Library

feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 38 (1995), S. 921-925 
    ISSN: 1530-0358
    Keywords: Rectovaginal fistula ; Advancement flap ; Gracilis transfer ; Coloanal anastomosis ; Sphincteroplasty
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The purpose of this study was to assess results of treatment of rectovaginal fistulas (excluding pouch vaginal fistulas) that have failed previous attempts at repair. METHOD: A retrospective chart review of all patients presenting with nonhealing rectovaginal fistula was performed. RESULTS: Twenty eight patients with persistent fistulas were identified. In 18 patients the fistula was classified as simple, and in 10 the fistula was complex. Fourteen fistulas were secondary to obstetric injury, five were caused by Crohn's disease, and nine patients had miscellaneous etiologies for their fistulas. Of patients with persistent simple fistulas, 13 (72 percent) of the fistulas healed, 5 after advancement flaps, 5 following sphincteroplasty, and 3 after coloanal anastomoses. Of persistent complex fistulas, only four of ten (40 percent) healed, one following sphincteroplasty, one with coloanal anastomosis, and two after gracilis transposition. A total of 23 advancement flaps were done in 17 patients with five fistulas healing (29 percent). Sphincteroplasty and fistulectomy was successful in six of seven patients (86 percent). Coloanal anastomosis resulted in healing of four of six patients (67 percent) in whom it was attempted. Gracilis muscle transfer was successful in two of two patients (100 percent). CONCLUSION: Persistent rectovaginal fistula presents a difficult management problem. Choice of operation must be tailored to the underlying pathology and type of repair previously done. Advancement flap repair is generally not recommended for persistent complex fistulas or for simple fistulas that have failed a previous advancement flap repair.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Au cours de ces trois dernières décennies, le Canada a développé un système de Santé universel exemplaire. Les problèmes de contraintes pécuniaires risque, cependant, de déstabiliser les bases de ce système qui par ailleurs caractérise bien le respect de ce pays pour la justice sociale. Le premier de ces deux article (part 1) décrit les caractéristiques assez uniques du système, fait une comparaison entre les autres systèmes de santé existant dans le monde, analyse la réaction du corps médical envers le contrôle du système qu'exigent les gouvernements, et enfin, expose comment la réduction en fonds et en hommes influence les valeurs et organisation qui ont fait fonctionner ces systèmes jusqu'à présent. Le deuxième article (part 2) résume le financement et l'organisation de la formation médicale, ainsi que l'impact que certains changements du système de santé auront sur l'enseignement post-universitaire. En particulier sont abordés les problèmes de certification, de validation de diplômes, l'influence des changements des caractéristiques de la population et la prise en charge des patients, les besoin en médecins, et les attentes du public de la profession médicale.
    Abstract: Resumen En los tres últimos decenios el Canadá ha desarrollado un sistema ejemplar de cobertura universal de la salud. Sin embargo, las actuales limitaciones de orden financiero amenazan con minar los fundamentos mismos del sistema que caracteriza el respeto que profesa el Canadá por la justicia social. El primero de estos dos artículos (Parte I) discute las características muy peculiares del sistema, un panorama comparativo de los sistemas universales de cobertura de salud, la reacción de la profesión médica al control gubernamental y, por último, las restricciones en cuanto a financiación y capital humano que obligan a revisar los valores y la organización que han mantenido al sistema hasta ahora. El segundo artículo (Parte II) revisa la organización y el financiamiento de la educación médica y el impacto de algunos cambios críticos en el sistema de atención de la salud sobre la educación médica de postgrado. Se revisan los asuntos relativos a los nuevos requisitos para licencia y certificación, las variaciones en demografía y los enfoques sobre provisión de servicios, las necesidades de recursos humanos y las actitudes y expectativas de la población.
    Notes: Abstract Over the past three decades Canada has developed an exemplary system of universal health care. However, current financial constraints threaten to undermine the very foundation of the system that represents Canada's respect for social justice. The first of these two articles (Part 1) discusses the unique characteristics of the system, a comparative view of universal health care systems, the reaction of the medical profession to governmental control, and finally the funding and manpower shortages that are compelling a review of the values and organization that have sustained the system thus far. The second article (Part 2) reviews the organization and funding of medical education and the impact of some critical changes in the health care system on postgraduate medical education. Issues related to new licensure and certification requirements, changing population demographics and approaches to health care delivery, manpower needs, and the attitude and expectations of the public are discussed.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Au cours de ces trois dernières décennies, le Canada a développé un système de Santé universel exemplaire. Les problèmes de contraintes pécuniaires risque, cependant, de déstabiliser les bases de ce système qui par ailleurs caractérise bien le respect de ce pays pour la justice sociale. Le premier de ces deux article (part 1) décrit les caractéristiques assez uniques du système, fait une comparaison entre les autres systèmes de santé existant dans le monde, analyse la réaction du corps médical envers le contrôle du système qu'exigent les gouvernements, et enfin, expose comment la réduction en fonds et en hommes influence les valuers et organisation qui ont fait fonctionner ces systèmes jusqu'à présent. Le deuxième article (part 2) résume le financement et l'organisation de la formation médicale, ainsi que l'impact que certains changements du système de santé auront sur l'enseignement post-universitaire. En particulier sont abordés les problèmes de certification, de validation de diplômes, l'influence des changements des caractéristiques de la population et la prise en charge des patients, les besoin en médecins, et les attentes du public de la profession médicale.
