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Biomedical subjects

K Goldenberg

Publications and source records attributed to K Goldenberg.

32 records · Page 2Linked to original sources
PubMed1987

An elective in primary care internal medicine for students in the preclinical years.

A two-week elective to introduce first- and second-year medical students to primary care internal medicine was developed and evaluated. Course time is divided between conference sessions (25 percent) provided by full-time clinical faculty members and office experience (75 percent) provided by volunteer clinical faculty members (general internists in private practice and in prepaid health plans). Evaluations by the students (n = 58) who took the elective consisted of a questionnaire assessment of the conference session topics, the student's ability to carry out course objectives, and the preceptor's teaching activities. The conference topics were highly rated, with a mean score of 4.1 on a rating scale ranging from 1 (unfavorable) to 5 (favorable). The course objectives and teaching activities were also well rated, with a mean score of 4.1 and 3.9, respectively, on a rating scale ranging from 1 (none) to 5 (outstanding).

Curriculum↗
PubMed1980

Molecular interactions in biomedicine: modulation of regulatory behavior by cross reactivity: relevance to analysis of receptor function.

The influence of cross reactivity on biomolecular regulation is not frequently incorporated into theoretical analysis and is often eliminated by experimental design. Nonetheless, cross reactive molecules produce effects on binding which may considerably modulate their behavior in quite diverse systems, i.e., drug-tissue receptor, antigen-antibody, substrate-enzyme, protein-DNA and hormone-tumor receptor interactions. In particular, certain effects vary at different concentrations suggesting a simple control mechanism.

Allosteric Regulation↗
PubMedDate not supplied

Periodic health examination: comparison of residency programs and national recommendations.

Health maintenance and disease prevention guidelines of primary care internal medicine residency (PCIM) programs were investigated and compared with recommendations of major national organizations. Preventive screening data were requested from 134 PCIM programs; 120 (90%) responded. Methods included seminars/lectures by 73 (61%), health maintenance flow sheets by 58 (48%), and a variety of other formats by 25 (21%) programs. A comparison of recommended flow sheet items (n = 33) from five major studies and 48 PCIM programs showed concordances (+/- SE) of 62% (+/- 5) with high-priority items (n = 15) and 33% (+/- 4) with low-priority items (n = 18). When an item's frequency or age range was examined, however, concordances were much lower. From our analysis, fewer than half the programs routinely used prompting systems, such as flow sheets, in their ambulatory clinics, and there was little uniformity in the frequencies and age ranges for those items employed. The data suggest that major study recommendations were underused and underemphasized.

Data Collection↗
PubMedDate not supplied

Impact of therapeutic guidelines on antibiotic use by residents in primary care clinics.

Inappropriate use of antibiotics has been well documented for inpatient settings, but there are few studies in ambulatory patients. In a prospective study, the authors monitored the outpatient prescribing patterns of internal medicine residents and evaluated the effect of placing a one-page set of antibiotic guidelines in each patient examining room. Appropriateness of antibiotic choices was scored periodically. A 12-month pre-intervention survey of antibiotic use showed that 50% of the choices were inappropriate. Comparison of a four-month post-intervention analysis with the same four-month interval in the pre-intervention period showed no significant difference between the percentages of inappropriate prescriptions. The most common reasons for inappropriate use were: 1) failure to document a clinically significant bronchial infection, and 2) inadequate evaluation of nonspecific urinary tract complaints. The authors conclude that the ready availability of information about appropriate antibiotic use is not effective in changing antibiotic choices, and that educational strategies regarding antibiotic use must also address diagnostic evaluation.

Anti-Bacterial Agents↗
PubMedDate not supplied

Screening for primary aldosteronism: hypokalemia in hypertensive patients.

A serum potassium determination is usually recommended for new hypertensive patients as a screening test for primary aldosteronism and as a baseline for drug therapy. Since hypokalemia is not specific for aldosteronism, the authors assessed its use and limitations as a screening test in nine reported studies of 303 patients with aldosterone-producing adenomas (n = 252) or adrenal hyperplasia (n = 51). The optimal potassium cutoff level and the predictive ability of hypokalemia to detect aldosteronism were analyzed in a primary care setting with different diseases, test characteristics, and prevalences. Optimal screening for primary aldosteronism occurred at serum potassium less than 3.2 mEq/l in a primary care, low-prevalence population, and at higher potassium levels in higher-prevalence populations. Other screening tests, such as urinary aldosterone levels and plasma renin activity, showed lower individual test performance characteristics, but when combined were similar in performance to serum potassium measurement.

Adenoma↗
PubMedDate not supplied

Tracking patient demographics and disease categories in a primary care residency.

The residency training of primary care physicians must include experiences with multiple types of ambulatory patients and disease processes. Most residency programs, however, do not accurately monitor or quantify these experiences. We developed a simple computerized system, using a relational data base, to record and track patient demographics and disease categories. This system maintains a profile for each resident physician which is used to guide the assignment of future patients. The system can be simply modified to meet the specific patient and/or disease characteristics needed.

Diagnosis-Related Groups↗