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Biomedical subjects

P Ramsden

Publications and source records attributed to P Ramsden.

4 recordsLinked to original sources

Is there a simpler method for predicting lower pole stone clearance after shockwave lithotripsy than measuring infundibulopelvic angle?

BACKGROUND AND PURPOSE: Several anatomic factors influence the clearance of lower pole stones treated with shockwave lithotripsy (SWL). One of these is the infundibulopelvic angle, but its measurement is complex. METHODS: We proposed a more simple measure of caliceal dependence, the caliceal pelvic height (CPH), which we defined as the distance between a horizontal line from the lowermost point of the calix containing the stone to the highest point of the lower lip of the renal pelvis. RESULTS: In 62 patients who had SWL for solitary lower pole stones, a CPH < 15 mm was associated with a stone clearance rate of 92%, whereas with a CPH > or = 15 mm, the clearance rate was only 52% (p < 0.05). A majority (74%) of the patients with an infundibular width of > or = 5 mm were rendered stone free compared with 40% of those with a width of < 5 mm (p < 0.05). CONCLUSION: Measurement of the CPH, in conjunction with other anatomic factors, may more accurately predict the outcome of SWL in patients with lower pole stones.

Adult↗

Some phenomena of medical students' diagnostic problem-solving.

This paper introduces a perspective on medical problem-solving that derives from recent studies of content-related learning. Results from a study of fourth-year medical students' approaches to understanding a data base of significant facts about a patient (a problem synthesis) are presented. By analysing data collected in interviews, we obtain categories of description that portray the qualitatively different ways in which the information in diagnostic problems is handled by these students. Two major categories describe the variability in approach: 'ordering' and 'structuring'. The latter category contains elements that most clinical teachers would regard as desirable; the former represents a less satisfactory approach. We provisionally identify two diagnostic strategies within each of these categories. The perspective has implications for improving instruction and assessment.

Clinical Clerkship↗

Urgency and urge incontinence of urine treated by prolonged bladder dystension: interim results.

Prolonged bladder distension has been used to treat patients with urgency and urge incontinence of urine. At follow-up varying from 14 to 24 months 17 out of 33 patients were symptom-free, 13 symptomatically improved and 3 unchanged. These results, as anticipated, are not so good as the initial early reported results, but are sufficiently encouraging for us to recommend prolonged bladder distension for the treatment of severe urgency and urge incontinence of urine.

Humans↗

Accountancy made simple.

A well-run accounts department is a boon to any organization. What are its functions within the NHS and how does it affect the daily lives of NHS professionals?

Accounting↗