Prospective comparison of curbside versus formal consultations.

BACKGROUND: Curbside consultations are commonly requested during the care of hospitalized patients, but physicians perceive that the recommendations provided may be based on inaccurate or incomplete information. OBJECTIVE: To compare the accuracy and completeness of the information received from providers requesting a curbside consultation of hospitalists with that obtained in a formal consultation on the same patients, and to examine whether the recommendations offered in the 2 consultations differed. DESIGN: Prospective cohort. SETTING: University-affiliated, urban safety net hospital. MAIN OUTCOME MEASURES: Proportion of curbside consultations with inaccurate or incomplete information; frequency with which recommendations in the formal consultation differed from those in the curbside consultation. RESULTS: Curbside consultations were requested for 50 patients, 47 of which were also evaluated in a formal consultation performed on the same day by a hospitalist other than the one performing the curbside consultation. Based on information collected in the formal consultation, information was either inaccurate or incomplete in 24/47 (51%) of the curbside consultations. Management advice after formal consultation differed from that given in the curbside consultation for 28/47 patients (60%). When inaccurate or incomplete information was received, the advice provided in the formal versus the curbside consultation differed in 22/24 patients (92%, P < 0.0001). CONCLUSIONS: Information presented during inpatient curbside consultations of hospitalists is often inaccurate or incomplete, and this often results in inaccurate management advice.

Aqueous extract of herba Scutellaria barbatae, a chinese herb used for ovarian cancer, induces apoptosis of ovarian cancer cell lines.

OBJECTIVES: Given the increasingly common use of complementary medicine in cancer patients, we tested the in vitro cytotoxicity of aqueous extracts of 15 traditional Chinese herbs with purported anticancer properties on ovarian and breast cancer cell lines. METHODS: Cell viability after treatment with herbal extract was measured by metabolism of a tetrazolium substrate. Apoptosis was measured by nuclear and DNA fragmentation and Annexin V binding. RESULTS: One herb, Herba Scutellaria barbatae, was cytotoxic to 100% (11 of 11) of actively proliferating ovarian lines tested and 50% (2 of 4) of actively proliferating breast cell lines tested. Confluent cultures were resistant to killing by herb, whereas subconfluent cultures were sensitive. Resistant proliferating cell lines expressed higher levels of bcl2. Transfection of the most sensitive ovarian cancer cell line (A2780) with bcl2 resulted in a noticeable protection against apoptosis, but there was no protection in other transfected lines. CONCLUSIONS: These results will be useful in guiding future studies of herbal aqueous extracts, as well as providing information for clinicians when patients are concurrently using these herbs along with conventional cancer therapies.