ABSTRACT
We describe a case of emergency endovascular stentgraft placement for acute traumatic rupture of the thoracic aorta in a patient with an associated unstable type II odontoid fracture. The stent-graft placement procedure was performed within 4 hours of admission under sedation and local anaesthesia while the neck remained externally splinted. After exclusion of the rupture the patient could then undergo treatment of the associated cervical fracture and other injuries
Subject(s)
AortaABSTRACT
Background: The Objective Structured Clinical Examination (OSCE) has become a respected and widely used tool for the assessment of clinical competence in medical education. Aim: To describe the first experience of an OSCE as a summative assessment in undergraduate Pediatric Internship, in two universities. Material and Methods: The OSCE was structured by a committee of faculty members of the 5 campi of University of Chile and I campus of the Catholic University. A 21 station OSCE was administered simultaneously to 124 Pediatric Interns (University of Chile =104, Catholic University=20), in 3 centers. A total of 50 faculty members participated in the examination. The OSCE consisted of 20 clinical problems, including videotape recordings, photographs, x-rays and laboratory exams, phantoms and 7 simulated standardized parents. Results: The average total OSCE score was 67.3 percent (range: 84.5 percent-43.5 percent). The maximum theoretic score was achieved in 19 stations. A significant correlation between station and total score, was found for 18 of the 20 clinical problems. Conclusions: The experience of using OSCE has been a success. The OSCE was an adequate procedure to assess a large number of interns simultaneously and it allowed us to measure the main objectives in all domains and a wide range of clinical competence of Pediatric Internship Programs
Subject(s)
Humans , Pediatrics , Education, Medical, Undergraduate/methods , Educational Measurement , Internship and Residency , Schools, MedicalABSTRACT
Background: During the last decade, academic life at the medical school of the Pontificia Universidad Cat-lica de Chile has been thoroughly affected by a curricular reform process. Changes started in 1993 and have continued up until now. This reform did not have an experimental design to allow for a scientific evaluation of its effects. However, it seems interesting to study the evolution of indices of academic performance of our students during this period. Aim: To evaluate the academic performance of medical students between 1989 and 1999. Subjects and Methods: All undergraduate students enrolled between 1989 and 1999. Academic performance was evaluated by 1) failure to pass one or more courses, 2) delay to complete the third year of studies, 3) withdrawal from school and 4) medical school grades. Results: All indices of academic performance changed during the period of study. Failure to pass, delay and withdrawal from school significantly decreased, whereas medical school grades improved, particularly in basic and pre-clinical subjects. Conclusions: Academic performance of medical students improved consistently between 1989 and 1999. While specific causal relationships cannot be established, we believe that this improvement is likely related to the curricular reform. This reform included horizontal and vertical integration of academic contents, greater emphasis in problem-based learning and additional instances of evaluation such as the repetition exam
Subject(s)
Humans , Male , Adult , Female , Education, Medical, Undergraduate/trends , Student Dropouts , Students, Medical , Curriculum , Schools, Medical/trendsABSTRACT
In the Spring of 1991 a random sample of young men from Upper Northern Thailand (mean age = 21 years) was interviewed by trained medical students from Chiang Mai University, serum samples were obtained and analyzed for prevalence of HIV-1 antibodies and for syphilis, and risk factors for HIV infection were assessed. It was found that Commercial Sex Workers (CSW) were the principal risk factor, that consistent condom use is rare, and the rates of HIV infection are rising rapidly. Sociodemographic background, homosexual behavior, drug use, and history of STD's were found to be not significant risk factors. The conclusions are that the education campaigns should be intensified to reduce the frequency of contact with CSW and to encourage consistent use of condoms.
Subject(s)
Adult , HIV Antibodies/blood , HIV Infections/epidemiology , HIV Seroprevalence , Homosexuality, Male , Humans , Male , Sex Work , Risk Factors , Substance-Related Disorders , Thailand/epidemiologyABSTRACT
In an attempt to study the mechanisms of heart damage in African trypanosomiasis; a group of dogs were infected with Trypanosoma brucei. The dogs developed an actue disease syndrome; and if not treated became terminally sick during the fourth week of infection. Post mortem and light microscopic examination demonstrated severe pancarditis involving the musculature; valves; vasculature and the conducting system. Transmission electron microscopy confirmed the histological findings and in addition revealed other changes in the heart. These included distention of myocardial cells with fluid; swelling of mitochondria and damage to their cristal membranes; and lipid deposition. Cellular infiltration; fibrin deposition; occluded capillaries and damaged autonomic nerve gagnlia were abserved. The changes in muscle cells; vasculature and nerve tissue may have been due to excessive inflammatory reactions caused bvy biologically active substances generated by trypanosomes themselves; or by immunological reactio;ns between trypanosomes and inflitrating cells. Such changes exacerbated the severity of heart damage; and possibly death due to heart failure