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Biomedical subjects

G J Magarian

Publications and source records attributed to G J Magarian.

At least 19 recordsLinked to original sources
PubMed1993

Influence of a medicine clerkship conference series on students' acquisition of knowledge.

PURPOSE: To determine whether an intensive conference series during a third-year medicine clerkship would produce a significant improvement in students' standard scores on the National Board of Medical Examiners (NBME) medicine subject examination when taken at the end of the clerkship and on the medicine section of the NBME Part II examination when taken during the fourth year. METHOD: A conference series of approximately 50 hours covering core topics of internal medicine was begun at the Oregon Health Sciences University School of Medicine in 1984-85. The series was repeated every 12 weeks, for each rotation of the third-year medicine clerkship. Standard scores on the NBME medicine subject examination taken at the end of the medicine clerkship and the medicine section of the NBME II taken in the fourth year were compared between the 173 students who participated in the conference series in 1984-85 and 1985-86 and the 466 students who took the clerkship from 1980-81 through 1983-84, before the conference series was implemented. The students' NBME II scores in surgery and pediatrics, the other disciplines that had 12-week clerkships but that did not implement curricular changes in 1984-85 and 1985-86, were also compared, as were the students' scores on the NBME I, which the students took prior to the medicine clerkship. RESULTS: The NBME I scores were not different between the two groups of students. The students who took the conference series had standard scores on the NBME medicine subject examination that were on average 49 points higher than the scores of those students who did not take the conference series. This difference was closely maintained on the medicine section of the NBME II, on which the group that took the series had a mean score that was 44 points higher. No improvement was seen in scores on the surgery and pediatrics sections of the NBME II: DISCUSSION: This retrospective review of students' performances on NBME medicine examinations taken at the end of the third-year medicine clerkship and as a component of the NBME II documents a substantial improvement in performance for students who took an intensive conference series as a part of the medicine clerkship curriculum. Further, the students' improved performance level carried over into the fourth year.

Clinical Clerkship↗
PubMed1992

A tutorial for students demonstrating adequate skills but inadequate knowledge after completing a medicine clerkship at the Oregon Health Sciences University.

Upon completing a clinical clerkship, some students demonstrate adequate clinical skills appropriate for that clerkship but do not demonstrate an adequate fund of knowledge or ability to apply their knowledge clinically. For such students, repeating all or a portion of the clerkship may not be appropriate. This study describes a tutorial provided such students after they had completed the medicine clerkship at the Oregon Health Sciences University. During a two-year period (academic years 1988-89 and 1989-90), six students were identified as needing remediation, and were enrolled in a tutorial coordinated by one faculty member with support from others. The experience was highly successful for all but one student, and the tutorial was uniformly viewed by the students who took it as one of their best experiences in medical school.

Clinical Clerkship↗
PubMed1992

Clinical significance in alcoholic patients of commonly encountered laboratory test results.

An improved understanding of medical problems of alcoholic patients can be gained from commonly encountered laboratory test results. Liver function tests--such as measures of alkaline phosphatase, gamma-glutamyl transpeptidase, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase--may provide evidence of altered hepatic activity of different types, such as obstruction and hepatocellular injury. Other test results may indicate impaired hepatic function, such as measurements of albumin, bilirubin, prothrombin time, and blood urea nitrogen. Alterations are also common in electrolytes, blood glucose, magnesium, phosphate, uric acid, and acid-base balance. Disturbances in hematologic function are not infrequent in alcoholic patients, including anemias from many causes, altered granulocyte responses, and thrombocytopenia.

Acid-Base Imbalance↗
PubMed1991

Gemfibrozil-induced myopathy.

Drug-induced myopathy has been reported with use of lovastatin, nicotinic acid, and clofibrate. A particularly severe form, often accompanied by rhabdomyolysis, has been reported with the use of lovastatin and gemfibrozil; however, as far as we know, no case has been documented with use of gemfibrozil alone. Herein, we report the first case (to our knowledge of gemfibrozil-induced myopathy, confirmed by drug rechallenge.

Clofibrate↗
PubMed1990

Evaluation of students in medicine clerkships.

