A written survey of second-year osteopathic medical students at West Virginia School of Osteopathic Medicine was conducted to determine if detrimental lifestyle changes had occurred in the first 15 months of their medical education. Fifty-two (79%) of the 66 students returned the survey. The large majority of the responders (96%) ...

This article is the second in a two-part series on the changing roles and responsibilities of today's medical director within a medical group setting. As the complexity and demands of the health system have changed, so have the challenges that the new medical director must face to be successful. The ...

The structure of Haller's organ in all major groups of soft ticks, family Argasidae, is reexamined, and hypotheses of setal homology are proposed based on a comparative study of developmental patterns. The larvae of most taxa have 7 setae in the anterior pit (1 serrate, 1 conical, 2 fine, 2 ...

This article is the first in a two-part series focusing on the changing role of the group Medical Director. While this article will address the typical job responsibilities of today's Medical Director, the next article will highlight stylistic considerations which often make the difference between the individual's success and failure.

This article presents a historical discussion of disease models of opiate addiction in the United States in the twentieth century. First, several approaches to defining disease are discussed. Then, the shifts in formulations of opiate addiction as a disease in the twentieth century in the U.S. are analysed in light ...

The primary purpose for implementing medical surveillance is to protect the general health and fitness of all employees. The next most frequent purpose of medical surveillance programs is to determine whether employees have the physical capability to perform their jobs (ie, surveillance to establish "fitness for duty"). The most commonly ...

No province in Canada has implemented an RVG, although both Alberta and British Columbia are in the final stages. Many complications exist. There is concern that those sections within the medical association that feel they will be financially disadvantaged will attempt to prevent the implementation of the RVG. They may ...

The author likens some major aspects of academic medical centers to tightly and carefully woven tapestries. The metaphor is intended to highlight the complexity of medical centers and to help those who are working to promote meaningful and sustainable innovations in medical education. Underlying the presentation is the premise that ...

When evaluating preanaesthetic abnormal serum potassium (S-K) levels, the anaesthetist often relies upon blood tests performed on admission to hospital 1 or more days prior to surgery. However, the S-K is often altered between admission to hospital and the induction of anaesthesia. In this study, we examined the effects of ...

OBJECTIVE: The cooperative efforts and educational activities associated with a major histamine2-receptor antagonist (H2RA) formulary change and the clinical and financial results are described. EVALUATION PROCESS: An extensive financial and clinical evaluation was conducted. Sources included primary literature, reference texts, institution-specific financial data, and reports of other hospitals' experiences. INTERVENTIONS: ...

Traditional Chinese medicine as it persists in several East and Southeast Asian countries, has undergone major changes. Such changes have reinforced the trading aspects of traditional Chinese medical practice with relatively little advantage for the medical care component. This paper examines the nature of changes in contemporary ethnic Chinese medical ...

Various medication therapies have been attempted to assist in detoxification and abstinence maintenance among cocaine users. The safety of these medications in this unique population has not been documented. Carbamazepine, an anticonvulsant being used with this population, is known to cause leukopenia and agranulocytosis in seizure patients. Analysis of data ...

In each nephron, a change in Cl delivered to the macula densa affects afferent arteriolar tone, and thus SNGFR. This phenomenon, called tubuloglomerular feedback (TGF), is the main function of the juxtaglomerular apparatus (JGA) and serves as the fine regulator of SNGFR. The phylogeny of the JGA strongly suggests that ...

A series of dynamic changes underway in Washington could transform the manner in which physicians learn of new pharmaceutical therapies. The potential impact of these changes is likely to significantly affect the manner in which physicians learn about and prescribe medications for years to come; the ultimate effect on patient ...

A method of analysing the factors which contribute to the length of stay in England as an acute medical in-patient has been developed, and applied in both real-time and cross-sectional studies. The major factors delaying discharge were found to be the time taken to respond to treatment and the actions ...

Exposure to microgravity and space travel produce several neurologic changes, including SAS, ataxia, postural disturbances, perceptual illusions, neuromuscular weakness, and fatigue. Inflight SAS, perceptual illusions, and ocular changes are of more importance. After landing, however, ataxia, perceptual illusions, neuromuscular weakness, and fatigue play greater roles in astronaut health and readaptation ...

This selective retrospective study was undertaken to establish whether the gallbladder contraction (ejection fraction) calculated during cholescintigraphy correlates with the histopathologic changes in the surgical specimen. The medical records of 243 patients who underwent hepatobiliary scintigraphy were reviewed. Of these, 215 patients had cholecystokinin cholescintigraphy and 100 went on to ...

This article discusses the current organization and doctrine for a medical platoon in an armour-heavy task force in light of experience gained in Operations Desert Shield and Desert Storm. The organization of and doctrine for the use of the platoon is covered first. This is followed by a discussion of ...

