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PubMedDate not supplied

Junior hospital doctors: a weighty issue.

We designed a study to ascertain the weight and type of items carried by junior hospital doctors in their white coats. Sixty consecutive doctors entering the hospital residence were invited to participate, 54 agreed. White coat contents were itemised and weighed. Mean weight carried was 1.63 Kg. Interns and SHOs carried significantly more than registrars (P<0.01) & (P<0.05). Medical specialties carried significantly more than surgical specialties (P<0.05). There were no statistical difference between males and females. 33% carried cigarettes. Junior hospital doctors carry the equivalent of almost two 1Kg bags of sugar with them in their white coats, this added weight may contribute to increased fatigue during long hours on duty. As doctors become more senior they carry less.

Career Mobility↗
PubMed2002

Got ears?

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Acoustics↗
PubMedDate not supplied

[Laennec and the creation of auscultation signs].

Toward the end of the 18th century, clinical diagnosis in medicine shifted its focus from reliance on symptoms, which translates to subjective experience of illness, to signs, objective manifestations of pathologic changes. Several techniques were developed to elicit signs in clinical practice, and Laennec used them routinely. He palpated and prodded his patients to get an idea of changes in internal organs. He also applied his ear directly to his patient's chest to hear their heartbeat. On one occassion, he was unable to use these techniques and had the happy occurrence of rolling up a notebook to hear his patient's chest. This led him to hear a great number of new sounds. Through detailed observations, he was able to describe, classify, and correlate these sounds with autopsy findings, thus creating a new semiology of chest diseases. In this essay explore how in which Laennec created his instrument and system of signs of chest diseases, and how he was able to transmit his inventions to his colleagues.

Auscultation↗
PubMed2003

The heart.

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Biomedical Research↗
PubMed2004

[Is transmission of heart murmurs via e-mail cost saving?].

BACKGROUND: The use of pre-recorded heart murmur in an electronic referral for a remote consultation can save children and their parents from having to travel to the nearest out-patient clinic. The heart sound can be recorded by the GP at the local health clinic and sent by e-mail to the specialist. 41 clinics in the North Norway healt region have invested in equipment that makes pre-recorded sound referrals possible. This study analyses whether this investment is a cost-saving technology or not. METHODS: A yearly average of 50 children with a heart murmur are referred to a specialist in Troms. The costs of using pre-recorded telemedicine were compared to the costs of patient travelling to the nearest secondary care centre. RESULTS: Pre-recorded heart sound referrals cost from 216 000 NOK more per year than the alternative of bringing patients to the out-patient clinic. The number of children with a heart murmur needed in order to break even must exceed 195 per year, i.e. 1.7 children per GP per year. INTERPRETATION: The number of children with a heart murmur in Troms is too low for this method to be a cost-saving approach.

Child↗
PubMed2004

Automated lung sound analysis in patients with pneumonia.

OBJECTIVE: To determine whether objectively detected lung sounds were significantly different in patients with pneumonia than those in asymptomatic subjects, and to quantify the pneumonia findings for teaching purposes. METHODS: At a community teaching hospital we used a multi-channel lung sound analyzer to examine a learning sample of 50 patients diagnosed with pneumonia and 50 control subjects. Automated quantification and characterization of the lung sounds commonly recognized to be associated with pneumonia were used to generate an "acoustic pneumonia score." These were examined in the learning sample and then prospectively tested in 50 patients and 50 controls. RESULTS: The acoustic pneumonia score averaged 13 in the learning sample and 11 in the test sample of pneumonia patients. The scores were 2 and 3 in the controls. The positive predictive value of a score higher than 6 was 0.94 in the learning sample and 0.87 in the test sample. The sensitivities in the 2 groups were 0.90 and 0.78, and the specificities were 0.94 and 0.88, respectively. Adventitious sounds were more common in pneumonia patients (inspiratory crackles 81% vs 28%, expiratory crackles 65% vs 9%, rhonchi 19% vs 0%). CONCLUSION: Our lung sound analyzer found significant differences between lung sounds in patients with pneumonia and in asymptomatic controls. Computerized lung sound analysis can provide objective evidence supporting the diagnosis of pneumonia. We believe that the lung-sound data produced by our device will help to teach physical diagnosis.

Aged↗