Tienda online donde Comprar Medical Decision Making al precio 38,28 € de Alan Schwartz | George B... more Tienda online donde Comprar Medical Decision Making al precio 38,28 € de Alan Schwartz | George Bergus, tienda de Libros de Medicina, Libros de Medicina Familiar y Comunitaria/General - Medicina general
Many of the terms used in medical decision making are foreign to clinicians. This problem creates... more Many of the terms used in medical decision making are foreign to clinicians. This problem creates a barrier that can prevent physicians from acquiring these new clinical tools. This glossary contains definitions of the most common terms as well as examples of their usage by using Down syndrome as the illustrative condition.
Background and Objectives: Identifying underperforming residents and helping them become fully co... more Background and Objectives: Identifying underperforming residents and helping them become fully competent physicians is an important faculty responsibility. The process to identify and remediate these learners varies greatly between programs. The objective of this study was to evaluate the remediation landscape in family medicine residency programs by investigating resident remediation characteristics, tools to improve the process, and remediation challenges. Methods: This study analyzed responses from the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2017. Survey questions included topics on faculty remediation training, remediation prevalence, tools for remediation, and barriers to remediation. Results: Two hundred sixty-seven of 503 program directors completed our survey (53% response rate). Most residency programs (245/264, 93%) had at least one resident undergoing remediation in the last 3 years. ...
Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for ... more Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for hip fracture. Patients may present with acute respiratory symptoms, including tachypnea, tachycardia and rales. Chest radiographs and clinical and laboratory findings alone cannot provide a firm diagnosis. A completely normal chest radiograph may be seen in up to 40 percent of patients with pulmonary embolism, and as many as 30 percent of persons with pulmonary embolism and no prior cardiopulmonary disease will have a PaO2 greater than 80 mm Hg. The ventilation/perfusion (V/Q) lung scan is central to guiding clinical decisions. V/Q scans interpreted as either normal, near normal or high probability are reasonably diagnostic. A low probability V/Q scan can exclude the diagnosis of pulmonary embolism only if the patient has a clinically low probability of pulmonary embolism. Intermediate V/Q scans are not diagnostic and call for further evaluation. Compression ultrasonography is sensitive ...
This article proposes an Integration Model for Health Services whose extent of complexity of care... more This article proposes an Integration Model for Health Services whose extent of complexity of care are included in the General System of Social Security in Health (SGSS) aimed at setting up a basic tool to enhance the effective and decisive response of the Colombian Healthcare System in the use and management of resources. The model allows carrying out an intrinsic assessment of the system administration, as well as of the resources and actors to be applicable to other integration systems and management of hospital resources at the national and international consensus. The analysis of complex systems is taken as fundamental issues to abstract the basic structure of interactions and assessment of possible emerging situations in the Management of Health System.
Skin and soft-tissue infections (SSTIs) are among the most common infections encountered by emerg... more Skin and soft-tissue infections (SSTIs) are among the most common infections encountered by emergency physicians. The spectrum of disease severity as seen by emergency physicians is wide, and can range from mild, uncomplicated cellulitis to cutaneous abscesses and necrotizing SSTIs. Infections can include acute, recurrent, and chronic wounds, and community-associated and health care-associated infections in immunocompetent or immunocompromised hosts. Because of the nature of their practice, emergency physicians encounter patients on a daily basis with a wide variety of mechanisms that lead to SSTIs. These can include animal and human bites, gunshot wounds, illicit drug injection, work-related injuries, pressure sores, and iatrogenic injuries caused by procedures (eg, intravenous lines). Similarly, infectious disease (ID) specialists see a variety of SSTIs in their practice; however, for the ID specialist the spectrum of disease is more skewed toward patients with a complicated course, those who had multiple treatment failures, and recurrent, severe, or rare and unusual infections. Unlike ID specialists, emergency physicians more frequently have to initiate empiric antibiotics because of the absence of culture and susceptibility results, more often have to consider life
Low-dose thiazide-type diuretics are recommended as initial therapy for most hypertensive patient... more Low-dose thiazide-type diuretics are recommended as initial therapy for most hypertensive patients. Chlorthalidone has significantly reduced stroke and cardiovascular end points in several landmark trials; however, hydrochlorothiazide remains favored in practice. Most clinicians assume that the drugs are interchangeable, but their antihypertensive effects at lower doses have not been directly compared. We conducted a randomized, single-blinded, 8-week active treatment, crossover study comparing chlorthalidone 12.5 mg/day (force-titrated to 25 mg/day) and hydrochlorothiazide 25 mg/day (force-titrated to 50 mg/day) in untreated hypertensive patients. The main outcome, 24-hour ambulatory blood pressure (BP) monitoring, was assessed at baseline and week 8, along with standard office BP readings every 2 weeks. Thirty patients completed the first active treatment period, whereas 24 patients completed both. An order–drug–time interaction was observed with chlorthalidone; therefore, data fr...
