MedBytes

http://www.isinet.com/isi/products/citation/sci/index.html#R

The ISI' Science Citation Index (SCI') provides access to current and retrospective bibliographic information, author abstracts, and cited references found in 3700 of the world's leading scholarly science and technical journals covering more than 100 disciplines. The Science Citation Index Expanded' format, available through the ISI Web of Science' and the online version, SciSearch', cover more than 5800 journals.

Key advantages and capabilities allows researchers to conduct broad-based, comprehensive searches that uncover all the relevant information they need. Provides cited reference searching, the unique ISI search and retrieval feature that lets users track the literature forward, backward, and through the database, breaking through disciplinary and geographic boundaries; Enables users to conduct multidisciplinary searches to discover hidden subject relationships

http://www.cnn.com/2003/LAW/02/23/bayer.documents/index.html

This Web site discusses newly released documents suggesting some executives at Bayer were aware there were problems with its anti-cholesterol drug Baycol well before the company pulled the drug from the market. The papers, given to CNN by an attorney in a personal injury suit against the company, include e-mails and depositions that appear to indicate Bayer was promoting the drug at the same time there were internal discussions about deaths related to Baycol.

http://www.medscape.com/viewarticle/457140

At this location, you'll find an article titled “Carotid Endarterectomy Worthwhile in Octogenarians.” It describes how carotid endarterectomy (CEA) offers a long-term relative survival benefit even in patients older than 80 years, according to the results of a population-based, record-linkage study published in the June 13 rapid access issue of Stroke.

Using the Western Australia Data Linkage System, the investigators analyzed records of all patients who had undergone CEA from 1988 to 1998. Of 1796 subjects, 151 were aged 80 years or older. The 5-year survival rate was 64.9% for patients 80 years or older, and 80.1% for patients younger than 80 years. Compared with a population matched for age and other factors, the relative survival at 5 years was 118% (95% Confidence Interval [CI], 102% – 134%) for patients aged 80 years or older, and 95% (95% CI, 92% – 97%) for patients younger than 80 years. Among the 1% of patients who suffered nonfatal strokes within 30 postoperative days, none was 80 years or older.

The authors write, “Long-term relative survival after CEA in patients 80 years of age (or older) was better than that of an age-matched population. The likelihood of living long enough to gain benefit from a CEA is not jeopardized by being too old.” See, Stroke. (2003), v. 34

http://www.medscape.com/viewarticle/457208

At this site, you'll find an article titled, “Temporary Inferior Vena Cava Filters Helpful in Critically Ill Trauma Patients.” According to the results of a prospective cohort study published in the June issue of the Archives of Surgery, temporary inferior vena cava (IVC) filters are safe and effective in critically ill surgical and trauma patients.

From May 1, 2001, to Oct. 1, 2002, 44 multiple-trauma patients and critically ill surgical patients underwent placement of the Gunther Tulip (Cook Inc.; Bloomington, IN) retrievable IVC filter by an interventional radiologist, using the femoral or internal jugular approach. All patients were at high risk for venous thromboembolism but had contraindications to low-dose heparin. Of the 44 patients, 37 (84%) were severely traumatized following blunt injury, with mean Injury Severity Score of 33 ' 2.

When the patient could safely be treated with heparin, the filter was removed. If it could not be removed within 14 days, it was relocated to prevent incorporation precluding retrieval.

No patients had complications associated with filter insertion or removal, but nine required filter relocation before retrieval. Of three filters that could not be removed, two had significant clots trapped below the filter and one had angulation preventing grasping of the filter. After IVC filter placement and removal, there were no documented instances of venous thromboembolism.

Study limitations included small sample size, less than rigorous patient selection criteria, and lack of long-term follow-up data. Arch Surg. 2003;138:591-595.