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Approximately 6 million fractures occur each year in the United States, with an estimated medical and loss of productivity cost of $99 billion. As our population ages, it can only be expected that these numbers will continue to rise. While there have been recent advances in available treatments for fractures, assessment of the healing process remains a subjective process. This study aims to demonstrate the use of micro-computed tomography (microCT)-based structural rigidity analysis to accurately and quantitatively assess the progression of fracture healing over time in a rat model. The femora of rats with simulated lytic defects were injected with human BMP-2 cDNA at various time points postinjury (t = 0, 1, 5, 10 days) to accelerate fracture healing, harvested 56 days from time of injury, and subjected to microCT imaging to obtain cross-sectional data that were used to compute torsional rigidity. The specimens then underwent torsional testing to failure using a previously described pure torsional testing system. Strong correlations were found between measured torsional rigidity and computed torsional rigidity as calculated from both average (R2 = 0.63) and minimum (R2 = 0.81) structural rigidity data. While both methods were well correlated across the entire data range, minimum torsional rigidity was a better descriptor of bone strength, as seen by a higher Pearson coefficient and smaller y-intercept. These findings suggest considerable promise in the use of structural rigidity analysis of microCT data to accurately and quantitatively measure fracture-healing progression. [ABSTRACT FROM AUTHOR]

Comments on two digital videos about outstanding teachers Fred Rogers and Albert Cullum. "Fred Rogers--America's Favorite Neighbor"; "A Touch of Greatness."

The article evaluates the video recording "Shining Bright: Head Start Inclusion," distributed by Paul H. Brookes Publishing.

Limited data are available describing the clinical characteristics, hospital treatment practices, and hospital and long-term death rates of patients hospitalized with decompensated heart failure (HF). To examine the descriptive epidemiology of acute HF in residents of a large New England metropolitan area during the 2 study years of 1995 and 2000, we reviewed the medical records of patients hospitalized with acute HF at 11 medical centers in the Worcester, Massachusetts, metropolitan area during 1995 and 2000 for purposes of collecting information about patients'' sociodemographic and clinical characteristics, hospital management approaches, and hospital and postdischarge mortalities. The mean age of 4,537 residents of the Worcester metropolitan area hospitalized with decompensated HF was 76 years, 57% were women, and most study patients had been previously diagnosed with several co-morbidities. The average duration of hospitalization was 6.3 days and 6.8% of patients died during hospitalization. Diuretics (98%) and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (54%) were the most common medications used to treat acutely ill patients. The 1- and 5-year death rates of hospital survivors were 39% and 77%, respectively, with no change observed in these death rates between our 2 study years. In conclusion, the results of this observational study in residents of a central New England metropolitan area provide insights into the characteristics, treatment practices, and short- and long-term death rates associated with this increasingly prevalent clinical syndrome. [Copyright &y& Elsevier]

This communication provides useful information for Foreign Medical Graduates (FMGs) planning to pursue post-graduate residency training in the United States of America (USA). While the number of residency training positions is shrinking, and the number of United States graduates has steadily declined over the past decade, the number of FMGs has also steadily increased. Unfortunately, as a result of the terrorist attack of September 11, 2001, the problem of obtaining training visas and sponsorship by the Educational Commission for Foreign Medical Graduates (ECFMG) will remain major problems for FMGs. This present review is by no means exhaustive. It should serve as a guideline to more detailed and focused information. It is extremely important to network with friends, family, and professional colleagues regarding the subjective and objective aspects of pursuing graduate medical education (GME) in the USA. Though the process is very protracted and at times frustrating and depressing; the visa hurdle will be the ultimate barrier to overcome. However, majority of FMGs eventually achieve the ultimate goal of obtaining superb training and experience in the United States. We highly recommend the book by Kenneth V. Iserson entitled "Iserson's Getting Into A Residency: A Guide for Medical Students" published by Galen Press Limited, Tucson, Arizona (ref# 10). It is a very useful source of information for medical students and residents planning further residency training in the United States of America. Useful Internet addresses are listed in Appendix 1.