Internal medicine journal
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Internal medicine journal · Jun 2009
Comparative StudyComparison of the MMSE and RUDAS cognitive screening tools in an elderly inpatient population in everyday clinical use.
We compared test score and performance times of Folstein's Mini Mental State Examination (MMSE) and the Rowland Universal Dementia Assessment Scale (RUDAS). Forty-six patients were recruited. The mean score was 20.6 for the MMSE and 20.5 for the RUDAS. ⋯ Surveyed clinicians preferred the MMSE because of greater familiarity. We concluded that the RUDAS correlates well with the MMSE and is no more time-consuming to perform. It has good clinical utility as a cognitive screening tool.
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Internal medicine journal · May 2009
Bronchoscopic diagnosis of endoscopically visible lung malignancies: should cytologic examinations be performed routinely?
Aims: The aim of this study was to determine the diagnostic yield of flexible bronchoscopy in endoscopically visible malignancies and to evaluate whether cytological examination including bronchial washings and brushings increase the diagnostic yield compared with bronchial biopsy alone. Methods We reviewed a series of bronchoscopies over a period of 7.5 years in which an endoscopically visible tumour was identified and which had a definite cytological or histological diagnosis of pulmonary malignancy obtained by bronchoscopy or any other examination. Results The above criteria were met by 174 bronchoscopies. ⋯ Conclusions The tumour detection rate with flexible bronchoscopy in endoscopically visible lung malignancies is high. Cytology-based sampling techniques by means of bronchial washings and brushings significantly increase the overall diagnostic yield compared to forceps biopsy only. Repeat bronchoscopies after an initial non-diagnostic bronchoscopy have a relatively high diagnostic yield, and should therefore be considered in all patients with endoscopically visible tumour.
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Internal medicine journal · Apr 2009
Delayed adverse reactions to total-dose intravenous iron polymaltose.
The rate of infusion reactions to total-dose intravenous iron polymaltose is very low, but the frequency and severity of adverse reactions following the infusion are unknown. In 50 consecutive patients, adverse reactions developed up to 2 days after the infusion in 26% and lasted 1-8 days (median 4). Severe systemic reactions occurred in 8%. Patients should be warned of the chance of delayed reactions and an alternative iron preparation should be considered if parenteral iron is again indicated.
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Internal medicine journal · Apr 2009
Comparative StudyThey just don't get enough! Variable intern experience in bedside procedural skills.
Medical school and resident training programmes offer different learning opportunities and outcomes. The aim of the study was to assess medical student and intern experience in common clinical procedures. ⋯ Interns and students receive variable experience to carry out procedural skills on patients. This makes designing training programmes difficult as training needs vary each year. Both mandatory supervision of key skills and opportunities to supplement limited experience are needed during the intern year to ensure a uniform experience.
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Medical malpractice litigation has become an important issue worldwide. Although many epidemiological studies have been carried out, most studies were conducted cross-sectionally in developed countries and focused on malpractice litigation. We conducted nationwide surveys to investigate physicians' experiences associated with malpractice in 1991 and 2005, respectively. ⋯ Compared with 1991, medical malpractice experiences were decreasing in prevalence, but increasing in severity in 2005. Additional studies, especially among different legal systems, are necessary to confirm these observations.