Biomedical subjects
E Walley
Publications and source records attributed to E Walley.
Smokable methamphetamine ('ice'): an old drug in a different form.
Methamphetamine has long been a drug of abuse. The smokable form of methamphetamine hydrochloride, called "ice" on the street, is twice as toxic as amphetamine and has clinical effects similar to those of cocaine. In the United States, methamphetamine use has spread eastward from Hawaii and California. Ice is a strong central nervous system stimulant. Chronic use may result in serious psychiatric, cardiovascular, metabolic and neuromuscular changes. Generally, patients presenting with methamphetamine toxicity can be treated conservatively in the emergency department. Long-term treatment usually requires drug rehabilitation and inpatient counseling.
Residents' formal knowledge acquisition and preferred learning styles.
BACKGROUND: Many family practice residency programs use the Myers-Briggs Type Indicator (MBTI) in their educational programs. Our purpose was to study the relationship between learning style, as determined by MBTI personality preferences, and residents' cognitive knowledge acquisition, measured by in-service training examination (ISTE) scores during the first and third years of residency. METHODS: We evaluated 36 residents using both their first- and third-year ISTE composite scores and their MBTI scores. ISTE scores were analyzed according to the MBTI personality factors. We used the Wilcoxon Rank-Sum Test to determine the association between the improvement in residents' ISTE scores between the first- and third-year examinations and preferred learning styles. RESULTS: Significant differences were found on the composite ISTE scores for the thinking/feeling and judgment/perception scales. Feelers increased ISTE scores more than thinkers (P = .031); judgers increased ISTE scores more than perceivers (P = .04). CONCLUSIONS: Results do not support the literature or current MBTI learning theory. Intuitive residents demonstrated no advantage over sensing residents. Residents using feeling/judgment as their preferred learning style acquired more knowledge over 3 years than their thinking/perceiving counterparts, as measured by ISTE scores.
Diabetic diarrhea. An underdiagnosed complication?
Diarrhea is a common gastrointestinal problem in diabetes, and its prevalence has been underestimated. The cause of diabetic diarrhea is unknown, but it is probably related to gastrointestinal motility disturbances secondary to diabetic autonomic neuropathy. Other causes (especially primary malabsorption syndromes and islet cell tumors) must be excluded. Treatment of diabetic diarrhea is largely symptomatic and only moderately effective. Antidiarrheal agents may ameliorate acute episodes. Broad-spectrum antibiotics and clonidine hydrochloride (Catapres) have had some success in long-term control. Most recently, subcutaneous administration of somatostatin analogues has been shown to be helpful, the main side effects being drowsiness and vomiting.
Graduate follow-up in the University of Mississippi family practice residency program.
Practice profiles in 120 University Medical Center Department of Family Medicine residency graduates were assessed by questionnaire and follow-up telephone calls. Physician credentials, career satisfaction, and evaluation of residency training were also addressed. Findings include some preferences for partnership or group practice settings and practices in communities of less than 25,000. Eighty percent of graduates remain in Mississippi, and most are satisfied with their careers and the residency training they received. Changing patterns in areas such as obstetrical care provided and Medicare/Medicaid acceptance suggest new surveys may be needed to provide the department with information that will assist in meeting its goals.
Substance abuse: the designer drugs.
Designer drugs, chemically altered compounds derived from federally controlled substances, have become a major cause of addiction and overdose deaths. These drugs include mescaline analogs, synthetic opioids, arylhexylamines, methaqualone derivatives and crack, a new form of cocaine. Sudden changes in mood, weight loss, depression, disturbed sleep patterns, deteriorating school or work performance, marital problems, and loss of interest in friends and social activities may be signs of drug addiction. Life-threatening complications of acute intoxication, such as hyperthermia, seizures, combative and psychotic behavior, and cardiorespiratory collapse, require prompt diagnosis and supportive intervention.
Physiologic stress in first-year residents: a preliminary study.
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Update on street drugs in Mississippi.
Drug abuse is on the rise in Mississippi. Treatment centers across the state report significant increases in substance abuse cases. Consequently, family physicians must have the most current, accurate information available and the skills with which to treat either an acute crisis or the chronic problems related to drug abuse. The authors present an overview of the clinical presentations and management of some of the most widely used designer drugs: crack, ecstasy and PCP.