Chief Physician Wang Defen’s Experience in Treating Thyroid Nodules based on Syndrome Differentiation

To summarize the experience of Chief Physician Wang Defen in the treatment of thyroid nodules. According to many years of clinical experience, Chief Physician Wang Defen believes that the occurrence of thyroid nodules is mostly affected by emotional factors. Qi stagnation, liver depression and fire, phlegm and Qi are the pathogenesis of the disease, which is closely related to liver Qi stagnation. Based on the basic treatment principle of Nourishing Yin, clearing heat, soothing liver and strengthening spleen, the prescription chose Danzhi Xiaoyao Powder plus or minus can often achieve good clinical efficacy.

Satisfaction of the Clinical Teachers on Standardized Residency Training Program (SRTP) in China

Background: Standardized Residency Training Program (SRTP) is a significant initiative to deepen health systems and medical education in developed countries like China. Despite prompting the SRTP nationwide and implementing it with various improvements, Chinese continuous medical education is still in its infancy. Compared with the residents, little is known about clinical teachers under SRTP in China; but clinical teachers effectively determine the training quality as a critical disseminator of knowledge, skills, and values in medical practice. Thus, the study aims to analyze critical factors affecting their cognitive job satisfaction and provide continuous improvements for SRTP.Methods: From December 1, 2018, to May 31, 2019, we conducted a self-design questionnaire from 13 SRTPs (including both training bases and professional bases) in Shaoxing city to evaluate participants' satisfaction. Altogether, 574 clinical teachers responded to the survey with generally high overall satisfaction. We adopted Chi-square Test and Fisher's Exact Test to evaluate the single impact factors affecting the satisfaction of clinical teachers. The multiple factors analysis applied the Logistic Regression model.Results: The male clinical teachers had significant differences in satisfaction of teaching content (OR: 0.675, [95%CI: 0.477~0.953]), conflicts between study and work (OR: 0.542, [95%CI: 0.371~0.791]), the attention of leaders (OR: 0.403, [95%CI: 0.252~0.645]) and subsidies of teachers (OR: 0.527, [95%CI: 0.347~0.805]). Compared with internal medicine, clinical teachers from Surgery (OR: 2.396, [95%CI: 1.365-4.206]) and other departments (OR: 2.409, [95%CI: 1.406-4.129]) were more satisfied when considered residents have high motivation on training. Besides, compared with attending physician, deputy chief physician (OR: 0.493, [95%CI: 0.310- 0.783]) and chief physician (OR: 0.683, [95%CI: 0.471-0.991]) more disagreed that residents' wage is good enough.Conclusion: Clinical teachers widely recognize the SRTP. However, teachers' satisfaction varied due to different genders, working clinical departments, and professional titles. The study also discussed possible reasons and strategy implications behind these findings, which combined unique Chinese society characteristics. Further, we believe the analysis and interpretations remind us of the applications of Western medical education methods, and theories also should consider the unique socio-cultural challenges.

Nadzór nad lecznictwem uzdrowiskowym ze szczególnym uwzględnieniem czynności kontrolno-nadzorczych nad zakładami lecznictwa uzdrowiskowego

Spa treatment, which constitutes an integral part of health care, is an organized activity consisting in providing health care services in the field of spa treatment or spa rehabilitation carried out in a spa by spa treatment facilities. In order to ensure the proper and efficient operation of this form of treatment in specially adapted facilities that are medical entities, this treatment is subject to professional supervision. Supervision over health resort treatment entails the control and evaluation of health resort treatment carried out in health resort treatment establishments. This issue is regulated primarily in the Act of 28 July 2005 on spa treatment, health resorts and health resort protection areas and in health resort communes, as well as in the Act of 15 April 2011 on medical activity. The study contains an analysis and evaluation of the legal regulations concerning the supervision of spa treatment. It discusses the basic terms related to spa issues and presents some concepts of control and supervision in terms of the doctrine. Spa supervision is characterized by specific regulations and the degree of complexity. This applies to individual issues that allow the reconstruction of the essence of supervision. These are the supervisory authorities, subject of supervision, the supervised entities, criteria and scope of supervision exercised and legal means of supervision. The authorities supervising the health resort treatment include the Minister of Health, the Voivode, the Minister of National Defense and the Minister of the Interior. In this article, in the analysis of the scope of his competences and control and supervisory powers great attention is paid to the Minister of Health as the central body of government administration in the field of matters belonging to the department of health administration managed by him. Due to the specific nature of supervision of this treatment carried out in the voivodeship, the legal position of the chief physician of the health resort, with whose help the voivode exercises this supervision, was analyzed. Since spa treatment is carried out in spa facilities in a health resort, the study contains the problem of separate control procedurescarried out in this area, within which special attention is paid to internal, management and ad hoc control.

