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Biomedical subjects

G Donoghue

Publications and source records attributed to G Donoghue.

5 recordsLinked to original sources

An innovative CME program in cardiology for primary care practitioners.

The authors describe an innovative continuing medical education (CME) program they developed to improve the ability of community practitioners to manage common cardiology problems. The program includes an objective structured clinical examination (OSCE) with nine standardized patient (SP) stations. The SPs are trained to use checklists to assess the examinees' clinical skills, and to enter the checklist data directly into computers located within each of the examining rooms. Checklists cover the participants' knowledge of cardiology, and their interviewing, physical-examination, and counseling skills. The computer immediately generates detailed individual reports, which include a skills report, reflecting performance of core skills across all nine stations with group means for comparison, and an omissions report, listing items missed in each case for each participant and, again, comparing the results with group means. Participants review and discuss their performances and then discuss identified learning issues with a cardiologist. The cardiologist also reviews state-of-the-art diagnosis and treatment for the cases presented in the OSCE. Participants have reported having a high regard for the program and have indicated that the program has left them better prepared to deal with clinical cardiology issues.

Attitude of Health Personnel↗

Base station prehospital care: judgement errors and deviations from protocol.

During a three-year period 5,944 paramedic runs were reviewed at the King/Drew Medical Center for deviations from prehospital management protocols established by the Los Angeles Paramedic Training Institute, and from standard medical practice. An overall compliance to the prehospital management protocols of 94% was found. Compliance to standard medical care was 97%. The most common deviations were failure to administer prophylactic lidocaine to patients having chest pain suggestive of myocardial ischemia and failure to apply cervical spine precautions in patients with suspected head trauma. Fifty percent of the radio operators who deviated from algorithms also were found to be making errors in judgment in standard medical care.

Algorithms↗

False positive dynamic imaging of the cerebral circulation due to a congenital anomaly.

False positive dynamic imaging of the cerebral circulation simulating vascular occlusive disease resulted from a clinically insignificant congenital variation in several patients at our institutions. The anomaly consisted of the asymmetrical caliber of the internal carotid and proximal anterior cerebral arteries. The 1 mm difference in the diameter of the internal carotid arteries was sufficient to be appreciated on dynamic imaging. The frequency of this anomaly was found to be 5% in a series of 200 bilateral carotid angiograms.

Adult↗

Tc-99m-pyrophosphate accumulation on prosthetic valves.

Tc-99m-stannous pyrophosphate myocardial imaging has been one of the most effective and sensitive procedures for detection of acute myocardial infarction since Bonte et al introduced it in 1974. However, many causes of false-positive studies have also been reported since then. Presented here is an abnormal case of a patient with aortic and mitral valve replacement.

Aortic Valve↗

Detection of bone metastases in urogenital malignancies utilizing 99mTc-labeled phosphate compounds.

A retrospective study of 99 patients with proved urogenital malignancies was done to determine the value of bone scanning versus roentgenographic skeletal survey in assessing the degree of metastatic involvement. Findings on bone scans were positive in 59 patients, and in 7 of these patients results of roentgenographic skeletal survey were negative; 11 additional patients had only minimal roentgenographic abnormalities in contrast to more extensive involvement demonstrated by bone scanning.

Adolescent↗