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Biomedical subjects

William R Hamilton

Publications and source records attributed to William R Hamilton.

2 recordsLinked to original sources

Weaving basic and social sciences into a case-based, clinically oriented medical curriculum: one school's approach.

Southern Illinois University School of Medicine recently completed its fourth year of a resource-session-enhanced, case-based, tutor-group-oriented curriculum. As an example of a curricular unit, the authors describe the implementation of the basic and clinical sciences in one of the four units in year one, and detail that unit's organization, logistics, content, rationale, and other characteristics. The Sensorimotor Systems and Behavior (SSB) unit is preceded by a cardio-respiratory-renal unit and is followed by an endocrine-reproductive-gastrointestinal unit. A Doctoring unit temporally spans each of these three units. The SSB unit is allotted an 11.5-week period that includes an aggregate of 2.5 weeks of available clinical time, 1.5 weeks for examinations and exam study time, and approximately 8.5 weeks for tutor-group sessions, mandatory laboratory sessions, and self-directed learning. Optional resource sessions are offered during a two- to four-hour block on a single morning each week. Clinical training in the SSB unit augments self-directed, laboratory, and tutor-group learning of neuroscience, gross anatomy, cell biology, physiology, biochemistry, behavioral and social science, embryology, limited pharmacology and genetics, and basic clinical neurology for first-year students. Although it is fast-paced and places heavy responsibility for independent learning on the students, the SSB unit culminates in significant achievement in the basic and clinical sciences. The unit provides substantial clinical training and practical experience in physical and neurological examinations that directly integrate with basic science knowledge. The unit reduces lecture-based instruction, demands self-determination, and promotes experience in team effort, professionalism, peer interaction, empathy in clinical medicine, and practical use of basic science knowledge.

Curriculum↗

Supplemental products used for weight loss.

OBJECTIVE: To review the scientific literature on several dietary supplements and herbal products commonly promoted for weight loss. DATA SOURCES: Recently published articles and abstracts identified through PubMed (May 1987-May 2003), MEDLINE (January 1966-May 2003), International Pharmaceutical Abstracts (January 1970-May 2003), and Natural Medicines Comprehensive Database (January 1995-May 2003) using the search terms supplement, herbal, weight loss, obesity, overweight, conjugated linoleic acid, ephedra, ephedrine, chromium, Garcinia cambogia, hydroxycitric acid, chitosan, and pyruvate. STUDY SELECTION: Performed manually by the authors. DATA EXTRACTION: Performed manually by the authors. Only single-agent, randomized, blinded, controlled studies with sufficient scientific rigor in overweight or obese subjects were included. DATA SYNTHESIS: Approximately 50 individual supplemental products and hundreds of combination products are promoted for weight loss. As a result, much confusion exists among health care professionals regarding the efficacy and safety of these products. Results for conjugated linoleic acid were positive in three clinical studies, with few adverse effects. Ephedra has been shown to be effective in promoting weight loss, especially when combined with caffeine, but it has a high adverse effect risk profile. The data regarding ephedra and ephedra combinations are conflicting, and many of the studies were poorly designed. Garcinia and chitosan have not shown much promise for weight loss, but little research has been done. Pyruvate has consistently shown positive weight loss effects. CONCLUSION: Overall, herbal products and dietary supplements promoted for weight loss lack sufficient supporting efficacy and safety data. More research is needed to draw definitive conclusions. Conjugated linoleic acid and pyruvate have the best supporting evidence, but larger and better-controlled trials are needed before pharmacists should recommend these agents to patients seeking to lose weight.

Clinical Trials as Topic↗