Protocol of perioperative and post-exposure antimicrobial prophylaxis in Morozovskaya Children City Clinical Hospital of Moscow Healthcare Department

In order to improve the clinical use of antibiotics in surgical departments of Morozovskaya Children City Clinical Hospital of Moscow Healthcare Department authors prepared, discussed and agreed upon a protocol for perioperative and post-exposure antimicrobial prophylaxis. The choice of antibiotics for systemic use was made according to the Antimicrobial Stewardship Program (ASP) stratification both for patients of type I (community-acquired infection without risk for shedding of polyresistant infectious agents) and type II (community-acquired infections with risk factors for shedding of polyresistant infectious agents). Study determined indications for post-exposure antimicrobial prophylaxis within the approved protocol. Following that the Chief Physician issued an Order On Division of Responsibility of all Members of the Operating Team and On Approval of the Protocol for Conducting Perioperative and Post-Exposure Antimicrobial Prophylaxis. As a result of the implementation of the protocol, by the end of 2020 clinical use of antibiotics in surgical departments has improved.

Management of residents in difficulty in a Swiss general internal medicine outpatient clinic: Change is necessary!

Aims of the study Residents in difficulty are a major cause for concern in medical education, with a prevalence of 7–15%. They are often detected late in their training and cannot make use of remediation plans. Nowadays, most training hospitals in Switzerland do not have a specific program to identify and manage residents in difficulty. The aim of the study was to explore the challenges perceived by physicians regarding the process of identifying, diagnosing, and supporting residents in difficulty in a structured and programmatic way. We explored perceptions of physicians at different hierarchical levels (residents (R), Chief residents (CR), attending physicians (A), Chief Physician (CP)) in order to better understand these challenges. Methods We conducted an exploratory qualitative study between December 2015 and July 2016. We asked volunteers from the Primary Care Division of the Geneva University Hospitals to partake to three focus groups (with CR, A, R) and one interview with the division’s CP. We transcribed, coded, and qualitatively analyzed the three focus groups and the interview, using a content thematic approach and Fishbein’s conceptual framework. Results We identified similarities and differences in the challenges of the management of residents in difficulty on a programmatic way amongst physicians of different hierarchical levels. Our main findings: Supervisors (CR, A, CP) have good identification skills of residents in difficulty, but they did not put in place systematic remediation strategies. Supervisors (CR, A) were concerned about managing residents in difficulty. They were aware of the possible adverse effects on patient care, but “feared to harm” resident’s career by documenting a poor institutional assessment. Residents “feared to share” their own difficulties with their supervisors. They thought that it would impact their career negatively. The four physician’s hierarchical level reported environmental constraints (lack of funding, time constraint, lack of time and resources…). Conclusion Our results add two perspectives to specialized recommendations regarding the implementation of remediation programs for residents in difficulty. The first revolves around the need to identify and fully understand not only the beliefs but also the implicit norms and the feeling of self-efficacy that are shared by teachers and that are likely to motivate them to engage in the management of residents in difficulty. The second emphasizes the importance of analyzing these elements that constitute the context for a change and of identifying, in close contact with the heads of the institutions, which factors may favor or hinder it. This research action process has fostered awareness and discussions at different levels. Since then, various actions and processes have been put in place at the Faculty of Medicine in Geneva.

