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Open access

Miguel A. Fernández-Villacañas, Matilde Moreno-Cascales, Sergio Alemán-Belando, Manuel Matías-Sánchez, Diego Flores-Funes, Carmen Botella and Joaquín García-Estañ

Abstract

Introduction: The present study analyzes the evaluation of communication skills by standardized patients (SPs) and medical evaluators (Es) in an OSCE setting.

Methods: The OSCE involved 189 sixth-year medical students, as well as 34 SPs and 63 Es. Communications skills were evaluated in 8 stations, simultaneously by SPs and Es. The SPs were actors who had been trained in the clinical case and who acted in accordance with a standardized script in a simulated clinical situation. The evaluators, also standardized, were Resident Doctors or staff Doctors from the Hospital Services involved.

Results: The global scores awarded to students for communication skills were very similar in both groups, although the score awarded by Es was significantly higher, and a direct relationship was also observed between the mean scores awarded by both groups. Evaluators awarded significantly higher scores than SPs in 7 out of the 10 items on the checklist. Female medical students also scored significantly higher than their male counterparts in many items, including external appearance, listening, cordiality, optimism, interest, expression and empathy.

Discussion: Our data indicate that SPs and Es evaluated communication skills in a similar manner in an OSCE setting, a finding which suggests that health-related professionals can be used as an alternative to SPs, thus helping to lower economic costs. Our study also confirms a gender difference (in favor of women) in the evaluation of communications skills by both groups.

Open access

Kehinde Kazeem Kanmodi, Faruk Abdullahi Mohammed, Njideka Jacob Nwafor, Omotayo Francis Fagbule, Miracle Ayomikun Adesina, Bashar Muhammad Aliyu and Precious Ayomide Ogundipe

Abstract

Background: Tobacco smoking is an addictive behavior with heavy risks accompanying its prolonged practice. Unfortunately, more and more people are indulging in tobacco smoking habits despite the public health education programs going on worldwide about the dangers associated with tobacco smoking behavior. This study aims to survey active shisha smokers in Birnin Kebbi Local Government Area (LGA), Kebbi State, Nigeria, on the awareness of the harmful effects associated with shisha smoking.

Methods: This study was a survey of 45 active shisha smokers in Birnin Kebbi LGA. Snowballing technique was adopted in participants’ recruitment. Study instrument was a questionnaire. Data collected was analyzed using SPSS version 20 software.

Results: Majority (32/45) of the participants were males, 16 had secondary school education, and 19 were within age range of 15 to 24 years. The majority (25/45) of them began to smoke shisha at the age of 18 years or more; also, 20 participants smoked shisha in all the 30 days prior to their participation in this study. Less than half of the study participants knew that: shisha is a stimulant (6/45), shisha smoke contains carbon monoxide (10/45), and the liquid in shisha could be replaced with alcohol (15/45). However, more than half of the participants knew that shisha contains nicotine (23/45) and tobacco (25/45). Only 16, 13, 11, 9, 5, 10, and 13 participants knew that shisha smoking could lead to cancer, cardiovascular diseases, increase in the risk of infections, reduced baby weight in pregnancy, gum and mouth disease, eye disease and blindness, and harm to non-smokers, respectively.

Conclusion: Many of the active shisha smokers surveyed in this study began smoking shisha at a young age. Also, a significant proportion of them were unaware of the health hazards associated with shisha use; hence the need to educate them and even the Nigerian public on the dangers associated with shisha use.

Open access

M. Petrova, S. Prokopenko, O. Eryomina, E. Mozheyko, D. Kaskaeva, O.A. Gavrilyuk and S. Eryomina

Abstract

In spite of recent significant advances in reduction of mortality and disability, coronary heart disease (CHD) remains widespread both in Russia and around the world. Coronary bypass graft surgery (CABG) has proved to be the most effective method of CHD treatment, providing that conservative therapy is not effective enough. The aim of the present study was to reveal and correct postoperative cognitive dysfunction (POCD), developed under the conditions of cardiopulmonary bypass (CB) in patients with CHD within 12 months after CABG.

A total of 87 patients were examined, all the patients underwent a course of drug therapy, 50 patients underwent a course of rehabilitation using computer-based stimulation programmes (once per day for 20 minutes within 10 days) in addition to medical therapy. A reliable improvement in results of the conducted research suggests that the proposed method provides safety and high performance in cognitive rehabilitation of patients with impairments of the higher brain functions after CABG. A relatively short course of rehabilitation (10 days) corresponded to the length of hospital stay of patients in the cardiac unit. However, even in such a short course we could obtain significant advantage in terms of efficiency of higher cortical functions recovery. Therefore, a course of rehabilitation using computer-based stimulation programmes in patients with coronary heart disease after CABG was proved to be an effective way of correcting cognitive function.

