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Biomedical subjects

K Hegmann

Publications and source records attributed to K Hegmann.

5 recordsLinked to original sources

DOT examinations: practical aspects and regulatory review.

Most certification examinations of commercial drivers are simple, and relatively few drivers are disqualified. If these examinations are not done properly, however, the public can be exposed to potentially unqualified drivers. Should an accident occur, the physician who examined the driver may be found liable. In performing driver certification examinations, the physician's primary responsibility is to the public. The Federal Motor Carriers Safety Regulations and supporting documents provide guidelines for the conditions that may be disqualifying and the conditions that may allow only temporary certification until better medical control is achieved. Some medical diagnoses, such as insulin-requiring diabetes mellitus, are automatically disqualifying, no matter how well the disease is controlled. Other conditions may require documented clearance from a specialist before certification is granted.

Accidents, Traffic↗

Use of fluorescence in situ hybridization to clarify a complex chromosomal rearrangement in a child with multiple congenital anomalies.

A child with multiple congenital anomalies was referred for cytogenetic evaluation. G-banded analysis showed a complex chromosome rearrangement involving 6 different chromosomes and 10 breakpoints. Fluorescence in situ hybridization (FISH) using whole chromosome painting probes and repetitive sequence probes was performed. In most cases the painting probes alone helped to clarify the G-banded results. However, in one instance, where the terminal band of the long arm of chromosome 1 was involved, the use of a telomeric probe was essential in defining the rearrangement.

Abnormalities, Multiple↗

Occupational medicine training program surveys.

Although the quantity of Occupational Medicine (OM) residents in training programs has risen in the past 15 years, there remains a significant shortage of OM physicians in the United States. A survey of OM residency program directors and residents and fellows (trainees) was accomplished to answer questions relevant to recruiting and supplying OM trained physicians. Twenty-six of 29 program directors (89.7%) replied. One hundred forty-three of 174 (82.2%) trainees responded. Fifty percent of responding program directors were satisfied with the current quantity of program applicants. Medical students were provided a median of 3 hours (range, 0 to 20 hours; mean, 5.35 hours) of formal OM teaching by the responding programs. Almost half of trainees, 68 (48.6%), did not receive formal OM instruction in medical school. An average of 5.4 +/- 13.3 hours of OM was taught to OM trainees in medical school. Disproportionate numbers of trainees were taught OM as fourth-year medical students and in other residencies. Reasons for pursuing OM training were diverse and often related to postgraduate clinical experience with OM. Only a total of 84 primary care residents (0.32%) rotate through the OM residency programs in an average year. We conclude that an insufficient quantity of qualified applicants, combined with limited exposure to OM in medical schools and low levels of contact with residents in primary care programs, will continue to hinder efforts to reduce the shortage of OM residents and physicians. Further training specifically targeting the fourth year of medical school and the primary care residencies may have the most impact on recruitment.

Certification↗

Medication reporting in the workplace.

Impairment from medication use in hazardous work environments has not been well studied. We analyzed incident events in an explosive manufacturing facility using a retrospective case control study to determine whether medication use was related to safety incidents. Medication use between the incident group and the controls was not significantly different. However, 23% of the incident group had been employed by the facility for less than 1 year compared with 2% of controls. Only 19% of restricted medication use was self-reported. In this study, being employed less than 1 year was a greater predictor of safety incidents than was medication use, and self-reporting did not reflect actual medication use. We conclude that medication use is not directly related to safety events and that a self-reporting program is difficult to justify in the corporate setting.

Accidents, Occupational↗