDade, Patrick G. O'Connor, Marcella Nunez-Smith, Dowin Boatright, Darin Latimore, Hyacinth R. C. Mason, and Mytien Nguyen
- Subjects
Gerontology ,Students, Medical ,Attitude of Health Personnel ,Research ,education ,MEDLINE ,Alpha (ethology) ,General Medicine ,Omega ,United States ,Online Only ,Medical Education ,Honor ,Cultural diversity ,Research Letter ,Humans ,Clinical Competence ,Association (psychology) ,Psychology ,Socioeconomic status ,Students medical ,Schools, Medical ,Societies, Medical ,Education, Medical, Undergraduate - Abstract
This cross-sectional study investigates the association between Alpha Omega Alpha (AΩA) honor society membership and medical student socioeconomic status.
- Published
- 2021
10. Making the Case for Equity in Graduate Medical Education
- Author
-
William A. McDade and Bonnie Simpson Mason
- Subjects
Medical education ,Graduate medical education ,Equity (finance) ,MEDLINE ,Internship and Residency ,General Medicine ,Cultural Diversity ,Education, Medical, Graduate ,Cultural diversity ,Humans ,Cultural Competency ,Healthcare Disparities ,Psychology ,Cultural competence - Published
- 2021
11. Equity Matters in Graduate Medical Education
- Author
-
Gizelle Clemens, Bonnie Simpson Mason, and William A. McDade
- Subjects
ACGME News and Views ,business.industry ,Political science ,Graduate medical education ,Equity (finance) ,Accounting ,General Medicine ,business - Published
- 2020
12. A New Biological Assay for Measuring Cyanide in Blood
- Author
-
James P. Lynch, Jonathan Moss, Avery Tung, and William A. McDade
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Cyanide ,Methemoglobin ,chemistry.chemical_compound ,Humans ,Medicine ,Bioassay ,Blood test ,Antidote ,Aged ,Cyanides ,Chromatography ,medicine.diagnostic_test ,business.industry ,Poisoning ,Reproducibility of Results ,Middle Aged ,Surgery ,Anesthesiology and Pain Medicine ,chemistry ,Spectrophotometry ,Toxicity ,Cyanide poisoning ,Colorimetry ,Female ,business ,Quantitative analysis (chemistry) ,Polarography - Abstract
UNLABELLED Clinical diagnosis of cyanide poisoning is complicated by the lack of an easy, convenient assay for cyanide concentration in blood. Therapy may be delayed with unconfirmed diagnosis because the conventional antidote to cyanide poisoning exposes patients to substantial risks. We developed a new spectrophotometric assay to measure cyanide by extraction into a sodium hydroxide trap, followed by the addition of exogenous methemoglobin as a colormetric indicator. Samples of blood from 15 healthy subjects and 5 patients who had received prolonged nitroprusside infusions were assayed. To optimize assay characteristics, methemoglobin concentrations, pH, temperature, incubation time, and buffer strengths were varied. Duplicate samples were assayed by using the polarographic method for assay validation. Over a range from 300 ng/mL to 7 microg/mL, the correlation between methods was r = 0.983. Interassay and intraassay variability were 5% and 2%, respectively. Samples drawn from the five patients and tested by using both methods yielded a correlation of r = 0.978. This new assay for cyanide in blood may greatly facilitate the diagnosis and treatment of cyanide ingestion. The use of methemoglobin as the colorimetric indicator in the assay contributes to its low cost and ease of use. IMPLICATIONS Cyanide, an important factor in death from burn-related inhalation injury, is difficult and time-consuming to measure. We developed a new, rapid blood test for cyanide using methemoglobin as a colormetric indicator. A rapid, accessible test for cyanide may speed the diagnosis and treatment of cyanide poisoning.
- Published
- 1997
13. Through the Physician's Eyes: The Racist Parent
- Author
-
William A. McDade
- Subjects
African american ,medicine.medical_specialty ,Affirmative action ,Health (social science) ,business.industry ,Health Policy ,media_common.quotation_subject ,education ,Bioethics ,Racism ,humanities ,Teaching hospital ,Issues, ethics and legal aspects ,Nursing ,Family medicine ,Ethical dilemma ,medicine ,Physician patient relationship ,business ,health care economics and organizations ,Medical ethics ,media_common - Abstract
An attending physician in an urban teaching hospital faces an ethical dilemma when a mother refused to allow an African American medical student to examine her child. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.
