Should the Retention trial of the Test of Memory Malingering be optional?

The present study examined the false negative error rate associated with the optional use of the Retention trial the Test of Memory Malingering (TOMM). TOMM scores from 150 traumatic brain injury and 150 chronic pain patients were examined. Results indicated that early termination of the TOMM resulted in 3% of patients going undetected by the TOMM. The practical cost of this error was minimized by the inclusion of at least one other SVT. Clinical implications are discussed.     

Dealing with dying patients: Difficulties and strategies in final-year medical students

The study reports on a questionnaire study of final-year medical students' self-reported attitudes to dealing with dying patients. All respondents had some direct clinical experience with dying patients, and reported that such encounters were largely unproblematic. Alleviating patient anxiety and counseling relatives were seen as important aspects of the doctor's role, along with diagnosis, and management of symptoms. “High fear” respondents were more likely to report difficulty in discussing the prognosis with the dying and to experience minor psychological problems.     

Professional involvement in sexuality counseling for patients with spinal cord injuries

A national survey was conducted to determine how occupational therapists and rehabilitation nurses conduct sexuality counseling in practice settings with spinal cord-injured patients. A review of the literature and results from the survey demonstrated a high priority concern for sexuality counseling in the total rehabilitation of the spinal cord-injured patient; however, many of the professionals surveyed did not conduct sexuality counseling as part of their job. This study provides data comparing the sexuality counseling approach taken by these two disciplines and identifies ways to eliminate the incongruities between recommendations made in the literature and actual clinical practice.     

Evaluation of a multifaceted "Resident-as-Teacher" educational intervention to improve morning report

Background  

Resident-led morning report is an integral part of most residency programs and is ranked among the most valuable of educational experiences. The objectives of this study were to evaluate the effect of a resident-as-teacher educational intervention on the educational and teaching experience of morning report.     

Fluorescence in situ hybridization analysis of chromosome 12p in paraffin-embedded tissue is useful for establishing germ cell origin of metastatic tumors.

The over-representation of chromosome 12p sequences is crucial for the development of invasive testicular germ cell tumors. Testicular cancer patients may have metastatic tumors of diverse histologic types, including adenocarcinoma, undifferentiated carcinoma, sarcoma, or other malignancies that lack features of germ cell tumors. We sought to investigate the possible germ cell origin of such tumors using interphase fluorescence in situ hybridization. In all, 10 metastatic malignant somatic-type tumors from patients with histories of testicular cancer, as well as one malignant somatic-type tumor from a patient with primary mediastinal germ cell tumor were studied and included: adenocarcinoma (five cases), poorly differentiated carcinoma (one), sarcoma (four), and neuroendocrine carcinoma (one). The tumors were analyzed using fluorescence in situ hybridization using 12p spectrum green and 12 centromeric spectrum orange probes in paraffin sections. The patients ranged in age from 27 to 55 years (mean, 43). Colon and lung cancers from patients without germ cell tumors were used as controls. Adequate signals were observed in all tumors. Gain of chromosome 12p was seen in six tumors. None of the control tumors showed 12p amplification. Fluorescence in situ hybridization for 12p amplification in routinely processed surgical specimens is a useful adjuvant diagnostic tool in confirming the germ cell origin of metastatic tumors having the histologic appearance of somatic-type neoplasms.