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Biomedical subjects

J A Benson

Publications and source records attributed to J A Benson.

At least 19 recordsLinked to original sources

Integrating emerging disciplines.

The dynamics of medicine force us to continually update the content of residency curricula. Before selecting the material to be added or withdrawn from the curricula, goals for the desired product must be established. Further, the potential effects of emerging disciplines on the structure and composition of departments and residencies must be carefully considered. The Residency Review Committee for Internal Medicine (RRC-IM) is the principal instrument for forcing the integration of emerging disciplines into clinical education. Several questions must be considered when deciding how best to integrate these new disciplines. Should selected internists be designated to teach them? What are the most appropriate training sites? Which disciplines should be linked for pedagogic efficiency and relevance? How do we separate the educational pathways for generalists and subspecialists? The strategy of requiring additional training for a second certificate from the American Board of Internal Medicine (ABIM) has served internal medicine well for 50 years. Innovations in science and technology, however, are occurring at an accelerated pace. One solution may be to separate standardized residency training into multiple 4-year tracks that produce variously skilled graduates.

Accreditation

Inhibition of dipteran larval neuromuscular synaptic transmission by analogues of philanthotoxin-4.3.3: a structure-activity study.

1. The blocking action of delta-philanthotoxin (PhTX-4.3.3), a wasp toxin composed of a polyamine chain, an aromatic amino acid (tyrosyl) nucleus and an aliphatic (butanoic) acid was studied, together with 33 structural analogues, at the glutamatergic neuromuscular synapse in larvae of the house fly, Musca domestica. 2. Shortening of the polyamine or the aliphatic acid chain, or removing the aromatic nucleus caused a decrease in potency. 3. An increase in potency was obtained by elongating the molecule in any of several directions: elongation of the polyamine chain with amine containing groups, by iodination of the aromatic moiety and by aliphatic or aromatic elongation of the butanoic acid.

Animals

Certification and recertification: one approach to professional accountability.

Professional accountability requires a self-regulating profession to set and maintain credible, useful standards for its members. Voluntary certification and recertification--evaluation by peers--serves the responsibility of the profession to establish and enforce its own standards. The goal of certification by the American Board of Internal Medicine is to improve the quality of medical care by ensuring that the certified internist and subspecialist possess the knowledge, skills, and attitudes essential to the provision of excellent care. Without a true constituency and with a valid certification process, the Board provides a credential sought by nearly every graduate resident and acceptable both to the profession and patients. Recertification now presents the opportunity to foster continuing scholarship and self-improvement throughout the career of an internist.

Certification

Changes in the medical knowledge of candidates for certification.

PURPOSE: To determine whether the medical knowledge of candidates from different types of medical schools changed between 1983 and 1988. SUBJECTS: Candidates for certification who took the 1983 to 1988 examinations in internal medicine were divided into five groups according to the type and location of the medical school they had attended and, in some instances, their citizenship: graduates of U.S. medical schools, of Canadian medical schools, and of osteopathic medical schools as well as U.S. citizens who graduated from foreign medical schools and non-U.S. citizens who graduated from foreign medical schools. DESIGN: Performance on items that were common to four pairs of the 1983 to 1988 certifying examinations (1983 and 1985, 1984 and 1986, 1985 and 1987, and 1986 and 1988) was analyzed. RESULTS: The scores of graduates of U.S. medical schools decreased, and the scores of non-U.S. citizens who graduated from foreign medical schools increased. Trends in the performance of graduates of Canadian and osteopathic medical schools and of U.S. citizens who graduated from foreign medical schools were not discernible. CONCLUSIONS: The cumulative decline in the performance of graduates from U.S. medical schools and the progressive improvement in the performance of non-U.S. citizens who graduated from foreign medical schools may ultimately manifest itself in patient care.

Canada

Ethics in cardiovascular medicine. Task Force IV: Scientific responsibility and integrity in medical research.

Ethical standards are a set of affirmative responsibilities to which the investigator must subscribe; behavior that is incompatible with these responsibilities should be presumed unethical, whether or not it is explicitly proscribed. This Task Force sought to present these standards as principles or guidelines. In undertaking research an investigator must accept that publicly funded or supported research is intended to yield public benefit; personal gain should be only incidental to and not at the expense of the public benefit. The responsibilities of the investigator are summarized as follows: Design of Research To develop a research design that effectively and efficiently addresses the scientific question while minimizing the likelihood of incorrect or misleading results. To protect the rights and welfare of human subjects, assure the humane use of laboratory animals and protect the safety of laboratory workers and the environment. Conduct of Research To ensure that accepted laboratory and research practices are followed and that all data are accurately collected and properly recorded; the investigator must participate in the review of original data. To carry out research in accordance with that approved by the institutional review board and ensure that fully informed consent is obtained, that the welfare of human subjects is protected and that animal welfare and laboratory safety procedures are carried out. To provide effective ongoing supervision of research trainees and technicians. In multidisciplinary collaborative research, to have at least an overview familiarity with the work outside his or her areas of expertise. In fixed protocol, multicenter collaborative research the investigator must be satisfied with the adequacy of the collaborative activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomedical Research

Performances of U.S. osteopathic and Canadian medical school graduates on the American Board of Internal Medicine Certifying Examinations, 1984-1988.

