数字医学发展趋势及在妇产科的应用

由于信息科学特别是计算机科学与技术的快速发展,推动人类社会进入了数字化时代。纵观科学发展史,科学技术的最新研究成果往往都是最先应用于医学和军事。数字医学就是人类社会进入数字化时代应运而生的新生事物,它是以现代医学和数字化高新技术相结合、涵盖了医     

重视抗生素在妇产科临床中合理应用

<正>1929年,英国细菌学家弗莱明发现了青霉素,这是人类医学科学发展史上的一个重大的里程碑。自1941年青霉素应用于临床后,人们相继发现了上万种抗生素,有200余种应用于临床。几十年来,抗生素的广泛应用已挽救了数以万计的生命,为维护人类的健康立下了不朽的功勋。     

数字医学在妇产科临床应用基础研究进展

数字医学是一门涵盖了多个学科领域的新兴交叉性学科。近年来,随着相关三维重建技术等的发展,其逐渐也在妇产科中得到了运用。该文对数字医学在妇产科的研究方法及临床应用基础研究进展进行了探讨。     

Pathologic examination of the placenta and its clinical utility: a survey of obstetrics and gynecology providers

Objective: To determine provider awareness of the College of American Pathologists (CAP) recommended guidelines for examination of placenta and evaluate the Obstetrician –Gynecologist’s perception of the clinical utility of placenta pathology reports.

Study design: An anonymous survey of Obstetrician Gynecologists who attended the national conference of The Central Association of Obstetricians and Gynecologists (CAOG) in 2013 assessing their knowledge of the CAP guidelines and utilization of information obtained from pathology reports. Chi-square or Fisher’s exact test were used to evaluate association between specialists and non-specialist providers as related to survey questions and multivariable logistic regression used to explore factors associated with utilization and awareness of the guidelines.

Results: A total of 218 providers attended the conference and 111 surveys were completed. Only 36% of participants were aware of the CAP guidelines for pathologic examination of the placenta. The odds that a physician with more than 15 years of experience will send a placenta for examination was 0.210 times that of physicians with less than 15 years of experience (CI 0.084, 0.521). The odds for awareness of the CAP guideline among subspecialists who participated in the study were 3.630 times the odds for non-specialist (CI 1.44, 9.147). In addition, the odds of sending a placenta for those physicians in a community hospital are 0.300 times that of physicians in a University hospital (CI 0.110, 0.820). The presence of a pathologist skilled in obstetrics and gynecology did not seem to affect awareness of the CAP guidelines, perception of the usefulness of the guidelines and likelihood of sending a placenta for examination. Only 21% of participants reported understanding the nomenclature used in pathology reports “all the time”. Participants ranked the explanation of adverse pregnancy outcome as the most useful clinical application of placenta pathologic examination and most advocated for continued placental pathologic examination.

Conclusion: Most of the participants in this study were not aware of the CAP guidelines. The study also revealed deficits in understanding the nomenclature on pathology reports even though providers overall recognized the clinical utility of pathologic examination of the placenta. This emphasizes the importance of actively incorporating the concept of pathologic changes of the placenta into the curriculum for training obstetrician gynecologists and pathologists and for institutions to streamline policies centered on pathologic examination of the placenta.     

Postgraduate school of obstetrics and gynecology and nongovernmental organizations: is collaboration possible?

We report the collaboration between the First Postgraduate School of Obstetrics and Gynecology at the University of Milan, Italy, and the nongovernmental organization “Emergency” that operates through its own hospitals in countries devastated by armed conflicts. The collaboration was centered on the maternity clinic that Emergency opened in 2003 in northern Afghanistan. After a woman resident spent 5 months on-site, the collaboration is now extended to all residents with a group with four areas of intervention: guidelines, clinical records and data collection, drugs and medical devices, and teaching material. In addition, it offers consultation by e-mail for any clinical issue that might arise.     

Ghana postgraduate obstetrics/gynecology collaborative residency training program: success story and model for Africa

