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At least 685 records · Page 38Linked to original sources
PubMedDate not supplied

Gastroesophageal reflux disease: current treatment approaches.

Gastroesophageal reflux disease is a common, usually lifelong, disorder resulting from chronic abnormal exposure of the lower esophagus to gastric contents. Motor dysfunction of the lower esophageal sphincter is the primary cause of this disease. At this writing, no medical therapies can completely resolve abnormal lower esophageal sphincter function; therefore, the treatment of gastroesophageal reflux disease centers on suppression of intragastric acid secretion. Available acid-suppressant medications include proton pump inhibitors, H2-receptor antagonists, and antacids. Of these, the proton pump inhibitors are recognized generally as the mainstays of both short-term and long-term therapy for gastroesophageal reflux disease. All have a low incidence of side effects and are well tolerated by most patients. Five proton pump inhibitors are available currently for patients with gastroesophageal reflux disease. Of these, esomeprazole has shown greater efficacy in controlling intragastric acidity than the others. For patients with erosive esophagitis, esomeprazole has demonstrated higher healing rates and more rapid sustained resolution of heartburn than omeprazole or lansoprazole after up to 8 weeks of once-daily treatment. Because new therapies for gastroesophageal reflux disease are highly effective, patients can be reassured that their disease will be well controlled and their symptoms resolved with a safe and appropriate treatment.

Gastroesophageal Reflux↗
PubMed1990

Dryander of Marburg and the first textbook of neuroanatomy.

Born in Wetter, Germany, in 1500, Johannes Eichmann (Dryander) studied medicine and anatomy at the University of Paris from 1528 to 1534. In 1535, he was appointed professor of medicine at the University of Marburg. During the next year he held two public dissections, and in 1536 he was the author of the first text illustrating a Galenic dissection of the human brain. An expanded edition of this early book, the Anatomiae pars prior, was published in 1537. These texts represented an important transition from the dogma of medieval scholasticism to the precise observations of Vesalius. The books depicted the brain in eight figures, with four additional plates describing the skull, skull base, and cranial sutures. Detailed illustrations of the dura mater, cerebral cortex, and posterior fossa structures with clear, but inaccurate, relationship to the cranial nerves demonstrated Dryander's reliance on his own dissections. In 1542, he published a translated edition of Mundinus' anatomy. As was common at that time, the text plagiarized a portion of Vesalius' Tabulae sex, which resulted in the famous anatomist's anger. Despite this, Dryander continued to write on medical subjects as well as mathematics and astrology until his death in 1560. Because he was a progenitor of rational scientific thought, his earlier books represented an important advance in the progression to modern anatomic description and illustration.

Anatomy, Artistic↗
PubMed1996

The Total Health Care Audit System: a systematic methodology for clinical practice evaluation and development in NHS provider organizations.

Writing in Medical Education in 1982, Fowkes (1982) noted the lack of general agreement within the medical profession on methods of audit, a deficiency previously articulated by Shaw (1980) and later emphasized by McIntyre (1985). More recently, a study by Black & Thompson (1993) of consultant and junior medical staff in four London district general hospitals revealed that 'many doctors did not understand how to undertake audit', and major research by both Hopkins (1993, 1994) and Buttery et al. (1994) described a multiplicity of methodological deficiencies in the general approaches to audit adopted by clinicians since the promulgation of the White Paper definition in 1989. Soundness of methodological approach is fundamental to securing the success of clinical audit within Provider organizations and is thus central to the generation of measurable improvements in the quality of clinical care being delivered to patients. It is therefore disturbing that methodological deficiencies may still be observed in general approaches to audit (Buttery et al. 1994), with no author yet recommending a formal system for critical inquiry into clinical practice. It was the recognition of the unsatisfactory nature of this situation which led us to develop a system aimed at assessing, in a critical fashion, the quality of the totality of care dispensed within NHS provider organizations. The system is presented here for the first time.

Algorithms↗
PubMed2005

The nature of qualitative comments in evaluating professionalism.

INTRODUCTION: We analysed written comments on clerkship evaluation forms to determine if they furthered our understanding of students' professional behaviour. METHODS: We transcribed all written comments related to professional behaviour for 1 medical school class in 4 major clerkships, then categorised the comments. Comments were coded into categories by two raters. They were also coded as positive, negative or equivocal. The 3 types of comments were each correlated with a Likert-type score for professionalism for each student in these same clerkships. RESULTS: Most comments covered initiative, working well with others, patient skills and working hard. Of the 1845 comments, 1721 were positive, 106 were negative and 18 were equivocal, neither wholly positive nor wholly negative. The total number of positive comments correlated with the students' numerical professionalism score (r = 0.29, P < 0.001); negative comments correlated negatively with the numerical professionalism score (r = -0.44, P < 0.001). Equivocal comments were significantly negative (r = -0.25, P = 0.002). Qualitative analysis revealed that equivocal comments were focused on maturity, initiative and teamwork. CONCLUSIONS: Written comments contain unique indicators of students' professional behaviour and are largely positive in nature; negative comments stand out by their rarity and intensity. There is a set of negative comments masked by evaluators in language that appears neutral or even partly positive that statistically resemble negative comments and should be regarded as such by students who receive this type of comments. Evaluators should be encouraged and trained to express their qualitative views of students.

