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Although competency-based medical education (CBME) has attracted renewed interest in recent years among educators and policy-makers in the health care professions, there is little agreement on many aspects of this paradigm. We convened a unique partnership - the International CBME Collaborators - to examine conceptual issues and current debates in CBME. We(More)
  • D M Long
  • 1991
The failed back or postlaminectomy syndrome is obviously multidimensional. Failure of therapy may result from structural abnormalities in the back, psychosocial influences, or a combination of both. The causes of back pain are largely unknown. Correlations with diagnostic studies are uncertain. The lack of precise diagnoses is reflected in a multiplicity of(More)
Disections of the dorsal rami of L1--5 were performed in human cadavers, and the course of the dorsal rami, their branches, and the innervation of the zygapophyseal joints in the lumbar region were specifically studied. At the L-1 through L-4 levels, the dorsal rami divide into medial and lateral branches within the intertransverse ligaments. Each medial(More)
Temperature differences between the lower extremities were measured using a computerized thermometric scanning system in order to compare the degree of thermal asymmetry in 144 patients with low-back pain. The patients displayed highly significant thermal asymmetries, with the involved limb being cooler (p less than 0.001). When asymmetries exceeded 1(More)
This review article outlines basic concepts and pathophysiological aspects of the chemistry of oxygen free radicals in all forms of brain injury and brain edema. Recent experimental studies have demonstrated that oxygen free radicals may be important mediators of brain injury and brain edema, and pharmacological antagonism of oxygen free radicals shows(More)
Peripheral nerve stimulating devices were implanted for pain control in 33 patients with a variety of disabling chronic pain conditions, which had persisted despite usual medical and surgical therapy. The implants were placed on major nerves innervating the area of the patient's pain. Records were obtained of each patient's stated relief from pain produced(More)
Over the past two decades, spinal cord stimulation devices and techniques have evolved from single-channel systems, with electrodes requiring laminectomy, into programmable "multichannel" systems with electrodes that may be placed percutaneously. We have reviewed our experience in 320 consecutive patients treated with these devices at our institution(More)
OBJECTIVE Improved clinical and economic outcomes for high-risk surgical procedures have been previously cited in support of regionalization. The goal of this study was to examine the effects of regionalization by analyzing the cost and outcome of craniotomy for tumors and to compare the findings in academic medical centers versus community-based hospitals.(More)
When a patient presents with an acute pain syndrome suggestive of a herniated lumbar disc, nonoperative treatment is almost always the rule. Urgent surgery is undertaken for intractable pain, significant or progressive neurological deficit, and abnormalities of bowel, bladder, or sexual function. Evaluation of the patient is not needed in typical cases(More)