There is an increase in the production of gallbladder stones (cholelithiasis) following gastrectomy associated with vagotomy; we hypothesized that in the presence of constant stimulation of the vagal system, there should be decreased production of gallstones. Forty-two myasthenia gravis patients taking continuous anticholinesterase medications underwent ultrasound study of the gallbladder; ...

The use of electroconvulsive therapy (ECT) in major depression typically involves sequential treatment trials. Most patients fail one or more antidepressant medications before receiving ECT, and patients who respond to ECT usually receive continuation pharmacotherapy. Indeed, ECT is the only somatic treatment in psychiatry that is typically discontinued when it ...

BACKGROUND: Accurately quantifying housestaff's workday activities is acquiring increasing importance as resources become constrained and programs become more accountable for medical education. The authors compared a traditional method of time analysis based on housestaff's estimates of how they spent their workdays with the results of a formal time-analysis study based ...

Treating casualties in a chemically hazardous environment constitutes a unique problem. Physical protection of the medical personnel may impair their performance and potentially affect patients' prognoses. The present study examined the effect of prolonged physical protection on the accomplishment of medical tasks related to trauma management. Sixty one emergency medical ...

The Illawarra General Practice Training Unit, which has been functioning for more than four years, offers a model of general practice education that addresses some of the fundamental issues concerning the introduction of the young doctor to the realities of working in the community as well as providing a centre ...

The view, background and motivation of providers of medical education was studied using a structured questionnaire which was sent to all those who organized courses for the Postgraduate Education Allowance in the West of Scotland. Two hundred and twenty-five replies were received from 254 course providers, giving an 88.6% response ...

Reversible leukopenia was documented in an 81-year-old woman treated with adjunctive ibopamine 100 mg t.i.d. for chronic congestive heart failure. Her antecedent medical history included stable, mild renal function impairment, mitral regurgitation, atrial fibrillation, recurrent transient ischaemic attacks and cholelithiasis. The drugs concomitantly used were digoxin, isosorbide dinitrate, frusemide, urapidil ...

Medical advances make continuing medical education (CME) necessary. Thirty practicing internists and 14 medical residents completed questionnaires and tests of critical appraisal knowledge designed to compare attitudes, behaviors, and skills for maintaining current knowledge. Eighteen internists were then given practical guidelines for "keeping up" with the literature, and this group ...

Proper medical supervision and care, especially the prescribing of appropriate pharmacologic therapy, combined with factual information, supportive guidance, and sympathetic counseling will ameliorate or enhance sexual function in most perimenopausal women. The preventive steps taken during the midlife years will help build a solid foundation to ensure continued sexual activity ...

Continuing medical education has been following essentially the same model for the past seventy years. The past decade has brought such significant change in society's expectations of medical professionals that medical schools, continuing medical education providers, and physicians themselves are being forced to consider alternate models. These pressures for change ...

Physician assisted suicide or active euthanasia is analyzed as a medicalization of the needs of persons who are suffering interminably. As with other medicalized responses to personal needs, the availability of active euthanasia will likely divert attention and resources from difficult social and personal aspects of the needs of dying ...

The aniline dye industry was created in 1856 when the Englishman William Perkin prepared the color mauve from aniline. Dye industries were then formed in several European countries, and each year thousands of new colors and shades were tested on fabrics. Scientists of that period used these new dyes to ...

The term academic continuing medical education (CME) is defined and explored from the perspective of forces that have made its usage necessary. These forces include the new understandings of the place, impact, and scope of CME, and, in particular, the increasing entrepreneurial interests in the field, unrelated to the improvement ...

A medical photograph in contradistinction to a snapshot accurately reproduces and maximizes clinically significant information while minimizing extraneous or irrelevant factors. Obtaining a top-notch medical photograph requires not only proper equipment but also rapid, sophisticated analysis of the clinical situation. Only then can major features including lesional size and distribution ...

Divers who suffer inner ear barotrauma are usually counseled to permanently avoid diving, reasoning that the injured inner ear is at increased risk of further damage. Twenty patients who suffered inner ear barotrauma while diving, but continued to dive against medical advice, were assessed on an interim basis for 1 ...

This essay reviews the influence that research on psychological processes in clinical reasoning has had upon the characteristics and formats of licensing examinations such as the new United States Medical Licensing Examination (USMLE) and its predecessors, emphasizes the implications of such research for the assessment of clinical competence at all ...