Open access

V. Galonsky, V. Chernov, R. Susloparova and A. Gradoboev

Abstract

Currently in the modern pedagogical process at a higher medical institution, teachers often shift emphasis towards the new technologies and methods for treating diseases. In this case, classical techniques, their development, and scientists who influenced the formation of orthopaedic dentistry are undeservedly downplayed in the training process. In order to preserve the interest of dental students in the historical process, it is necessary to teach the material taking into account modern processes that occur in orthopaedic dentistry. We searched for materials on the history of prosthetic dentistry in the scientific and historical literature. A special attention was paid to those moments of history that had been reflected in the present through modern materials, schools or methods of treating patients. After the selection of the materials and their discussion, the teaching staff of the KrasSMU Department-Clinic for Prosthetic Dentistry made proposals regarding each of the nine training cycles. In each study cycle, we included some information about historical moments and personalities that are known to be important for students’ moral education and learning. Specifically, we used information taken from the scientific and historical literature, autobiographies, memoirs of contemporaries, and presentations containing material suitable for assimilation. Thus, we managed to naturally include the history of prosthetic dentistry into the educational process.

The applied approach to teaching the history of medicine had many positive aspects. Following up the development of views on various prosthetic dentistry issues allowed us to provide a more natural introduction to complex clinical disciplines. We emphasized the scientific experience continuity and the interdisciplinary approach to professional issues. A number of positive moral and ethical qualities were discussed that have allowed scientists to achieve significant results in their activities. Through the demonstration of domestic scientists’ achievements, we carried out promotion of patriotism among the students. Considering the above advantages, we emphasize the importance of teaching the history of prosthetic dentistry in educating future dentists.

Open access

V. Shprakh, S. Gorbacheva and M. Golubchikova

Abstract

Issues of education quality have acquired special relevance since the beginning of the 20th century. Implementation of the idea of quality in the educational organisation is promoted by use of the international ISO standards regulating quality of the management system. Certification of a quality management system in an organisation ensures its sustainable development. Experience of such work exemplified by additional medical education organisation is presented in the article.

The present paper addresses approaches to implementation of the following quality management principles: customer focus; leadership; involvement of people; process approach; continuous improvement; evidence-based decision making; relationship management; system approach to management. The structure of processes in the medical education institution is presented including the major process “Professional training and retraining in the field of health care”, main (core) processes: “Educational activities” and “Scientific activities”; management processes: “Strategic planning”, “Documentation management”, “Records management”, “Internal audits”, “Nonconformity management”, “Corrective and preventive actions”, “Monitoring and measurement of processes and educational services”, “Quality management system analysis by senior management”; supporting processes: “Personnel management”, “Work environment management and information support”, “Financial and economic support”, “Library services”, “Methodical support of the educational process and training for teachers”, “Publishing activities”. All processes are designated in a consistent model with special codes, which helps to streamline the document management system in the organisation.

Open access

Kalina Grivcheva Stardelova, Aleksandar Stojanovik, Rozalinda Popova Jovanovska, Sonja Stavrik, Magdalena Dimitrova, Neda Milevska Kostova and Vladimir Serafimoski

Abstract

We describe the clinical course of a patient who developed high-grade lymphoma during immunosuppression treatment with cyclosporine A, following liver transplantation. After anti-neoplastic polychemotherapy treatment, the remission of lymphoma was confirmed and maintained for over four years.

The patient, a 27 year old female had liver transplantation at the age of 17, due to acute liver failure, caused by non-diagnosed Wilson disease. Nearly seven years post-transplantation, the patient was diagnosed with non-Hodgkin B-cell lymphoma (NHBCL), potentially induced by Cephalosporin A therapy. After the treatment with rituximab and CHOP therapy (r-CHOP protocol), remission was determined using computer tomography. Remission is maintained to date.

A review of reported cases of post-transplant lymphoproliferative disorders (PTLDs) in liver transplanted (LT) patients showed that the onset of PTLDs is the highest in the first year after transplantation. In addition, remission rates of NHBCL in LT patients are not much elaborated in the literature. It is our opinion that the presented case is rare, both from the aspect of timeline of occurrence of the PTLD and the achieved remission, using r-CHOP protocol.