This article reports the results of a survey of the 124 medical schools in the United States and Puerto Rico, mailed in late 1986; the majority of the responses from 101 schools were received in early 1987. The authors report their findings concerning the overall process used by these schools to evaluate medicine clerks, specifically identifying the importance given to subjective evaluations, made by attending physicians and/or housestaff, compared with the importance given to clerks' performances on objective means of evaluation based on written and/or oral examinations, whether national or faculty-developed. The study reveals that the subjective evaluations of clerks by faculty attending physicians and by housestaff working with the clerks were used by 98 and 83 of the responding schools, respectively, and were given the greatest evaluative weight. Examinations of all types were used by 87 of the responding schools. The National Board of Medical Examiners (NBME) Part II Medicine Examination was the most frequently used and heavily weighted examination, followed by written faculty examinations. Oral examinations were the least frequently used evaluative tools, carried the least weight, and were rarely used without another examination. In light of their findings, the authors maintain that further research should be done to clarify whether the NBME Part II Medicine Examination is an appropriate instrument to measure the knowledge acquired during clerkship experiences.

Clinical Clerkship↗
PubMed1990

A national survey of grading systems used in medicine clerkships.

To better understand the variety in U.S. medicine clerkship grading terminology, the number of grading levels, and the distribution of grades within each level, the authors surveyed medicine clerkship directors in the United States and Puerto Rico in 1986 and 1987. Completed questionnaires were returned from 101 of the 124 medical schools (81%). Descriptor grades were the most commonly used form of grading of medicine clerks, used in 68 of the 101 responding schools; letter grades were used by another 28 of the schools; and four schools used a numerical grading system. Although descriptor grades were most commonly used for grading medicine clerks, there was lack of consistency in their use between schools. The authors discuss the data related to letter grades and descriptor grades across this representative sample of U.S. medical schools.

Achievement↗
PubMed1990

Transcutaneous electrical nerve stimulation (TENS) for treatment of severe angina pectoris refractory to maximal medical and surgical management--a case report.

This report describes the use of a transcutaneous nerve stimulator for the treatment of severe angina pectoris in a young man refractory to maximal medical management after coronary angioplasty and coronary bypass surgery. Its successful use resulted in a marked clinical improvement and an impressive reduction in hospitalizations and other utilization of health care resources. Consideration for use of a transcutaneous nerve stimulator should be given in similar patients when all other accepted medical and surgical treatment modalities fail to provide adequate pain control.

Adrenergic beta-Antagonists↗
PubMed1990

Syndrome of diminished vasodilator reserve of the coronary microcirculation (microvascular angina or syndrome X): diagnosis by combined atrial pacing and thallium 201 imaging--a case report.

Patients with angina-like chest pain without evidence of epicardial coronary artery disease or coronary arterial vasospasm are becoming increasingly recognized. These are often related to noncardiac causes including esophageal, musculoskeletal, and hyperventilatory or panic states. However, recently a subgroup of such patients are being recognized as having true myocardial ischemia and chest pain on the basis of diminished coronary microvascular vasodilatory reserve (microvascular ischemia or Syndrome X). The authors describe such a patient who was found to have replication of anginal pain associated with a reversible ischemic defect on thallium 201 imaging during atrial pacing, suggesting ischemia in this myocardial segment. Resolution of angina and ST segment electrocardiographic changes of ischemia occurred with cessation of pacing. We believe this is the first report of a patient with this form of myocardial ischemia diagnosed by this method and should be considered in patients with anginal chest pain after significant coronary artery disease and coronary vasospasm have been excluded.

Angina Pectoris↗
PubMed1984

Absence spells. Hyperventilation syndrome as a previously unrecognized cause.

Absence spells in adults have been recognized in association with disorders of excessive somnolence, transient ischemia of the temporal lobes, and seizure disorders. A 66-year-old man who presented with a history of absence spells for more than 20 years is described. After diagnosis of a hyperventilation syndrome without an associated seizure disorder, educational and behavioral therapy without the use of medication has produced a long, continuing remission of these spells. The hyperventilation syndrome continues to present in many ways, often without recognition by physicians for prolonged periods. The case presented exemplifies this problem and may be the first report of absence spells caused by hyperventilation.

Aged↗