Familiarity with and adherence to the above principles may not make you claim- or judgment-proof, but they should improve patient care in your office and decrease your exposure to medicolegal interventions. Always bear in mind that medical practice is not a right conferred upon you by virtue of your medical ...

In 1988, a confidential postal questionnaire was prepared in order to assess the techniques used routinely in France for prophylaxis of aspiration of gastric contents in obstetrics. Of the 297 anaesthetists who responded, 81% (237) worked almost always and 19% worked occasionally in obstetric anaesthesia. Although obstetric anaesthesia is considered ...

Forty-six percent (274 of 600) of the members of the Texas Society of Psychiatric Physicians responded to a mailed survey that addressed retirement issues. Forty-seven percent of respondents were 60 to 69 years of age. Only 12% were female. Ninety-one percent were white, with 86% of respondents married. Only 24% ...

Heart donor demand far exceeds supply. We evaluated donor referrals to 1 organ procurement agency in an attempt to determine why many potential cardiac donors are not used. Of 430 referrals between September 1989 and August 1991, 169 hearts (39%) were harvested. In potential donors ultimately not yielding a heart, ...

Recent advances have reduced the risks of anaesthesia to a virtually immeasurable level. However, if the specialty wishes to continue to foster support, it will require active promotion of the benefits, not hazards, of our practice. The few published surveys of the image of the anaesthetist show that the public ...

This final rule responds to public comments on the October 9, 1991 interim final rule with comment period that set forth the Secretary's determination, required under section 1834(a)(7)(A) of the Social Security Act, of the meaning of the term "continuous" as that term is used in defining a period of ...

A firsthand historical account of some of the significant contributions of the steroid research group at the Schering Corporation (Bloomfield, NJ, USA) to the discovery and/or development of important therapeutic agents is presented. These include the discovery of the antiinflammatory corticosteroid drugs prednisone, prednisolone, and betamethasone, all of which, more ...

RATIONALE AND OBJECTIVES: The purpose of Radiology on the Air was to assess the technical and educational feasibility of providing radiologic continuing medical education via a fully interactive live telecommunications network. METHODS: Thirty-nine radiologic conferences were broadcast over the communications network of the Microelectronics Center of North Carolina (MCNC). Category ...

Despite an extensive medical literature over the past ten years, patients continue to die needlessly of overwhelming postsplenectomy infection. Although physicians have become increasingly cognizant of this syndrome in children, many remain unaware of the risk to asplenic or hyposplenic adults with no underlying medical problems. In addition, many older ...

Learning needs assessment is the term applied to the process of identifying or diagnosing a learner's educational needs. It is the foundation of a systematic continuing medical education (CME) programme. Needs assessment has been identified as the most pressing problem of medical education directors in North America. Furthermore, the CME ...

In an attempt to increase participation by established general practitioners (GPs) in continuing medical education (CME) the Department of Health in 1990 created an allowance (the Postgraduate Education Allowance, PGEA) to be spent by GPs on the educational provision of their choice. Although the PGEA has increased attendance by established ...

When the vectors of force required to close the ideal surgical wound are analysed, it is apparent that suture tension varies with the pattern of suture. For a given closing force, perpendicular interrupted sutures have the least tension. Symmetrical continuous sutures require greater suture tension, and this increases the more ...

The need for continuing medical education (CME) is now well recognized. The challenge is to make it effective. CRISIS, an acronymn, stands for the criteria which must be met to produce effective CME programmes: convenience, relevance, individualization, self-assessment, interest, speculation and systematic. CRISIS is a practical tool, based on 15 ...

Chinese herbal medicines (CHM) are commonly used in Hong Kong. To determine the importance of adverse reactions to CHM as a cause of medical admissions in Hong Kong, all 1701 patients admitted to two general medical wards at the Prince of Wales Hospital over an eight-month period were prospectively studied. ...

Medical planning requires the expedition physician to draw from many aspects of the knowledge base of wilderness and environmental medicine and to learn and use lessons from those that have gone before. The medical plan is dependent on parameters of the expedition objective, scope, and resources and is developed cooperatively ...

Orientation programs for medical interns generally bombard new physicians with a barrage of information from the hospital director of medical education, the chief executive officer, and other hospital personnel, as well as from a number of outside speakers. Advanced cardiac life-support training and social events round out the orientation program, ...

We present a case study in which severe agitation was reduced and independent functioning increased in a traumatically brain-injured individual. The subject's behaviour for the year prior to admission was characterized by increasing rates of maladaptive behaviours and corresponding increases in pharmacological attempts at behaviour management. Upon admission, the subject ...

