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Biomedical subjects

A Kaufman

Publications and source records attributed to A Kaufman.

At least 19 recordsLinked to original sources
PubMed1992

Health of the public. The academic response. Health of the Public Mission Statement Working Group.

Aging of the population, increasing prevalence of chronic and disabling illnesses with multiple social and behavioral risk factors, concern about quality of care, and escalating costs of medical care require fundamental changes in the way that academic health centers discharge their mission. This article describes a newly developed "Mission Statement" for academic health centers that wish to contribute positively to the health of the populations that they serve. A shift toward addressing the needs of the public may produce increasing institutional strength, long-run stability, and enhanced productivity, as well as higher quality, more cost-effective care for patients. Seventeen centers in the Health of the Public Program are currently conducting activities that implement the described mission elements. The goals and objectives described herein create a foundation for change, with more balanced institutional goals, and could turn an emerging confrontation between academe and its public into an opportunity for both.

Academic Medical Centers↗
PubMed1991

Comparison of adolescent health care provided at a school-based clinic and at a hospital-based pediatric clinic.

Adolescents are an underserved population lacking adequate access to health care. School-based clinics have been promoted as one strategy to improve both access and care. We studied the degree to which such clinics provide services that either differ from or complement conventional health care service. Six categories of primary diagnoses were collected from adolescent visits to a high school clinic and from a nearby hospital-based pediatric clinic, both serving an indigent, predominantly Hispanic, inner-city community. Comparison of patterns of clinic utilization showed that the school-based clinic received significantly more visits for counseling and health care maintenance, while the pediatric clinic received more visits for acute and chronic illnesses. The school-based clinic appeared to improve access to health care for adolescents by allowing confidential visits for issues less easily addressed at more conventional health care sites.

Adolescent↗
PubMed1990

Uncontrolled bleeding during endodontic treatment as the first symptoms for diagnosing von Willebrand's disease. A case report.

Von Willebrand's disease has been established as the most common hereditary hemorrhagic disease. Endodontic treatment, when possible, rather than extraction is the treatment of choice in patients suffering from such a disease. A case is presented in which, during regular endodontic treatment, uncontrollable bleeding occurred, suggestive of a generalized bleeding disorder. A thorough hematologic examination revealed von Willebrand's disease, which the patient was not aware of. The dental surgeon can play an important role in the diagnosis and treatment of such patients.

Adult↗
PubMed1990

Diphallus with third urethra.

An unusual case is reported of a fifteen-year-old adolescent boy, who was born with two independent phalli. Both organs featured separate, completely developed urethras, including an extra urethral remnant in the right penis. A third hypospadic perineal urethral duct equipped with a mechanical sphincter also could be identified histologically. Bilateral simultaneous erections could be achieved easily. A review of published cases suggests that this may be the first example of a complete diphallia coexisting with a third urethra.

Adolescent↗
PubMed1990

A constitutive O6-methylguanine-DNA methyltransferase of Rhizobium meliloti.

We have identified a DNA methyltransferase activity of the nitrogen-fixing bacterium, Rhizobium meliloti, that repairs O6-methylguanine lesions. Repair of the O6-methylguanine residue results in transfer of the methyl group to a cysteine residue of a 28,000-dalton protein. The O6-methyltransferase activity is expressed constitutively and R. meliloti does not exhibit an adaptive response to alkylating agents.

DNA Repair↗
PubMed1990

Rurally based education: confronting social forces underlying ill health.

Skills needed by physicians to address and prevent our communities' leading causes of premature death--injuries, cancer, cardiovascular disease, homicide, and suicide--are not in the typical roster of medical school learning experiences. And traditional, urban, hospital-based venues of medical education scarcely model for students appealing careers in the community. These twin problems are especially severe in rural America. Yet rural training sites are ideal locations for students to confront the array of social, political, and economic forces underlying ill health in our society. If learning in medical schools is to be suitable for rural practice, students must receive early and sustained exposure to rural communities and to rural physician role models. To facilitate this educational redirection, medical schools must (1) sensitize their existing faculty and residents to community health needs via in-service training on community health topics, (2) encourage faculty and residents to provide service and education outreach to rural communities, and (3) promote rural health research. Finally, to prevent the marginalization of rural health concerns within the academic agenda, efforts should be made to develop university-community partnerships in which model rural training practices and a "field" teaching faculty are established and nourished by the medical center.

