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Biomedical subjects

Bernard M Karnath

Publications and source records attributed to Bernard M Karnath.

14 recordsLinked to original sources
PubMed2004

A comparison of faculty-led small group learning in combination with computer-based instruction versus computer-based instruction alone on identifying simulated pulmonary sounds.

BACKGROUND: Computer-based learning has gained widespread acceptance in medical curricula, but can it replace faculty-led teaching. PURPOSE: To investigate the effectiveness of independent computer-based learning of pulmonary auscultation alone and in combination with faculty-led teaching. METHODS: The first method involved independent computer-based instruction (CBI; Group 1) of 113 second-year medical students. The second method involved a combination of faculty-led instruction and independent CBI (Group 2) of 79 second-year medical students. A pretest-posttest method of assessment was used. RESULTS: The pretest showed recognition rates of 48% for Group 1 and 46% for Group 2, whereas the posttest showed recognition rates of 81% for Group 1 and 88% for Group 2. The posttest clinical correlation scores were identical with both groups scoring 93 percent. CONCLUSIONS: The study demonstrates that student learning of pulmonary auscultation is similar whether a computer-based independent instructional approach is used alone or in combination with faculty-led sessions.

Auscultation↗
PubMed2003

Electrocardiographic manifestations of proximal left anterior descending artery occlusion.

We report the case of a 51-year-old woman who presents with a 2-week history of episodes of pressure like chest pain. The initial electrocardiogram was not indicative of myocardial ischemia or infarction and the cardiac enzymes remained normal during the initial hospital day. However, the precordial T waves inverted and progressively deepened on the second hospital day and the patient underwent cardiac catheterization with percutaneous coronary angioplasty and stent placement of the left anterior descending coronary artery with good results. The postprocedure electrocardiogram showed complete resolution of the inverted precordial T waves. The development of new T-wave inversions in the precordial leads of patients presenting with unstable angina is predictive of significant stenosis of the left anterior descending coronary artery. This subgroup of patients has a poor prognosis if medical therapy alone is instituted. Early cardiac catheterization and revascularization is recommended for these patients. Evidence has shown that 75% patients with these electrocardiogram changes who are not revascularized developed extensive anterior wall infarction within a few weeks.

Arterial Occlusive Diseases↗
PubMed2003

Endocarditis during pregnancy.

The incidence of infective endocarditis during pregnancy has been reported to be 0.006%. The maternal mortality rate can reach 33%, with most deaths related to heart failure or an embolic event. The rate of fetal mortality can reach 29%. Heart diseases are the most important nonobstetric causes of maternal death during pregnancy, accounting for 10% of maternal deaths. As many as 3% of women have a form of cardiac disease diagnosed during or in the period preceding pregnancy, with 70 to 80% of the cardiac conditions having congenital causes.

Adult↗
PubMed2002

Preoperative cardiac risk assessment.

Heart disease is the leading cause of mortality in the United States. An important subset of heart disease is perioperative myocardial infarction, which affects approximately 50,000 persons each year. The American College of Cardiology (ACC) and American Heart Association (AHA) have coauthored a guideline on preoperative cardiac risk assessment, as has the American College of Physicians (ACP). The ACC/AHA guideline uses major, intermediate, and minor clinical predictors to stratify patients into different cardiac risk categories. Patients with poor functional status or those undergoing high-risk surgery require further risk stratification via cardiac stress testing. The ACP guideline also starts by screening patients for clinical variables that predict perioperative cardiac complications. However, the ACP did not feel there was enough evidence to support poor functional status as a significant predictor of increased risk. High-risk patients would sometimes merit preoperative cardiac catheterization by the ACC/AHA guideline, while the ACP version would reserve catheterization only for those who were candidates for cardiac revascularization independent of their noncardiac surgery. A recent development in prophylaxis of surgery-related cardiac complications is the use of beta blockers perioperatively for patients with cardiac risk factors.

Adrenergic beta-Antagonists↗