- Published
- 2013
14. Sickle Cell Disease
- Author
-
William A. McDade
- Published
- 2011
15. Contributors
- Author
-
Sanjib Adhikary, Jorge Aguilar, Charles Ahere, Moustafa Ahmed, Jane C. Ahn, Shamsuddin Akhtar, David B. Albert, Nasrin N. Aldawoodi, John T. Algren, Gracie Almeida-Chen, David Amar, Zirka H. Anastasian, Stephen Aniskevich, Solomon Aronson, Harendra Arora, Amit Asopa, Joshua H. Atkins, John G. Augoustides, Mohammad Fareed Azam, Catherine R. Bachman, Douglas R. Bacon, Andrew D. Badley, Emily Baird, Alethia Baldwin, Ryan Ball, Amir Baluch, David Bandola, Shawn Banks, Paul G. Barash, Kathleen E. Barrett, Shawn T. Beaman, Jonathan C. Beathe, Christopher D. Beatie, W. Scott Beattie, Perry S. Bechtle, G. Richard Benzinger, Lauren Berkow, Jeffrey M. Berman, Wendy K. Bernstein, Arnold J. Berry, Frederic Berry, Ulrike Berth, Walter Bethune, Sumita Bhambhani, Shobana Bharadwaj, Neil Bhatt, Frederic T. Billings, Wendy B. Binstock, David J. Birnbach, Michael Bishop, Stephanie Black, Mary A. Blanchette, James M. Blum, Krishna Boddu, Lara Bonasera, Richard L. Boortz-Marx, Cecil O. Borel, Gregory H. Botz, Charles D. Boucek, William Bradford, Jason C. Brainard, Michelle Braunfeld, Ferne R. Braveman, Caridad Bravo-Fernandez, Peter H. Breen, Marjorie Brennan, Tricia Brentjens, Megan A. Brockel, Jay B. Brodsky, Todd A. Bromberg, Adam J. Broussard, Chris Broussard, Carmen Labrie-Brown, Robert H. Brown, Charles S. Brudney, Sorin J. Brull, Claude Brunson, Trent Bryson, Jacob M. Buchowski, Stefan Budac, Zachary D. Bush, John Butterworth, Lisbeysi Calo, Christopher Canlas, Ayana Cannon, Shawn M. Cantie, Lisa Caplan, Marco Caruso, Davide Cattano, Charles B. Cauldwell, Laura Cavallone, Maurizio Cereda, Thomas M. Chalifoux, Susan Chan, Theodore G. Cheek, Alexander Chen, Samuel A. Cherry, Albert T. Cheung, Grace L. Chien, Peter T. Choi, Christopher Ciarallo, Franklyn Cladis, Anthony J. Clapcich, Richard B. Clark, Mindy Cohen, Neal H. Cohen, Robert I. Cohen, Stephan J. Cohn, Aisling Conran, Richard I. Cook, Randall F. Coombs, David M. Corda, Daniel Cormican, Darren Cousin, Vincent S. Cowell, Lyndsey Cox, Paula A. Craigo, Richard C. Cross, Roy F. Cucchiara, William H. Daily, Gaurang Dalal, Priti Dalal, Michael Danekas, Ahmed M. Darwish, Ribal Darwish, Suanne M. Daves, Kathleen Davis, Peter J. Davis, Bracken J. De Witt, Ellise Delphin, Seema Deshpande, Dawn P. Desiderio, Tricia Desvarieux, Laura K. Diaz, Christian Diez, Sanjay Dixit, Meenakshi Dogra, Karen B. Domino, Kathryn Dorhauer, Todd Dorman, Don D. Doussan, James Duke, Ann C. Duncan, Frank W. Dupont, Andrew Dziewit, L. Jane Easdown, R. Blaine Easley, Thomas J. Ebert, David M. Eckmann, Talmage D. Egan, Seth Eisdorfer, Nabil M. Elkassabany, Ryan P. Ellender, Logan S. Emory, Monique Espinosa, Lucinda L. Everett, Nauder Faraday, James J. Fehr, James M. Feld, Lynn A. Fenton, Laura H. Ferguson, Matthew Fiegel, Aaron M. Fields, Gordon N. Finlayson, Alan Finley, Gregory W. Fischer, Gary Fiskum, Molly Fitzpatrick, Russell Flatto, Lee A. Fleisher, Ronda Flower, Annette G. Folgueras, Patrick J. Forte, Joseph F. Foss, Charles J. Fox, William R. Furman, Robert Gaiser, David R. Gambling, Scott Gardiner, Matthew L. Garvey, Abraham C. Gaupp, Steven Gayer, Jeremy M. Geiduschek, Frank