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S Vial

Publications and source records attributed to S Vial.

11 recordsLinked to original sources
PubMed1992

[Accreditation of training centers for medical specialists].

A National Committee from the Association of Medical Faculties has conducted a process of accreditation of training centers for specialists. Over a period of 13 years, 483 centers have been reviewed. Rejection of accreditation has been based on inadequate Faculty staff, or insufficient technical support for practice and teaching. Maximal number of trainees for each program are defined according to the available facilities. The Committee makes a strong recommendation to keep training programs under direct tuition from Medical Schools, especially faced with the interest of other medical care institutions in developing in service training. Also, a recommendation is put forward to organize cooperative programs among different Medical Schools and to give special emphasis to training programs for specialists in short supply.

Accreditation↗
PubMed1992

[Certification of specialists and their training outside the university].

A better appraisal of the training of medical specialists has been possible since the establishment of the National Certification Board in 1984. Participation of training centers outside the university environment has been considerable. Thus, after certification of the first 4500 medical specialists, it was noted that 7.5 of all applicants and 25% of those applying for official programs have received training in one or more of 137 extra-university programs. The quality and contents of these programs is variable. Their emergence is an inevitable fact derived from shortage of training centers in university teaching hospitals. Some control of these training programs is required to ascertain minimal standards of quality.

Certification↗
PubMed1991

Estimating impacts on developing countries of the decrease in U.S. training opportunities for foreign medical graduates.

Between 1973 and 1983, the number of foreign nationals from developing nations who entered the United States for graduate medical education decreased by approximately 90%. Many of those who would have studied in the United States if this decrease had not occurred would have returned home to serve their countries. To estimate the impact of this loss, a survey was conducted in six major cities in Latin America between 1983 and 1989. Selected local medical students interviewed 554 physicians who had returned home after U.S. training and 60 of their classmates who had not trained there. The findings indicate that the returned physicians had given approximately twice as much time to teaching, research, and medical administration as did those who had not left home. The authors maintain that this and related findings show how the curtailment of opportunities for training foreign nationals in the United States is detrimental to both the aspirations of developing nations and the influence of the United States in world affairs.

Adult↗
PubMed1990

[Human recombinant erythropoietin (rH-EPO) in chronic hemodialysis patients].

We studied 7 patients on chronic hemodialysis before and after 12 weeks of therapy with human recombinant erythropoietin. The drug was administered intravenously, 3 times a week at doses increasing from 50 to 125 U/kg. Dialysis was performed for 4 hr, 3 times a week and no blood transfusions were used during the study. An increased tolerance to daily physical activities was observed in all patients. Hematocrit increased from 19 +/- 3.4 to 28 +/- 4.1 and hemoglobin from 6.7 +/- 1.3 to 9.4 +/- 1.5, p less than 0.01. No changes were detected in blood pressure, weight, liver function tests and nutritional values. No patient developed either absolute (ferritin less than 30 ng/ml) or relative iron deficiency (transferrin saturation less than 20%) during the study. Efficiency of dialysis remained unaltered. No secondary effects from the drug were observed. Thus, this study confirms the clinical usefulness of human recombinant erythropoietin in patients with chronic renal failure and anemia on chronic dialysis.

Adult↗
PubMed1990

[IgA nephropathy (Berger's disease). Our experience in 78 cases].

We studied 78 patients with a diagnosis of IgA nephropathy. Renal biopsy was indicated in 69 patients by the presence of macroscopic hematuria (52%), microhematuria or proteinuria (22%), nephrotic syndrome (10%), severe hypertension with microhematuria or renal failure (14%) or nephritic syndrome (1%). Nine were healthy subjects being studied as live kidney donors. An association with IgG and/or IgM was present in 92% of patients. Serum IgA was elevated in 36% of patients. Hypertension was present in 30% and decreased renal function in 29%. Patients with serum creatinine above 1.5 mg/dl tended to be older (33.8 vs 28.7 years) and to have hypertension (52% vs 19%). Among 25 patients followed for more than 12 months renal function remained stable in 44%, deteriorated in 20% and 36% developed renal failure. The latter was associated to older age, hypertension, absence of macroscopic hematuria and nephrotic syndrome. The 9 live donors had no clinical manifestations of renal disease. Thus, IgA nephropathy is a highly variable clinical entity, both in its manifestations and its prognosis. An asymptomatic course is demonstrated in some subjects.

