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Biomedical subjects

R Powrie

Publications and source records attributed to R Powrie.

7 recordsLinked to original sources

Teaching internal medicine residents about medical problems in pregnancy.

When they became aware that many of their internal medicine residents were not being routinely exposed to a representative range of medical illnesses in pregnancy, the authors set out to develop and implement a brief practical curriculum on the medical problems of pregnancy. They began with a retrospective chart review of 562 consultations with pregnant women and used their findings to develop nine 15-minute lectures that covered a majority of the concepts essential to the care of the medically compromised pregnant woman. Topics included hypertension in pregnancy, the febrile pregnant woman, and renal disease in pregnancy. The authors also created a learner handout, a teaching script, teaching cases, and a bibliography for each lecture. Residents have responded well to the curriculum, and their mean pre- and posttext scores have shown that the lectures improved their knowledge of obstetric medicine. This brief-lecture format may be adapted to other special topics in residency training and readily integrated into already-crowded training schedules.

Curriculum↗

Should women with human immunodeficiency virus be delivered by cesarean?

Vertical transmission of human immunodeficiency virus (HIV) accounts for most new pediatric cases in the United States. With the routine use of zidovudine in the antepartum, intrapartum, and postnatal periods, transmission of HIV from mother to infant has decreased significantly during the past 5 years. Most transmission occurs during labor and delivery, so the effect of mode of delivery recently has been investigated. Several studies support cesarean to further reduce infection in newborns. However, those studies are limited by lack of data on concomitant effects of viral load and effects of combined antiretroviral therapy. There also might be increased operative morbidity in this population. Therefore, we suggest caution in establishing cesarean as a standard for delivery of HIV-infected women.

Cesarean Section↗

Medical problems during pregnancy.

Dramatic physiologic changes are part of normal human pregnancy. The physiologic alterations of pregnancy have the potential to affect chronic diseases, to unmask subclinical conditions, or to alter the presentation and course of newly acquired illnesses. An update in selected topics of obstetric medicine follows, focusing on clinical entities in which there have been significant advances in diagnosis or management. Additionally, reviews of selected medical disorders, such as HIV infection and asthma, that are rising in incidence in women of reproductive age are included.

Asthma↗

Continuing medical education in marital and family therapy: a survey of South Australian psychiatrists.

OBJECTIVE: South Australian psychiatrists were surveyed to determine their impressions of the usefulness of marital and family therapy (MFT) in the management of serious psychiatric conditions and to ascertain their previous experience with Continuing Medical Education (CME) about family therapy. It was expected that psychiatrists' preferences regarding CME would be related to their clinical experience of the usefulness of MFT. METHOD: One hundred and twenty psychiatrists returned a questionnaire about their training, clinical and research interests, with ratings of the usefulness of MFT and CME preferences. This represented 65% of those eligible for the CME programme. RESULTS: Thirteen percent of the respondents found MFT to be extremely useful and a further 47% found it moderately useful in their current practice. There was evidence of a possible training effect: respondents who had previous CME rated MFT as more useful, especially for mood disorders. Furthermore, the treatment of mood disorders seemed to have a particular relevance in family psychiatry, making a statistically unique contribution to ratings of MFT usefulness in the respondents' total practice. Sixty-nine percent of the respondents requested further CME in family therapy. This represented 45% of all South Australian psychiatrists. Respondents who rated MFT as more useful in practice were significantly more likely to be interested in CME. CONCLUSIONS: There seems to be sufficient interest and clinical experience among psychiatrists for MFT to be included in CME courses. It is recommended that further training focus on major mental disorders, especially mood disorders and schizophrenia.

Adult↗