Biomedical subjects
S Glick
Publications and source records attributed to S Glick.
Antibiotic usage in Kupat Holim (Sick Fund) clinics. A pilot survey and evaluation.
A survey of antibiotic prescribing patterns of six physicians in two Sick Fund clinics was carried out during a one-month period. Over 1,200 antibiotic prescriptions and their therapeutic indications were reviewed. Ampicillin was the most commonly prescribed drug. Most of the prescriptions were for treatment of infections of the upper respiratory tract. Over one half of all antibiotic prescriptions were for presumably viral upper respiratory infections (URI), and half of all patients diagnosed as having viral URI received an antibiotic prescription. A method for measuring the quality of antibiotic usage by physicians in infections of the upper respiratory tract was developed and tested. The method is readily applicable to Sick Fund clinics and, in a trial run, proved capable of demonstrating large differences among physicians in their antibiotic prescribing habits for viral URI, tonsillitis, and otitis media.
[Internal medicine--where to?].
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Measuring clinical competence of medical students.
Evidence of clinical competence for medical students entering the clinical clerkships at the University of Kansas College of Health Sciences is established by passing two different examinations: a 100 item multiple choice examination and a videotaped history and physical examination by each student of a simulated patient, being rated by that patient and two examiners. In 1976 the class of 196 medical students took an average 1.85 written examinations per student. With 70% or better constituting a passing score, 30.6% passed on the first attempt, 55.6% the second, 11.2% the third and 2.5% the fourth. Each student passed the televised practical examination and had the opportunity to review his or her videotape with a critiqued data base and the examiners' and simulated patient's evaluations in hand. Correlation coefficients for all 196 students between scores of written examinations, medicine tutors, examiners and professional patients revealed weak but significant correlations between the assessments of examiners and medical tutors and assessments of examiners and written examination scores, but not between other evaluations. This scheme of proof of competence appears to be objective and direct, and serves the convenience of both students and teaching staff.
Renal function during treatment of inappropriate secretion of antidiuretic hormone with demeclocycline.
Two patients with the syndrome of inappropriate secretion of antidiuretic hormone were studied in a metabolic ward during treatment with 1.2 g demeclocycline daily. In both patients, demeclocycline treatment led to increased renal water excretion with consequent correction of hyponatremia and hypo-osmolality. Three episodes of reversible deterioration in glomerular filtration rate developed in these patients. Each episode was accompanied by clinical evidence of extracellular fluid volume contraction, and on each occasion there was an inappropriate natriuresis with daily urinary sodium excretion remaining above 50 mEq. Although demeclocycline effectively reverses the electrolyte abnormalities of this syndrome, the potentially dangerous side effects that may develop exclude the routine usage of the drug.
Significance of hyperprolactinemia in 70 women with amenorrhea.
The clinical, radiological and hormonal findings in 70 amenorrheic patients are described. Hyperprolactinemia was found in 18 patients (25.7%) who were divided into three groups: nine patients with functional secondary amenorrhea, six patients with radiological evidence of pituitary tumor, and three patients with primary amenorrhea. One of the latter group had primary hypothyroidism. Plasma gonadotropin concentrations were normal or low in most patients, with the exception of five women with ovarian failure in whom the levels were significantly raised. Galactorrhea was diagnosed in 23 patients (32.8%), and in 16 of them plasma prolactin levels were elevated. Recent experience has shown that reduction of prolactin levels to normal by removal of prolactin-secreting tumors or by treatment with bromocriptine results in the restoration of normal menstrual cycles and fertility. The hormonal and radiological identification and characterization of hyperprolactinemic amenorrhea are therefore of prime importance.
An outbreak of digoxin intoxication.
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Occupational health in Israel: research and prevention approaches for the 1990s.
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