The hydrophobic, photoreactive probe 3-(trifluoromethyl)-3-(m-[125I]iodophenyl)diazirine ([125I]TID) was used to characterize the effects of lipids and detergents on acetylcholine receptor (AChR) conformation. Affinity purified AChR reconstituted into dioleoylphosphatidylcholine (DOPC), dioleoylphosphatidic acid (DOPA), and cholesterol showed the same pattern of [125I]TID-labeling and demonstrated the same reduction in labeling of all four subunits ...

Gingial hyperplasia is a complication which may be seen in a significant number of patients taking nifedipine (Procardia, Pfizer) a commonly used medication for cardiac vessel dilitation. This is a report of gingival changes in a 43-year-old hypertensive male who began using the calcium channel blocking agent during his active ...

The motor disturbance in Parkinson's disease affects all voluntary movement, including innate rhythmical processes such as gait, breathing, and chewing. While there are good descriptions and pathophysiological hypotheses of the changes in gait less is known about the way masticatory movements are affected. By means of a three-dimensional optoelectronic recording ...

Changes in medications and behavior were recorded for residents of three nursing homes where a psychogeriatric rehabilitative program was either absent, maintained, or discontinued. Residents without the program received the greatest number of psychotropics. Discontinuation of the program was associated with two problems: (a) fewer reductions in medications and (b) ...

The omission of the Wiggins Content Scales occurred because of the number of items deleted as well as the addition of items to the MMPI-2. The purpose of this study is to compare scorings of the items on the Wiggins Scales of the MMPI and the items that remain on ...

The interaction of (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1- piperazinyl)-7-oxo-7H-pyrido[1,2,3-de] [1,4]benzoxazine-6-carboxylic acid hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4) with fenbufen, a nonsteroidal anti-inflammatory agent, in mice was assessed by convulsive seizure and subsequent death in comparison with that of other new quinolones such as DR-3354 (the R-(+)-isomer of ofloxacin), ofloxacin, norfloxacin, enoxacin and ciprofloxacin. Although treatment ...

What makes a statement interesting? In Expts 1 and 2, merely increasing the amount of background knowledge on a topic did not always increase the interest for statements on that topic. However, background knowledge that combined with a statement to create an interesting implicit proposition did increase interest. In Expt ...

Predicting the future is a chancy business. In line with other medical specialties, gastroenterology will be subject to rapid and profound changes in the coming decades and will have to adapt and renew its approach to the way medicine will be practised. The pressures to change will be in several ...

Neck pain and neck injury are common complaints among military aviators flying high performance (HPF) aircraft. Since all candidates for military flying training with the Royal Norwegian Air Force have to meet HPF medical standards, medical selection procedures include a radiological examination of the spine. Nine films of the vertebral ...

This notice announces that effective April 1, 1992, Medicare carriers will no longer accept nonstandard claims. These are claims accompanied by attachments, in lieu of the biller entering required information in designated blocks of prescribed claims forms. This change is intended to eliminate costly and inefficient claims processing practices for ...

The first documented description of acute altitude sickness was published by Father Acosta in 1590. Acosta described this sickness when he traveled through a pass across the Andean divide in central Peru near the mountain Pariacaca. Almost all the maps of modern Peru do not name this mountain. We present ...

In writing a history of any illness there is always a dilemma whether to attempt the story of the condition 'itself', the medical attempts to define its nature, or to glimpse it via our changing reactions. The easiest is a straightforward account of the attempts of scientists to solve a ...

Chemical peeling of facial skin has become a valuable adjunct in the armamentarium of the facial aesthetic surgeon. Among the various techniques available, phenol solutions are the most commonly used. Peeling produces a controlled, partial-thickness chemical burn of the epidermis and the outer dermis. Several techniques are available to "fine ...

A 61-year-old man with palmoplantar keratoderma with an unusual tonotubular keratin is reported. The histologic findings, genetic transmission, and clinical course were similar to epidermolytic palmoplantar keratoderma (Voerner type), but keratinocytes ultrastructurally displayed a tonotubular cytoskeleton, which has not been previously described, instead of a tonofilamentous one. Electrophoretically, we found ...

Dramatic changes have occurred in society since the Second World War. These include great advances in science and medicine. Such changes are likely to continue at an ever increasing rate. The changes and possible implications for health care delivery over the next fifty years are discussed. These changes and their ...

Anabolic-androgenic steroids are used in the treatment of numerous medical conditions, including Fanconi's anemia, hypogonadism, hereditary angioedema, hypopituitarism and impotence. However, because of their potent anabolic properties, athletes began to use them to enhance body strength, size and endurance. Despite warnings from the medical and scientific communities of dangerous side ...

