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G Bodner

Publications and source records attributed to G Bodner.

67 records · Page 4Linked to original sources

Does tenure protect the salaries of medical school faculty?

When faculty have tenure, are their salaries protected? If so, what portion and in what circumstances? In the era of managed care and shrinking resources, these questions are becoming particularly important at medical schools because salaries there tend to be higher than salaries elsewhere in academia and because those salaries are more commonly dependent on outside funding. A fundamental question that will increasingly be asked is whether reductions in the salaries of tenured faculty are legally permissible. To a large extent, the answer is a matter of interpreting what each medical school has contractually obligated itself to do regarding tenure; generally, schools' tenure rules support the legal right to impose a salary reduction. But, in fact, the historical record shows few instances of such reductions. Thus there are few judicial decisions regarding tenure that can help predict how particular tenure contracts are likely to be interpreted. In this situation, faculty and institutions can be expected to interpret the historical absence of salary reductions for tenured faculty in contrasting ways. Generally, if the written policies are clear, past practices will play little or no legal role. If the policies are unclear, institutions must show that their practices were primarily related to the pre-1994 conditions of mandatory retirement and have little relevance to present circumstances. Although the main historical purpose of tenure was the protection of academic freedom, can the protection of salary be encompassed within this purpose? Usually not; the current situation is almost always one in which cost concerns, not political ones, motivate medical schools to reduce the salaries of faculty with reduced funding or practice incomes. The author concludes that although there are few precedents and many unexplored issues, it is clear that tenure was not intended to protect full salaries at most medical schools. His view is that in appropriate circumstances, reductions in the salaries of tenured faculty are legally achievable.

Budgets↗

[Virtual CT colonoscopy. Examination technique, limitations and perspectives].

Virtual CT-colonoscopy is a post-processing method which allows for reconstruction of inner bowel surface structures from helical CT datasets. The reconstructed images simulate the views which are known from fiberoptic endoscopy. Since colorectal cancer is the second main cause of death in USA and Europe today and since recent screening recommendations are often ignored by the public, a non-invasive or minimal-invasive procedure for colonic evaluation would offer some benefits. Virtual CT-colonoscopy generally involves three essential steps: patient preparation with cleansing of the bowel and administration of an air enema, helical CT-examination by using appropriate scan parameters, and interactive 3D rendering of the volume data-set. Although recent studies have demonstrated that polypoid lesions of about 5 mm size are well detectable and although virtual colonoscopy offers many advantages over fiberoptic endoscopy, some technical and clinical limitations must still be noted. Thus, the current inability of virtual colonoscopy to provide texture and color leads to problems in identifying flat lesions; the presence of retained or adherent fecal matter may result to false positive diagnosis and collapsed segments of bowel may cause problems as they cannot subsequently be evaluated during image reconstruction. Virtual endoscopy is still in its infancy and further technical and clinical developments are necessary. Virtual CT-colonoscopy may then prove to be equal or superior to colonoscopy in sensitivity and specificity for polyp detection and be able to reduce the number of unnecessary colonoscopic procedures.

Colonoscopes↗

Effects of ethanol on human natural killer cell activity: in vitro and acute, low-dose in vivo studies.

Chronic use of ethanol may cause a variety of immunological abnormalities in humans. In this study, we have determined the effects of an acute, low dose of ethanol (0.5 g/kg), administered either intravenously or orally, to normal, nonalcoholic male volunteers, on natural killer cell (NK) activity. We have also examined the effects of a 4-hr incubation with ethanol, in concentrations ranging from 0 to 320 mg/dl, on human NK activity in vitro. NK activity was measured by the 51Cr release assay technique in all of these studies, using peripheral blood mononuclear cells prepared from blood obtained from healthy, nonalcoholic volunteers. Eight subjects received ethanol in vivo; cells from nine subjects were used for the in vitro studies. Blood ethanol concentrations were determined at multiple time points before and after ethanol administration for the in vivo studies; for the in vitro studies, ethanol concentrations were measured from each assay sample both before and after the incubation period. Gas chromatography was used for determinations of both blood alcohol and medium ethanol concentrations. Results of the in vivo studies showed that a single dose of ethanol (0.5 g/kg), administered either intravenously (with resultant peak blood levels transiently up to 89 mg/dl) or orally (with resultant peak blood levels transiently up to 40 mg/dl at the time of the NK assay), did not alter NK activity. However, results of the in vitro studies showed a significant dose-dependent decrease (p < 0.001) in NK activity when ethanol exposure was sustained for 4 hr at concentrations of 80 mg/dl and above.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Octogenarian subjects have low postprandial levels of chylomicron remnants: a possible explanation for protection against atherosclerosis.

