Biomedical subjects

Roland Brilla

Publications and source records attributed to Roland Brilla.

3 recordsLinked to original sources

PubMed2005

Are neurology residents in the United States being taught defensive medicine?

OBJECTIVE: To study whether and how fear of litigation and defensive medicine are communicated during residency training and to assess whether this affects residents' attitudes. METHODS: Neurology residents in the US (n=25) and, as a control group, Neurology residents training in Germany (n=42) were asked to rate multiple items regarding litigation, defensive strategies and how often these issues are raised by teaching physicians. Statistic analysis was performed using nonparametric tests. RESULTS: Residents in both countries indicated that litigation is an "important problem", although US residents stated this significantly more often (p<0.001). Initiation of tests motivated mainly by fear of litigation (p=0.004) and explicit teaching of defensive strategies by teaching physicians (p<0.02) were reported more often by US residents. CONCLUSION: Neurology residents in both the US and Germany perceive a litigational threat, but significantly less so in Germany. This difference may result at least in part from teaching of defensive strategies reported more often in US programs.

Defensive Medicine↗

PubMed2004

Clinical and neuroradiologic features of 39 consecutive cases of West Nile Virus meningoencephalitis.

BACKGROUND: West Nile Virus (WNV) is a flavivirus WNV that has spread westwards across North America in recent years. It can cause a febrile illness and infection of the central nervous system, which is associated with poor outcome. METHODS: We retrospectively studied the clinical and neuroradiologic features of 39 consecutive patients admitted during summer of 2002 that had IgM in the cerebrospinal fluid positive for WNV. RESULTS: Fever, headache and altered mentation were predominant clinical features. Clinically significant involvement of lower motor neurons was seen in few cases. Magnetic resonance imaging (MRI) of the brain did not show changes attributable to meningitis or encephalitis except for one case of subcortical signal abnormalities. Unfavorable prognostic factors are old age, decreased level of alertness and elevated serum creatinine. CONCLUSIONS: Encephalopathic presentations, with or without additional neurological focality, dominated this series. Fever and meningitic signs are often absent. Involvement of lower motor neurons was uncommon. Given the paucity of positive findings, the value of MRI to support the diagnosis of WNV-meningoencephalitis is limited.

Adolescent↗

PubMed2004

Introducing new technology: handheld computers and drug databases. A comparison between two residency programs.

There have been numerous efforts to introduce and increase the use of handheld computers, also called personal digital assistants (PDA), in health care, one of which is the distribution of PDAs to Neurology residents at the University of Illinois at Chicago. The authors examined the success of this intervention by comparing PDA use and user attitudes between residents of the intervention group and residents in another residency program where the use of PDAs is neither encouraged nor discouraged. The authors examined in particular the use of drug databases on the PDA as its currently most popular application in health care. The use of PDAs for purposes not related to health care was widespread among individuals in both programs, but the use of drug databases was significantly more common in the control group, which can be interpreted as a success of the intervention.

Adult↗