Sociological analysis of the medical field: using Bourdieu to understand the processes preceding medical doctors' specialty choice and the influence of perceived status and other forms of symbolic capital on their choices.

Several studies have demonstrated that medical students and doctors rank specialties differently in terms of perceived status and prestige. At the same time some of the specialties have problems with recruiting and retaining staff. This study aimed to understand what constitutes status and prestige in the medical field and how it influences medical doctors' choice of specialty. By using a sociological perspective and applying Bourdieu's theoretical concepts of field, symbolic capital and perceived status, we analysed young doctors' journeys towards their chosen specialty. We conducted 15 in-depth semi-structured interviews. The data was analysed using content analysis. The findings suggest that medical specialties carry different social status. In the field of power, surgery is seen as the most prestigious of all specialties. However, in the future it might be a less attractive choice when young doctors tend to view their profession less as an identity and more like a job. For specialties perceived as low status, the challenge is to raise popularity by better describing to young doctors the characteristics and advantages of these specialties.

Colocalization of hyperpolarization-activated, cyclic nucleotide-gated channel subunits in rat retinal ganglion cells.

The current-passing pore of mammalian hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels is formed by subunit isoforms denoted HCN1-4. In various brain areas, antibodies directed against multiple isoforms bind to single neurons, and the current (I(h)) passed during hyperpolarizations differs from that of heterologously expressed homomeric channels. By contrast, retinal rod, cone, and bipolar cells appear to use homomeric HCN channels. Here, we assess the generality of this pattern by examining HCN1 and HCN4 immunoreactivity in rat retinal ganglion cells, measuring I(h) in dissociated cells, and testing whether HCN1 and HCN4 proteins coimmunoprecipitate. Nearly half of the ganglion cells in whole-mounted retinae bound antibodies against both isoforms. Consistent with colocalization and physical association, 8-bromo-cAMP shifted the voltage sensitivity of I(h) less than that of HCN4 channels and more than that of HCN1 channels, and HCN1 coimmunoprecipitated with HCN4 from membrane fraction proteins. Finally, the immunopositive somata ranged in diameter from the smallest to the largest in rat retina, the dendrites of immunopositive cells arborized at various levels of the inner plexiform layer and over fields of different diameters, and I(h) activated with similar kinetics and proportions of fast and slow components in small, medium, and large somata. These results show that different HCN subunits colocalize in single retinal ganglion cells, identify a subunit that can reconcile native I(h) properties with the previously reported presence of HCN4 in these cells, and indicate that I(h) is biophysically similar in morphologically diverse retinal ganglion cells and differs from I(h) in rods, cones, and bipolar cells.

No effects of piroxicam on osteopenia and recovery after Colles' fracture. A randomized, double-blind, placebo-controlled, prospective trial.

In a randomized double-blind study involving 42 postmenopausal women with a displaced Colles' fracture, we investigated whether piroxicam, a nonsteroid anti-inflammatory drug, can reduce posttraumatic osteopenia and improve the rate of recovery. In an earlier study [3] we found a bone-sparing effect caused by piroxicam after external fixation of the rabbit hindleg. The patients were treated with a below-elbow paster slab for 4 weeks after the reduction. The bone mineral content of the forearm bones was measured with a single-photon absorptiometer 8 weeks after the fracture. There was a mean 7% bone mineral decrease in the radius and 5% in the ulna among the patients treated with piroxicam versus 10% in the radius and 7% in the ulna in the placebo group. However, this difference was not significant. Piroxicam did not decrease the rate of fracture healing. The patients who received piroxicam had significantly less pain during plaster treatment, but there was no difference in the rate of functional recovery between the groups.

Bone mineral loss after Colles' fracture. Plaster case and external fixation equivalent.

The bone mineral content of the radius and ulna was analyzed in 31 postmenopausal women with displaced Colles' fractures. Sixteen fractures were treated with a below-the-elbow plaster case and 15 with primary external fixation. The bone mineral content of the forearm bones was measured with a photon absorptiometer 9 (6-24) months later. There was a mean 15 percent mineral decrease in the radius, but no difference between the two treatment groups. The decrease did not correlate with the age of the patient, nor was there any correlation with grip strength or range of wrist motion. The more severe fractures, according to the Frykman classification, had a more pronounced mineral loss than the simpler fractures.