Stanford Health Policy is a joint effort of the Freeman Spogli Institute for International Studies and the Stanford School of Medicine
Center for Immersive and Simulation-based Learning
Li Ka Shing Center for Learning and Knowledge
291 Campus Drive, LK001
Stanford, CA 94305-5134
David M. Gaba, M.D. is Associate Dean for Immersive and Simulation-based Learning and Director of the Center for Immersive and Simulation based Learning (CISL) at Stanford University School of Medicine. He is Professor (with tenure) of Anesthesiology, Perioperative and Pain Medicine at Stanford and Founder and Co-Director of the Simulation Center at Veterans Affairs Palo Alto Health Care System where he is also a Staff Physician.
Over the last 30+ years Dr. Gaba's laboratory has worked extensively on human performance and patient safety issues. His laboratory is a pioneer in applying organizational safety theory to health care. The laboratory is also the inventor of the modern full-body patient simulator and is responsible for adapting Crew Resource Management training from aviation to healthcare, first for anesthesia and then for many other healthcare domains. He is a key pioneer in the development of cognitive aids and Emergency Manuals in healthcare. He has been the principal investigator on grants from a wide variety of federal and foundation funders. Dr. Gaba is an author on over 130 original articles, commentaries, and editorials in a wide diversity of peer-reviewed journals. He is the author more than 25 book chapters, and lead author of a well-known book Crisis Management in Anesthesiology (now in its 2nd edition). After serving on the editorial boards of several academic and medical journals, Dr. Gaba is the founding and current Editor-in-Chief of the indexed peer-reviewed journal Simulation in Healthcare (now in Volume 11), the only indexed peer-reviewed journal on simulation, published by the Society for Simulation in Healthcare (SSH).
Dr. Gaba is long-time member of the Executive Committee of the Anesthesia Patient Safety Foundation and a founding member of the Research Committee of the National Patient Safety. He is a founding and current Board member of both the SSH and Advanced Initiatives in Medical Simulation (AIMS). Dr. Gaba was awarded the 2003 David M. Worthen Award from the Department of Veterans Affairs; the 2007 Teaching Achievement Recognition Award from the International Anesthesia Research Society; Kaiser Award for Innovative and Outstanding Contributions to Medical Education, Stanford University School of Medicine, May, 2010; The Society for Technology in Anesthesia, J.S. Gravenstein Award for Lifetime Achievement, January, 2011, and the 2011 (inaugural) Veterans Affairs Under Secretary for Health Award for Excellence in Clinical Simulation Training, Education and Research. In 2015 Dr. Gaba received the Eliasberg Award from the Icahn School of Medicine at Mount Sinai, New York City.
In his spare time he rides a short wheelbase recumbent road bicycle, reads (and listens to audiobooks) voraciously, avidly follows at a serious level developments in physics and space sciences, and occasionally plays golf and bridge. He used to do many other interesting things including epee fencing, flying, scuba diving, rock climbing, soccer (goaltender), skiing, glass blowing -- but is currently (sadly) retired from all of those activities.
Context: Helicobacter pylori commonly infects humans; however, its mode of transmission remains unknown.
Objective: To determine how humans-the primary host for H pylori-shed the organism into the environment.
Design: Controlled clinical experimental study conducted from February through December 1998.
Setting: Clinical research unit of a hospital in northern California.
Patients: Sixteen asymptomatic H pylori-infected and 10 uninfected adults.
Intervention: A cathartic (sodium phosphate) and an emetic (ipecac) were given to all infected subjects and an emetic was given to 1 uninfected subject.
Main Outcome Measure: Confirmed H pylori isolates cultured from stool, air, or saliva before and after catharsis and emesis and from vomitus during emesis. Isolates were fingerprinted using repetitive extragenic palindromic (REP) polymerase chain reaction and species identity was confirmed by sequencing the 16s ribosomal RNA gene.
Results: All vomitus samples from infected subjects grew H pylori, often in high quantities. Air sampled during vomiting grew H pylori from 6 (37.5%) of the 16 subjects. Saliva before and after emesis grew low quantities of H pylori in 3 (18.8%) and 9 (56.3%) subjects, respectively. No normal stools and only 22 (21.8%) of 101 induced stools grew the organism, although 7 (50.0%) of 14 subjects had at least 1 positive culture (2 stool culture samples were contaminated by fungus and were not included). Fingerprints of isolates within subjects were identical to one another but differed among subjects. No samples from uninfected subjects yielded H pylori.
Conclusions: Helicobacter pylori can be cultivated uniformly from vomitus and, occasionally, from saliva and cathartic stools. The organism is potentially transmissible during episodes of gastrointestinal tract illness, particularly with vomiting.