Postprandial lipoprotein metabolism may play an important role in the development of atherosclerosis. It is widely believed that in healthy octogenarians, the atherogenic process occurs very slowly. In the present study, postprandial lipoprotein metabolism was examined in 14 octogenarian subjects (mean age, 84 +/- 4.2 years) and 19 younger controls (mean age, 50 +/- 4.8 years) using the vitamin A-fat loading test, in which intestinally derived lipoproteins are specifically labeled with retinyl palmitate (RP). Results indicated that mean peak chylomicron remnant RP levels and the areas below the chylomicron remnant RP curve were significantly lower in the octogenarian group than in the controls (625 +/- 329 vs 1321 +/- 688 micrograms/L and 3740 +/- 1078 vs 6162 +/- 1063 micrograms/L.h, respectively; p < .0001). No differences were found between the two groups in chylomicron RP levels or in lipolytic activity. The study suggests that octogenarians do not exhibit the decrease in chylomicron lipolysis that usually accompanies aging. In addition, these subjects have significantly lower levels of chylomicron remnants in the circulation. Since accumulation of these particles has been implicated in the development of atherogenesis, our findings may indicate a major mechanism of atherosclerosis prevention in healthy octogenarians.

Aged↗

Bilateral femoral neck fractures as a result of coeliac disease.

An elderly patient presenting with severe tetany secondary to hypocalcaemia causing bilateral fractures of the femoral necks, was proved to have coeliac disease. Severe muscle pains, an organic mental syndrome and personality changes are rare complications of coeliac disease and are reversible with treatment.

Aged↗

Dialysis-induced eosinophilia.

Blood eosinophils were counted by the counting-chamber method in 21 regular hemodialysis patients. Before dialysis, eosinophil counts were within the normal range in all patients (mean 98 cells/mm3, range 6-350). After the first 15 min of hemodialysis, with not reused coils or hollow-fiber dialysers, a significant drop in eosinophil counts was noted in all patients. The mean drop was 37.5% of the initial value (range 28-100%). At the end of the 5-hour dialysis, the eosinophil counts rose significantly in all patients but 1. The mean rise was 521% of the initial counts (range 22.3-1576%). Simultaneous neutrophil counts showed the already described drop at 15 min with a return to predialysis levels at 5 h. Predialysis IgE serum concentrations were lower than normal (mean 24.8, range 4.5-58 units/ml), and did not change at the end of the dialysis. It seems that pulmonary sequestration is responsible for both neutropenia and eosinopenia early in dialysis. The marked eosinophilia at 5 h may be the result of a release of eosinophilotactic substances induced by the dialysis procedure itself.

Adult↗

Finger injuries in extreme rock climbers. Assessment of high-resolution ultrasonography.

Dynamic high-resolution ultrasonography findings obtained in 34 extreme rock climbers with finger injuries were compared with those in 20 healthy volunteers. Thicknesses of the flexor tendon and A-2 flexor tendon pulley system were measured at the base of the proximal phalanx. The distance between the tendon and phalanx was evaluated with the finger in extension and in forced flexion as a measure of bowstringing. Gliding ability of the flexor tendons was assessed during active and passive motion. Compared with healthy volunteers, climbers showed a significantly increased thickness of the flexor tendons and the flexor tendon pulley system but no impairment of the gliding mechanism. Only in climbers did the distance between tendon and phalanx increase from 0.14 cm (+/-0.07) during extension to 0.30 cm (+/-0.09) during forced flexion. In three climbers with complete A-2 pulley ruptures this distance was up to 0.51 cm (+/-0.15) during forced flexion. Clinically unsuspected synovial cysts, thickened joint capsules, fibrous tissue, or fluid collection were found only in climbers. We concluded that dynamic ultrasonography is a valuable tool for accurate assessment of early changes in "climber's finger." It provides useful information, especially in cases where clinical evaluation is difficult, and should be performed to select appropriate therapeutic management.

Adult↗