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Biomedical subjects

R E Pinkerton

Publications and source records attributed to R E Pinkerton.

13 recordsLinked to original sources
PubMed1983

Preemployment multiphasic screening in an urban manpower training program.

Preemployment health examinations have long occupied a central role in industrial medicine, providing company physicians with baseline health status and physical limitations for each employee. We evaluated a similar multiphasic screening examination in 662 young, minority applicants to an urban manpower training program. Resulting from this screening was a substantial number of patients with positive serology (1%), positive gonorrhea cultures (3%), excessive daily ethanol ingestion associated with liver enlargement (13%), decreased visual acuity (24%) and dental caries (23%). These findings are markedly different than those reported for preemployment screening in industry, suggesting the need for a specific health screening protocol for applicants to manpower training programs.

Adult↗
PubMed1983

Congestive heart failure.

Congestive heart failure in adults should be conceptualized and dealt with as a clinical syndrome. It is neither a diagnosis nor a disease as such. Patients with heart failure present with clusters of symptoms that define sets of systemic congestion, pulmonary congestion, and inadequate cardiac output. Some have potentially correctable anatomic or metabolic defects, others have myocardial failure, and some have both as underlying causes of the syndrome. A careful analysis of the symptom clusters may provide important clues to the underlying etiologic diagnosis, which should be established before initiating therapy for heart failure.

Adult↗
PubMed1981

Electrocardiographic training in primary care residency programs.

To evaluate ECT interpretation in physicians training for primary care, we tested residents in two residency programs (one internal medicine, one family medicine) for their ability to interpret ECGs produced in an ambulatory practice. An 18-item examination used abnormal tracings from a university hospital ambulatory unit, including six technical problems generated in the daily operation of the unit. Ability increased with advancing graduate level; however, performance for both internal medicine and family medicine residents fell short of the expected level. Residents completing training in both programs incorrectly interpreted many of the technical problems (eg, limb lead reversal) as well as the usual ECG diagnoses (eg, acute pericarditis). This study suggests that ECG training of primary care residents should be supplemented to meet specific needs of the ambulatory component of primary care practice.

Ambulatory Care↗
PubMed1981

Preventing dental caries.

Since most children do not see a dentist until age three, family physicians have the opportunity to initiate proper dental care and thus reduce the incidence of dental caries. In addition to oral hygiene and dietary modification, optimal fluoride ingestion in the first few years of life produces lifelong resistance to dental caries. Knowledge of the pathology of dental caries and use of appropriate fluoride dosages enables the family physician to apply a highly effective preventive regimen in daily practice.

Child↗
PubMed1980

Resident physician performance in a continuing education format. Does newly acquired knowledge improve patient care?

As part of an educational program in preventive dentistry for family medicine residents, we evaluated changes in systemic fluoride prescribing habits related to newly acquired knowledge. Residents, unaware of the study, were randomly assigned to one of two groups and shown a videotape describing preventive dental techniques. We supplemented the tape viewed by one group with specific instructions explaining the implementation of the information in patient care. Residents in both groups demonstrated the ability to learn and maintain their level of knowledge during a three-month period. Daily chart audits, however, revealed no substantial increase in correct prescribing of systemic fluoride to pediatric patients for either group. Only subsequent individual monitoring and reinforcement achieved the desired behavior. The acquisition of new knowledge by resident physicians under these circumstances did not lead to its application in daily patient care. This result parallels reported difficulties in altering physician behavior by continuing medical education, and suggests that residency programs are an appropriate setting to initiate improved physician performance in response to acquired knowledge.

Child↗
PubMedDate not supplied

Urinary tract symptoms: microbiologic evaluation in rural family practice.

In order to define the etiology of urinary symptoms in rural family practice, this study examines 106 patients (88 women, 18 men) who went to their family physicians in private practice or a resident-faculty practice with genitourinary symptoms. Evaluation of each patient included history, physical examination, urinalysis, and urine or cervical cultures for bacteria, Mycoplasma, and Chlamydia. Using agar plate culturing techniques, 37 patients (35 percent) were identified as having significant urine bacteria. Chlamydia was rarely associated with urinary tract symptoms. Mycoplasma hominis, however, was isolated and felt to be etiologic in 19 (22 percent) of the 88 symptomatic women (P = 0.0026). Older women (mean age 42 years, P less than 0.001) with greater than 5 white blood cells per high-power field (WBC/hpf) on microscopic urinalysis (P less than 0.001) were likely to have cystitis and significant bacteria on urine culture. Younger women (mean age 31 years, P less than 0.001) with less than 5 WBC/hpf (P less than 0.001) had negative urine cultures and were likely to have M. hominis as a pathogen. These results demonstrate that the etiology of genitourinary symptoms seen in rural family practice may vary substantially from those seen in other patient care settings.

Adult↗