RESUMO
OBJECTIVES: The transition from medical student to intern is associated with a significant increase in workloads and responsibilities. This includes using the electronic medical record (EMR), which can lead to challenges in information gathering and patient care; however, no formal residency interventions exist in the use of an EMR for information gathering, with most EMR training occurring in the clinical setting. The present study aimed to improve information gathering on patient care and enhance the confidence of Internal Medicine interns in information gathering. METHODS: We performed a pre- and postprospective study in July 2021. All of the Internal Medicine interns at our community hospital were included. A pre- and postassessment to evaluate interns' confidence was distributed to participants during orientation week and at the end of the inpatient Internal Medicine rotation. A pre- and postconfidence assessment was collected at the beginning and end, respectively, of each intern's inpatient Internal Medicine rotation. RESULTS: Seventeen (85%) interns completed both the preassessment and postassessment. Use of an EMR guide led to a significant increase in completeness of patient information gathering (preassessment: 73.2% ± 18.4% vs post-EMR guide: 94.7% ± 7.4%, P < 0.001) and in intern confidence (P = 0.001). CONCLUSIONS: The use of an EMR guide was well received among Internal Medicine interns and led to increased completeness in patient information gathering. Residency programs may benefit from developing an EMR guide to improving the transition of interns during residency.
Assuntos
Registros Eletrônicos de Saúde , Internato e Residência , Humanos , Assistência ao Paciente , Carga de Trabalho , Competência ClínicaRESUMO
Haematological engraftment was assessed in 804 autologous transplants. Neutrophil recovery occurred in over 99% within 14 d but platelet recovery was delayed beyond this time in 14·8%. Time to recovery was dependent on the progenitor cell dose infused. The minimum CD34+ cell threshold adopted in this study (2 × 106 /kg) was safe although recovery was faster with a dose >5 × 106 /kg. CD34+ cell doses of between 1 and 2 × 106 /kg were also acceptable if either the granulocyte-macrophage colony-forming cell dose exceeded 2 × 105 /kg or this dose was due to splitting a higher yield harvest. Prompt neutrophil recovery affords important quality assurance for laboratory processing.
Assuntos
Sobrevivência de Enxerto , Hematopoese , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas , Adolescente , Adulto , Idoso , Contagem de Células Sanguíneas , Feminino , Transplante de Células-Tronco Hematopoéticas/métodos , Transplante de Células-Tronco Hematopoéticas/normas , Humanos , Masculino , Pessoa de Meia-Idade , Garantia da Qualidade dos Cuidados de Saúde , Fatores de Tempo , Condicionamento Pré-Transplante , Transplante Autólogo , Resultado do Tratamento , Adulto JovemRESUMO
The hippocampal CA2 subfield was initially identified by Lorente de Nó as an anatomically distinct region based on its cytoarchitectural features. Although there is an enormous body of literature on other hippocampal subfields (CA1 and CA3), relatively little is known about the physiological and developmental properties of CA2. Here we report identification of the CA2 region in the mouse by immunostaining with a Purkinje cell protein 4 (PCP4) antibody, which effectively delineates CA3/CA2 and CA2/CA1 borders and agrees well with previous cytoarchitectural definitions of CA2. The PCP4 immunostaining-delineated CA2 neurons have distinguishable differences in cell morphology, physiology, and synaptic circuit connections compared with distal CA3 and proximal CA1 regions. The average somatic sizes of excitatory cells differ across CA1-3, with the smallest to largest somatic size being CA1Assuntos
Região CA2 Hipocampal/crescimento & desenvolvimento
, Região CA2 Hipocampal/metabolismo
, Regulação da Expressão Gênica/genética
, Proteínas do Tecido Nervoso/metabolismo
, Análise de Variância
, Animais
, Animais Recém-Nascidos
, Região CA2 Hipocampal/citologia
, Calbindina 2/genética
, Proteínas de Ligação ao Cálcio/metabolismo
, Estimulação Elétrica
, Potenciais Pós-Sinápticos Excitadores
, Fator 2 de Crescimento de Fibroblastos/metabolismo
, Técnicas In Vitro
, Proteínas Luminescentes/genética
, Potenciais da Membrana/genética
, Camundongos
, Camundongos Endogâmicos C57BL
, Camundongos Transgênicos
, Neurônios/metabolismo
, Neurônios/fisiologia