Etudiants inscrits aux facultés de médecine du Canada, 1976-77.

The 1976-77 statistical study of medical school enrollment by the Association of Canadian Medical Colleges shows that total enrollment in Canadian medical schools had increased 103.8% since 1960-61, although the rate of increase had decreased to almost zero by 1976-77. Women accounted for 30.3% of the total enrollment in 1976-77 (for all years of the course), which represents an increase of more than 550% in the 17-year period; for the 16 schools the proportion ranged between 23.9% and 43.8%. Enrollment of foreign students had decreased from 340 in 1966-67 to 90 (1.2%) in 1976-77; 71 of the 90 students were American. For the entire nation the mean number of medical students per 10 000 population was 3.1, but in British Columbia the figure was only 1.5. Of the Canadian and landed immigrant students 94.5% were attending medical school in their home province.     

L'utilisation de services de santé et de médicaments par des personnes âgées de Montréal qui reçoivent des soins maintien à domicile.

A survey was conducted among 160 persons aged 64 year or more in Montreal who were receiving home care. They answered at home a questionnaire on their use of health care services and drugs, and showed the interviewer all the drugs they were taking. In comparison with similar data from elsewhere, the use of health care services (an average of 8.0 encounters with a physician per person per year) and of drugs (an average of 5.3 per person) by this group seems high. Perhaps this group of people was obviously sicker than others of the same age, but this remains to be shown. Moreover, despite the reported frequency of health problems, it is uncertain whether such use of services and drugs was necessary. The question is raised whether the home care system is doing for the patient what it was intended to do.     

Les médecins du Québec: majoritairement pour l''avortement

Over 80% of Quebec's doctors recognize serious mental health dangers, the probability of fetal damage, or pregnancy due to rape as sufficient grounds for abortion. The most liberal 19% also accept pregnancy out of wedlock, or lack of economic support as a sufficient reason, but another 14% reject any basis for abortion, though among those some would accept a few criteria if the abortion were performed by another doctor. These results come from a random sample of the 12,000 doctors registered with the Quebec Medical Association. The high response rate of 45.4% gave ultimate representation to 10% of the medical population of Quebec. 90% of the doctors wanted a uniform set of criteria for hospital abortion committees, which now vary greatly. Protestant and Jewish hospitals being more liberal than Catholic ones. They also stressed sex education, access to contraceptives and services of birth regulation as necessary to stem overuse of abortions. The doctors were unsure of their legal position regarding abortion and tended to consider the law more restrictive than it is. Over 60% do want abortion removed from the Criminal Code. The number of referrals to hospital committees has increased between 1971-1975 though even in 1975 less than 132 doctors made more than half the demand. In 1975 doctors sent 30.1% of abortion demands to a committee, 20.7% to a clinic in the U.S., 14.8% to another doctor, 13.4% to a reference center, 10.4% to a Quebec clinic, 1.9% to a clinic elsewhere in Canada, and 8.7% of the cases were neither referred nor granted an abortion by the doctor. Most doctors agree that necessary action on the abortion issue includes discussions and conferences on the subject for medical personnel and the development of public awareness of the problem.     

Enseignement médical permanent à Laval: Programme extra-muros (automne 1964)

The 1964 fall program of Continuing Medical Education sponsored by Laval University during September and October comprised 55 medical meetings held in 18 regions of the eastern part of the Province of Quebec for the benefit of practitioners. The prerogative of selecting topics rested with the medical board of the regional hospital, together with determination of the time and date of the meeting. The teaching was essentially clinical and practical: presentation of patients, cases or files, followed by a short period of questions and answers, and finally a lecture (30-40 minutes) on an aspect of the selected subject; each meeting lasted at least four hours. A committee appointed by the Faculty of Medicine, Laval University, selected the teacher, co-ordinated the whole program and ensured the quality of the presentation. Attendance varied from 50% to 100% of the doctors in a given region.     

L'enseignement des sciences morphologiques dans 13 facultés de médecine canadiennes

A survey of teaching of morphologic sciences in Canadian medical schools has shown that few radical changes have taken place in most schools. The survey has also shown the following: (a) department chairmen have a major influence on teaching of morphologic sciences; (b) they are worried about the diminishing time alloted to them; (c) students, by their choice of electives, do not seem to share that worry; (d) lectures remain popular, as does disection in most schools; and (e) audiovisual methods, especially rediology, are becoming more popular but are not yet used on a very large scale.     

Invalidité temporaire et troubles émotifs.

The author deals with temporary incapacity, as currently expressed by "sick leave." Minor psychiatric problems are involved more and more as a cause of temporary incapacity, and sometimes the duration of such leaves of absence is much longer than might be warranted by the nature of the problem. Challenges by paying agents and employers are more and more frequent. On the basis of literature of a very general nature the author distinguishes between a difficult personal situation, a symptom, an illness, functional limitations and invalidity, the last one being at the crossroads between medical, personal and social reasons. The author emphasizes the particular difficulties experienced by physicians faced with that kind of problem and describes the rapid intervention needed to deal with the underlying reasons for an obvious request for a leave of absence.     

Evaluation comparée des effets subjectifs de la dextroamphétamine, du méthylphénidate et du placebo

The subjective effects of dextroamphetamine, methylphenidate and placebo were evaluated in 16 medical students during the period just prior to their final oral examinations. The subjects served as their own controls. The order of administration of the three medications for each student was randomized, and a double-blind technique was used throughout. A questionnaire method was employed for the collection of results, which proved to be a useful and effective means. It demonstrated that dextroamphetamine, methylphenidate and placebo were statistically different from one another with regard to their effect on efficiency of studying, fatigue, duration of sleep and appetite. There were also significant differences in the number of side effects caused by the three medications. The stimulants, however, did not increase the number of study hours, nor was their use recommended by the students when preparing for important examinations.     

Effets de la chirurgie á coeur ouvert sur les mécanismes de défense contre lea infections bactériennes

Extracorporeal circulation during open-heart surgery may damage cellular and humoral factors in the blood. Phagocytic functions of circulating polymorphonuclear leukocytes were investigated in 10 patients 1 day before, then 1 hour, 2, 4 and 10 days after open-heart surgery. Transient diminutions in the phagocytic capacity of polymorphs was found for Staphylococcus aureus and Escherichia coli in one patient, and E. coli only in two patients up to the 4th postsurgical day. A positive correlation was found between the duration of extracorporeal circulation and the transient diminutions in phagocytic capacity for these three patients. However, the bactericidal capacity of polymorphs and their capacity to reduce nitroblue tetrazolium were normal in all patients. The serum concentrations of total hemolytic complement, C3, IgG and IgM were generally diminished up to the 4th day after surgery, but the opsonic power of the serum was almost normal in all the patients.     

Correction de l'hypertension intracrânienne créée par compression mécanique directe du cerveau

An attempt has been made to correct cerebral hypertension induced by direct compression of the brain in a group of six dogs. The animals, which had been previously fitted with an inflatable subdural rubber balloon, were either kept eupneic (isolated mechanical hypertension) or deliberately hypoventilated (mixed mechanical and acidotic hypertension). In the first instance, administration of urea brought the intracranial pressure back to control values while, in the second case, injection of an amine buffer controlled only the acidotic component of intracranial hypertension.