Team-based learning in the internal medicine clerkship didactics.

Background: Active-learning approaches, such as team-based learning, are infrequently used in internal medicine clerkship didactics even though there is increasing evidence to suggest medical students prefer it over traditional lecture-based learning. In this study, five team-based learning sessions were incorporated into three blocks of a 12-week internal medicine clerkship.

Methods: The goal of this quasi-experimental study was to compare learner engagement, satisfaction and preference between team-based learning and lecture-based learning in the internal medicine clerkship didactics.

Neonatal Intensive Care Unit Mixed Lipid Emulsion Use Associated With Reduced Cholestasis at Discharge in Surgical Patients.

Introduction: Parenteral nutrition associated cholestasis (PNAC) is a common morbidity in neonates requiring total parenteral nutrition (TPN). Previous studies in infants with intestinal failure have shown a benefit of mixed lipid emulsion (MLE) in reducing PNAC. It is not known whether this benefit extends to a general neonatal intensive care unit (NICU) population, where MLE is used on a selective basis.

Ammonite habitat revealed via isotopic composition and comparisons with co-occurring benthic and planktonic organisms.

Ammonites are among the best-known fossils of the Phanerozoic, yet their habitat is poorly understood. Three common ammonite families (Baculitidae, Scaphitidae, and Sphenodiscidae) co-occur with well-preserved planktonic and benthic organisms at the type locality of the upper Maastrichtian Owl Creek Formation, offering an excellent opportunity to constrain their depth habitats through isotopic comparisons among taxa. Based on sedimentary evidence and the micro- and macrofauna at this site, we infer that the 9-m-thick sequence was deposited at a paleodepth of 70-150 m.

Participation of the general gynecologist in surgical staging of endometrial cancer: analysis of cost and perioperative outcomes.

Objective: To compare the cost and perioperative outcomes of endometrial cancer staging when the procedure is performed by a gynecologic oncologist alone or when a general gynecologist participates in the procedure.

Methods: A retrospective analysis was performed on a series of women with clinical stage I endometrial cancer treated at a single institution between 1/98 and 12/00. The patients were grouped according to the participation of a general gynecologist in their surgery.

Extensive calvarial tuberculosis: rare complication of tuberculous mastoiditis.

Tuberculous mastoiditis is a well-documented entity with decreasing incidence in recent years. Tuberculous osteitis of the skull is even rarer. The case of a 58-year-old male with tuberculous mastoiditis complicated by extensive tuberculous osteitis of the skull is presented.

Health, morality, and housing: the "tenement problem" in Chicago.

In this article, I trace the history of Chicago's Health Department, exploring when and how housing conditions came to be considered a serious social problem requiring municipal regulation. Although journalists and labor leaders were among the first Chicagoans to link tenement housing to the spread of contagious disease, Health Department officials quickly began regulating the city's housing stock under their own authority. I argue that in attempting to eliminate the dangers of contagious disease, a long-standing public health threat, health officials drew new attention to the dangers of multifamily dwellings and set a precedent for government regulation of living conditions in tenement dwellings.

Nasopharyngeal lipoma--a rare clinico-pathological entity.

A lipoma situated within the posterior wall of the nasopharynx is reported. Only three lipomas of the nasopharynx in adults have previously been reported. The value of CT scan and cytology in making the preoperative diagnosis of a lipoma at this location is discussed.

Appendicitis: an unusual cause of infected abdominal aortic aneurysm.

An unusual case of appendicitis, which presented as an infected aortic aneurysm is described. Gas was noted in the wall of the aneurysm on abdominal radiographs and computed tomography, due to the formation of an appendico-aortic fistula. Computed tomography also demonstrated a contained rupture of the aneurysm.

Morphology and physiology of cells in slice preparations of the posteroventral cochlear nucleus of mice.

In an effort to understand what integrative tasks are performed in the cochlear nuclei, the present study was undertaken to describe neuronal circuits in the posteroventral cochlear nucleus (PVCN) anatomically and physiologically. The cochlear nuclear complex receives auditory information from the cochlea through the auditory nerve. Within the cochlear nuclei, signals travel along several parallel and interconnected pathways.

Gastrointestinal tuberculosis in patients with pulmonary tuberculosis.

Proven or suspected intestinal tuberculosis was diagnosed in 23 (46 per cent) of 50 patients with smear-positive, cavitating pulmonary tuberculosis. The diagnosis was regarded as proven in 14 patients and suspected in the remaining nine. The frequency of proven gastrointestinal disease increased with the severity of the pulmonary tuberculosis.

Radionuclide scintigraphy in tuberculous enteritis.

Scintigraphy with indium-111 labeled leucocytes and gallium-67 citrate was performed on 6 patients with proven tuberculous enteritis. The ability of both techniques to visualize areas of disease in this condition was demonstrated. When compared with endoscopy (either upper gastrointestinal endoscopy or colonoscopy), Ga-67 citrate had a sensitivity of 0.

The CT appearances of ruptured abdominal aortic aneurysms.

There is no place for investigative CT scans in patients who have the classical triad of abdominal aortic aneurysm rupture, namely excruciating abdominal pain or backache, a pulsatile mass and hypotension. These patients require immediate surgery. However, in the absence of this triad, CT scans play an important role in the diagnosis of abdominal aortic aneurysm rupture.

Liquid-crystal thermographic mammography. A preliminary assessment of a controversial modality.

Thermography is a simple and safe technique for examination of the breast. An analysis of 200 subjects examined by means of this non-invasive investigation demonstrates that it is a reasonably sensitive method. Its main applications are in the young symptomatic patient, mass surveys and the annual assessment of the 30-50-year age group.