Atherosclerotic renal artery stenosis is a common clinical problem for which the optimal therapeu... more Atherosclerotic renal artery stenosis is a common clinical problem for which the optimal therapeutic strategy remains to be defined. However, renal artery stenting procedures have significantly increased as one approach to treat this clinical problem. Despite improvements in device design and technical performance of the procedure, the benefits and results of randomized clinical trials of renal artery stenting as a therapy remain confusing. Understanding the epidemiology, pathophysiology and natural history of renal artery stenosis are central to improving the outcomes of renal artery stenting. Developing both noninvasive and invasive predictive tools to better identify which patient will respond to renal revascularization will also be beneficial. In this article, we will present an overview of atherosclerotic renal artery disease. The results of renal artery stenting will be discussed and from this, the available noninvasive and invasive tools available to assess the clinical and hemodynamic significance of renal artery stenosis will be presented.
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 2001
Gestational diabetes mellitus (GDM) is defined as a glucose intolerance first recognised in pregn... more Gestational diabetes mellitus (GDM) is defined as a glucose intolerance first recognised in pregnancy. The World Health Organization (WHO) in 2015 revised the definition into either diabetes in pregnancy (DIP) which includes pre-existing diabetes (type 1 or type 2) that antedates pregnancy or diabetes diagnosed during pregnancy with the WHO diagnostic criteria for diabetes mellitus (DM) in the nonpregnant state, and GDM for milder forms of hyperglycaemia in pregnancy. The main purpose of the screening and diagnosis of GDM is to identify pregnancies in which the foetus is at a high risk of an adverse perinatal outcome, and the mother and the offspring are of serious long-term sequelae. This review of the literature provides an overview of associated prevalence, risk factors and diagnosis of GDM. It also addresses the benefits of screening with supportive evidence. Based on this review, we recommend especially in low-resourced countries such as the Caribbean, adoption of a universal screening with the two-step method.
Tienda online donde Comprar Medical Decision Making al precio 38,28 € de Alan Schwartz | George B... more Tienda online donde Comprar Medical Decision Making al precio 38,28 € de Alan Schwartz | George Bergus, tienda de Libros de Medicina, Libros de Medicina Familiar y Comunitaria/General - Medicina general
Many of the terms used in medical decision making are foreign to clinicians. This problem creates... more Many of the terms used in medical decision making are foreign to clinicians. This problem creates a barrier that can prevent physicians from acquiring these new clinical tools. This glossary contains definitions of the most common terms as well as examples of their usage by using Down syndrome as the illustrative condition.
Background and Objectives: Identifying underperforming residents and helping them become fully co... more Background and Objectives: Identifying underperforming residents and helping them become fully competent physicians is an important faculty responsibility. The process to identify and remediate these learners varies greatly between programs. The objective of this study was to evaluate the remediation landscape in family medicine residency programs by investigating resident remediation characteristics, tools to improve the process, and remediation challenges. Methods: This study analyzed responses from the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2017. Survey questions included topics on faculty remediation training, remediation prevalence, tools for remediation, and barriers to remediation. Results: Two hundred sixty-seven of 503 program directors completed our survey (53% response rate). Most residency programs (245/264, 93%) had at least one resident undergoing remediation in the last 3 years. ...
Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for ... more Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for hip fracture. Patients may present with acute respiratory symptoms, including tachypnea, tachycardia and rales. Chest radiographs and clinical and laboratory findings alone cannot provide a firm diagnosis. A completely normal chest radiograph may be seen in up to 40 percent of patients with pulmonary embolism, and as many as 30 percent of persons with pulmonary embolism and no prior cardiopulmonary disease will have a PaO2 greater than 80 mm Hg. The ventilation/perfusion (V/Q) lung scan is central to guiding clinical decisions. V/Q scans interpreted as either normal, near normal or high probability are reasonably diagnostic. A low probability V/Q scan can exclude the diagnosis of pulmonary embolism only if the patient has a clinically low probability of pulmonary embolism. Intermediate V/Q scans are not diagnostic and call for further evaluation. Compression ultrasonography is sensitive ...