Gencorelli, Eric Gewirtz, Ghaleb A. Ghani, Charles P. Gibbs, Jeremy L. Gibson, Lori Gilbert, Kevin J. Gingrich, Gregory Ginsburg, Christopher Giordano, Christine E. Goepfert, Hernando Gomez, Santiago Gomez, Alanna E. Goodman, Stephanie R. Goodman, Alexandru Gottlieb, Ori Gottlieb, Allan Gottschalk, Basavana Gouda Goudra, Harry J. Gould, Nikolaus Gravenstein, Megan Graybill, William J. Greeley, Patrick Guffey, Ala Sami Haddadin, John G. Hagen, Karim Abdel Hakim, Michael Hall, N. James Halliday, Raafat S. Hannallah, Jeremy Hansen, C. William Hanson, Charles B. Hantler, Andrew P. Harris, Jonathan Hastie, Henry A. Hawney, Stephen O. Heard, James E. Heavner, James G. Hecker, Elizabeth A. Hein, Eugenie Heitmiller, Mark Helfaer, Lori B. Heller, Andrew Hemphill, Adrian Hendrickse, Frederick A. Hensley, Ian A. Herrick, Douglas Hester, Eric J. Heyer, Michael S. Higgins, Roberta Hines, Charles W. Hogue, Kenneth J. Holroyd, Natalie F. Holt, Simon J. Howell, Faisal Huda, Keith E. Hude, Hayden R. Hughes, James M. Hunter, Brad J. Hymel, James W. Ibinson, Karen E. Iles, Robert M. Insoft, Shiroh Isono, Yulia Ivashkov, Bozena R. Jachna, Anna Jankowska, Norah Janosy, Arun L. Jayaraman, Nathalia Jimenez, Judy G. Johnson, Lyndia Jones, Edmund H. Jooste, Zeev N. Kain, Maudy Kalangie, Philip L. Kalarickal, Ihab Kamel, Mia Kang, Ivan Kangrga, Ravish Kapoor, Helen W. Karl, Christopher Karsanac, Swaminathan Karthik, Jeffrey A. Katz, Alan Kaye, Adam M. Kaye, A. Murat Kaynar, Nancy B. Kenepp, Miklos D. Kertai, Mary A. Keyes, Sarah Khan, Swapnil Khoche, David Y. Kim, Jerry H. Kim, Kimberly M. King, Jeffrey Kirsch, Matthew A. Klopman, Paul R. Knight, Donald D. Koblin, W. Andrew Kofke, Vincent J. Kopp, Joseph R. Koveleskie, Courtney Kowalczyk, Valeriy V. Kozmenko, Kaylyn Krummen, Sapna R. Kudchadkar, Nathan Kudrick, Adrienne Kung, C. Dean Kurth, Robert Kyle, J. Lance LaFleur, Jason G. Lai, Kirk Lalwani, William L. Lanier, Dawn M. Larson, Richard M. Layman, Chris C. Lee, Mark J. Lema, W. Casey Lenox, Jacqueline M. Leung, Roy C. Levitt, Jerrold H. Levy, J. Lance Lichtor, Charles Lin, Sharon L. Lin, Karen S. Lindeman, Lesley Lirette, Ronald S. Litman, Qianjin Liu, Renyu Liu, Wen-Shin Liu, Justin Lockman, Stanley L. Loftness, Martin J. London, Philip D. Lumb, M. Concetta Lupa, Anne Marie Lynn, Devi Mahendran, Jeffrey Mako, Anuj Malhotra, Vinod Malhotra, Andrew M. Malinow, Mark G. Mandabach, Dennis T. Mangano, Sobia Mansoor, Inna Maranets, Jonathan B. Mark, Sinisa Markovic, H. Michael Marsh, Choendal Martin, Nicole D. Martin, Douglas Martz, Veronica A. Matei, Letha Mathews, Lynne G. Maxwell, Philip McArdle, John P. McCarren, Brenda C. McClain, Brian McClure, William A. McDade, Kathryn E. McGoldrick, Brian J. McGrath, Gregory L. McHugh, David McIlroy, Jason McKeown, Thomas M. McLoughlin, R. Yan McRae, William L. Meadow, Sameer Menda, William T. Merritt, David G. Metro, Berend Mets, Hosni Mikhaeil, David W. Miller, Jessica Miller, Mohammed Minhaj, Marek A. Mirski, Nanhi Mitter, Alexander J.C. Mittnacht, Raj K. Modak, Pierre Moine, Constance L. Monitto, Richard C. Month, Richard E. Moon, Laurel E. Moore, Roger A. Moore, Thomas A. Moore, Debra E. Morrison, Jonathan Moss, John R. Moyers, Jesse J. Muir, Adam J. Munson-Young, Stanley