This study assessed the changes of the subgingival/marginal microflora during fixed prosthodontic procedures and evaluated the effect of adjunctive rinsing with 0.12% chlorhexidine on the subgingival/marginal microflora during fixed prosthodontic treatment. Thirty patients scheduled for fixed prosthodontics were randomly assigned to either rinsing with 15 ml of tap water b.i.d. ...

A simple three-parameter description of medical technology is introduced to investigate the relationships between technical change, welfare, and type of insurance contract. The value of a particular change in technology depends on the existing form of contract. The marginal equilibrium expected utility to consumers of different types of technical change ...

Nitrous oxide is now recognised as an important contributor to the 'greenhouse' effect. Each year the medical profession unwittingly adds a very small burden of this gas to the atmosphere. Unfortunately, the long lifetime of nitrous oxide means that all emissions into the atmosphere are significant. By making small changes ...

The changes in the composition of glycoconjugates in the colon of human embrya and fetuses were studied using the methods of lectin histochemistry. Glycosylation was estimated in various sections of the colon during the development with special attention to intracellular localization. The changes were compared with the process of glycosylation ...

The influence of 5 g fosfomycin i.v. every 12 hours on the intestinal and pharyngeal flora was studied in eight healthy, male volunteers. The Escherichia coli counts were markedly reduced during application and returned to normal in all subjects within a maximum period of 12 days. The total count of ...

Changes in mean elevation, dispersion, overall configuration, and code type of well-defined MMPI profiles were examined after transformation to estimated MMPI-2 profiles. A total of 34 MMPI profiles from both Gilberstadt and Duker (1965) and Marks, Seeman, and Haller (1974) were analyzed using contemporary MMPI-2 T-scores. Results yielded a reduction ...

This paper analyzes how economic factors (relative expected earnings, relative expected hours worked, and relative length of training period) affect the distribution of medical residents across specialties. The results show that the percent of residents in a given specialty changes more than proportionately when relative hours change (hours elasticities averaged ...

This study investigated changes in the supervisors' and supervisees' perceptions of the supervisory relationship and the extent to which their perceptions were congruent. Salient dimensions of supervision were identified which predict the quality of the relationship. Twelve supervisory dyads involved in predominantly ongoing supervisory relationships completed an adapted Vanderbilt Psychotherapy ...

A manometric study to determine the role of gastro-oesophageal reflux in Barrett's oesophagus was performed on 20 patients with Barrett's oesophagus and 53 patients with reflux oesophagitis without Barrett's oesophagus (25 with mild oesophagitis and 28 with severe oesophagitis). For the same reason, the 20 patients with Barrett's oesophagus also ...

In a recent article, Gottman and Krokoff (1989) presented a fascinating and counterintuitive portrayal of a temporally related dynamic relationship of marital conflict and marital satisfaction. Unfortunately the results from which their conclusions spring are quite problematic. In a 2-wave, extreme-groups design, Gottman and Krokoff used raw change in satisfaction ...

This is the fourth in a series of reports bringing changes in the names of fungi of microbiological, industrial and medical importance to the attention of workers in these fields. The series is sponsored by the Division of Mycology of the International Union of Microbiological Societies (IUMS) and prepared under ...

Longitudinal voice quality changes following Isshiki thyroplasty type I were investigated in a group of 13 patients exhibiting unilateral vocal fold paralysis. Thyroplasty type I medializes the paralyzed fold by using a Silastic implant for external lateral compression of the abducted fold. No perioperative complications were experienced. We observed significantly ...

It is a decade since the last review article on otolaryngology in this Journal. In that time there have been significant advances in the practice of an ever-changing specialty which originally started off as a surgical specialty designed to drain abscesses from the bony boxes in the head, namely the ...

In this article a description is given of the development of the function of patient education coordinator in the Netherlands. In general, these developments have been successful. The differences in emphasis between the work of Dutch coordinators and those in the United States are discussed, set against the background of ...

The major changes resulting from the AIDS diagnosis and illness were measured, described and classified in the Behavioural Systems Model's eight subsystems--achievement, affiliative, aggressiveness/protectiveness, dependence, ingestive, eliminative, restorative and sexual. Thirty male AIDS patients with Kaposi's Sarcoma were drawn as a convenience sample from a major medical centre's outpatient clinic. ...

The introduction of closed chest cardiac massage by Dr William Kouwenhoven and associates has markedly changed the outcome of patients with cardiac arrest. The fortuitous discovery of the simple yet ingenious concept of closed cardiac massage has saved countless lives. In fact the manuscript published by Kouwenhoven and colleagues has ...