Use of standardized patients in a freshman emergency medicine course.

The curriculum of our freshman emergency medicine course now includes group interviews with standardized patients to introduce communication skills more effectively to students. Our goals for the standardized patient encounters are 1) to start the interview learning process in a nonthreatening environment, 2) to begin to use rudimentary techniques to obtain a history of present illness, 3) to gain insight into a patient's perception of a medical interview, and 4) to learn to project empathy and compassion when talking with patients. The standardized patients technique is one method emergency medicine educators can use to maximize effectiveness in undergraduate medical education.

The midsternal stripe: a sign of dehiscence following median sternotomy.

Sternal dehiscence is a recognized complication of median sternotomy in 2.5-4.8% of patients.

Systemic arteriovenous fistula simulating severe valvular aortic stenosis.

A patient with a renal arteriovenous fistula is described. She was though to have valvular aortic stenosis because of a history of rheumatic fever, symptoms of congestive heart failure and syncope, and the presence of a harsh systolic murmur with a thrill in the aortic area. Cardiac catheterization revealed a left-to-right shunt of 8.

The relationship of platelet coagulant activities to venous thrombosis following hip surgery.

Platelets have recently been shown to trigger intrinsic coagulation by two alternative pathways, protect active clotting factors from inactivation by plasma inhibitors and catalyse intrinsic coagulation reactions on the platelet surface to form fibrin. To determine whether these platelet coagulant activities (PCA) might have a role in the pathogenesis of DVT, 29 patients have been studied before and after arthroplasty or other surgery for fractured hip or degenerative hip disease. The occurrence of DVT was detected by [125I]fibrinogen uptake in the legs and confirmed by venography.