OBJECTIVE: We describe a residency program in Ghana that was developed to train obstetrics/gynecologist specialists for Ghana and the subregion to promote and manage the reproductive health of women and to reduce a high maternal mortality rate. STUDY DESIGN: The Carnegie-supported program, begun in 1989, is a 5-year residency in the two medical schools in Ghana, but with one central coordinating office. It has features that equip the graduate resident to practice in his/her environment. The fourth year of the program is unique: the resident attends a hospital management course for 3 months, goes for a clinical rotation in the United States or United Kingdom for 3 months, and moves to live and work in a rural district hospital for 6 months. RESULTS: The success rate of the Ghanaian residents in the examination of the West African College of Surgeons has been three to four times higher than the overall pass rate. As of October 2002, the program had produced 26 specialists, all of whom are practicing in Ghana. In contrast, of 30 specialists who were trained abroad between 1960 and 1980, only 3 specialist had returned home by the end of the 1980s. The current chairpersons of the two medical schools are graduates of the program. Carnegie financial support for the program came to an end in January 2000, but the Ghana Ministry of Health has increased its support enthusiastically. The program is being sustained. Maternal mortality and morbidity rates are falling slowly in the two teaching hospitals; case fatality rates have been reduced markedly. New residents are entering the program and are progressing to completion. CONCLUSION: The program has been an unqualified success and merits replication.     

A survey of career-decision factors for obstetrics and gynecology residents in Taiwan

ObjectiveThe recruitment of obstetrics and gynecology residents has been challenging in Taiwan since 2000. There are a lots factors influencing applying, including career interest and prospects, lifestyle, salary, litigation, stress level, time demands of specialty work and gender consideration. The purpose of this study was to evaluate the factors influencing the career choice of current OB/GYN residents and identify the important factors influencing recruitment.Materials and methodsA cross-sectional questionnaire of career-decision factors was sent to all 280 residents during December, 2019. Total 16 factors were rated on a 5-point Likert and were ranking by their average score on the scale. Gender of residents was analyzed for their association with the scores by a two-sample test and two-tailed t test.Results91 (32.5%) residents responded and 61 were female and 30 were male. The top influencing factor was being interested in clinical expertise with an average score of 4.32. The second factor was having a great sense of accomplishment in saving people with an average score of 3.82, followed by it being easier to become a medical practitioner at 3.77. The lowest scoring factor was fewer hours of work, with an average score of 1.77 and a safer working environment with a score of 2.33 was the second lowest factor. Female residents agreed that it was easier to get specialist certification with a score of 3.0. This score was significantly higher than male doctors at 2.63 with p value of 0.017.ConclusionCareer interest and prospects were key influencing factors for applying OB/GYN residents. Minimizing the influence of detracting factors like heavy workload and medical litigation was also effective. Enrolling new residents is key to maintaining adequate staffing in specialties in healthcare. Establishing a safer work environment and determining the optimal workload will be the next reforms in the future.     

翻转课堂教学模式在妇产科学带教中的应用

目的 翻转课堂是一种新颖有效的教学模式,本研究将翻转课堂教学模式引入妇产科见习带教中,探讨该模式在妇产科见习教学过程中的应用与意义.方法 选取至温州医科大学附属第一医院妇产科见习的大四学生60名,研究组采用翻转课堂教学模式,对照组采用传统教学模式.分别对两组学生进行问卷调查、成绩考核来评价相应教学模式效果.结果 研究组...     

数字化三维重建技术在妇产科疑难病例诊断中的应用

数字化三维重建技术是妇产科临床应用中的新兴技术,有利于妇产科疑难疾病的诊断、治疗。该文从数字化三维重建技术评估病灶血供来源和特点、评估病灶血流量及分布特点、重建部分器官和肿瘤病灶实体的外观以及和周围器官的毗邻关系方面进行了阐述。     

The obstetrics and gynecology clerkship: building a better model from past experience

OBJECTIVE: The study was undertaken to identify factors contributing to the poor student perception of the obstetrics and gynecology clerkship. STUDY DESIGN: Third-year medical students at the University of Michigan complete an annual questionnaire about the overall quality of their clinical experiences. In addition, at the end of each rotation, the students complete an evaluation form assessing various aspects of their learning experience. We reviewed data collected from 2000 to 2002. We calculated effect sizes using mean scores and SDs to compare individual aspects of the learning environment across the clerkships. RESULTS: Twenty-six percent of the third-year medical students at the University of Michigan rated the strength of their obstetrics and gynecology experience as very or exceptionally strong. Compared with the other 6 clerkships, the rotation had one of the lowest ratings for overall quality. Aspects of the clerkship experience we identified as potentially explaining this overall poor rating include the clarity of the clerkship goals and objectives, clarity of expectations for student performance, accessibility of faculty, experiences in learning history-taking skills, experiences in learning physical examination skills, and student perception that they were treated in a respectful/professional manner. CONCLUSION: Aspects of the clerkship experience identified by this study as potentially explaining the low ratings of the obstetrics and gynecology rotation should be studied in greater detail. Addressing these factors will be critical for improving the overall student perception of the obstetrics and gynecology clerkship.