To the 90-th Anniversary of Maya K. Bukhrashvili

Description of the professional activities and merits of the chief physician of one of the oldest children's hospitals in Moscow - .K.A. Timiryazev Children's Hospital №20 - Maya K. Bukhrashvili, celebrating her anniversary.

You are not born a Person, you become a Person

A surgeon working in the northern regions of Yakutia, chief physician, resident physician at the Second Pirogov Moscow ‘Order of Lenin’ State Medical University, surgeon-phthisiologist of Yakutia Institute for Research in Tuberculosis—this is the quality path of Innokenty Vinokurov in his career of a doctor and an innovative surgeon and phthisiologist. This professional development was underpinned by a number of great human qualities such as keen-witted character, strong work ethic, strong will of a northerner, commitment, curiosity, refined perception of the environment, creativity in everything he ever attempted to do. An innovative surgeon, a research scientist, a novelist—Innokenty Vinokurov, who dedicated more than 40 years of his life to healing and serving others, fell victim to the horrible pandemic of the 21st century, which took his life on June 21, 2020.

Congratulations on the anniversary of Alexey Vasilyevich Shabunin!

The staff of the journal "Annals of the Russian Academy of Medical Sciences" congratulates on the 60th anniversary of the corresponding member of the RAS, chief physician of the S.P. Botkin City Clinical Hospital , Chief Surgeon of the Moscow Healthcare Department, Honored Doctor of the Russian Federation, Professor Alexei Vasilyevich Shabunin.

Brawler and Snitch: Lev Petrovich Kryzhanovsky, Resident of the Omsk Military Hospital (Using Archival Sources)

This publication continues the author's research related to the Siberian exile period of the biography of F. M. Dostoevsky. Based on archival and memoir sources, the article reveals the identity of another medical doctor of the Omsk Military Hospital — resident Lev Petrovich Kryzhanovsky. It corrects the misconceptions and the erroneous conclusions about him and about the Siberian circle of the writer. The memoirs of Jozef Boguslavsky identify the namesake of the resident, an exiled Pole Karol Kryzhanovsky and his wife Natalia Stepanovna Kryzhanovskaya. She turned out to be Dostoevsky's Omsk acquaintance, who became the prototype for the poor widow Nastasya Ivanovna in The House of the Dead. These archival documents introduced into scientific discourse elucidate a profile of L. P. Kryzhanovsky. This allows us to compare it with the profile of the resident Ya. Ya. Lovchinsky provided in the author's previous publication and to draw conclusions about the identity of the prototype of the medical doctor in the book. In addition, the materials clarify certain details of the investigation into Kryzhanovsky's denunciation of the chief physician Troitsky for “great commutation and indulgence for the political prisoners,” identified in Martyanov's notes. They also describe the poor conditions in the Omsk Military Hospital, which were portrayed in The House of the Dead. All of the above provides an opportunity to fill in the gaps in the circumstances of the penal servitude of the Petrashevsky Circle members F. M. Dostoevsky and S. F. Durov.

Lévy Lajos életrajza

Lajos Lévy (Budapest, 1875 - London, April 7, 1961) was not a practising psychoanalyst, nevertheless, he played an important role in the history of Hungarian psychoanalysis. He studied medicine at the universities of Budapest, Vienna and Tübingen. After graduating, he was engaged in Heidelberg for a few years. Returning home, he became a student and friend of Béla Székács at Rókus Hospital, served for a while for the Worker's Insurance Institute then he was appointed to the chief internist of Mária Valéria Military Hospital and Zita Military Hospital. Since 1928 he was employed by the most developed Hungarian health facility of that age, the Jewish Hospital, where he served first as a chief physician, later on however he headed the whole institute. While having recognised the importance of electrocardiography, he was among the first physicians who arranged an electrocardiographic laboratory in Hungary. He was the editor of the progressive medical weekly Gyógyászat, on pages of which he propagated successfully the psychoanalysis and psychosomatics. After his retirement (1945) he suffered from depression. Later on, he emigrated to the UK to his brother and sister. His 6000-volume library was nationalised. He died in London from heart disease. This study is the ever published and most detailed biography of Lajos Lévy.