Muravchick, John M. Murkin, Peter Nagele, Peter A. Nagi, Daniel A. Nahrwold, Michael L. Nahrwold, Madhavi Naik, Manchula Navaratnam, Stephan P. Nebbia, Priscilla Nelson, Thai T. Nguyen, Viet Nguyen, Stavroula Nikolaidis, Zoulfira Nisnevitch, Dolores B. Njoku, Mary J. Njoku, Edward J. Norris, Omonele O. Nwokolo, Daniel Nyhan, William T. O'Byrne, Edward A. Ochroch, Andrew Oken, Nathan Orgain, Nancy E. Oriol, Pedro Orozco, Andreas M. Ostermeier, Andranik Ovassapian, Mehmet S. Ozcan, Ira Padnos, Sheela S. Pai, Nirvik Pal, Dhamodaran Palaniappan, Susan K. Palmer, Howard D. Palte, Wei Pan, Oliver Panzer, Sibi Pappachan, Anthony Passannante, Dennis A. Patel, Dilipkumar K. Patel, Kirit M. Patel, Samir Patel, Shalin Patel, Sanup Pathak, Minda L. Patt, Ronald W. Pauldine, Olga Pawelek, Tim Pawelek, Kiarash Paydar, Ronald G. Pearl, Christine Peeters-Asdourian, Padmavathi R. Perela, Charise T. Petrovitch, Patricia H. Petrozza, Dennis Phillips, Mark C. Phillips, Christine Piefer, Edgar J. Pierre, S. William Pinson, Evan G. Pivalizza, Raymond M. Planinsic, Don Poldermans, Joel M. Pomerantz, Jason E. Pope, Wanda M. Popescu, Vivian H. Porche, Jahan Porhomayon, Dmitry Portnoy, Corinne K. Postle, Paul J. Primeaux, Donald S. Prough, Ferenc Puskas, Carlos A. Puyo, Forrest Quiggle, Mary Rabb, Bronwyn R. Rae, Muhammad B. Rafique, Jesse M. Raiten, Arvind Rajagopal, Srinivasan Rajagopal, Gaurav Rajpal, Chandra Ramamoorthy, Ira J. Rampil, James G. Ramsay, James A. Ramsey, Vidya N. Rao, Joana Ratsiu, Selina Read, Ronjeet Reddy, Leila L. Reduque, David L. Reich, Karene Ricketts, Cameron Ricks, Bernhard Riedel, Jyotsna Rimal, Joseph Rinehart, James M. Riopelle, Stacey A. Rizza, Amy C. Robertson, Stephen Robinson, Peter Rock, Yillam F. Rodriguez-Blanco, Michael F. Roizen, Daniel M. Roke, Ryan Romeo, Joseph Rosa, David A. Rosen, Kathleen Rosen, Stanley H. Rosenbaum, Andrew D. Rosenberg, Andrew L. Rosenberg, Henry Rosenberg, Meg A. Rosenblatt, Steven Roth, Brian Rothman, Justin L. Rountree, Matthew J. Rowan, Marc Rozner, Ryan Rubin, Stephen M. Rupp, W. John Russell, Thomas A. Russo, Alecia L. Sabartinelli, Tetsuro Sakai, Orlando J. Salinas, Paul L. Samm, Jibin Samuel, Tor Sandven, Ted J. Sanford, Joshua W. Sappenfield, Ponnusamy Saravanan, Subramanian Sathishkumar, R. Alexander Schlichter, Eric Schnell, David L. Schreibman, Armin Schubert, Peter Schulman, Todd A. Schultz, Alan Jay Schwartz, Jamie McElrath Schwartz, Jeffrey J. Schwartz, Benjamin K. Scott, Joseph L. Seltzer, Tamas Seres, Daniel I. Sessler, Navil F. Sethna, Amar Setty, Paul W. Shabaz, Pranav Shah, Saroj Mukesh Shah, Milad Sharifpour, Joanne Shay, Jay Shepherd, Jeffrey S. Shiffrin, Marina Shindell, Daniel Siker, Richard Silverman, Brett A. Simon, Nina Singh, Ashish C. Sinha, Robert N. Sladen, Kieran A. Slevin, Tod B. Sloan, Kathleen Smith, Timothy E. Smith, Victoria Smoot, Denis Snegovskikh, Betsy Ellen Soifer, Molly Solorzano, James M. Sonner, Aris Sophocles, James A. Sparrow, Joan Spiegel, Bruce D. Spiess, Ramprasad Sripada, Stanley W. Stead, Joshua D. Stearns, Kelly Stees, Clinton Steffey, Christopher Stemland, John Stene, Christopher T. Stephens, Tracey L. Stierer, O. Jameson Stokes, Bryant W. Stolp, David F. Stowe, Ted Strickland, Suzanne Strom, Erin A. Sullivan, Michele