Effect of students' choosing surgery as a career on their performances on the NBME mini-boards and Part II examinations.
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Career Choice↗
Biomedical subjects
M Weaver
Publications and source records attributed to M Weaver.
Characteristics of adopted juvenile delinquents.
There have been many reports describing the uniqueness of adopted children and adolescents' delinquent behaviors in terms of both their delinquent characteristics and courts' treatment of them. A total of 43 adopted juveniles, 32 extrafamilial (1.0%) and 11 intrafamilial (0.3%) adoptions were initially identified out of 3,280 juvenile delinquents. The adopted subjects were then compared with the demographically matched and offense matched nonadopted subjects. The family variables, such as marital and employment status of parents, were significantly different. However, there were only a few discernible trends, and in general there were no significant differences between the adopted and nonadopted juveniles in terms of their offense characteristics and dispositions.
Adolescent↗
Breast cancer in nonpalpable lesions: can mammographic parenchymal pattern improve the predictive value of biopsy?
The increasing number of women referred for surgical biopsy of nonpalpable breast lesions detected by screening mammography led to a retrospective review of all such cases from October 1, 1986 to September 30, 1990. There were 165 consecutive, wire-localized, excisional biopsies of radiographic lesions performed on 158 patients during this 4-year period. A positive (i.e., malignant) result was found in 16 patients (10%); all but one of these 16 patients had stage I disease at subsequent treatment. Examination of historical factors (age, family history, prior biopsy, breast symptoms) and mammographic factors (mass, microcalcification, irregular borders, new lesion, parenchymal pattern of increased fibroglandular density) revealed that no patient with a diffuse parenchymal pattern of increased fibroglandular density had a malignant diagnosis. This finding was statistically significant (P = 0.002) by chi-square analysis. This negative relationship of radiographic parenchymal pattern to early cancer in nonpalpable lesions is contrary to what one would expect, based on several reports in the radiology literature. Over one-third (36%) of the author's patients had the increased fibroglandular x-ray pattern, making this finding potentially important for surgeons evaluating the patient with a nonpalpable lesion detected by mammography.
Adult↗
The spouse: a factor in recovery after acute myocardial infarction.
Literature supports the concept that the response of a patient's spouse influences the recovery process of a patient after an acute myocardial infarction (AMI). This was a 6-month, longitudinal, descriptive study of 17 married couples in which one of the pair experienced his or her first AMI. The study examined the question: "Is there a relationship between the spouse's social support, family stress, marital satisfaction, and sexual comfort and the patient's recovery after AMI?" Data were collected at three times during the 6-month period after AMI. Results showed a significant relationship between the spouse's family stress, marital satisfaction, and sexual comfort and the patient's recovery. Also, a significant relationship was found between the spouse's sexual comfort and marital satisfaction. This was the first reported study that examined sexual comfort over time and investigated sexual activities other than intercourse.
Adult↗
An interactive perspective on the health beliefs & practices of rural elders.
1. In this study, major themes involving health were closely tied to an affective response of "feeling good" and cognitive appraisal of health status as "being able to function." 2. Rural elderly who participated in the study reported engaging in at least one activity to maintain their health and tended to rely on their own appraisal and resources to manage health problems. 3. Half of the participants indicated a need for services such as blood pressure and diabetic screening, health education classes on diet, cholesterol reduction, hypertension and diabetes management, new therapies in health care, and life management counseling.
Aged↗
Final Medicare anti-fraud and abuse safe harbor regulations.
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Fraud↗
Influence of clerkship structure and timing on individual student performance.
Student oral and written surgical clerkship performances may be related to the clerkship structure and the time of year the students rotate through the clerkship. The influence of calendar block, hospital site (university hospital, affiliated private tertiary-care hospital, and rural preceptor experience), and the mix of general surgical versus subspeciality rotations on oral and written student surgery clerkship scores was analyzed. Multivariate analysis of variance revealed significant differences in score for calendar block (p = 0.02) only; this difference resided in the written examination. The various combinations of rotations were not different from one another in terms of measured outcome.
Clinical Clerkship↗
The effect of surgery clerkship timing on fourth-year students' surgery knowledge.
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Education, Medical, Undergraduate↗
[The significance of ungulocoriitis septica (traumatic) in the toe of the bovine claw].
