关键词： 内科学   临床见习   专科带教模式   大内科带教模式  

摘要： 目的:为了探索医学生内科学临床见习带教模式。方法:2000年级和2001年级医学生临床专业294名和预防专业的130名,临床和预防专业各分为2组,(1)专科带教模式组:临床148名,预防68名;(2)大内科带教模式组:临床146名,预防62名。结果:专科带教模式组的临床医学专业学生的轮科成绩为84.7±3.5分,明显高于大内科带教模式组(82.8±6.8分,P<0.05);预防医学专业学生的轮科成绩为82.6±4.9分,明显高于大内科带教模式组(80.9±2.7分,P<0.05)。结论:专科带教模式优于大内科带教模式。

关键词： 中医内科学   临床   教学方法  

摘要： 我院是河南中医学院的临床医院，中医内科教研室承担着中医内科学等课程的课堂授课、临床见习和毕业实习3个阶段的教学任务。在临床教学和实践过程中，教研室积极探索临床教学方法，不断总结经验，现介绍如下。

摘要： 《国际内科学杂志》（原《国外医学内科学分册》）是由中华人民共和国教育部主管、中山大学附属第三医院承办的一本国家级医学期刊，自2007年全面改版以来，在广大审稿专家、作者及读者的关心支持下，不断进步和发展，现已被美国化学文摘、万方数据库、中国核心期刊（遴选）数据库、中文科技期刊全文数据库（维普资讯）、中国期刊全文数据库等收录。主要栏目设有综述、论著（包括临床论著和基础研究论著）、述评、病例报告、会议报道、药物与临床、最新医学信息等栏目。

关键词： Communicable Diseases  

摘要： Background: Our institution experienced an increase in the frequency of vancomycin-resistant enterococci (VRE) clinical isolates, which rose 5-fold from 2004 to 2005. We sought to measure the prevalence of VRF carriage among medical inpatients in a tertiary hospital in Jerusalem and estimate the rate of acquisition during hospitalization. Methods: During 2006, we performed 3 cross-sectional surveys, including 1039 patients, representing 3 phases of hospitalization: admission, hospital stay, and discharge. Perianal/stool samples were Cultured for VRF. Results: VRE carriage was 3.8% (95% confidence interval [CI] = 1.8% to 6.9%) on admission, 15% (95% Cl = 9% to 23%) at discharge, and 32% (95% Cl = 24% to 40%) among inpatients. Among inpatient carriers, 60% of the isolates represented a single strain. Recent previous hospitalization was the most significant predictor for identifying carriers on admission. Conclusions: Our study demonstrates that substantial VRE transmission occurred during hospitalization. Identification of carriers on admission should supplement effective application of infection control methods in attempting to decrease VRE nosocomial spread and burden. Copyright (C) 2009 Association for Professionals in infection Control and Epidemiology, Inc.

关键词： Asymmetric dimethylarginine   Emergency room   Outcome   Cardiovascular disease   Risk factor   Time of stay  

摘要： Introduction: For patients attending the emergency room (ER) valid diagnostic criteria which identify patients at risk for an adverse outcome are needed. We investigated the predictive value of asymmetric dimethylarginine (ADMA) in unselected patients attending an internal medicine ER regarding outcome of the patients and duration of stay in the hospital. Patients and methods: Patients (n=417) attending the ER were classified according to their primary diagnosis. Routine laboratory tests were performed and ADMA was determined. Patients were followed for a primary endpoint of in hospital death and complicated outcome. Results: ADMA levels were highest in patients with a cancer-related diagnosis (0.76 (0.63-0.93) mu mol/L) and in patients with a cardiovascular diagnosis (0.69 (0.60-0.80) mu mol/L;p<0.001). Overall, we found increasing proportions of patients experiencing the primary end point over the quartiles of ADMA (4.6%, 8.2%. 9.6%, and 15.8%;p=0.007). ADMA had the highest predictive value for the primary endpoint in patients with cardiovascular disease (odds ratio 19.4;p=0.029). In a Cox proportional hazard model ADMA was an independent predictor of the length of hospitalization (hazard ratio 2.0 (95% CI: 1.3-3.3);p=0.006) in the entire cohort. Conclusion: We conclude that ADMA independently predicts future complications and hospitalization in patients attending an ER. (C) 2008 Elsevier B.V. All rights reserved.

关键词： Physical and emotional exhaustion state   Internal Medicine   Observation for unspecified condition   内科学   medical student   DIRECTORS   Internal Medicine   burnout syndrome  

摘要： Burnout is a syndrome of emotional exhaustion, depersonalization, and a sense of low personal accomplishment that leads to decreased effectiveness at work. Prevalent in medical students and residents, burnout is associated with suicidal ideation, decreases in empathy, and medical errors. Although the causes of burnout among physicians-in-training are unknown, modeled burnout by academic faculty may be a contributing factor. Despite this speculation, little is known about the prevalence or consequences of burnout in internal medicine clerkship directors who instruct, advise, and counsel medical students and are responsible for organizing students' experiences in the field of internal medicine. Here, Dyrbye et al evaluate the prevalence of burnout and its relationship to faculty attitudes toward students.

关键词： education leaders   oral case presentations   clinical clerks  

摘要： Little is known about the expectations of undergraduate internal medicine educators for oral case presentations (OCPs). We surveyed undergraduate internal medicine educational leaders to determine the degree to which they share the same expectations for oral case presentations. Participants were institutional members of the Clerkship Directors of Internal Medicine (CDIM). We included 20 questions relating to the OCP within the CDIM annual survey of its institutional members. We asked about the relative importance of specific attributes in a third-year medical student OCP of a new patient as well as its expected length. Percentage of respondents rating attributes as "very important" were compared using chi-squared analysis. Survey response rate was 82/110 (75%). Some attributes were more often considered very important than others (p < .001). Eight items, including aspects of the history of present illness, organization, a directed physical exam, and a prioritized assessment and plan focused on the most important problems, were rated as very important by > 50% of respondents. Respondents expected the OCP to last a median of 7 minutes. Undergraduate internal medicine education leaders from a geographically diverse group of North American medical schools share common expectations for OCPs which can guide instruction and evaluation of this skill.

关键词： 内科学  

ISBN: (纸本)9787530850565

摘要： 本书共13章，内容包括：呼吸系统疾病、循环系统疾病、消化系统疾病、泌尿系统疾病、血液及造血系统疾病、内分泌和代谢系统疾病、风湿病和结缔组织病等。

关键词： 住院病人   内科学   危险因素   抗生素相关性腹泻  

摘要： 目的探讨引起内科住院患者抗生素相关性腹泻（AAD）的相关因素。方法回顾性分析内科住院AAD患者80例和同期住院应用抗生素但无AAD患者680例的临床资料，对可能影响AAD的因素进行单因素分析与Logistic回归模型分析。结果排除抗生素本身影响因素外，Logistic回归模型分析结果显示年龄大、禁食、病情重、侵袭性操作是AAD的独立危险因素。结论除合理使用抗生素外，诸多因素可引起内科住院患者AAD发生；加强对老年重症患者监测、减少侵袭性操作、早期肠内营养或经口进食，同时补充益生菌可预防和减少AAD发生。