Sumler, Dajin Sun, Lena Sun, Esther Sung, Veronica C. Swanson, Judit Szolnoki, Joe Talarico, Gee Mei Tan, Darryl T. Tang, Paul Tarasi, René Tempelhoff, John E. Tetzlaff, Alisa C. Thorne, Arlyne Thung, Vasanti Tilak, Kate Tobin, Joseph R. Tobin, Michael J. Tobin, R. David Todd, Matthew Tomlinson, Thomas J. Toung, Lien B. Tran, Minh Chau Joe Tran, Kevin K. Tremper, Sanyo Tsai, George S. Tseng, Kenneth J. Tuman, Avery Tung, Cynthia Tung, Rebecca Twersky, Mark Twite, John A. Ulatowski, Michael Urban, Manuel C. Vallejo, Andrea Vannucci, Albert J. Varon, Anasuya Vasudevan, Susheela Viswanathan, Alexander A. Vitin, Wolfgang Voelckel, Ann Walia, Russell T. Wall, Terrence Wallace, Shu-Ming Wang, David C. Warltier, Lucy Waskell, Scott Watkins, Denise Wedel, Stuart J. Weiss, Charles Weissman, Nathaen Weitzel, Gregory Weller, Gina Whitney, Robert A. Whittington, Danny Wilkerson, Nancy C. Wilkes, Michael Williams, Jimmy Windsor, Bernard Wittels, Gregory A. Wolff, Andrew K. Wong, Stacie N. Woods, A.J. Wright, Zheng Xie, Christopher C. Young, Ian Yuan, Francine S. Yudkowitz, James R. Zaidan, Paul Zanaboni, Warren M. Zapol, Angela Zimmerman, and Maurice S. Zwass
- Published
- 2011
16. Beneficial effects of nitric oxide breathing in adult patients with sickle cell crisis
- Author
-
James R. Eckman, William A. McDade, Melanie L. Cooper, C. Alvin Head, Tohru Ikuta, Paul Swerdlow, and Ratan Mani Joshi
- Subjects
Adult ,Male ,Narcotics ,Randomization ,Visual analogue scale ,Pain ,Anemia, Sickle Cell ,Placebo ,Nitric Oxide ,Young Adult ,Double-Blind Method ,Administration, Inhalation ,medicine ,Humans ,Pain Measurement ,Inhalation ,Morphine ,business.industry ,Therapeutic effect ,Oxygen Inhalation Therapy ,Hematology ,medicine.disease ,Combined Modality Therapy ,Blood pressure ,Anesthesia ,Acute Disease ,Breathing ,Female ,business ,Vaso-occlusive crisis ,Cell Adhesion Molecules - Abstract
Pain from vaso-occlusive crisis (VOC) is the major cause of hospitalization in patients with sickle cell disease (SCD). The beneficial therapeutic effects of inhaled nitric oxide (NO) on the pathophysiology of SCD have been reported. A double-blind, randomized, placebo-controlled clinical trial was conducted to determine whether NO breathing reduces acute VOC pain in adult patients and to study the safety of inhaled NO. Twenty-three patients experiencing acute VOC were enrolled. After randomization but before treatment, five were found to not meet final eligibility criteria. Nine patients were assigned to inhaled NO (80 ppm) and nine to placebo (21% O2). Primary outcome was the mean change in pain scores after 4 hr of inhalation, measured on a 10-cm visual analog scale (VAS). Both groups had similar baseline VAS pain scores but inhaled NO significantly reduced pain scores compared with placebo (P 5 0.02) at the end of NO inhalation. Secondary outcome was parenteral morphine use at baseline, 4, and 6 hr. Parenteral morphine use was lower in the inhaled NO group, but the difference was not statistically significant.Safety assessments included systolic blood pressure measurements,pulse oximetry readings, concentration of delivered nitrogen dioxide, and concentration of methemoglobin (metHb). None of these NO toxicities was observed.
