ABSTRACT
The aim of this project was to develop a training programme to help consultants supervising postgraduate medical trainees to fulfil their role as Educational Supervisors. A training needs analysis was conducted which revealed that consultants did not appreciate the importance of some of their new duties. This was mainly because of the lack of clear perception of their new roles. Hence training needs to be provided.
Subject(s)
Education, Medical, Graduate/methods , Educational Measurement/methods , Mentors/education , Teaching/methods , Humans , London , Program DevelopmentABSTRACT
As a results of the introduction of structured training in postgraduate medical education we undertook a survey of North Thames stakeholders in health authorities and trusts to ascertain views on the implications of the specialist registrar grade on the future shape of the clinical workforce. Trusts and health authorities expressed concern over the training of specialist doctors at the expense of training generalists to provide patient care.
Subject(s)
Attitude of Health Personnel , Clinical Medicine/education , Education, Medical, Graduate/methods , Education, Medical , Medical Staff, Hospital/education , Specialization , State Medicine/organization & administration , Health Services Administration , Humans , Physician Executives , Public Health , United Kingdom , WorkforceABSTRACT
A retrospective study was made of all 28 soldiers with chronic pancreatitis first diagnosed between 1978 and 1989. All patients were male, alcohol was the aetiological factor in 90%, the mean age at diagnosis was 30 and the commonest mode of presentation was with recurrent painful episodes of pancreatitis. Endocrine and exocrine pancreatic insufficiency occurred in a quarter and a third of patients respectively and one third required surgical intervention.
Subject(s)
Military Personnel , Pancreatitis , Acute Disease , Adult , Age Factors , Alcoholism/complications , Chronic Disease , Diabetes Complications , Diabetes Mellitus/therapy , Humans , Male , Pancreatitis/complications , Pancreatitis/diagnosis , Pancreatitis/etiology , Pancreatitis/surgery , Prevalence , Recurrence , Retrospective Studies , United Kingdom/epidemiologyABSTRACT
Fifty-eight cases of snake bite seen at the British Military Hospital, Dharan, Nepal during 1989 were studied prospectively. Data is presented on the epidemiology and outcome of snake bite in this area of lowland Nepal with details of the age and sex of patients, date and time of bite, delay in arrival at hospital, use of tourniquets, circumstances of the bite, and snake identification. Neurotoxicity due to envenomation was recorded in 11 patients. No case of coagulopathy was recorded. The overall case fatality was 5.2% but mortality amongst those exhibiting signs of neurotoxicity was 27.3%.
Subject(s)
Snake Bites/epidemiology , Adolescent , Adult , Child , Child, Preschool , Female , Hospitals, Military , Humans , Incidence , Infant , Male , Middle Aged , Nepal/epidemiology , Prospective Studies , Seasons , Snake Bites/physiopathology , Snake Bites/therapy , Survival Rate , Time Factors , Tourniquets/statistics & numerical data , Treatment Outcome , United KingdomABSTRACT
A case of meningococcal septicaemia is described in which the clinical presentation resembled that of viral hepatitis, and which responded rapidly to treatment with penicillin.
Subject(s)
Hepatitis, Viral, Human/diagnosis , Meningococcal Infections/diagnosis , Sepsis/diagnosis , Adult , Diagnosis, Differential , Hepatitis, Viral, Human/complications , Humans , Male , Meningococcal Infections/complications , Meningococcal Infections/drug therapy , Military Personnel , Nepal/ethnology , Penicillin G/therapeutic use , Sepsis/complications , Sepsis/drug therapy , United KingdomABSTRACT
The effects of an intensive rehabilitation course on plasma high-density lipoprotein (HDL) levels were studied in 40 men, aged 29 to 56 years, with ischemic heart disease. The exercise consisted of aerobic activities that induced up to 80% of the maximal heart rate during three 20-minute periods daily for 5 days a week; the program lasted 3 weeks. Significant increases were found in the levels of HDL and HDL2 and their ratios to total plasma cholesterol. These changes were similar in nonsmokers of cigarettes and in men who gave up or reduced smoking during the course and contrasted with negligible changes in those who continued to smoke.
Subject(s)
Coronary Disease/rehabilitation , Lipoproteins, HDL/blood , Physical Exertion , Adult , Cholesterol/blood , Cholesterol, HDL , Coronary Disease/blood , Heart Rate , Humans , Lipoproteins, HDL2 , Male , Middle Aged , SmokingABSTRACT
Sixty-four outpatients with ulcerative colitis receiving maintenance treatment with sulphasalazine were studied to relate disease activity to serum concentrations of sulphapyridine. Of 43 patients in remission, 32 had serum sulphapyridine levels over 20 microgram/ml. Ten of the 21 patients with active disease were for various reasons taking inadequate doses of sulphasalazine, as indicated by low serum sulphapyridine levels, and of the remaining 11 patients, who had serum levels over 20 microgram/ml, nine had faecal stasis proximal to active distal colitis and went into remission when treated with hydrophilic colloid or bran and an unchanged sulphasalazine dosage. This suggests that to be effective the metabolites of sulphasalazine must be delivered in the faeces to the lumen of the diseased distal segment of the colon. High serum concentrations of sulphapyridine produce side effects; therefore slow acetylators of sulphapyridine need lower doses of sulphasalazine. Estimations of serum sulphapyridine concentrations, as well as identifying the patient's acetylation phenotype, can also be useful in assessing his compliance with treatment.
