Quelques considérations sur l'enseignement de la médecine physique et de la réhabilitation

Particularly since World War II physical medicine and rehabilitation have assumed a growing importance. The efforts of the Canadian Association of Physical Medicine and Rehabilitation, following a survey of Canadian universities, to increase the theoretical and practical teaching of physiatrics are emphasized. It is considered important that the teaching of physical medicine and rehabilitation should be carried out concurrently with other medical and surgical teaching programs. Paramedical and auxiliary rehabilitation personnel should participate in the teaching program. The number of hours devoted to physiatrics should be increased, and the medical student should be permitted to choose physical medicine and rehabilitation as a part of his internship program.     

La radioprotection des patients en médecine nucléaire : état des lieux en Tunisie

Recent health indicators for Tunisia are encouraging: there is one doctor for every 1000 inhabitants, in contrast to 1471 in 1996; life expectancy at birth is 73.8 years compared with 71.6 years in 1996; and the infant mortality rate is down from 29.7 per thousand in 1996 to 19.5 per thousand. The health infrastructure in Tunisia is partly private and partly public, supported by a well-organized network of university hospitals and clinics and a central pharmaceutical service that imports and distributes drugs. In 1990, there was only one nuclear medicine centre in Tunisia at the Salah Azaiez Institute. In 2013, there are 12 centres, between public and private, with around forty doctors and 50 technicians using 15 gamma cameras, seven single-head, four dual-head and three SPECT/CT. Positron emission tomography (PET) will be acquired in short delay. Training for doctors and technicians in quality control for this new equipment and quality assurance in multimodal molecular imaging will soon become a priority. The protection of patients against radiation remains a major concern for these Departments. The regulatory and institutional framework has been established since 1980. Because of their oldness, they may not be suitable for radiation protection of persons exposed for medical purposes. An assessment of the practice of nuclear medicine can be helpful to standardize used protocols and to optimize the dose delivered to the patients during different nuclear medicine procedures in vivo.     

Delivery of postgraduate medical education--who pays?

As the cost of academic postgraduate medical education increases the DHSS may sometimes need to fund established academic posts or sessions within universities, and it must recognise the need for salaried sessional commitments by clinical tutors and encourage universities to integrate them more effectively into regional medical schools. Such activities will otherwise increasingly impose on undergraduate departments teaching demands that are neither practicable nor proper.     

Disability; is it permanent?

Too often cases of industrial injuries are submitted for permanent disability rating before maximum recovery is attained and the condition is permanent and stationary. This is frequently a situation that is detrimental to the injured working man, since his physical disability might be further reduced by additional treatment, and his future earning power and economic status thus be improved. Also it may be detrimental to the insurance carrier and/or employer, since in some instances it results in increased permanent disability award payments for portions of the condition which are not truly permanent. Inadequate medical reports also are a frequent cause of unfair awards. The necessary factors used to arrive at proper conclusions, the errors that have been observed and the importance of this problem are discussed.     

DISABILITY—IS IT PERMANENT?

Too often cases of industrial injuries are submitted for permanent disability rating before maximum recovery is attained and the condition is permanent and stationary.This is frequently a situation that is detrimental to the injured working man, since his physical disability might be further reduced by additional treatment, and his future earning power and economic status thus be improved. Also it may be detrimental to the insurance carrier and/or employer, since in some instances it results in increased permanent disability award payments for portions of the condition which are not truly permanent.Inadequate medical reports also are a frequent cause of unfair awards. The necessary factors used to arrive at proper conclusions, the errors that have been observed and the importance of this problem are discussed.     

