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Biomedical subjects

R G Bing-You

Publications and source records attributed to R G Bing-You.

5 recordsLinked to original sources
PubMed1992

Serum estradiol but not gonadotropin levels decrease acutely after insulin-induced hypoglycemia in cycling women.

Although corticotropin-releasing hormone (CRH) acutely suppresses gonadotropin-releasing hormone (GnRH) secretion in animal models, its effect on the hypothalamic-pituitary-gonadal axis in humans is not well defined. To further evaluate the acute effects of adrenal axis activation on the hypothalamic-pituitary-gonadal axis in humans, we employed a model of insulin-induced hypoglycemia to stimulate endogenous CRH secretion in eight cycling women. Serum samples were obtained immediately before and 15, 30, 45, 60, 75, 90, and 120 min following iv insulin (0.15 U/kg) or saline injection. To ensure that the degree of hypothalamic-pituitary-adrenal activation in our subjects was similar to that observed in severely ill patients with hypogonadotropism, serum cortisol (F) levels were also measured in a group of acutely ill patients selected to have hypogonadotropism. All women experienced symptomatic hypoglycemia after insulin injection. Differences between serum F levels in hypoglycemic vs. control sessions were evident at 30 min (P < 0.01) and maximum at 120 min (P < 0.0001) after insulin injection. Serum estradiol levels were significantly lower following hypoglycemia than during control sessions (P < 0.001). In contrast, serum LH and FSH levels were not significantly different between control and hypoglycemic sessions. Peak serum F levels in these hypoglycemic women were similar to F levels in critically ill patients with hypogonadotropism. These results demonstrate that stress and/or hypoglycemia can acutely decrease circulating estradiol levels. In addition, these data suggest that endogenous CRH does not play a major role in acute suppression of GnRH (over 2 h) in humans. Further studies are required to identify longer term effects of CRH on GnRH secretion which may be present in hypothalamic amenorrhea or hypogonadotropic hypogonadism of critical illness.

Adult↗
PubMed1992

Medical students' perceptions of themselves and residents as teachers.

Eighty-three medical students from one class at the University of Vermont College of Medicine were surveyed as to their perceptions of both themselves and residents as teachers. Sixty seven percent of the students felt that residents played a significant role as teachers during the first clinical year. Students estimated that one-third of their knowledge could be attributed to housestaff teaching. A large majority of students wanted to teach students during medical school (80%) and residency (93%). Ninety percent of students surveyed would participate in a workshop to improve teaching skills prior to beginning residency; of this group, forty nine students ranked the importance of components of a teaching skills workshop. The findings suggest that medical students are interested both in learning teaching skills and teaching during medical school and during residency.

Humans↗
PubMed1991

Changes in students' attitudes and values during medicine versus surgery clerkships.

A prospective study of students' attitudes and values was conducted during medicine and surgery clerkships over the first clinical year. Students who finished the surgery clerkship first were more cynical and intolerant of ambiguity than the medicine students. Surgery students also felt they lacked self-confidence and had stronger feelings of being victimized. Cynicism and attitudes towards ambiguous situations improved during the medicine clerkship. Feeling victimized was strongly correlated with their problems with self-confidence, with cynicism, and a feeling of having to submit to authority figures. The findings of this study suggest that the clerkship order significantly affects the development of students' attitudes. Students also became more punitive and less confident as the first clinical year progressed. The implications of these changes in attitude on educational planning are discussed.

Attitude of Health Personnel↗
PubMed1990

Training residents in clinical teaching skills: a resident-managed program.

A resident-managed program to improve teaching skills and examine residents' perceptions of teaching was conducted for internal medicine residents at Maine Medical Center. A modification of the Fewett (1982) teaching model was applied as an adjunct to an ongoing resident teaching program. Twenty-six of 29 residents voluntarily participated in a series of workshops over a 6 month period. A low attrition rate and high level of acceptance of the format were observed. Teaching programs are manageable by a senior resident and can be of potential benefit.

Clinical Competence↗