Open access

Aleksandra Pivkova Veljanovska, Zlate Stojanoski, Lazar Chadievski, Irina Panovska Stavridis, Sanja Trajkova, Lidija Cevreska and Borche Georgievski

Abstract

Posterior reversible encephalopathy syndrome (PRES) is one of the most serious complication after allogeneic stem cell transplantation in paediatric setting. It is most commonly reported as adverse event of immunosuppressive strategies during transplantation. We present a case of a 7 years old girl with myelodysplastic syndrome (MDS) treated with allogeneic stem cell transplantation (ASCT) at our department. Diagnosis of PRES was confirmed by imaging techniques during the first month after transplant and it was very likely connected with cyclosporine neurotoxicity. The aim of this article is to present our first experience in diagnosing and treating PRES in paediatric stem cell transplantation. Our experience showed that PRES is one of the reasons for higher transplant related mortality in children. Early prediction of factors contributing to PRES and closely monitoring of patient’s vital signs, especially blood pressure, neurological status and vision are the main contributors for challenging the patient with another immunosuppressive agent that has less neurological toxicity. Still studies have to be initiated to confirm the influence of PRES on transplant outcome.

Open access

Nazar M. Kostyshyn, Liybov P. Kostyshyn, Marta I. Servetnyk and Mechyslav R. Grzegotsky

Abstract

Study of the influence of vibration oscillations of different frequency, amplitude and vibration acceleration on the structural and functional state and mechanisms of muscle tissue remodelling. An experimental study was conducted on sexually mature male rats. The rats of the four experimental groups were subjected to vertical vibration oscillations of 15, 25, 50 and 75 Hz, respectively. It has been established that pathological changes in muscle tissue in the form of different variants of damage and remodelling tend to increase, which correlates with the frequency of vibration, amplitude and vibration acceleration level, as in the 2nd group, where the maximum permissible vibration levels did not exceed the established allowable norms, and in other groups of animals, where the permissible levels of total vibration were exceeded. By increasing vibration acceleration for more than 1.25 m/s2 (0.13 g, frequency more than 25 Hz and amplitude of 2 mm), severe damages are observed in the form of alterative changes of muscle fibres with the disappearance of transverse strain, homogenization of sarcoplasm, fragmentation with dissociation fibres on separate beams, partial and subtotal myocytolysis, and necrosis of separate fibres. Inflammation is rapidly increasing with the increase in the frequency of vibration and the level of vibration acceleration for more than 5.0 m/s2 (0.51 g).

Open access

Abstract

The sad news about the death of Acad. Yucel Kanpolat (September 17, 2016), a famous scholar, a pioneer in the field of neurosurgery, and a friend of the Republic of Macedonia, saddened the members of the Editorial Board of the journal PRILOZI of the Department of Medical Sciences of the Macedonian Academy of Sciences and Arts, of which he was a member, as well as the other members of the Academy. Yucel Kanpolat was an international figure, linking Turkey to almost every country in the world. Neurosurgery has lost a very special surgeon, scientist and humanitarian. During the visit to the Macedonian Academy of Sciences and Arts in 2011, we discussed the cooperation between the Turkish Academy of Sciences and the Macedonian Academy of Sciences and Arts, which he respected very much, as well as the role of the academies. He delivered a lecture on The Mission of Academia in the Age of Science, PRILOZI, MASA, XXXII, 2, p. 7-10 (2011), which we reprint in addition.

Open access

Kristina Pavlovska, Marija Petrushevska, Kalina Gjorgjievska, Dragica Zendelovska, Jasmina Tonic Ribarska, Igor Kikerkov, Liljana Labachevska Gjatovska and Emilija Atanasovska

Abstract

The active metabolite of azathioprine, 6-thioguanine nucleotide (6-TGN) is the main component responsible for the immunosuppressive effect in treatment of inflammatory bowel disease (IBD).

The aim of this study was to assess the correlation between the concentration of 6-thioguanine nucleotide and disease activity, azathioprine-related adverse effects and time duration of treatment in patients with inflammatory bowel disease.

Thirty-four patients were included in this study. Type of disease, gender, time duration of therapy and adverse effects were recorded. Metabolite concentration was determined by high performance liquid chromatography.

Twenty-one percent of patients have experienced an adverse effect, with leucocytopenia most commonly occurring (42.9%). More adverse effects were registered when patients were treated with azathioprine in a period of less than 3 months in comparison to the group of patients that have been under therapy between 3-12 months and more than 12 months (p˂0.05). Most of the patients that presented any adverse effect had high 6-TGN concentration (>450 pmol/8x108 Er). The mean value of 6-TGN metabolite concentration in IBD patients treated with azathioprine was 437.46 pmol/8x108 Er ± 198.82 pmol/8x108. The time duration of azathioprine treatment did not have any significant impact on the achieved 6-TGN concentration (p>0.05).Twenty patients (58.9%) had achieved remission after therapy initiation with azathioprine.

More alertness is recommended to clinicians towards patients in the first 3 months of the therapy. Our study demonstrated that higher 6-TGN concentration is associated with azathioprine toxicity.