The purpose of this investigation on ETCO2 monitoring was to determine if the monitors would function effectively in the aircraft. When compared in a cumulative manner, little difference between the three monitors was noted. The ETCO2 monitor appears to function in the fixed-wing aircraft when transporting critically ill, mechanically ventilated ...

The accrediting agency for U.S. and Canadian medical education programs, the Liaison Committee on Medical Education (LCME), was founded 50 years ago at a 1942 meeting of leaders of the Association of American Medical Colleges (AAMC) and the American Medical Association. The author, using sources from the AAMC archives and ...

We describe a continuous-speech interface for Quick Medical Reference (QMR), which allows physicians to input spoken descriptions of physical-examination findings, or observations. We analyze the difficulties in designing a continuous-speech interface for systems that use medical terminology. We present a method for matching spoken findings names expressed in natural language ...

The University of Nebraska Medical Center uses the recently established NEB*SAT state-owned satellite television system to transmit several types of educational presentations to rural Nebraska. The system represents the latest in a series of pioneering two-way television activities which have opened educational opportunities to students and professionals off-campus. Compressed video, ...

There is a constant need for all doctors to be 'renaissance health professionals', to have a mastery of a broad set of medical, communication and information-processing skills. Education in these areas must continue after graduation to produce the most effective medical care. With the changing face of medicine in the ...

Continuing education (CE) courses in pharmacy and medicine often overlap with regard to their informational content. At the present time, however, it is feasible that two pharmacists could attend the same national meeting that has continuing medical education (CME) approval status and only one of them would receive CE credit ...

We are setting forth in this interim final rule with comment period the Secretary's determination, required under section 1834(a)(7)(A) of the Social Security Act, of the meaning of the term "continuous" as that term is used in defining a period of continuous use for which we make payments for durable ...

The Obligatory Continuing Medical Education (CME) programme of the Royal Australian College of Obstetricians and Gynaecologists (RACOG) which is linked to time-limited certification has now been in operation for over a decade. Its somewhat unique features have attracted widespread interest both nationally and internationally and may be seen as part ...

Interventional radiological techniques of the lower genitourinary (GU) tract are large and varied and continue to expand because of technological advances and also because budgetary restraints are being placed on our medical society. This has stimulated continuous search for alternative ways of treating disease in a more cost-effective fashion. As ...

The increasing importance of continuing medical education (CME) in psychiatry is discussed. The need to take account of the principles of adult education (AE) and also of the diversity of current psychiatric practice and individual differences when developing CME programmes is emphasised. The relevance of mandatory CME to the assessment ...

Helicopter and fixed-wing air medical transportation provides an important role in the management of critically-ill patients. As the use of cardiac pacemakers continues to grow, knowledge of their expanding capabilities and sophistication is important. The environments of our "airborne intensive care units" are subject to many sources of electromagnetic and ...

In New Zealand until the 1920s, most births occurred at home or in small maternity hospitals under the care of a midwife. Births subsequently came under the control of the medical profession and the prevalent medical ideology continues to support hospitalised birth in the interests of safety for mother and ...

A survey of the involvement in and attitudes towards continuing medical education of 101 general practitioners achieved a 95% response rate. Ninety per cent of the 96 doctors worked in practices which held meetings the content of which was organized by representatives of pharmaceutical companies but only 46% worked in ...

Formal audits of the continuing medical education activities of physicians licensed in Michigan were undertaken to assess compliance with a law mandating participation in 150 hours of continuing medical education each 3 years. A random sample of all physicians renewing their licenses in 1987 and 1988 were asked to provide ...

Severe hypothermia with cardiopulmonary arrest often requires prolonged resuscitation while rewarming procedures are implemented. A 63-year-old male in cardiopulmonary arrest with a core body temperature of 23.7 C was resuscitated successfully after core rewarming by means of a two-chest-tube continuous thoracostomy lavage procedure. This lavage procedure resulted in effective and ...

This short review sets out some general facts and features concerning the development of continuing medical education (CME) in Europe. The review is intended as a basis for proposing plans and action for CME in the future. Europe, as it happens, was the birthplace and cradle of both scientifically based ...

The authors report on the outcome of treatment of 116 outpatients with chronic schizophrenia who were assigned to a 2-year, single-blind course of treatment with either targeted or continuous medication. These patients were not restricted to those who were good candidates for a medication reduction strategy. Continuous medication was superior ...