Due to the specific anatomy at the toe of the claw, inflammation of the corium at this site is characterised by a rapid spread to the distal phalanx. Radiography is important for the diagnosis and essential for determining the prognosis. In the early stage of the condition, therapy consists of correct wound care and relieving the affected claw from weight-bearing by applying an orthopaedic shoe to the partner claw. Resection of the claw toe is indicated if there is evidence of osteolysis. The postoperative healing period frequently lasts more than two months; there is a tendency to hypergranulation. Deformation of the claw due to irregular horn growth following surgery may occur. Compared to the treatment by amputation, the economic life of the patient is longer following resection and there are no restrictions on use.
Animals↗
Improving access to pediatric health care in Mississippi.
Working under the Mississippi Postneonatal Death Impact Project, the Mississippi Chapter of the American Academy of Pediatrics, in conjunction with the State Department of Health, helped improve access to pediatric health care in Mississippi. This was accomplished by developing a statewide telephone information and referral service (telephone case management), enlisting primary care physicians to treat a limited number of children without specific compensation and staging a public awareness campaign. System barriers encountered were identified and interagency coordination and cooperation suggested. This effort could be easily replicated and expanded.
Child Health Services↗
Do first- and second-year preclinical course scores predict student performance during the surgical clerkship?
The study proposed to determine if a preclinical basic science index comprised of anatomy, behavioral medicine, biochemistry, microbiology, pathology, pharmacology, and physiology courses or any one of these basic science courses would predict student performance during surgical clerkship. The basic science index demonstrated a correlation of 0.55 and 0.35 with the individual student's written and oral clerkship scores, respectively. A stepwise multiple regression using a backward stepping algorithm was applied; the dependent variables were oral and written clerkship scores, and the independent variables were the basic science courses. Microbiology, pathology, and physiology course scores were predictors of written score (R = 0.60). Pathology course scores were the sole predictor of oral score (R = 0.43). Medical student basic science performance was not a strong forecaster of performance on the surgical clerkship. The pathology basic science score was the only consistent predictor of performance on the written and oral evaluations given at the end of the clerkship.
Clinical Clerkship↗
Diflubenzuron application to citrus and its impact on invertebrates in an adjacent pond.
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Animals↗
Smoking patterns during cognitive performance.
Studies on the effects of smoking and performance in learning and memory tasks have followed one of two strategies: (a) either subjects are required to smoke at fixed intervals and/or rates, or (b) subjects are permitted to smoke freely in the absence of any monitoring or observation of smoking acts. The present studies allowed free smoking within a structured context, while exposed to intelligence test items for 30 seconds. Subjects were observed to vary their smoking acts (puffing, tapping) as a function of the temporal characteristics of the task. Subjects followed the same pattern across two independent studies. Such findings have clear implications for smoking studies since they indicate that how and why subjects smoke may (a) vary with context, and (b) affect different task inputs.
Adult↗
Restricted production of interleukin 4 by activated human T cells.
Interleukin 4 (IL-4) is secreted by activated T cells and pleiotropically modulates both B- and T-lymphocyte function. In murine helper (CD4+) T-cell clones IL-4 production appears to be regulated independently of interferon gamma and interleukin 2. To determine whether production of these lymphokines is also differentially regulated in uncloned human T cells, we studied lymphokine production by normal human peripheral T cells and T-cell subsets after in vitro polyclonal activation. After maximal induction of lymphokine expression, IL-4 mRNA was detectable in less than 5% of CD4+ and 1-2% of unfractionated T cells, whereas approximately 33% and 60% of CD4+ cells expressed detectable mRNA for interferon gamma and interleukin 2, respectively. This finding correlated with dramatically lower production of IL-4 mRNA and protein than of interferon gamma and interleukin 2 by peripheral blood and tonsillar T cells. The helper-inducer (CD4+ CD45R-) T-cell subset, which significantly enhances in vitro immunoglobulin production, accounted for the preponderance of IL-4 mRNA accumulation and protein production by CD4+ T cells; nevertheless, cells with detectable IL-4 mRNA constituted less than 10% of the CD4+ CD45R- subset. Limitation of IL-4 production to a comparatively small population of normal human T cells could selectively regulate the effects of this lymphokine in T-cell-mediated immune responses; such selective regulation may be a fundamental mechanism for restricting the potentially pleiotropic effects of certain lymphokines to appropriate responder cells.
