Croatian medical journal
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Academic medicine comprises education, research, and medical care, respectively provided by medical schools, research institutions, and teaching hospitals. Thus far, academic medicine has been unsuccessful in establishing, protecting, promoting, and improving the quality of care. Its role in that area should therefore be reconsidered. ⋯ Early exposure of medical students to the principles and practices of quality of care improvement would be a starting point for a life long process of experience-based learning that allows physicians to change and improve practice through the application of relevant knowledge and skills. It is essential that changes in graduate and postgraduate education and training be introduced, to improve an understanding of the importance of focusing on the care process from the patient's perspective as well as on the need for interdisciplinary cooperation and team performance as prerequisites for good medical care. Their education should also emphasize the measurement of the quality of delivered care, provide an understanding of the demand of society for accountability and how to meet it, as well as competence in using the principles and practice of quality improvement to provide, document, and improve the quality of care in institutions of academic medicine.
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One of the many problems of academic medicine is its detachment from actual health problems of the population. Family medicine has a potential of bridging this gap. The paper describes the positive experience from introducing family medicine as a new academic discipline to the medical school in Slovenia. ⋯ Medical academic establishment has benefited by being exposed to new ideas in research and education. The key to success was the fact that the academic world accepted a newcomer to its midst and that the newcomer managed to integrate its principles into the rules of the academic environment. The next step in this process is to apply some of the positive experiences of the family medicine department to the curriculum reform of the entire faculty.
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To classify ocular lymphomas in patients treated at the Zagreb University Hospital Center according to the new classification of the World Health Organization (WHO) and to determine factors with prognostic significance. ⋯ Most ocular adnexal lymphomas usually have a B-cell immunophenotype, the morphologic and immunohistochemical features of extranodal marginal zone B-cell lymphoma, and a favorable prognosis. Our data suggest that CD43 could be useful to separate the group of patients with extranodal marginal zone B-cell lymphomas with unfavorable prognosis from those that have a good prognosis. CD43 positive ocular lymphomas are associated with a higher rate of subsequent distant recurrence and the rate of lymphoma-related death.
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Scientific approach to academic medicine crisis would require research to provide evidence for the present state of academic medicine and future actions. The prerequisites for such a research would be clear definitions, appropriate indicators, and measuring instruments. The approach should be holistic, covering tripartite academic medicine activity: education, research, and health care.