    Abstract: Resumen En los tres últimos decenios el Canadá ha desarrollado un sistema ejemplar de cobertura universal de la salud. Sin embargo, las actuales limitaciones de orden financiero amenazan con minar los fundamentos mismos del sistema que caracteriza el respeto que profesa el Canadá por la justicia social. El primero de estos dos artículos (Parte I) discute las características muy peculiares del sistema, un panorama comparativo de los sistemas universales de cobertura de salud, la reacción de la profesión médica al control gubernamental y, por último, las restricciones en cuanto a financiación y capital humano que obligan a revisar los valores y la organización que han mantenido al sistema hasta ahora. El segundo artículo (Parte II) revisa la organización y el financiamiento de la educación médica y el impacto de algunos cambios críticos en el sistema de atención de la salud sobre la educación médica de postgrado. Se revisan los asuntos relativos a los nuevos requisitos para licencia y certificación, las variaciones en demografía y los enfoques sobre provisión de servicios, las necesidades de recursos humanos y las actitudes y expectativas de la población.
    Notes: Abstract Over the past three decades Canada has developed an exemplary system of universal health care. However, current financial constraints threaten to undermine the very foundation of the system that represents Canada's respect for social justice. The first of these two articles (Part 1) discusses the unique characteristics of the system, a comparative view of universal health care systems, the reaction of the medical profession to governmental control, and finally the funding and manpower shortages that are compelling a review of the values and organization that have sustained the system thus far. The second article (Part 2) reviews the organization and funding of medical education and the impact of some critical changes in the health care system on postgraduate medical education. Issues related to new licensure and certification requirements, changing population demographics and approaches to health care delivery, manpower needs, and the attitude and expectations of the public are discussed.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    ISSN: 1573-1677
    Keywords: high stakes examination ; multi-center OSCE ; national licensure examination ; OSCE (objective structured clinical examination) ; physician examiners ; physician judges ; standard setting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 1994 and 1995, the Medical Council of Canada used an innovative approach to set the pass mark on its large scale, multi-center national OSCE which is designed to assess basic clinical and communication skills in physicians in Canada after 15 months of post-graduate medical training. The goal of this article is to describe the new approach and to present the experience with the method during its first two years of operation. The approach utilizes the global judgments of the physician examiners at each station to identify the candidates with borderline performances. The scores of the candidates whose performances are judged to be borderline are summed for each station, yielding an initial passing score for all stations and then the examination as a whole. The latter score is then adjusted upward one standard error of measurement for the final passing score and is used as one of the criteria to pass the examination. Based on the results to date, the new approach has worked well. The advantages, disadvantages and areas of possible refinement for the approach are reviewed.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    ISSN: 1573-1677
    Keywords: modeling ; motor skill learning ; practice ; surgical education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of modeling a simple surgical task on the subsequent performance of pre-clinical medical students was investigated. Groups of students read a verbal description of the excision of a skin lesion and closure of the resulting wound. Subsequently, groups watched zero, one, or four videotapes in which expert surgeons demonstrated the task. Finally, students had to perform the task themselves four times. During the performances, students were rated by operating room nurses using a checklist and a global rating scale of surgical performance. Time to perform the task was also recorded. In general, the results showed significant effects of experimental condition and trial number: Subjects who watched either one or four models demonstrated similar performance and performed better than subjects who did not watch any model. Later trials showed better accomplishments than earlier trials, both in terms of the quality of the surgery and speed. For some measures, significant interaction effects were found, suggesting that the advantages of watching a model are reinforced, rather than weakened, by practical experience with the task. The results are discussed with respect to the literature on modeling of motor skill tasks and the practical implications for surgical education.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Advances in health sciences education 1 (1996), S. 215-219 
    ISSN: 1573-1677
    Keywords: OSCE ; global ratings ; examiners
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The Medical Council of Canada makes use of examiners' pass/borderline/fail judgments of candidates' performances in OSCE stations in defining cutting scores for these stations. This process assumes that there is consistency in the judgments of different examiners used in the same stations at different testing sites. This assumption was tested using the results of the fall 1994 administration of part 2 of the Medical Council of Canada Qualifying Examination. The Council anticipated using the examiner based global ratings as part of the OSCE station scores in the fall 1995 administration of the examination. In this study, the fall 1994 results were used to estimate to what extent test reliability would increase with the addition of the global ratings.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...