Daily ocean monitoring since the 1860s shows record warming of northern European seas

Ocean temperatures in most parts of the world are increasing and are expected to continue to rise during the 21st century. A major challenge to ecologists and marine resource managers is to understand and predict how these global changes will affect species and ecosystems at local scales where temperature more directly affects biological responses and species interactions. Here, we investigate historical variability in regional sea surface temperature in two large heavily exploited marine ecosystems and compare these variations with expected rates of temperature change for the 21st century. We use four of the world's longest calibrated daily time series to show that trends in surface temperatures in the North and Baltic Seas now exceed those at any time since instrumented measurements began in 1861 and 1880. Temperatures in summer since 1985 have increased at nearly triple the global warming rate, which is expected to occur during the 21st century and summer temperatures have risen two to five times faster than those in other seasons. These warm temperatures and rates of change are due partly to an increase in the frequency of extremely warm years. The recent warming event is exceeding the ability of local species to adapt and is consequently leading to major changes in the structure, function and services of these ecosystems.     

Kinetics of product formation in batch and continuous culture of Clostridium barkeri

Summary The main fermentation end products in batch culture (unlimited glucose supply) of Clostridium barkeri were butyrate and lactate. The specific rate of butyrate production was linearly proportional to the growth rate while the specific rate of lactate production increased at low growth rates. In a glucose limited chemostat culture butyrate production was partly growth associated while acetate and lactate production was growth associated. Lactate was, however, only produced at high dilution rates. By varying the glucose concentration in the inflowing medium it was shown that lactate production was stimulated by a high feeding rate of the carbon source. These results are discussed in view of the fructose-1,6-diphosphate dependent lactate dehydrogenase activity in many other organisms.     

α—硫辛酸对6—羟多巴胺诱导的PC12细胞凋亡的影响

PC12 cell line, a clonal cell line derived from a pheochromocytoma of rat adrenal medulla, was used as a model of dopaminergic neuron in vitro to study the effect of alpha-lipoic acid on the 6-OHDA induced apoptosis. The results from MTT method show that 6-OHDA decreased the cell survival rate obviously. Through TUNEL (TdT-mediated dUTP-biotion nick end labeling) and Flow cytometer (FCM) detection, we found that 6-OHDA triggered cell apoptosis and induced necrosis. It was confirmed by the different percentage of cell survival rate and apoptosis concluded from FCM and MTT. alpha-lipoic acid was used as antioxidant to protect the cell from 6-OHDA's injury. The result indicateed that alpha-lipoic acid can partly prevent apoptosis induced by 6-OHDA but fail to prevent necrosis since it can decrease the apoptotic cell from 20.09% to 3.09%, just as increased cell survival rate from 56.8% to 72.6% but can not reach the normal level showed by MTT assay. Biochemical approach showed the cell's antioxidant ability especial for SOD activity and GSH content increased after the treatment of alpha-lipoic acid. The data suggest that alpha-lipoic acid may protect PC12 cells from apoptosis induced by 6-OHDA through the antioxidant path.     

地方医科大学实验动物管理工作水平评价指标体系的构建

目的构建地方医科大学实验动物管理工作水平评价指标体系,为高校实验动物管理工作的评价提供参考。方法根据研究主题确定咨询专家人选37人,采用Delphi法进行问卷调查和统计分析。结果两轮咨询问卷回收率分别为70．27％和76．92％。权威系数为0．855;第二轮指标体系的协调系数为0．486。结论本次研究构成的地方医科大学实验动物管理工作水平评价指标体系是可靠的。     

Virtual telepathology in Egypt,applications of WSI in Cairo University

Telepathology, the practice of pathology at a long distance, has advanced continuously since 1986. Today, fourth-generation telepathology systems, so-called virtual slide telepathology systems, are being used for education applications. Both conventional and innovative surgical pathology diagnostic services are being designed and implemented as well. We have a successful experience in Egypt in applying the static & dynamic techniques in a pilot project between the Italian Hospital in Cairo (NPO) and the Civico Hospital in Palermo This project began in 2003 and continued till now. In 2004, centers in Venice, London and Pittsburgh participated actively in our project. During the past seven years we consulted on many problematic pathological cases with these different specialized pathological centers in Italy, UK & USA. In addition to the highly specialized scientific value of consulting on the cases and exchanging knowledge, we saved a lot of time and money and succeeded in providing our patients with a better medical service. In view of this success we have already established a new Digital Telepathology unit (DTU) in the pathology department, Cairo University, using the latest technique of telepathology which is Whole Slide Imaging (WSI) since one year. This unit is considered the first Digital pathology unit in all the universities of the whole Middle East. During the passed year we created a digital pathology library for the under graduate students using the WSI technique and changed the teaching method of the histopathology slides to be completely digital. We are building another digital pathology library (for post graduate candidates) which will be available to all pathology candidates in Egyptian universities & universities in the surrounding Arabic countries. We are also creating a digital pathology network between pathology centers in the Middle East for exchanging knowledge & telepathology.     

