Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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A new instrument for coniotomy was developed and tested with cadaver experiments. The instrument should be simple, easy to handle, and should not have the various drawbacks of the existing devices. The new instrument was tested by 17 medical students and medical doctors on fresh human cadavers. ⋯ After entering the larynx, the tube can be connected to an inflating bag. The correct seat of the tube was tested by inflation, with a calibrated probe or with laryngoscopy. The results of our tests encourage the development of this new instrument for industrial production.
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One of the most important structures involved in the pathogenesis of occipital headache is the lateral atlanto-axial joint. Previous studies demonstrated that injection of this joint with local anesthetic can alleviate occipital headache, while injection of contrast medium exacerbates it. ⋯ Following our observations on their distribution, we propose a target for local anesthetic injection of the C2 articular branches that is based on reliable landmarks and is easily identifiable at fluoroscopy. We suggest that local anesthetic injection at this target point could be of benefit in the relief of occipital pain due to cervical trauma or degenerative disease involving the lateral atlanto-axial joint.
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During the past 50 years, physicians have become increasingly dissatisfied with certain aspects of their profession. Dissatisfaction has intensified with the advent of managed care in the late 20th century, the medical liability crisis, and the growing divergence between the professional and personal expectations placed upon physicians and their practical ability to meet these expectations. These and other factors have encroached on physician autonomy, the formerly ascendant professional value within medicine. ⋯ This means foregoing the 20th century's preferred "independent physician" model in favor of a new professional structure based on teamwork and collaboration. Convincing established physicians to embrace such a model will be difficult, but opportunities exist for significant progress among a new generation of physicians accustomed to the realities of managed care, flexible practice models, and health information technology. The teaching of clinical anatomy, given its incorporation of student collaboration at the earliest stages of medical education, offers a prime opportunity to introduce this generation to a reinvigorated code of professionalism that should reduce physician dissatisfaction and benefit society.
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Respect for patient confidentiality is one of the core concepts of professionalism and should have high priority in medical education. Confidentiality should be introduced early in the curriculum so that students understand their ethical, professional, and legal obligations throughout their medical studies and later professional career. ⋯ A Faculty development program on confidentiality and data protection will inform and support teachers in delivering these objectives. It is recommended that medical schools have a policy on patient confidentiality and a disciplinary procedure for the management of students who breach patient confidentiality.