Abstract Background. On July 12, 2010, Boston Medical Center (BMC), the busiest emergency department (ED) in Massachusetts, with more than 100,000 adult patient visits per year, consolidated its two fully functional EDs into one. In preparation for this consolidation, BMC implemented systems changes to mitigate potential negative effects on both ...

For patients with epilepsy, anti-epileptic medication is generally the first line of treatment, but treating pregnant women with epilepsy can be a challenge. Standard anti-epileptic medications have caused developmental abnormalities, so much effort has been put into developing antiepileptic medications with minimal teratogenic effects. In this experimental study, the new-generation ...

Medical Education 2011 Objectives  Sexual harassment in medical education has been studied in the Americas, Europe and Asia; however, little is known about sexual harassment in Middle Eastern cultures. Our initial aim was to describe the sexual harassment of female doctors-in-training by male patients and their relatives in Turkey. During ...

Background: International experience has demonstrated that the medical profession is becoming less dominated by men. This "feminization of medicine" has been a topic of much debate in the medical literature. As the gender ratio in the profession changes, it is likely that a greater proportion of undergraduate education will be ...

The 2020 Vision of Faculty Development Across the Medical Education Continuum conference, and the resulting articles in this issue, addressed a number of topics related to the future of faculty development. Focusing primarily on the development of faculty members as teachers, conference participants debated issues related to core teaching competencies, ...

To examine the validity of selected entry level characteristics in relation to the GCE A/L examination as independent predictors of performance of students in medical school. A retrospective, analytical study was done at the Faculty of Medicine, University of Kelaniya. Student characteristics at entry were described by sex, the average ...

Studies indicate mental health improvement can occur via religious communities offering social support and other resources. Many people from many cultures regard medicine as a supernatural or magical treatment that can somehow lead to a better state of living. In medical advertising, female role portrayal involves the blending of beauty, ...

Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual behaviors and methods of contraception, among college/university students of Karachi, Pakistan. Study Design: Cross-sectional observational study. Place and Duration of Study: Higher Education Commission-recognized government and private colleges/universities in Karachi from 2005-2006. Methodology: Two colleges/universities were randomly ...

This article examines the ways in which female same-sex desires were represented across a range of nineteenth-century European medical writings. While recognizing the conceptual innovations of the late-nineteenth-century psychiatric idea of "sexual inversion," it argues that the category of "sexual invert" was positioned alongside other medical representations of same-sex desires, ...

The issue of whether medical practitioners should perform "ritual nicks" as a method of meeting demand for female genital mutilation (FGM) has recently been debated in the United States and Australia. Due to increasing numbers of people arriving and settling in Australia from African nations in which FGM is customary, ...

By probing the processes of exclusion of transsexuals from the political sphere, this article offers contributions to social and political theory through an examination of the processes of exclusion from the category "human." This article considers how the erasure of investment in their own embodied sex constructs a platform from ...

After the Great Northern War in 1721, Sweden ceased to be an important military power. Instead, the kingdom concentrated on developing science. Swedish research got international fame with names as Carolus Linnaeus, Pehr Wargentin and Anders Celsius. Medical research remained limited and malaria was common especially in the coastal area ...

Although male factors contribute to approximately half of all cases of infertility, no specific cause can be found to explain the majority of abnormalities found in semen parameters. Specific and effective medical treatment is restricted to rare endocrine disorders. As a consequence, various empirical medical treatments are often used to ...

Deep vein thrombosis (DVT) remains a major cause of in-hospital morbidity and mortality. Effective DVT prophylaxis is available but underutilized. We sought to describe physician understanding of DVT epidemiology and prophylaxis practices. All medical and surgical residents, and hospitalist attendings were invited to participate in an on-line survey. Physicians were ...

Prehospital surgical amputations are rarely necessary. This paper gives a historical perspective, the indications and contraindications for limb amputations, and details a simple technique for both surgeons and non-surgically qualified medical personnel.

Keloids and hypertrophic scars are abnormal responses to wound healing. In general, keloids may exhibit proliferative growth beyond the margins of the scar and will remain persistent; whereas hypertrophic scars will stay contained to the original wound and may regress over time. The authors will discuss the five different types ...

A case is presented of a 27-year-old Caucasian woman that presented with an oval purplish patch with defined borders on her right cheek. It was swollen and tense, with a mottled surface due to scarring. Histologic examination indicated discoid lupus erythematosus and the patient was initially treated with medical therapy. ...

To conduct the first prospective randomized controlled trial, evaluating and comparing the effect of medical and surgical treatment of chronic rhinosinusitis (CRS) on quality of life. Ninety patients with CRS, who remained symptomatic after initial medical treatment with Dexarhinaspray duo and nasal douche, were randomized either to medical or surgical ...

