RESUMEN
Supernumerary nipples and supernumerary breast tissue are often dismissed as cosmetic curiosities. These structures have the potential for pathologic degeneration and may be associated with significant congenital abnormalities. In a prospective comparison of 100 Native American women to 100 non-Native American women, these accessory organs were found much more commonly in Native American women. Careful attention should be given to thorough evaluation and long term follow-up of any patient in whom this anomaly is found.
Asunto(s)
Mama , Coristoma/cirugía , Indígenas Norteamericanos , Pezones/anomalías , Neoplasias de la Mama/patología , Transformación Celular Neoplásica/patología , Coristoma/etnología , Coristoma/patología , Comparación Transcultural , Femenino , Humanos , Pezones/patología , Factores de Riesgo , South DakotaRESUMEN
This pilot study evaluates the consistency of experts' ratings of students' performances on the National Board of Medical Examiners' Computer Based Examination (CBX) cases and the relationship of those ratings to the CBX's scoring algorithm. The authors were investigating whether an automated scoring algorithm can adequately assess an examinee's management of a computer-simulated patient. In 1989-90, at the Michigan State University College of Human Medicine, eight students, completing a surgery clerkship, each managed eight CBX cases and took a computer-administered, multiple-choice examination. Six clerkship coordinators rated the students' performances in terms of overall management, efficiency, and dangerous actions. The ratings correlated highly with scores produced by the CBX's scoring system.
Asunto(s)
Competencia Clínica , Simulación por Computador , Evaluación Educacional/métodos , Cirugía General/educación , Simulación de Paciente , Algoritmos , Prácticas Clínicas , Proyectos PilotoRESUMEN
General anesthesia in premature babies is associated with a significant risk of life-threatening apnea. Spinal anesthesia in the high-risk infant is simple, safe, and effective, but the incidence of apnea with its use has not been previously determined. The total absence of apnea in 84 high-risk infants suggests that surgery below the umbilicus under spinal anesthesia can safely be performed on an outpatient basis in preterm infants or babies with a history of apnea. Ketamine as an adjunctive agent adds no apparent risk. The technique is relatively easy, surgery is not compromised, and parental acceptance is high.
Asunto(s)
Anestesia General/efectos adversos , Anestesia Raquidea/normas , Apnea/epidemiología , Hernia Inguinal/cirugía , Recien Nacido Prematuro , Apnea/diagnóstico , Apnea/etiología , Estudios de Seguimiento , Edad Gestacional , Humanos , Incidencia , Recién Nacido , Monitoreo Fisiológico/normas , Factores de Riesgo , Resultado del TratamientoRESUMEN
We have reviewed 84 patients managed with cutaneous ureterostomy during the last 18 years. If at least 1 hypertrophied and dilated ureter is available cutaneous ureterostomy is a safe and effective diversion, with satisfactory late functional results. Stomal stenosis remains a continuing problem but usually is managed easily if present. Cutaneous ureterostomy should be used in selected patients until the ideal form of vesical substitution is achieved.