- Published
- 2010
17. The effect of premedication with OTFC, with or without ondansetron, on postoperative agitation, and nausea and vomiting in pediatric ambulatory patients
- Author
-
James P. Lynch, Rachel Rubin, Madelyn Kahana, Wendy Binstock, William A. McDade, and Cathy Bachman
- Subjects
Male ,Methyl Ethers ,Time Factors ,Nausea ,Population ,Administration, Oral ,Placebo ,Ondansetron ,Sevoflurane ,Postoperative Complications ,Double-Blind Method ,medicine ,Humans ,education ,Child ,Psychomotor Agitation ,education.field_of_study ,Dose-Response Relationship, Drug ,business.industry ,Analgesics, Opioid ,Fentanyl ,Anesthesiology and Pain Medicine ,Treatment Outcome ,Ambulatory Surgical Procedures ,Anti-Anxiety Agents ,Anesthesia ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Ambulatory ,Anesthetics, Inhalation ,Postoperative Nausea and Vomiting ,Vomiting ,Premedication ,Female ,medicine.symptom ,business ,Postoperative nausea and vomiting ,Preanesthetic Medication ,medicine.drug - Abstract
Summary Background : The purpose of this study was to evaluate, in the pediatric ambulatory surgical population, the efficacy of: (i) oral transmucosal fentanyl citrate (OTFC), when given preoperatively, to reduce postoperative excitement associated with sevoflurane, and (ii) intravenous ondansetron to reduce postoperative nausea and vomiting (PONV) associated with OTFC. Methods : This randomized, double-blinded, placebo controlled study evaluated the efficacy of OTFC [normal dose (ND) = 10–15 μg·kg−1 or low dose = 100 μg] compared with placebo in the prevention of postoperative agitation; and the efficacy of ondansetron (0.1 mg·kg−1 to 4 mg) compared with placebo to reduce PONV associated with OTFC. Results : There were 125 patients evaluated (2–10 years old, ASA class I or II and weight 10–40 kg). Preoperatively OTFC was associated with an increased likelihood of cooperation at baseline (P = 0.018). Postoperatively there was a higher incidence of vomiting in children that received OTFC. The anxiety/agitation of patients entering the PACU was significantly less in children who received OTFC ND (P
- Published
- 2004
18. Through the Physician's Eyes: A Racist Parent
- Author
-
William A. McDade
- Subjects
Issues, ethics and legal aspects ,Health (social science) ,Health Policy - Published
- 2001
19. Through the Physician's Eyes: The Despair of Health Disparities
- Author
-
William A. McDade
- Subjects
medicine.medical_specialty ,Health (social science) ,business.industry ,Health Policy ,education ,Health literacy ,Bioethics ,Race and health ,Health outcomes ,Health equity ,Issues, ethics and legal aspects ,fluids and secretions ,Nursing ,Family medicine ,parasitic diseases ,Health care ,Medicine ,business ,Cultural competence ,Medical ethics - Abstract
A physician discusses potential factors underlying disparities in health care and health outcomes and advocates for standards to improve cultural competence, improve health literacy, and reduce disparities. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.
- Published
- 2001
20. On the formation and crystallization of sickle hemoglobin macrofibers
- Author
-
William A. McDade and Robert Josephs
- Subjects
Sickle Hemoglobin ,Double strand ,Hemoglobin s ,Molecular Structure ,Chemistry ,Macromolecular Substances ,Hemoglobin, Sickle ,Limiting ,Anemia, Sickle Cell ,In Vitro Techniques ,Antiparallel (biochemistry) ,law.invention ,Crystallography ,Hemoglobins ,Microscopy, Electron ,Structural Biology ,law ,Electron micrographs ,Humans ,Crystallization - Abstract
We have characterized new aspects of macrofiber structure and assembly which provide a mechanism for macrofiber formation from fibers. After the formation of fibers, HbS forms macrofibers by the association of small, organized bundles of partially fused fibers. These macrofibers consist of double strands, packed into antiparallel rows, and are identical to double strands found in crystalline HbS, except that the double strands in macrofibers are axially displaced from their crystalline position and are twisted about the particle axis, whereas in crystals they are linear. In lateral views, electron micrographs of macrofibers show prominent sets of "rows." We use the number of these rows to designate a particular type of macrofiber. In this study we present micrographs of macrofibers with 3 to 11 rows visible in lateral views. Such particles contain from 20 to 200 double strands. The pitch of a macrofiber is coupled to the number of rows in a manner so that the angle between the molecules in the outermost double strand is always 1.8°. This observation has led us to propose that the factor limiting the extent of lateral growth of macrofibers is distortions in bonding between the hemoglobin molecules in the outermost double strands. Similar considerations have provided an explanation of the factors that limit the lateral growth of fibers. Finally, we propose a simple mechanism for the formation of macrofibers from fibers. This mechanism postulates that integral numbers of fibers form specific types of macrofibers and has the virtue of conserving the polarity of the fibers.