Vascular insufficiency of the upper extremity can be due to acute vascular injury, chronic vasospastic disease, and occlusive disease. Its treatment requires a thorough understanding of the vascular anatomy of the upper extremity, diagnostic modalities, and medical and surgical management options. Promising advances continue to be made in surgical treatment ...

Barrett's esophagus (BE) is a change in the esophageal mucosa as a result of long-standing gastroesophageal reflux disease. The importance of BE is that it is the main risk factor for the development of esophageal adenocarcinoma, whose incidence is currently growing faster than any other cancer in the Western world. ...

The aim of this study was to investigate the prevalence of common geriatric conditions in a tertiary medical center. We conducted a cross-sectional, hospital-wide survey of 455 inpatients, aged 65 and older, from 24 medical and surgical units of a 2200-bed urban academic medical center in Taiwan. Patients were screened ...

Medical waste management has not received enough attention in recent decades in Iran, as is the case in most economically developing countries. This study investigated the quantities, generation rate, quality and composition of medial waste generated by hospitals in Sistan and Baluchestan province in Iran. A comprehensive inspection survey was ...

Obesity is a public health epidemic with medical, psychological and economic consequences. It continues to increase globally in prevalence and severity. Despite numerous behaviourally, medically or pharmacologically guided treatments, an effective non-surgical long-term treatment approach has not been identified. Bariatric surgery has surfaced as a viable option for a subset ...

Chronic rhinosinusitis (CRS) is a condition characterized by persistent inflammation due to intrinsic mucosal hypersensitivity or persistent infection. Proper medical treatment with antibiotic, leukotriene modifiers, oral corticosteroids, or even aspirin desensitization for the sinus inflammation can prevent the need for surgical intervention. The key to delineating the specific medical application ...

Medical waste is a necessary by-product of any hospital environment; however, the majority of regulated medical waste is produced in the OR from the use of disposable surgical supplies (eg, drapes, gowns, basins, gloves, sponges). We conducted a concept comparison project in the ORs of two large medical centers in ...

OBJECTIVE: To compare survival of dogs with a congenital portosystemic shunt (CPSS) that received medical or surgical treatment. DESIGN: Prospective cohort study. ANIMALS: 126 client-owned dogs with a single CPSS. PROCEDURES: Dogs were examined at 1 of 3 referral clinics, and a single CPSS was diagnosed in each. Dogs received ...

BACKGROUND: Vesicoureteric reflux is usually managed medically. When medical management fails, the patient is referred for surgical intervention. The aim is to protect the kidneys from progressive damage. This study investigates if significant kidney damage has occurred during medical treatment prior to surgical intervention. MATERIALS AND METHODS: Case notes of ...

Poor communication between referring clinicians and specialists may lead to inefficient use of specialist services. San Francisco General Hospital implemented an electronic referral system (eReferral) that facilitates iterative pre-visit communication between referring and specialty clinicians to improve the referral process. The purpose of the study was to determine the impact ...

The National Longitudinal Study of Adolescent Health and the National Health and Nutrition Examination Survey reported that over 40% of the US population is overweight. The average weight loss attained by medical management programs is neither sufficient nor durable enough to treat medically complicated obesity. An estimated 220,000 bariatric procedures ...

This article reviews the epidemiology of benign prostatic hyperplasia (BPH), evaluation of patients with lower urinary tract symptomatology (LUTS), and management of patients with BPH and LUTS. The evaluation includes history and physical examination, laboratory testing, and specialized studies. The management includes medical and surgical options. Medical options include alpha-1-adrenergic ...

Consistency of photographic documentation is essential for facial plastic surgery, a visual surgical subspecialty. Photographs are often used to validate surgical outcomes but have many other uses including education, publication, and marketing. Utilization of a properly equipped medical portrait studio will dramatically increase the quality of photographic images. In this ...

Often, rhinoplasty patients present not just for aesthetic correction, but for improvement of their nasal breathing due to functional abnormalities or problems. Because the aesthetic and functional problems must be addressed together, an understanding of both the internal and external anatomy is essential. In this article, the authors review the ...

Obesity and Type 2 diabetes mellitus (T2DM) are closely interrelated, and are two of the most common chronic, debilitating diseases worldwide. Surgical approaches to weight loss (bariatric surgery) result in marked improvement of T2DM, however randomized trials directly comparing the efficacy of surgical and medical approaches are lacking. The Surgical ...

Circumcision is the only surgical procedure imbued with multiple sacred meanings across many cultures. Though countless medical benefits have been attributed to circumcision, it is an operation that historically has had greater symbolic significance than medical utility. We examine how the symbolic significance of circumcision influences how it is performed ...