Antigens, Differentiation, T-Lymphocyte↗
The structure and function of dental-care markets. A review and agenda for research.
The growth of dental health services over the past 15 years has produced several issues in dentistry. Because economic markets are the cornerstone of dental delivery in the US, informed responses to these issues require a thorough understanding of dental-care markets. The empirical literature is reviewed to examine the structure of dental markets, to assess the major determinants of market equilibrium, and to examine the social and health consequences of dental-care markets. Results reveal that while dental markets are imperfectly competitive, it is unclear whether prices exceed competitive levels. Little is known about the effects of dental markets on public oral health and society. Future research is proposed in two broad areas: 1) updating early studies conducted when few Americans had dental insurance benefits; and 2) path-breaking research to advance our knowledge of dental-care markets in particular and medical-care markets in general.
Community Participation↗
Transient blastemia in phenotypically normal newborns.
Two normal appearing infants presented in the newborn period with elevated white blood cell counts and immature blast cells. Initial bone marrow karyotype analysis showed trisomy of chromosome 21 in all metaphases. In both patients blastemia spontaneously resolved and percentage of trisomy 21 cells decreased. One infant required multiple exchange transfusions and pericardiotomy. The other patient had undifferentiated blasts and continued to have subtle hematopoietic abnormalities greater than 2 years later. Both children have had normal growth and development. The clinical course of these patients emphasizes the need for aggressive supportive care without use of cytotoxic drugs in phenotypically normal newborns with blastemia showing trisomy 21.
Down Syndrome↗
Oral neomycin and erythromycin compared with single-dose systemic metronidazole and ceftriaxone prophylaxis in elective colorectal surgery.
A prospective randomized trial was performed to compare oral neomycin and erythromycin with single-dose intravenous metronidazole and ceftriaxone in elective colorectal surgery. The study was discontinued after 60 patients were entered. The overall rate of infection was 41 percent in the oral neomycin and erythromycin group (n = 29) compared with 9.6 percent in those who received intravenous metronidazole and ceftriaxone (n = 31) (p less than 0.01). Infections in the oral group were principally due to resistant Staphylococcus aureus, Bacteroides fragilis, and Escherichia coli. Preoperative administration of oral neomycin and erythromycin was associated with a significant reduction of Escherichia coli counts (1 X 10(7) to 3 X 10(5) organisms/ml, p less than 0.05) compared with the intravenous group, but there was no significant reduction in the counts of Bacteroides fragilis (2 X 10(8) to 1 X 10(7) organisms/ml) and there was an increase in the counts of Clostridia (2 X 10(4) to 1 X 10(6) organisms/ml). These results indicate that single-dose systemic prophylaxis with appropriate antibiotics is superior to oral neomycin and erythromycin.
Administration, Oral↗
Prognostically significant classification of immune changes in AIDS with Kaposi's sarcoma.
Sixteen immunological parameters were assessed quantitatively for their value in providing an immunologically-based and prognostically significant classification of the immune alteration in 97 patients with AIDS and Kaposi's sarcoma (AIDS-KS). The dimensions of reductions in the T4 (T helper-inducer cells) subpopulation of lymphoid cells in the T4-T8 ratio were found to correlate most closely with prognosis. Most other immunological changes did not relate to clinical course. T4 lymphocyte levels greater than 300/microL and a T4-T8 ratio greater than 0.5 indicated a relatively good prognosis, eg, 85% to 95% survival at 12 months. T4 levels less than 100/microL and/or a T4-T8 ratio less than 0.2 had a very poor prognosis, eg, less than 25% survival at 12 months. Intermediate T4 levels and T4-T8 ratios had intermediate prognosis. These immunological findings were found to have independent prognostic value for survival when compared with disease classifications based on tumor stage (I through IV) or on clinical status A (without) or B (with fever, night sweats, or weight loss). Reduced proliferative capacity, increased OKT10 antigen expression, elevated levels of serum IgA, and immune complexes also correlated with prognosis. Elevated levels of serum IgG, cellular HLA-DR expression, and skin test anergy occurred frequently in AIDS-KS but did not have prognostic significance. Variations in level of total lymphocyte, T8 (T suppressor/cytotoxic) cell, gamma FcR receptor-positive cell number, NK activity, or level of serum IgM were less common in AIDS-KS and did not correlate with prognosis.
Acquired Immunodeficiency Syndrome↗