Curriculum↗
PubMed1990

Mast cell heterogeneity in chronic idiopathic urticaria.

Patients with chronic urticaria are more sensitive to codeine skin testing than other allergic individuals. Nonlesional skin in most patients with chronic urticaria was found to contain increased numbers of both total and atypical mast cells. The presence of increased mast cell density was found to correlate with the degree of clinical (dermatographism) and functional (codeine skin test) skin sensitivity.

Adolescent↗
PubMed1989

School phobia.

Refusal to attend school requires prompt action and may demand 'diplomatic' as well as clinical skills. It is important to identify the problem quickly and take decisive action, otherwise the situation may become very difficult. GPs should also be aware of factors such as learning disorders and 'misplaced sympathy'.

Attitude of Health Personnel↗
PubMed1989

The New Mexico experiment: educational innovation and institutional change.

Over the past ten years the University of New Mexico School of Medicine has conducted an educational experiment featuring learner-centered, problem-based, community-oriented learning. The experiment was introduced into an established institution by means of an innovative educational track running parallel to the more conventional curriculum. Students in the innovative track, compared with those in the conventional tract, tended to score lower on the National Board of Medical Examiners (NBME) Part I examination (basic sciences) and higher on NBME Part II (clinical sciences), received higher clinical grades on clinical clerkships, and experienced less distress. They were more likely than conventional-track students to retain their initial interest in or switch their preference to careers in family medicine. The parallel-track strategy for introducing curriculum reform succeeded in fostering institutional acceptance of continuing educational innovation. Generic steps in overcoming institutional barriers to change are identified.

Curriculum↗
PubMed1989

The change process and medical education.

Successful innovators in medical education accurately diagnose institutional barriers to innovation and employ effective strategies for overcoming these barriers. These institutional barriers and successful strategies are described with illustrative vignettes. They are generic to medical schools all over the world.

Curriculum↗
PubMed1988

Medical education in China for the 21st century: the context for change.

A national conference on Medical Education in China for the 21st Century was convened in Beijing in November 1986. Over 6 days, leading medical educators and Ministry of Public Health officials from across China presented China's future health service needs and debated opportunities and constraints in meeting those needs by various innovations in medical education. Recent political upheavals have left many educators wary of innovation. There are major, conflicting demands between the needs of rural primary care service and the needs of medical schools to replenish medical school professional ranks depleted by the Cultural Revolution. Multiple and varied experiments in medical education will be encouraged among China's medical schools. China will probably amalgamate indigenous and foreign education experiments, offering the world community new and important innovations in medical education.

China↗
PubMed1988

Effects of oxytocin on cation content and electrophysiology of frog skin epithelium.

We measured effects of oxytocin on current-voltage (I-V) relations of frog (Rana catesbeiana) skins impaled with an intracellular microelectrode. In both Cl- and Cl(-)-free (SO4(2-) solutions, oxytocin caused an approximate doubling short-circuit current (Isc) and a depolarization of the cell membrane. Increase in apical membrane slope conductance, chord conductance, and permeability after oxytocin correlated with the increase in amiloride-sensitive Isc. Oxytocin also increased basolateral membrane conductance (gb). In Cl-, the shift in the voltage intercept of the apical membrane I-V relation (Ea) implied increased intracellular Na+ activity (a(Na)c) after oxytocin. In isolated frog skin epithelia, a similar increase in intracellular [Na+] after oxytocin was demonstrated by flame photometry. In SO4(2-), changes caused by oxytocin in both Ea and in flame photometrically determined cell [Na+] were minimal. The voltage intercept of the basolateral membrane I-V relations (Eb) was shifted by oxytocin in both Cl- and SO4(2-) solutions. Assuming that the basolateral membrane is selectively permeable to K+, changes in K+ obtained from Eb were in disagreement with those obtained by flame photometry. These results suggest that 1) the increase in a(Na)c caused by oxytocin is not essential to produce either the increase in gb or Isc and 2) ions other than K+ make an important contribution to basolateral membrane conductance.

Animals↗