This article proposes an Integration Model for Health Services whose extent of complexity of care... more This article proposes an Integration Model for Health Services whose extent of complexity of care are included in the General System of Social Security in Health (SGSS) aimed at setting up a basic tool to enhance the effective and decisive response of the Colombian Healthcare System in the use and management of resources. The model allows carrying out an intrinsic assessment of the system administration, as well as of the resources and actors to be applicable to other integration systems and management of hospital resources at the national and international consensus. The analysis of complex systems is taken as fundamental issues to abstract the basic structure of interactions and assessment of possible emerging situations in the Management of Health System.
Skin and soft-tissue infections (SSTIs) are among the most common infections encountered by emerg... more Skin and soft-tissue infections (SSTIs) are among the most common infections encountered by emergency physicians. The spectrum of disease severity as seen by emergency physicians is wide, and can range from mild, uncomplicated cellulitis to cutaneous abscesses and necrotizing SSTIs. Infections can include acute, recurrent, and chronic wounds, and community-associated and health care-associated infections in immunocompetent or immunocompromised hosts. Because of the nature of their practice, emergency physicians encounter patients on a daily basis with a wide variety of mechanisms that lead to SSTIs. These can include animal and human bites, gunshot wounds, illicit drug injection, work-related injuries, pressure sores, and iatrogenic injuries caused by procedures (eg, intravenous lines). Similarly, infectious disease (ID) specialists see a variety of SSTIs in their practice; however, for the ID specialist the spectrum of disease is more skewed toward patients with a complicated course, those who had multiple treatment failures, and recurrent, severe, or rare and unusual infections. Unlike ID specialists, emergency physicians more frequently have to initiate empiric antibiotics because of the absence of culture and susceptibility results, more often have to consider life
Low-dose thiazide-type diuretics are recommended as initial therapy for most hypertensive patient... more Low-dose thiazide-type diuretics are recommended as initial therapy for most hypertensive patients. Chlorthalidone has significantly reduced stroke and cardiovascular end points in several landmark trials; however, hydrochlorothiazide remains favored in practice. Most clinicians assume that the drugs are interchangeable, but their antihypertensive effects at lower doses have not been directly compared. We conducted a randomized, single-blinded, 8-week active treatment, crossover study comparing chlorthalidone 12.5 mg/day (force-titrated to 25 mg/day) and hydrochlorothiazide 25 mg/day (force-titrated to 50 mg/day) in untreated hypertensive patients. The main outcome, 24-hour ambulatory blood pressure (BP) monitoring, was assessed at baseline and week 8, along with standard office BP readings every 2 weeks. Thirty patients completed the first active treatment period, whereas 24 patients completed both. An order–drug–time interaction was observed with chlorthalidone; therefore, data fr...
Atherosclerotic renal artery stenosis is a common clinical problem for which the optimal therapeu... more Atherosclerotic renal artery stenosis is a common clinical problem for which the optimal therapeutic strategy remains to be defined. However, renal artery stenting procedures have significantly increased as one approach to treat this clinical problem. Despite improvements in device design and technical performance of the procedure, the benefits and results of randomized clinical trials of renal artery stenting as a therapy remain confusing. Understanding the epidemiology, pathophysiology and natural history of renal artery stenosis are central to improving the outcomes of renal artery stenting. Developing both noninvasive and invasive predictive tools to better identify which patient will respond to renal revascularization will also be beneficial. In this article, we will present an overview of atherosclerotic renal artery disease. The results of renal artery stenting will be discussed and from this, the available noninvasive and invasive tools available to assess the clinical and hemodynamic significance of renal artery stenosis will be presented.
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 2001
Gestational diabetes mellitus (GDM) is defined as a glucose intolerance first recognised in pregn... more Gestational diabetes mellitus (GDM) is defined as a glucose intolerance first recognised in pregnancy. The World Health Organization (WHO) in 2015 revised the definition into either diabetes in pregnancy (DIP) which includes pre-existing diabetes (type 1 or type 2) that antedates pregnancy or diabetes diagnosed during pregnancy with the WHO diagnostic criteria for diabetes mellitus (DM) in the nonpregnant state, and GDM for milder forms of hyperglycaemia in pregnancy. The main purpose of the screening and diagnosis of GDM is to identify pregnancies in which the foetus is at a high risk of an adverse perinatal outcome, and the mother and the offspring are of serious long-term sequelae. This review of the literature provides an overview of associated prevalence, risk factors and diagnosis of GDM. It also addresses the benefits of screening with supportive evidence. Based on this review, we recommend especially in low-resourced countries such as the Caribbean, adoption of a universal screening with the two-step method.
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Papers by George Bergus