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Biomedical subjects

H V Barnes

Publications and source records attributed to H V Barnes.

At least 19 recordsLinked to original sources
PubMed1992

Potential influences of residencies' health risk policies on their rankings by Ohio applicants.

Residents' health risks constitute an area of increasing concern for hospitals and residencies. This study examined the importance of health risk policies in the context of students' selection of residencies. In 1991, all 836 fourth-year students in six Ohio medical schools were surveyed about their attitudes regarding residencies' policies on drug screening, HIV (human immunodeficiency virus) testing, and smoke-free workplaces. Of 763 surveys able to be delivered, 341 (45%) were returned. Substantial subsets of the students indicated that they would rank lower or not at all a program that required pre-residency drug screening (22%) or HIV testing (31%). Conversely, almost half the students (48%) responded that they would rank a program higher whose institution has a smoke-free policy. A discussion of potential factors affecting these findings is presented, with recommendations for hospitals, residencies, and residency applicants.

AIDS Serodiagnosis↗
PubMed1991

Hypothyroidism and acquired von Willebrand disease.

A 15-year-old female with acquired von Willebrand disease associated with hypothyroidism is presented and discussed. The patient was initially seen for right lower quadrant abdominal pain and menorrhagia. Once hypothyroidism was diagnosed and treated her coagulation abnormality resolved.

Adolescent↗
PubMed1989

Medical student, resident, and faculty use of a computerized literature searching system.

The experiences of medical students, residents, and faculty with a computerized literature searching system were evaluated. Third-year medical students, internal medicine and family practice residents, and full-time and voluntary faculty at one medical school had the opportunity to use a full-text and bibliographic medical literature retrieval system free of charge for an eleven-month period. Subjects conducted nearly nine thousand literature searches over a period of 942 system hours. Questionnaire data showed that participants could learn to use and would use an electronic information system, felt capable of using the system, utilized the system for a variety of purposes and in a number of different ways, and viewed the system as a valuable tool in searching the medical literature. The results are discussed in the context of the educational needs of the four user-groups and medical education planning by institutions.

Computer User Training↗
PubMed1989

A combined primary care residency in internal medicine and pediatrics.

The authors describe the development and evaluation of a primary care residency program encompassing both internal medicine and pediatrics. The combined residency is a four-year program of alternating six-month rotations in the two disciplines. One-fourth of the program is ambulatory medicine and includes training in a clinic for children and adults. Patient demographics are maintained for each resident, and an ambulatory-medicine-focused curriculum consisting of weekly conferences and self-directed independent study is used. The program is routinely evaluated and is highly rated by patients and residents. Factors critical to its success include emphasizing goals and experiences in outpatient versus inpatient care, developing an ambulatory practice to help support resident salaries, adequately preparing residents to take the board examinations in both disciplines, and providing a comprehensive primary care curriculum.

Ambulatory Care↗
PubMed1977

Antithyroid drug therapy for toxic diffuse goiter (Graves disease): thirty years experience in children and adolescents.

Since 1946 104 children and adolescents with toxic diffuse goiter have been treated. Sixty-seven were treated with a thioamide for more than 12 months. Remission occurred in 61%. Twenty-five patients had a 12-hour perchlorate discharge test to determine the least frequent dose schedule required for disease control: 68% could be controlled on a single daily dose and an additional 25% on an every 12-hour schedule. A one-hour radioiodine uptake on combined therapy and change in thyroid gland size during treatment were found to be highly correlated with the presence of a spontaneous remission. Thirty-six patients have been treated by subtotal thyroidectomy. To date 65% have developed permanent hypothyroidism. In the author's opinion, thoamides are the treatment of choice for the majority of children and adolescents.

Adolescent↗
PubMed1977

Medical management of Crohn's disease in adolescence.

