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Biomedical subjects

J R Brill

Publications and source records attributed to J R Brill.

4 recordsLinked to original sources
PubMed2000

Normocytic anemia.

Anemia is a common problem that is often discovered on routine laboratory tests. Its prevalence increases with age, reaching 44 percent in men older than 85 years. Normocytic anemia is the most frequently encountered type of anemia. Anemia of chronic disease, the most common normocytic anemia, is found in 6 percent of adult patients hospitalized by family physicians. The goals of evaluation and management are to make an accurate and efficient diagnosis, avoid unnecessary testing, correct underlying treatable causes and ameliorate symptoms when necessary. The evaluation begins with a thorough history and a careful physical examination. Basic diagnostic studies include the red blood cell distribution width, corrected reticulocyte index and peripheral blood smear; further testing is guided by the results of these studies. Treatment should be directed at correcting the underlying cause of the anemia. A recent advance in treatment is the use of recombinant human erythropoietin.

Adult↗
PubMed1997

Establishing proficiency in flexible sigmoidoscopy in a family practice residency program.

BACKGROUND AND OBJECTIVES: Fiberoptic flexible sigmoidoscopy (FFS) is widely used by family physicians to evaluate abdominal problems and screen for colorectal cancer. We evaluated data on exams performed by family practice residents to determine the number of supervised procedures needed for technical proficiency at FFS. METHODS: We reviewed data recorded from all FFS procedures done at a family practice residency from October 1986-July 1994. RESULTS: A total of 262 exams were performed by 55 residents at the Family Practice Center. There was modest correlation between increasing numbers of exams and increased unassisted depth of insertion (UDI). Maximum UDI was achieved after 10-15 supervised exams. Factors such as patient gender, prior surgery, and preparation quality were also significantly correlated with UDI. Significant differences in training experience and patient selection were seen between male and female residents. CONCLUSIONS: Maximal UDI is reached after 10-15 procedures. Differences in training experiences and successful UDI based on resident gender should be studied further.

Adolescent↗