The Mount Sinai journal of medicine, New York
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Medical professionalism encourages physicians to place their patients interests above self-interest. In recent years, many medical organizations, including the American Board of Internal Medicine (ABIM), Association of American Medical Colleges (AAMC), and the American Medical Association (AMA), have developed initiatives to strengthen medical professionalism. ⋯ One crucial question facing medical educators is whether the concepts of professionalism can be taught to medical students and residents. This paper draws upon the author s thirty years of experience in teaching clinical medical ethics to provide guidance on how to teach the concepts of professionalism to students and residents.
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Principles of medical professionalism include humanistic values, altruism, ethical and moral behavior, and a lifelong commitment to scholarship and learning. These principles can provide behavioral guidelines to residents, fellows and their teacher-physicians during the formative years of postgraduate training. This short paper presents some of the challenging professional questions raised during these years of training, where medical professionalism may help to guide us.
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Selected orthopedic surgical procedures, such as total joint arthroplasty and spinal instrumentation, have some of the highest perioperative transfusion rates of all surgical procedures. Blood transfusions carry the risk of complications, including the transmission of disease, immunomodulation, and hemolytic and non-hemolytic reactions. Strategies that reduce or remove the risk of allogeneic transfusion include preoperative autologous donation, acute normovolemic hemodilution, perioperative cell salvage techniques, deliberate hypotension, and pharmacologic interventions. This paper will review the current status of these therapies in the orthopedic surgical patient.
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New trends in pediatric anesthesia for ambulatory surgery will be described. Preoperative preparation as well as care of pediatric patients requiring sedation outside of the operating room are emphasized.
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Historical Article
The evolution of intraoperative transesophageal echocardiography.
In this article, the development of intraoperative transesophageal echocardiography (TEE) is reviewed. It took two decades to develop the present clinical applications of TEE. This modality will continue to serve as a monitor and diagnostic tool to ensure better care of patients in the operating room and the intensive care units.