Medical student abuse: perceptions and experience

Summary. A questionnaire containing 18 vignettes of common clinical educational situations with potentially abusive treatment of medical students and a 10-item attitude assessment about abusive behaviour were administered to the first-and fourth-year medical students at a mid-west US university medical school. The first- and fourth-year groups did not differ significantly on perceived abusiveness of most of the vignettes, although several of the individual vignettes were perceived significantly differently by the two groups. As hypothesized, the fourth-year students had experienced such situations more frequently. Attitudes towards abusive behaviour did not differ between the two groups. The authors contrast teaching interactions perceived as educationally useful and not abusive with those seen as abusive and not useful and offer explanations for the differences observed. Finally, the possible implications of the results for medical education are discussed.     

Rapid 31P spectroscopy on a 4-T whole-body system

Initial 31P spectroscopy results from a 4-T whole-body system are reported. Localized spectra from the human head, liver, and calf were obtained using DRESS, slice-interleaved DRESS, and volume 3DFT spectroscopic imaging techniques. Substantial reductions in data acquisition times to 10 s-4 min were achieved relative to previous similar experiments at 1.5 T. Some gain in spectral resolution (as measured in ppm) was also realized in the head.     

Use of fibronectin and somatomedin-C as markers of enteral nutrition support in traumatized patients using a modified amino acid formula

The purpose of this study was to evaluate the use of serum fibronectin and serum somatomedin-C as nutritional markers during enteral nutrition support (ENS) of critically ill, traumatized patients using an enteral product containing high concentrations of branched-chain amino acids. Twelve critically injured patients received a standard enteral formula with 30 g of a 44% branched-chain amino acid supplement added to each liter of formula. Fibronectin concentration, somatomedin-C concentration, and nitrogen balance were measured on study days 1, 4, 7, 14, 21, 28 or until adequate oral intake began. Both fibronectin and somatomedin-C concentrations increased significantly from baseline by day 7 of ENS. Nitrogen balance increased significantly from baseline by day 4. On days 14 and 21, only somatomedin-C and nitrogen balance increased significantly from baseline. Nitrogen balance was significantly correlated with somatomedin-C concentration (r = 0.53, p less than 0.01), cumulative caloric intake (r = 0.68, p less than 0.01), and cumulative nitrogen intake (r = 0.72, p less than 0.01). The results of this study suggest that serum somatomedin-C is useful and serum fibronectin has potential in monitoring nutrition support response in critically ill, traumatized patients.     

Cord blood amino acid concentrations from neonates of 23-41 weeks gestational age

Amino acid concentrations were measured in the cord blood serum from neonates following 23-41 weeks gestation. These values were then correlated with the gestational age of the newborns. A significant (p less than 0.05) correlation was observed with the concentrations of six amino acids, and five of these correlations were negative. The significance of these normative data are discussed and compared with currently available cord blood aminogram data.     

Effect of Yag-laser anterior capsulotomy on the biochemical content of aqueous humor

Elevation of prostaglandins and protein in the aqueous humor is an immediate response to Yag-laser anterior capsulotomy. There was a significant correlation between prostaglandins and thromboxane to the elevation of intraocular pressure. The elevation of protein concentration was proportional to the elevation of prostaglandin F1, but not to thromboxane. The biochemical changes in the aqueous humor were more severe as laser power was increased above 3 mj. While the role of prostaglandins in the elevation of intraocular pressure is uncertain, the present data recommend the selection of laser power below 3 mj to avoid pressure rise instead of inhibition of all prostaglandin synthesis by medication.     

Endothelial function and aqueous humor flow rate in patients with Fuchs' dystrophy

Using a two-dimensional scanning fluorophotometer, we studied 50 subjects with symmetric ocular involvement of Fuchs' dystrophy without epithelial edema. Twenty-six subjects with confluent or nearly confluent cornea gutata with increased corneal thickness and 24 subjects with mild to moderate cornea guttata with normal corneal thickness were compared to normal control subjects. There were no statistically significant differences in endothelial permeability between the three groups. Corneal thickness was significantly increased in the subjects with confluent to nearly confluent guttae, however. These results suggest that endothelial pump function may be affected in subjects with advanced cornea guttata with stromal edema.