Personality correlates in faculty ratings of resident competence.
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Biomedical subjects
Publications and source records attributed to W M Rodney.
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Ectopic pregnancy continues to be a major clinical problem and is the leading cause of death in the first trimester of pregnancy. Diagnosis can be elusive. A thorough knowledge of the clinical spectrum of this disease, as well as the diagnostic tools available to the primary care clinician, provides the opportunity for making an early diagnosis. This is essential if the morbidity and mortality of ectopic pregnancy are to be reduced.
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The asymptomatic carotid bruit is not an uncommon finding in patients aged 45 years and older. The presence of such a finding has been associated with an increased incidence of stroke and cardiovascular death. The optimal evaluation and management of such patients are still unresolved. Noninvasive carotid evaluation appears to be useful for defining the degree of carotid artery stenosis and possibly in identifying a particular subset of patients at high risk for stroke. Whether patients with asymptomatic carotid bruits are best managed medically or surgically remains controversial and will require further investigation.
Flexible sigmoidoscopy became available in 1976. To date, studies comparing it with rigid sigmoidoscopy support an increase of 2.5 to six times in the flexible sigmoidoscope's ability to detect polyps, and a two- to threefold increase in detection of colonic neoplasms in the same patients. This paper summarizes the current reported results of flexible sigmoidoscopy to date and describes the instrument and procedure as done at the UCLA Family Practice Residency Program. The flexible sigmoidoscope deserves evaluation for widespread primary care application.
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The flexible sigmoidoscope may represent a partial solution to the longstanding problem of physician and patient noncompliance with sigmoidoscopy for the detection of colorectal cancer. A three-year longitudinal audit of medical records revealed at least a sevenfold increase in the number of sigmoidoscopies performed after the introduction of flexible sigmoidoscopy to a salaried medical group. This procedure has made a significant contribution to patient care and resident education in the UCLA family practice residency program.
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Schirmer's test is a simple, semiquantitative test of tear production. It is based on the physical tendency of a fluid to travel along a strip of porous material by capillary action due to surface tension. Sterile strips, standardized and prepackaged, are available from local scientific supply houses. The low cost and simplicity of this test make it useful in confirming the diagnosis of diseases involving decreased lacrimal secretion.
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Acne vulgaris is a common skin disorder that is socially disabling to some degree in the majority of adolescents. Effective management of this disease has two major components: a strong physician-patient relationship and a sound medical regimen. The former is necessary to foster patient compliance with the long-term therapeutic regimen required, as well as to reduce the disease's potential for emotional scarring. The rational usage of the various topical and systemic medications available will serve to decrease the frequency and severity of exacerbations as well as to minimize possible scarring. Specific recommendations as to moisturizers and cosmetics are included.
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Termination of pregnancy by means of "menstrual extraction" is a useful procedure for family physicians opting to offer this service to their patients. It is an easily performed procedure which, when compared to the presently available avenues for abortion, offers significant advantages in cost, diminished morbidity, and the opportunity for continuity of care by the primary physician. The procedure is successful in properly selected patients 99 percent of the time.
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