P R Health Sci J
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The 21st century brings new challenges to academic medical centers and universities who are responsible to prepare health professionals. These academics medical centers and universities need to respond more effectively to the demands of the health market place. The Health Care reform has brought about many changes within the health care field. ⋯ Advance practice nurses and paramedics will take over some of physicians' duties such as diagnose and prescription of medications and treatment to the patients. For individuals to move vertically to positions and to be marketable in health care settings, they need to increased their personal and technical skills, and health care knowledge. In order to survive, the health care professional will need to gain increased competencies and skills in several areas rather than obtain proficiency in one specific area.
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The purpose of this study was to determine the causes, epidemiologic baseline data and clinical characteristics of a group of patients referred to a tertiary care center in Puerto Rico with the diagnosis of dilated cardiomyopathy. ⋯ A comparison with previously described series in the medical literature regarding this subject is presented, along with the most prominent clinical characteristics of the studied population. It is felt that the findings presented will require further study of the underlying causes and clinical course of this condition in a larger patient sample and a longer follow-up period.
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The purpose of this study is to evaluate the use of Intraoperative Autotransfusion (IAT) as a second stage in the use of autologous blood to reduce the need of allogeneic transfusions. We reviewed the medical records of 41 pediatric patients who underwent spinal fusion procedures from September 1991, to August 1993. ⋯ The use of preoperative autologous blood donation in combination with IAT has proven to be a safe method of operative blood loss replacement in pediatric age patients. Exclusive use of autologous blood can reduce or eliminate transfusion reactions and exposure to transfusion transmitted agents and helps to increase the blood reserve at blood banks.