The therapy of Crohn's disease in adolescence must balance the natural disease history of growth suppression, debilitation, and progression against possible drug-related adverse effects on growth and development. In contrast to published guidelines which usually suggest episodic and symptomatic treatment of relapses, we have attempted to suppress disease activity throughout adolescence. Sixteen consecutive adolescent patients treated with continuous medical therapy for a mean duration of 3.5 years are presented. Fourteen received long term prednisone therapy for maintenance of disease suppression. All 16 have been asymptomatic or have had only mild symptoms which did not interfere with regular activities. Only 1 subject had to be rehospitalized. He subsequently underwent bowel surgery. Aternate day corticosteroid administration has been attained in 11 patients; 10 are growing and developing at a normal rate. In total, 13 of 16 have achieved pubertal development appropriate for age. The 8 patients with distal ileal disease have had a consistently excellent response to medical therapy. There have been no major adverse effects from drug therapy. It is concluded that an effort to suppress disease activity continuously in adolsecents with Crohn's disease is warranted. Excellent symptomatic control and normal rate of growth can be expected in patients with primarily ileal disease.

Adolescent↗
PubMed1977

Senior medical students as patient-preceptors to introduce basic history and physical examination skills to second year medical students.

Senior medical students are used as the patient and the preceptor to introduce the fundamentals of history taking and physical examination to sophomore medical students and this technique compared to the established method for teaching basic skills at the University of Iowa. Senior medical students were equally as effective as staff (residents, fellows, and faculty) in teaching the techniques of history and physical examination and statistically better than staff in providing the sophomore with a) suggestions as to how to improve their technique, and b) how their approach might affect the patient's attitude and behavior.

Evaluation Studies as Topic↗
PubMed1976

Differential ovarian and adrenal vein catheterization.

Twenty-two hirsute women underwent percutaneous adrenal and ovarian vein catheterization to differentiate and localize excessive hormonal output. All studies were done under fluoroscopic control; catheter placement was verified by venography, and blood samples were withdrawn for hormonal analysis. The right ovarian vein was successfully sampled in 42 per cent of attempts; the left ovarian vein, in 75 per cent; the right adrenal vein, in 56 per cent; and the left adrenal vein, in 100 per cent. Bilateral catheterization did not prove clinically useful. First, anatomic variations in venous size and drainage made catheterization and bilateral sampling difficult. Second, adrenal secretion is both episodic and parallel, necessitating both simultaneous catheterization and serial sampling for adequate diagnosis. The stress of the procedure may provoke increased adrenal output. Third, since ovarian secretion is not parallel, and since increased hormone output has been documented in that ovary containing developing follicles or a corpus luteum, distinguishing ovarian dysfunction proved difficult. Finally, for a time-consuming procedure, patient discomfort cannot be disregarded. This technique has not proved to be a reliable means of determining the site of androgen hypersecretion and thus cannot be recommended in the routine evaluation of female hirsutism.

17-Ketosteroids↗
PubMed1976

The teenager with pubertal delay.

All adolescents are concerned about their growth and development, and 2 to 3 per cent may have a delay in pubertal maturation. In most cases this is constitutional, and careful evaluation and thoughtful management will help alleviate their anxiety.

Adolescent↗
PubMed1975

Diagnostic use of luteinizing hormone releasing hormone in primary amenorrhea.

Thirty-eight patients with primary amenorrhea were evaluated by the administration of luteinizing hormone releasing hormone (LHRH). The LHRH stimulation test was not helpful in differentiating those patients who will proceed to normal menses from those who will continue to have prolonged dysfunction. Similar responses were observed in patients with different pathology, which indicates that the LHRH test must be utilized in conjunction with a carefully planned evaluation if it is to be useful in differentiating a hypothalamic from a pituitary defect. The finding of a patient with hypergonadotropism by serum radioimmunoassay and negative gonadotropins by bioassay suggests that the radioimmunoassay may detect a biologically inactive molecule and indicates that both assays are essential in the evaluation of primary amenorrhea.

Adolescent↗