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Biomedical subjects

S W Tolle

Publications and source records attributed to S W Tolle.

At least 55 records · Page 3Linked to original sources
PubMed1989

Internal medicine residents' preferences regarding medical ethics education.

Three hundred and twenty-three residents in six internal medicine programs in three states were surveyed concerning what they wanted to learn about medical ethics and how they would prefer to learn it; they were also asked to indicate what medical ethics education they had already received. Specifically, the residents were given a list of 35 medical ethics topics and asked to indicate whether they would like more attention to a topic, or whether it had received enough or too much attention. (They could also indicate that they though the topic was inappropriate for attention during residency.) The residents were also given a list of 17 teaching methods for medical ethics and asked to indicate whether each method was very useful, somewhat useful, or not useful. Sixty-one percent of the residents responded. Approximately three-fourths of these had had some formal teaching about medical ethics in both medical school and residency, and nearly all indicated that they wanted more ethics training on specific topics. Certain topics were chosen as particularly suitable or unsuitable for such training; many of those judged as deserving more attention concerned legal issues and end-of-life issues. Most of the responding residents regarded standard clinical teaching formats as very useful for learning about medical ethics but regarded several other methods are not useful. The authors discuss the implications of these and related findings.

Adult↗
PubMed1988

Subspecialty differences in responding to patient death--comparing cardiologists with oncologists.

Cardiac deaths are more likely to be unanticipated than cancer deaths by patients, their families, and their physicians. We hypothesized that differing physician attitudes toward dying patients may affect the degree of expectation of death. To evaluate differences in attitudes and behaviors among subspecialists, we surveyed a randomly selected population of California subspecialists; 44 of 136 (32%) of cardiologists and 91 of 167 (55%) of oncologists responded. Oncologists experienced three times as many deaths as cardiologists and reported having discussed code status more often with patients who died. Cardiologists' patients' deaths were more often unexpected and occurred more frequently in intensive care units. In addition, their patients were more likely to be given cardiopulmonary resuscitation. Oncologists reported being more comfortable dealing with dying patients and having less desire to avoid them. When presented with patient scenarios, however, cardiologists' and oncologists' responses were similar when discussing and estimating prognosis and likelihood of successful therapy.

Attitude to Death↗
PubMed1987

Responsibilities of primary physicians in organ donation.

As transplantation success rates have improved, the demand for donor organs has steadily increased. A shortage of donor organs has led to legislation requiring hospital personnel to provide families routinely with the opportunity to authorize organ donation. Primary physicians have an important role in identifying potential donors while continuing to assure that the survivors' needs are met. The major implications of organ donation for the primary physician are reviewed. Patients who die will more frequently be eligible as cornea, skin, or bone donors, but the criteria for both tissue and internal organ donation are reviewed. Ethical issues unique to organ donation and responses of survivors to donation requests are described. If appropriately offered, the opportunity to authorize an anatomic gift can be a source of comfort to survivors while the donation provides the benefits of transplantation to persons on organ waiting lists.

Ethics, Medical↗
PubMed1985

Preparing the medically compromised patient for surgery.

Preparing the medically compromised patient for surgery requires identifying and treating preoperative risk factors and anticipating postoperative complications. Preoperative evaluation of all patients should include careful screening for bleeding disorders and prior anesthetic complications and assessment of nutritional status. In addition, patients with preexisting cardiac, pulmonary, and endocrine problems must be identified, since these problems represent the greatest risk factors for postoperative complications. Perioperative care is more effective when directed at specific organ systems. Communication among internists, anesthesiologists, and surgeons promotes optimal treatment for surgical patients with medical illness.

Cardiovascular Diseases↗
PubMed1984

Mycoplasma pneumoniae pneumonia. Experience at a referral center.

Mycoplasma pneumoniae pneumonia is usually a benign illness, and respiratory complications and extrapulmonary manifestations occur rarely. In this series, patients admitted to a referral hospital with this disorder had unusual symptoms, signs and findings on chest roentgenograms and laboratory studies. Pneumonia was often severe and extrapulmonary manifestations were frequent, resulting in prolonged hospital stays and illnesses. Although this extreme end of the spectrum of disease caused by M pneumoniae is not representative of this type of pneumonia as seen in outpatients, it is important to realize that patients admitted to hospital with severe, complicated pneumonia frequently have unusual manifestations of a common disease.

Adolescent↗