Tendencies in the Herring Population Development of the Baltic Sea

During the 1960's a change in population structure of Baltic herring started which resulted in the dominance of spring spawners in the entire Baltic since the beginning 1970's. Autumn spawning herring is very rare in the yields of fisheries since. This development has been accompanied by a likely increase of the total stock biomass of herring in the area. Yields of herring fisheries increased remarkable up to 1984, partly as a result of increased fishing effort. Recent developments of stock biomasses point to dependencies on fluctuations of growth rates. Growth is influenced by several environmental factors but is very likely especially dependent on abundance of food and on temperature. Eutrophication of the Baltic Sea increased perhaps the abundance of food for the planktonfeeding herring but it may have been contributing to the depletion of autumn spawning herring via the declining oxygen content of bottom water layers during the past 20 years.     

Limitations on diversity in basic science departments

It has been over 30 years since the beginning of efforts to improve diversity in academia. We can identify four major stages: (1) early and continuing efforts to diversify the pipeline by increasing numbers of women and minorities getting advanced degrees, particularly in science, technology, engineering, and math (STEM); (2) requiring academic institutions to develop their own "affirmative action plans" for hiring and promotion; (3) introducing mentoring programs and coping strategies to help women and minorities deal with faculty practices from an earlier era; (4) asking academic institutions to rethink their practices and policies with an eye toward enabling more faculty diversity, a process known as institutional transformation. The thesis of this article is that research-intensive basic science departments of highly ranked U.S. medical schools are stuck at stage 3, resulting in a less diverse tenured and tenure-track faculty than seen in well-funded science departments of major universities. A review of Web-based records of research-intensive departments in universities with both medical school and nonmedical school departments indicates that the proportion of women and Black faculty in science departments of medical schools is lower than the proportion in similarly research-intensive university science departments. Expectations for faculty productivity in research-intensive medical school departments versus university-based departments may lead to these differences in faculty diversity.     

Factor analysis of teacher professional development in Chinese military medical universities

Background and purpose: Teacher professional development potentially enhances teachers’ professional morale, knowledge, skills and autonomy, which helps improve the quality of education. The military medical university is an important medical education institution in China; however, studies of teacher professional development within military medical universities are still lacking. This study aimed to explore the factors that influence teacher professional development in Chinese military medical universities. Methods: We interviewed 19 experts from China’s Third Military Medical University to identify factors that affect teacher professional development and used these factors to prepare a questionnaire. The data were collected through a random, anonymous questionnaire survey of 371 teachers at three military universities in China, analysed by exploratory factor analysis and verified by confirmatory factor analysis (CFA). Results: We obtained five main factors, which explained 66.691% of the total variance and were found to have a good data fitting according to the CFA results. Conclusions: Teaching experience, shared vision, policy and material security, professional competence and psychological motivation primarily affect teacher professional development in Chinese military medical universities. We can only achieve teacher professional development goals through comprehensive consideration, coordinated arrangement and content improvement of these five factors.     

Fertility at low and high altitude in central Nepal

Abstract

Data are reported on ages of menarche, first marriage and first childbirth, migration, venereal disease, birth control, birth spacing and on completed fertility rate in populations of Central Nepal living at low (8,500 feet) and high altitude (12,400 feet). The high‐altitude population reported a significantly lower completed fertility rate which could be partly accounted for by later age at marriage and first childbirth and increased birth spacing. Longer post‐partum ammenorhea and breast feeding did not account for the increased average pregnancy gap.     