Clinical Clerkship↗
PubMed1993

Autonomy and the akratic patient.

I argue that the distinction which is current in much writing on medical ethics between autonomous and non-autonomous patients cannot cope comfortably with weak-willed (incontinent) patients. I describe a case involving a patient who refuses a blood transfusion even though he or she agrees that it would be in his or her best interests. The case is discussed in the light of the treatment of autonomy by B Brody and R Gillon. These writers appear to force us to treat an incontinent patient either as autonomous, just like a rational agent whose decisions are in accordance with his beliefs or as non-autonomous, like comatose patients or children. Though neither is entirely satisfactory I opt for describing such patients as autonomous but point out that in cases like this the principle of respect for autonomy does not give a determinate answer about how the patient ought to be treated.

Adaptation, Psychological↗
PubMed1995

Values education: a new direction for medical education.

This paper suggests that medical education should redirect resources to values education, specifically developing new strategies to improve the process of clarification of values. The author suggests using the values journal method which is based on a systematic record of students' personal value systems reflected in their stories and life experience; and on their responses to case presentation. Generating a personal values journal helps students define who they are, what their social and professional roles are, what their expectations are and where they are going. Keeping values journals promotes students' decision-making capacity, and equips them with the necessary skills to teach their future patients how to generate their own value systems. The development of a well defined values journal is a preparatory stage for active participation in clinical conferences or group discussion, and for effective communal dialogue among the group's members.

Autobiographies as Topic↗
PubMed2002

Emerging narrative forms of knowledge representation in the health sciences: two texts in a postmodern context.

Qualitative health researchers have recently begun to experiment with narrative forms of knowledge representation, often incorporating postmodern theory and related constructivist epistemology. However, misunderstanding of these ideas may lead to rejection of, or lack of interest in, these unconventional texts, which in turn might impede the use of narrative forms in the health sciences. The author's aim is to "open up" the provocative domain of ideas about knowledge representation and explain how the forms operate. Two texts are described with respect to narrative plotting, author's stance, character building, voices, and rhetorical tropes: Troubling the Angels, Patti Lather and Chris Smithies's account of support groups for women living with HIV/AIDS, and The Social Meaning of Surgery, Nicolas Fox's description and sociological analysis of daily life in the operating theater. Other examples of emerging forms are integrated and made relevant to the substantive texts chosen for analysis.

Anecdotes as Topic↗
PubMed1989

Lecture note-taking, learning and recall.

Note-taking by students is generally seen as an integral and essential part of the process of learning from lectures. Here we review the literature on the efficiency of students' note-taking and the extent to which they actually learn as a direct or an indirect result of taking notes. Attention is also paid to the relevance of research in this area to modern lecturing practice and to the problems of researching in the area.

Attention↗
PubMedDate not supplied

Prescription for love.

Harlequin Mills & Boon Limited is looking to recruit nurses to write realistic medical romances for one of its highly popular fiction series.

Health Personnel↗
PubMedDate not supplied

Making practice retirement acquisition work for you.

Author Richard Holdren writes that medical practice acquisition can have a dramatic impact on hospital and group practice revenue in a "zero-sum game," where both parties are competing for a shrinking patient and dollar base. Holdren describes how such a program is built on the concepts of support management and "grow your own."

Ancillary Services, Hospital↗
PubMed1988

Customer relations data aids marketing efforts.

A customer relations information system can help improve a hospital's marketing performance. With such a system, the author writes, a medical center can easily redirect its information systems away from the traditional transaction-oriented approach toward the building of long-lasting relationship with customers.

Consumer Behavior↗
PubMed1999

Methods for improving emergency department operational process.

It's not just the pain or injury that gives patients a natural aversion to visiting the emergency department, but the ED's entire operational process. William Schumacher, M.D., a board-certified emergency medical physician, writes about ways to improve efficiency and make the ED experience more agreeable.

Clinical Protocols↗
PubMed2001

Making our voices heard: Why student journals are crucial.

The studentBMJ has provided a forum for medical student debate for the past eight years. The issues that students need to discuss deserve dedicated journal space. Being able to comment on issues such as admissions policies and teaching styles may affect many future generations of doctors as well. As there are thousands of doctors in training world wide, the more ways available for students to express themselves, the better. A specific journal for Croatian medical students will allow a national perspective on these issues as well.

Adult↗