- Published
- 1993
21. REDUCING POSTOPERATIVE AGITATION IN PEDIATRIC PATIENTS
- Author
-
Alicia Y. Toledano, Dennis W. Coalson, C. Bachman, V. Kulkarni, A. Conran, R. Dorfman, William A. McDade, Wendy Binstock, J. L. Lichtor, and Madelyn Kahana
- Subjects
Ondansetron ,Anesthesiology and Pain Medicine ,business.industry ,Anesthesia ,Medicine ,business ,FentaNYL Citrate ,medicine.drug - Published
- 1999
22. On the assembly of sickle hemoglobin fascicles
- Author
-
Robert Josephs, Bridget Carragher, William A. McDade, and Christopher Miller
- Subjects
business.industry ,Chemistry ,Hemoglobin, Sickle ,Crystal structure ,Fascicle ,Molecular physics ,law.invention ,Microscopy, Electron ,Optics ,X-Ray Diffraction ,Structural Biology ,law ,Screw axis ,Lattice (order) ,Humans ,Fiber ,Twist ,Electron microscope ,Crystallization ,business ,Molecular Biology - Abstract
Deoxyhemoglobin S fibers associate into bundles, or fascicles, that subsequently crystallize by a process of alignment and fusion. We have used electron microscopy to study the formation of fascicles and the changes in fiber packing that occur during the conversion of fascicles to crystals. The first event in crystallization involves fibers forming fascicles that are initially small and poorly ordered but, with time, become progressively larger and more highly ordered. After six to eight hours, the fibers in a fascicle form a crystalline lattice. The three-dimensional unit cell parameters of this lattice are a = 1300 A , b = 365 A , and c = 210 A (the a axis is parallel to the fiber axis). Fibers have an elliptical cross-section whose major and minor axes are 250 A and 185 A, respectively. When projected on to the unit cell vectors, these dimensions are 210 A and 155 A, so the unit cell dimension of 365 A implies that there are two fibers per unit cell. Theoretically, fibers could pair so that each member of the unit cell is oriented in the same direction (parallel) or opposite directions (antiparallel). Fourier transforms of electron micrographs (or models) cannot distinguish between these alternatives, since the two arrangements produce very similar intensity distributions. The orientation of the fibers was determined from cross-sections of the fascicles in which the fibers are seen end-on. In this view the images of the fibers are rotationally blurred because the fibers twist 30 ° to 40 ° about their helical axis through the 300 A to 400 A thick section. We have been able to remove the rotational blur from each of the fibers in the unit cell using the procedures described by Carragher et al. The deblurred images of the two fibers in the unit cell are related by mirror symmetry. This relationship means that the fibers are antiparallel. These observations suggest that crystallization of fibers in fascicles is mediated by assembly of the fibers into antiparallel pairs that contain equal numbers of double strands running in each direction.
- Published
- 1989
23. Structural analysis of polymers of sickle cell hemoglobin
- Author
-
Bridget Carragher, William A. McDade, Murray Becker, David A. Bluemke, Michael J. Potel, and Robert Josephs
- Subjects
Point spread function ,business.industry ,Chemistry ,Square (algebra) ,law.invention ,Convolution ,Section (fiber bundle) ,Optics ,Structural Biology ,law ,Computer Science::Computer Vision and Pattern Recognition ,Cartesian coordinate system ,Deconvolution ,Fiber ,Twist ,business ,Molecular Biology - Abstract
We have examined the structure of hemoglobin S fibers, which are associated into large bundles, or fascicles. Electron micrographs of embedded and cross-sectioned fascicles provide an end-on view of the component fibers. The cross-sectional images are rotationally blurred as a result of the twist of the fiber within the finite thickness of the section. We have applied restoration techniques to recover a deblurred image of the fiber. The first step in this procedure involved correlation averaging images of cross-sections of individual fibers in order to improve the signal-to-noise ratio. The rotationally blurred image was then geometrically transformed to polar co-ordinates. In this space, the rotational blur is transformed into a linear blur. The linearly blurred image is the convolution of the unblurred image and a point spread function that can be closely approximated by a square pulse. Deconvolution in Fourier space, followed by remapping to Cartesian co-ordinates, produced a deblurred image of the original micrograph. The deblurred images indicate that the fiber is comprised of 14 strands of hemoglobin S. This result provides confirmation of the fiber structure determined using helical reconstruction techniques and indicates that the association of fibers into ordered arrays does not alter their molecular structure.
- Published
- 1988
24. Fascicles of hemoglobin S fibers
- Author
-
Robert Josephs, William A. McDade, and Robert Vassar
- Subjects
Hemoglobin s ,Chemistry ,General Medicine ,Anatomy - Abstract
The substitution of valine for glutamic acid at the β 6 position of hemoglobin results in a mutant protein whose solubility is dramatically decreased in the deoxygenated form. The deoxygenated protein polymerizes to form long, solid helical rods called fibers. The red blood cells of sickle cell anemia patients are filled with these fibers that distort the cell into the rigid shapes pathognomonic for the disease. In stirred solutions of purified HbS, fibers are the first of a series of metastable intermediates that ultimately crystallize. Fibers have the potential to form either larger particles, called macrofibers, or bundles, called fascicles.