Adolescent↗
PubMed1989

[Hemodialysis: vascular access with double lumen catheter].

We evaluated the results of hemodialysis performed with 106 double lumen catheters in 87 patients (mean age 52, range 10-82). 46 patients had chronic and 38 acute renal failure; 2 had respiratory distress syndrome and one refractory heart failure. Catheter flow ranged from 100 to 250 ml/min (mean 207) and effective clearance from 64 to 171 ml/min (mean 125). Only one catheter was used in 75 patients (86%), 2 in 7 and more than 2 in 5. Causes of failure included inadequate flow (9), coagulation (6) and displacement (4). In nine instances, severe complications developed: sepsis (3), local infection (4), hematoma (1) and vagal reaction (1). Three patient with catheters located in the subclavian vein developed vein stenosis, requiring angioplasty in 2 and graft in 1. Thus, double lumen catheter is easy to place and helps preserve future vascular sites in chronic hemodialysis.

Acute Kidney Injury↗
PubMed1989

[The teaching hospital].

The teaching hospital is essential for Medical schools. Careful selection of students and a faculty with a commitment of teaching are very important. Development of a critical attitude and care for ethical principles should always be present. The acquisition of high technology should be considered a means for academic development rather than a purpose in itself. A national accreditation process is an important step towards achieving these goals in all teaching centers. A stronger cooperation between universities and national health authorities is urgently needed to avoid deviations in postgraduate training that are observed today.

Accreditation↗
PubMedDate not supplied

[Acute renal insufficiency secondary to ureteral obstruction].

Acute renal insufficiency due to ureteral obstruction is relatively uncommon and gives rise to difficulties of diagnosis and treatment. The series presented here analyzes these aspects in 24 patients who had 27 episodes of proven anuria due to ureteral obstruction. Their average age was 62. Six patients had only one kidney (25%). The most common etiology was cancer (two thirds of the cases), mainly of genitourinary origin (10/16). Calcium or uric acid urethral lithiasis was the main cause of obstruction in the benign group. Treatment corresponded to a wide range of obstruction removal procedures depending on the etiology, but in the secondary to cancer it was very aggressive and the most used was nephrostomy. The decision to perform any treatment of obstructive anuria in patients with cancer should take into account a variety of important aspects amongst which prevail the prognosis of the basal illness, the handling of cancerous pain, the complications and mortality associated with the procedure and the patient's prospects.

Acute Kidney Injury↗
PubMedDate not supplied

[Renal function in normal and malnourished children given different doses of vasopressin in continuous infusion].

The effects of vasopressin administered by continuous infusion (0.75 and 0.5 mU/m2/minutes) was studied in two groups of three normal and two groups of 5 and 8 malnourished children given 0.5 and 0.3 mU/m2/minute. The following parameters were analyzed: urine volume, osmolality, water reabsorption, PAH, urea and inulin clearances, Na and K urinary excretion. Malnourished children had a urine volume 3 to 5 times higher than the normal groups. Vasopressin increased urine volume initially, but a mild antidiuretic effect followed in the normal groups. In malnourished children with a high CH2O, antidiuresis showed quite important figures with vasopressin. A transient fall in PAH and inulin clearances was observed with vasopressin in both malnourished groups with a mild drop in the normal group. Natriuresis with a higher % of the filtered sodium excretion was observed in the malnourished groups and in normal children with 0.5 mU of vasopressin. These results show that vasopressin had similar effects, but at a different level in the normal and malnourished children that we studied.

Diuresis↗