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Biomedical subjects

J B Vannatta

Publications and source records attributed to J B Vannatta.

15 recordsLinked to original sources
PubMed2001

The OU College of Medicine responds to the demand for educating medical professionals in palliative care.

This past decade the medical community saw an increase of national interest in the training and educating of physicians to provide quality end-of-life care for patients. This article describes the efforts of the University of Oklahoma College of Medicine to respond to the demand for educating medical professionals in end-of-life care. A Palliative Care Program was created to develop and implement new courses, seminars, and lectures for medical students, residents, and practicing physicians. Palliative medicine is in the process of being integrated into the OU academic medical environment so that all trainees, regardless of their educational level, have the opportunity for didactic and clinical exposure to end-of-life care.

Curriculum↗
PubMed2000

A history of the University of Oklahoma College of Medicine: perspectives on funding the educational mission.

This paper discusses the history of the University of Oklahoma College of Medicine. The history from the perspective of the political environment has been published by Mark R. Everett and Alice A. Everett, and the third edition of that series will be published soon by Regents Professor Mark Allen Everett, MD. These volumes are essential reading for a thorough understanding of the history of the college. In this paper, I will concentrate on the history of funding the educational mission. It is an interesting study of the politics of a state institution and reflects the history of the chronic underfunding of higher education in the state of Oklahoma.

Education, Medical, Undergraduate↗
PubMed1996

Comparison of standardized patients and faculty in teaching medical interviewing.

PURPOSE: This randomized controlled study compared the interviewing skills of first-year medical students receiving feedback primarily from standardized patients (SPs) with those of students receiving feedback primarily from faculty. METHOD: All 154 first-year students at the University of Oklahoma College of Medicine in 1993-94 were video-taped to assess baseline and post-instruction interviewing skills. All the students, randomized to one of three study groups, attended two four-hour workshops on interviewing skills. Instruction in the groups was as similar as possible except in the matter of who provided feedback. Two rating systems were used to rate the videotaped interviews for performances of targeted skills. RESULTS: Complete, usable data were available for 120 (78%) of the students. Skill ratings using the Arizona Clinical Interview Rating Scale were significantly higher for the "types of questions used" and "use of empathy" items in the SP-led feedback group. No significant difference in ratings was detected among the groups as measured by the Rotor Interactional Analysis System. CONCLUSION: The SPs were at least as effective as the faculty in effecting behavioral changes in the first-year medical students' interviewing skills.

Education, Medical, Undergraduate↗
PubMed1984

Phosphorus administration in patients with profound hypophosphatemia.

The influence of severe hypophosphatemia (less than or equal to 1.0 mg/dl) on vitamin D metabolism was prospectively determined in 11 patients before and after intravenous phosphorus administration. Evidence of liver dysfunction was present in ten patients. The mean (+/- SE) plasma 25 hydroxycholecalciferol [25(OH)D] was significantly decreased before phosphorus therapy when compared to control subjects (9.4 +/- 1.3 vs. 17.8 +/- 1.3 ng/ml, P less than 0.001). With phosphorus administration, serum phosphorus increased from 0.59 +/- 0.07 to 2.58 +/- 0.09 mg/dl while 1,25 dihydroxycholecalciferol [1,25(OH)2D] decreased from 34.6 +/- 4.3 to 14.3 +/- 2.9 pg/ml (P less than 0.001). Plasma 25(OH)D, plasma immunoreactive PTH (both amino and carboxyterminal) and serum calcium did not change after phosphorus administration, suggesting that phosphorus alone was responsible for the change in plasma 1,25(OH)2D concentration. An inverse correlation was found between serum phosphorus and plasma 1,25(OH)2D (r = -0.62, P less than 0.005). In addition, a direct correlation was observed between plasma 25(OH)D and 1,25(OH)2D both before (r = 0.66, P less than 0.005) and after (r = 0.74, P less than 0.005) phosphorus administration. Thus, the decrease in 1,25(OH)2D levels with phosphorus therapy suggests a role of serum phosphate in the regulation of this sterol, and hypophosphatemia or phosphorus depletion may change the relationship of substrate [25(OH)D] to product [1,25(OH)2D].

Adult↗
PubMed1983

High-dose intravenous phosphorus therapy for severe complicated hypophosphatemia.

To evaluate the efficacy and safety of a simple approach to intravenous phosphorus therapy, we prospectively studied ten adult patients with severe hypophosphatemia (less than or equal to 1 mg/dl), two or more clinical reasons for the hypophosphatemia, and normal renal function. They were treated with a solution containing 0.32 mmol of phosphorus per kilogram of body weight. This amount of phosphorus was infused intravenously over 12 hours and repeated every 12 hours until the serum phosphorus was greater than or equal to 2 mg/dl. The serum phosphorus, potassium, magnesium, and calcium levels were measured at six hours, 12 hours, and every 12 hours thereafter. The serum phosphorus level was greater than or equal to 2 mg/dl in one patient at six hours, three patients at 12 hours, three patients at 24 hours, four patients at 36 hours, and one patient at 48 hours. The serum calcium was measured every 12 hours and at no time was any patient dangerously hypocalcemic. Administration of 0.32 mmol of phosphorus per kilogram of body weight intravenously over a 12-hour period is both efficacious and safe in severely hypophosphatemic patients with multiple causes of hypophosphatemia, normal renal function, and no hypercalcemia.

Adult↗
PubMed1982

Treatment of refractory hypophosphatemia.

Profound hypophosphatemia developed in a patient with chronic alcoholism. Multiple causative factors were identified and were thought to account for the initial failure of phosphorus repletion. High-dose intravenous phosphorus was effective in restoring serum phosphorus to normal with no observable adverse effects. Because of the high degree of correlation between hypophosphatemia and hypomagnesemia, we recommended that serum magnesium be determined in all hypophosphatemic patients.

Alcoholism↗
PubMed1981

Efficacy of intravenous phosphorus therapy in the severely hypophosphatemic patient.

To evaluate the efficacy and safety of a simple approach to intravenous (IV) phosphorus therapy, ten adult patients with severe hypophosphatemia (less than or equal to 1 mg/dL) and normal renal function were studied prospectively. They were treated with a solution containing 9 mmole of phosphorus as monobasic potassium phosphate (KH2PO4), infused continuously every 12 hours. Serum phosphorus, potassium, and calcium levels and urinary excretion of phosphorus were measured every 12 hours. The serum phosphorus level was significantly improved at 12 hours, more than 1 mg/dL in all patients at 36 hours, and normal in six patients at 48 hours. The serum potassium level was never above normal, and serum calcium levels declined in only one patient. Administration of 9 mmole of phosphorus as KH2PO4 every 12 hours is both safe and efficacious IV therapy for severe hypophosphatemia in the adult patient with normal renal function and without hyperkalemia or hypercalcemia.

Acute Disease↗
PubMed1976

Superior mesenteric artery (Wilkie's) syndrome: report of three cases and review of the literature.

Of the three cases of superior mesenteric artery (Wilkie's) syndrome presented, one was associated with anorexia nervosa; this association has not been reported before. Two patients were treated surgically with a duodenojejunostomy, and one was treated medically. Vascular compression of the duodenum is a controversial subject. The syndrome probably is more common than generally recognized and is underdiagnosed due to its exclusion from the differential diagnosis of small-bowel obstruction. Its recognition is important because early diagnosis of a partial obstruction may allow for medical rather than surgical intervention, as exemplified by our third case.

Adolescent↗