The performances of Canadian medical school graduates and U.S. osteopathic medical school graduates who first took the American Board of Internal Medicine Certifying Examination between 1984 and 1988 were compared with the performances, during the same period, of U.S. and foreign medical school graduates. Approximately 100 Canadian graduates took the examination each year; by 1988 the number of osteopathic graduates taking it was 102, double the number participating in 1984. Nearly all the Canadian graduates attended university or university-affiliated residencies, whereas half of the osteopathic graduates attended non-university-affiliated programs. For their overall clinical competence and for the eight components of clinical competence, the Canadian graduates were rated highest, followed by the U.S., osteopathic, and foreign graduates. The Canadians' average examination scores were also highest. The authors discuss the relatively low level of performance of the osteopathic graduates, but conclude that these graduates appear to be an untapped source of talented physicians for internal medicine residencies. The limitations of studying self-selected groups of candidates are also discussed.

Canada

Trends in medical knowledge as assessed by the certifying examination in internal medicine.

The past decade has seen less competition for medical school positions accompanied by the declining interest of medical students in internal medicine. At the same time, the number of first postgraduate-year positions in internal medicine residencies has increased, as has the number of first-year residents who take those positions. The purpose of this study was to examine trends in the medical knowledge of internal medicine residents during the past 6 years. Comparison of performance on the items common to pairs of the certifying examinations of the American Board of Internal Medicine from 1983 to 1988 revealed that the scores of candidates in the reference group have declined, but not dramatically. This trend has occurred among candidates from the top residency programs as well as all other residency programs, and it is present in candidates of all levels of overall clinical competence. Continuing declines in this area could ultimately affect patient care.

Canada

A complement fixation test for antibody to the contagious equine metritis organism.

A complement fixation test (CFT) based on that used for brucellosis (Brinley Morgan and others 1971) has been developed for use on the sera of horses exposed to the contagious equine metritis (CEM) organism. None of 50 single samples from horses thought to be unexposed to the CEM organism was positive to the test, although five showed inconclusive reactions. Samples were examined from 41 mares either proved to be infected or from an infected stud. Of these 21 were positive, 11 were inconclusive and nine were negative. The relationship of the CFT to reactions in the other tests used in this condition is discussed--the serum agglutination test (SAT) and antiglobulin test (AGT) (Benson and others 1978). Complement fixing antibodies appear to remain for a longer period in the infected animal, and are therefore more likely to be of use in the diagnosis of the chronic carrier state.

Agglutination Tests

The course of serum antibody development in two ponies experimentally infected with contagious metritis.

Serum agglutination tests, anti-globulin tests, and complement fixation tests were carried out on sera taken over a period of 98 days from two fillies experimentally infected with the contagious equine metritis organism. The pattern, and significance in diagnosis, of these results is discussed. All 3 tests showed positive titres in the acute phase of experimental disease; reactions in the complement fixation test persisted longest.

Agglutination Tests

Axonal adaptations to osmotic and ionic stress in an invertebrate osmoconformer (Mercierella enigmatica Fauvel). I. Ultrastructural and electrophysiological observations on axonal accessibility.

The giant axons in Mercierella are overlaid by narrow glial processes which provide an incomplete covering of the axonal surface. Where more complete covering occurs the intercellular clefts are not sealed by tight junctional complexes. Ionic lanthanum penetrates to the surfaces of axons from sea-water-adapted animals (in normal saline and during initial exposure to hyposmotic saline) and, also, to the surface of hyposmotically adapted axons. A relatively free intercellular access to the axon surfaces is also indicated by the rapid electrical responses of sea-water-adapted axons to hyposmotic dilution and of hyposmotically adapted axons to sodium-deficient saline. The giant axon possesses an unusual ultrastructural specialization: hemidesmosome-like structures (associated with the axon membrane) which are connected to a network of neurofilaments within the axon. Theoretical considerations suggest that these structures could enable the axons to withstand appreciable excesses in intracellular hydrostatic pressure resulting from osmotic imbalance during hyposmotic stress.

Action Potentials