Canadian family physician Médecin de famille canadien
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External cephalic version (ECV) for breech presentation at term substantially reduces the incidence of breech birth and cesarean section. Appropriate counseling and surveillance is important to ensure an acceptably low complication rate and reduce potential for litigation. Even a high success rate for ECV only minimally reduces the overall cesarean section rate.
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Acute gastrointestinal hemorrhage is a common problem that requires prompt recognition and management to prevent serious morbidity and mortality. Management goals are stabilization of the patient with vigorous fluid resuscitation followed by investigation and definitive treatment of the bleeding source. Endoscopy is often the initial diagnostic test and allows therapeutic measures to be performed at the same time.
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Tracking residents' experiences in clinical settings is difficult. We describe a computerized tracking program that can be used to catalogue and evaluate clinical experience. Using the program, learners can evaluate and validate their experiences, and educators can identify setting and preceptor strengths and weaknesses. The program is adaptable to other settings, inexpensive, and easy to use.
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To document the number and pattern of psychiatric and psychosocial referrals to community resources by family physicians (FPs) and to determine whether referral practices correlate with physician variables. ⋯ Family physicians in Hamilton-Wentworth made few referrals to psychiatric and psychosocial services. Only physician sex and year of graduation correlated significantly with numbers of referrals made. Recent graduates of both sexes made significantly more referrals to psychiatric clinics and counseling services than their older colleagues.