The attitudes and knowledge of medical students towards surrogacy.

We aimed to evaluate the attitudes and knowledge of medical students' towards surrogacy as a means of assisted reproduction. An online survey was sent to medical students from UK universities, 185 anonymous replies were received. A total of 72.2% agreed with surrogacy as a means of assisted reproduction; 43.9% thought the intended mother was the legal mother at birth; 28.7% correctly identified the surrogate mother as the legal mother; 76.0%felt that the intended mother should be the legal mother at birth; 15.2% thought surrogacy arrangements were enforceable by law; 29.2% correctly knew they were not. There was no difference in knowledge of surrogacy among students who had studied obstetrics and gynaecology compared with those who had not. Medical students were generally tolerant in their attitudes to surrogacy. There were discrepancies between the position of UK law governing surrogacy and the personal views of medical students.

Thermal infrared spectral band detection limits for unidentified surface materials.

Infrared emission spectra recorded by airborne or satellite spectrometers can be searched for spectral features to determine the composition of rocks on planetary surfaces. Surface materials are identified by detections of characteristic spectral bands. We show how to define whether to accept an observed spectral feature as a detection when the target material is unknown. We also use remotely sensed spectra measured by the Thermal Emission Spectrometer (TES) and the Spatially Enhanced Broadband Array Spectrograph System to illustrate the importance of instrument parameters and surface properties on band detection limits and how the variation in signal-to-noise ratio with wavelength affects the bands that are most detectable for a given instrument. The spectrometer's sampling interval, spectral resolution, signal-to-noise ratio as a function of wavelength, and the sample's surface properties influence whether the instrument can detect a spectral feature exhibited by a material. As an example, in the 6-13-mum wavelength region, massive carbonates exhibit two bands: a very strong, broad feature at ~6.5 mum and a less intense, sharper band at ~11.25 mum. Although the 6.5-mum band is stronger and broader in laboratory-measured spectra, the 11.25-mum band will cause a more detectable feature in TES spectra.

Pulmonary embolism: even your patient is at risk.

The American Society of Plastic Surgeons' Clinical Guidelines specifically focuses on reducing complications from deep vein thrombosis and pulmonary embolism (PE). The incidence of these problems in plastic surgery is low. A 1998 survey of plastic surgeons found the incidence of deep vein thrombosis and PE in facelift patients to be 0.39% and 0.16% respectively (McDevitt, 1999). Despite the low occurrence of these complications in plastic surgical patients, PE is the third leading cause of death in the United States. PE is evasive and often deadly and therefore requires respect and understanding by all members of the health care team.

To end itself by death: suicide in Shakespeare's tragedies.

The tragedies of William Shakespeare make frequent use of suicide, some accomplished, some merely contemplated. Although his intent was their dramatic context, the Bard nonetheless clearly anticipated many features being discussed today, including assisted suicide, imitative ("copycat") suicide, and suicidal ideation by individuals with depression or disabilities. Recent debate over how often these factors influence the incidence of suicide rarely invokes their historical longevity. They are not new, so changes over the years in societal, religious, legal, and medical attitudes toward suicide must be considered when trying to understand their role. This review attempts to show that many such features of and attitudes toward suicide circa 1600 were perceived by Shakespeare and incorporated into his plays. In the 15 plays classified as tragedies, there are 13 definite and 8 possible suicides, ie, a total of 21 incidents for evaluation. Among the 13 overt suicides, at least 7 are depicted as being admirable under the circumstances at the time. Also, in various ways, 4 of these 13 were assisted, and at least 3 others contain an imitative element. Overall, the action of taking one's life is presented in a neutral or even favorable light, and the audience is left with a mingling of pity and admiration for the victim, not reproach.

Taxing health benefits: snake oil ... or smart health policy?

Limiting the tax-free treatment of employer-paid health benefits is a cornerstone of managed competition, the health reform approach favored by the Clinton Administration. Organized labor argues that the idea is a double-whammy for wage-strapped workers, while a leading academic calls it a good solution to one of the nation's worst public policies.

Achieving healthy weights.

Only 5% of patients dieting to achieve permanent weight loss will be successful and reap the associated health benefits. Ninety-five percent will be unsuccessful. The health implications of failed dieting attempts are numerous and include negative effects on both physical and psychological well-being. Better alternatives to dieting help patients take small, positive, enjoyable steps toward healthy eating, active living, and a positive self-image.

Pericardiocentesis.

Cardiac tamponade is a life-threatening condition resulting from compression of the cardiac chambers by a pericardial effusion. The principal cause of pericardial effusion is malignant disease of the pericardium, but infectious causes and cardiac trauma are common as well. The patient with cardiac tamponade demonstrates an abnormal pulsus paradoxus, and clinical signs of shock and impending cardiovascular collapse occur with very severe cardiac compression. Relief of the increased intrapericardial pressure is mandatory to establish adequate cardiac output. The definitive treatment of cardiac tamponade is emergent removal of enough pericardial fluid to acutely lower intrapericardial pressure. Echocardiographic guidance may be used if immediately available, but is not required to perform pericardiocentesis in a critical situation. Placement of a pulmonary artery catheter prior to pericardiocentesis is not indicated in cardiac tamponade. Once cardiac output and tissue perfusion have been restored, further drainage procedures such as pericardial catheter placement or surgical drainage are indicated. Therapeutic measures to address the underlying disease process should be initiated after pericardial drainage is accomplished.