- Published
- 1986
25. The structure of sickle hemoglobin fibers within fascicles
- Author
-
Bridget Carragher, Robert Josephs, Murray Becker, Michael J. Potel, David A. Bluemke, and William A. McDade
- Subjects
Sickle Hemoglobin ,Pathology ,medicine.medical_specialty ,Chemistry ,medicine ,General Medicine - Abstract
The structure of HbS fibers has been analyzed from electron micrographs of negatively stained particles using three-dimensional reconstruction techniques. Fibers are composed of the same structural unit as crystals, namely the Wishner-Love double strand, but the arrangement of the double strands in fibers and crystals is quite different. This raises questions regarding the manner in which such structures might fuse to form crystals. The crystallization must be accompanied by a considerable rearrangement of the double strands and the fibers, which have net polarity, must combine in such a way as to form a non-polar crystal. It is of interest in this regard to consider whether the structure of fibers associated into ordered bundles, or fascicles, differs from the structure of individual fibers. The structure and interaction of fibers within large arrays may have clinical significance as it is the formation of bundles of fibers within the red blood cell which leads to the clinical manifestations of sickle cell disease.
- Published
- 1987
26. Modeling of Longitudinal Sections of Sickle Hemoglobin Fascicles
- Author
-
Robert Josephs, Ann R. Bradlow, Bridget Carragher, and William A. McDade
- Subjects
Sickle Hemoglobin ,Pathology ,medicine.medical_specialty ,business.industry ,Medicine ,General Medicine ,business - Abstract
In vivo, deoxyhemoglobin S fibers associate into bundles, or fascicles. It is the formation of these bundles within red blood cells which leads to the clinical manifestations of sickle cell disease. A similar phenomenon is observed in vitro. Fascicles are initially small and poorly ordered but, with time, become progressively larger, more tightly packed and more highly ordered. The most tightly packed fascicles display crystalline order and form “crystals of fibers”. We have constructed computer generated models of longitudinal projections of crystalline fascicles of sickle hemoglobin (HbS) fibers. A comparison of the models with electron micrographs provides a means of accurately determining the three dimensional packing arrangement of fibers and the nature of the fiber-fiber interactions within fascicles.Electron micrographs of longitudinal sections of well ordered fascicles reveal a number of characteristic views, one of which is shown in figure 2a. The different views observed in the micrographs arise because of differing orientations of fascicle sections relative to the angle of projection. This was demonstrated by experiments in which the specimen was tilted about its long axis. Different views could be interconverted by varying the angle of tilt.
- Published
- 1988
27. The orientation of sickle hemoglobin fibers within fascicles
- Author
-
Bridget Carragher, William A. McDade, Christopher Miller, and Robert Josephs
- Subjects
Sickle Hemoglobin ,Materials science ,Orientation (mental) ,General Medicine ,Biomedical engineering - Abstract
Highly ordered bundles of deoxyhemoglobin S (HbS) fibers, termed fascicles, are intermediates in the high pH crystallization pathway of HbS. These fibers consist of 7 Wishner-Love double strands in a helical configuration. Since each double strand has a polarity, the odd number of double strands in the fiber imparts a net polarity to the structure. HbS crystals have a unit cell containing two double strands, one of each polarity, resulting in a net polarity of zero. Therefore a rearrangement of the double strands must occur to form a non-polar crystal from the polar fibers. To determine the role of fascicles as an intermediate in the crystallization pathway it is important to understand the relative orientation of fibers within fascicles. Furthermore, an understanding of fascicle structure may have implications for the design of potential sickling inhibitors, since it is bundles of fibers which cause the red cell distortion responsible for the vaso-occlusive complications characteristic of sickle cell anemia.
- Published
- 1988
28. Further Experiences with Jejunal Gastrostomy
- Author
-
Henry N. Harkins, Robert E. Condon, Lloyd M. Nyhus, William C. McDADE, and John K. Stevenson
- Subjects
Gastrostomy ,medicine.medical_specialty ,business.industry ,Stomach ,medicine.medical_treatment ,digestive, oral, and skin physiology ,Reflux ,Gastroenterology ,digestive system diseases ,Surgery ,Jejunum ,Abdominal wall ,Stomach surgery ,medicine.anatomical_structure ,Internal medicine ,Humans ,Medicine ,Sphincter ,Esophagus ,business ,Digestive System Surgical Procedures - Abstract
An ideal permanent gastrostomy should allow for simple administration of food and also should prevent the reflux of food or the leakage of acid gastric chyme onto the anterior abdominal wall. Having become discouraged with many of the usual gastrostomy methods, particularly as related to the reflux of acid gastric chyme (Fig. 1), we sought a new method which would have the advantages of an ideal gastrostomy. Merendino and Dillard (1955) used an isolated loop of jejunum as a substitute sphincter between esophagus and stomach. One of the outstanding features of this operation has been the prevention of gastroesophageal reflux due, apparently, to the peristaltic action of the jejunal loop. It seemed to us that such a loop had a potential quality that would be useful in the construction of a permanent gastrostomy. On the basis of these considerations, a technique evolved using an isolated loop of jejunum between the
- Published
- 1961
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.