OBJECTIVES: To examine the clinical effectiveness and cost-effectiveness of tonsillectomy/adeno-tonsillectomy in children aged 4-15 years with recurrent sore throats in comparison with standard non-surgical management. DESIGN: A pragmatic randomised controlled trial with economic analysis comparing surgical intervention with conventional medical treatment in children with recurrent sore throats (trial) and a ...

BACKGROUND: We examined factors affecting the choice of surgical versus medical treatment of severe aortic stenosis and evaluated associated patient survival. METHODS: We retrospectively reviewed data from all patients diagnosed with severe aortic stenosis at a Veterans Affairs medical facility between January 1997 and April 2008. RESULTS: Of 345 patients ...

To determine outcome after medical or surgical treatment of postpartum mares with confirmed or presumptive uterine tears. Case series. Postpartum mares were included if foaling had occurred within 7 days and uterine tear was confirmed surgically or, in medically treated mares, by palpation or presumed based on peritonitis. Information (age, ...

Specialty distribution in Kenya continues to exhibit gender disparities despite the increasing number of female medical students graduating each year. This study aimed at assessing specialty preferences and factors influencing these choices among male and female medical students in Kenya. Four hundred and fifty medical students, from first to fifth ...

Essential tremor (ET) is one of the most common movement disorders in the world. Despite this, only one medication (propranolol) is approved by the Food and Drug Administration (FDA) to treat it. Fortunately, recent studies have identified some additional medications as treatment of ET. Surgical procedures, such as deep brain ...

Application development is often guided by the usage of software libraries and toolkits. For medical applications, the toolkits currently available focus on image analysis and volume rendering. Advance interactive visualizations and user interface issues are not adequately supported. Hence, we present a toolkit for application development in the field of ...

While endoluminal procedures are now commonly done for symptomatic peripheral arterial disease, vein bypass remains the gold standard for revascularization. Lower extremity vein bypass procedure success is dependent on patient factors, surgical judgment and technique, including use of medications. Cardioprotective medications have proven efficacy to decrease morbidity and mortality, but ...

A significant proportion of the Australian population resides nonmetropolitan regions. For the majority of these smaller regional centers, the surgical service delivery has been traditionally provided by either solo or two-person surgical practices. As medical students' interest in rural practice declined, new models were created to ensure medical care in ...

BACKGROUND:Recognition of and early intervention for patients with acutely deteriorating conditions is often the responsibility of medical-surgical nurses. This study examined the effect of simulation on medical-surgical graduate nurses' perceived ability and confidence in responding to patient clinical emergencies. METHOD:Fifty medical-surgical graduate students participated in high-fidelity immersive simulations. Questionnaires completed ...

John Louis Borsch Jr, MD (1873-1929), was an ophthalmologist from Philadelphia who spent most of his career in France. During his lifetime he was probably best known as the inventor of the first fused bifocal lens, which was marketed very successfully as the Kryptok lens. He may be better known ...

This study examines the consequences for medical specialists of participating in multidisciplinary medical team meetings in terms of perceived clinical autonomy, domain distinctiveness, and professional accountability. These consequences may influence their willingness to cooperate and the quality of teamwork. The authors hypothesized that multidisciplinary medical team meetings would be more ...

BACKGROUND: The clinical venous thromboembolism (VTE) burden remains high in the United States, despite guidelines recommending that safe and effective VTE prophylaxis be available. This study assesses the real-world rate of appropriate inpatient VTE prophylaxis in hospitalized U.S. medical and surgical patients at risk of VTE, in accordance with the ...

Surgical simulation technology has advanced significantly in recent years. Medical-simulation validation studies have established that surgical skills honed using a simulator significantly improved trainee performance by decreasing operating times, improving efficiency, and decreasing errors. Integration of surgical simulation technologies into the medical training and education system improves the quality of ...

It has been almost 30 years since the introduction of percutaneous nephrolithotomy (PCNL) as a safe, effective, and efficient method for large stone fragmentation and removal. While considered a highly effective technique, a surgical procedure alone cannot address the underlying metabolic conditions that may cause either new stone formation or ...

The most common causes of gastrointestinal colic at an equine referral hospital in South Africa were determined following retrieval of the medical records of horses admitted during a 10-year study period. The study included 935 horses of which 28% were admitted after hours. Most horses were Thoroughbreds (54%), male (57%), ...

OBJECTIVE: To relate a 6-year, short-term experience of utilizing fine needle aspiration cytology (FNAC) during medical-surgical missions in the impoverished areas of the Philippines. STUDY DESIGN: FNAC is a simple, accurate, fast and economical procedure and requires the simplest devices to implement. During medical-surgical missions to the poorest areas in ...