Failed medical management in ovarian pregnancy despite favorable prognostic factors--a case report

Primary ovarian pregnancy is a rare form of ectopic pregnancy that must be demonstrated with use of 4 Spiegelberg criteria. It is usually diagnosed at laparotomy or laparoscopy, although it may resemble a hemorrhagic corpus luteum. Successful conservative management of ovarian pregnancy with methotrexate has been reported only occasionally. This may be partly because of the rarity of this condition and partly because when medical treatment is successful, the patient does not need to undergo laparotomy or laparoscopy, and an occasional ovarian pregnancy may have been diagnosed as a tubal pregnancy. We present a case of ovarian pregnancy (diagnosed at laparotomy) for which initial medical management with methotrexate failed despite favorable prognostic factors. Whether the unusual location (ovary) could have contributed toward treatment failure is unknown.     

Why do pied flycatcher females mate with already-mated males?

The contribution of the pied flycatcher Ficedula hypoleuca male in parental care was studied to examine why some females mate with already-mated males. No difference in feeding rate was found between older and yearling monogamous males, when comparing nests at the same time. Monogamous and primary females were helped significantly more in parental care by the male than were secondary females of polygynous males. Females could only partly compensate for the absence of a male and of nestlings were reduced in nests with low male assistance. Differences in mate and territory quality were far too slight to make it advantageous for females to choose already-mated males instead of mating with monogamous males. We suggest that males, by being polyterritorial, deceive females into accepting polygyny; and females can be deceived since they do not have time to find out the marital status of males.     

Requirements of British universities for higher medical degrees.

OBJECTIVE--To examine the requirements and opportunities for obtaining a doctor of medicine or master of surgery degree from a university in the United Kingdom other than the graduate''s own, particularly in the case of foreign graduates. DESIGN--Review of regulations governing the award of doctor of medicine and master of surgery degrees in British universities. SETTING--All 19 universities in the United Kingdom offering clinical courses. MAIN OUTCOME MEASURE--Availability of degrees to graduates of other universities. RESULTS--Opportunities for obtaining a degree differed widely among the medical schools, one university (Edinburgh) not admitting graduates of other universities in any circumstance. Of the remaining universities, none would consider a graduate who had not worked in the area where the medical school was located. CONCLUSION--The wide differences in opportunity among the medical schools may put some foreign graduates at a disadvantage compared with other graduates. This problem may become more severe as the number of graduates from the European Community who settle in Britain increases.     

MEDICAL RESEARCH—The Program of the U. S. Public Health Service

Federal Government expenditures for medical research have increased apace in the last ten years. The increase in federal research funds has stimulated support from private sources; contributions from other than federal sources have doubled.More than half of medical research funds are being used by universities, hospitals, and other nonprofit institutions, and less than one-fourth by laboratories of the Federal Government.Grants-in-aid of research, fellowships and extended training are made on the advice of Advisory Councils made up of leaders in the various research fields. The previous record of research by staffs and faculties of institutions is taken into account. Special attention is given to unknown investigators and small projects.Noninterference with a scientist in the conduct of research is a basic principle of all grants. He may change the direction of his research to pursue promising leads without asking permission.Continuity of grants so that promising projects need not be abandoned at the end of a grant period is given special consideration.     

Medical research; the program of the U.S. Public Health Service

Federal Government expenditures for medical research have increased apace in the last ten years. The increase in federal research funds has stimulated support from private sources; contributions from other than federal sources have doubled. More than half of medical research funds are being used by universities, hospitals, and other nonprofit institutions, and less than one-fourth by laboratories of the Federal Government.Grants-in-aid of research, fellowships and extended training are made on the advice of Advisory Councils made up of leaders in the various research fields. The previous record of research by staffs and faculties of institutions is taken into account. Special attention is given to unknown investigators and small projects. Noninterference with a scientist in the conduct of research is a basic principle of all grants. He may change the direction of his research to pursue promising leads without asking permission. Continuity of grants so that promising projects need not be abandoned at the end of a grant period is given special consideration.