Bernard Klemenz - Academia.edu (original) (raw)
Papers by Bernard Klemenz
PubMed, 1997
Computer access to the medical literature has become more convenient than ever with MEDLINE and o... more Computer access to the medical literature has become more convenient than ever with MEDLINE and other bibliographical databases available on CD-ROM. The benefits of literature searching by computer include improvements in the quality of medical decision making and cost effectiveness of patient care. However, the results obtained by physicians with amateur searching skills are often inferior to those obtained through the traditional service mediated by a skilled librarian. To ensure that future physicians develop the skills necessary for effective use of the medical literature, it is essential to provide training in literature searching by computer at medical school.
British Journal of General Practice, Apr 1, 2011
(AF), the most common arrhythmia, increases the risk of stroke. OBJECTIVE To review the evidence ... more (AF), the most common arrhythmia, increases the risk of stroke. OBJECTIVE To review the evidence on screening for AF in adults without prior stroke to inform the US Preventive Services Task Force.
British Journal of General Practice, Aug 30, 2018
One sunny April day in 2014 we knocked on the cottage door. We had arranged to see Julian Tudor H... more One sunny April day in 2014 we knocked on the cottage door. We had arranged to see Julian Tudor Hart but his wife Mary told us he was not well. 'But wait a minute', she said. 'Yes', it was OK to come in. Julian was in pain from sciatica and rather fed up. However, he roused himself and within moments the conversation was flowing. As it then did over lunch and all afternoon. He was then 87 and had spent most of his working life at Glyncorrwg Health Centre, in a former mining valley in South Wales. His leftwing lay deep and he stood unsuccessfully for parliament three times as a Communist Party candidate. Although personally charming, considerate, and hospitable, he still was fiercely opposed to politicians whom he thought were betraying ordinary people. We ranged over his considerable research, the 'Inverse Care Law' being the prime example. By his life he showed that it was possible to combine daily practice with substantial academic work. In 2006, he was awarded the inaugural Discovery Prize by the RCGP as 'a general practitioner who has captured the imagination of generations of GPs with his groundbreaking research'. He was respected by those who held very different views from his own, and in turn freely admitted learning from those who opposed him. Retirement for Julian was clearly not inactivity and his passion never faltered as we talked. Inevitably the time to leave drew near and we admired the view over the Gower from his window. We broached the question of why the glorious creation we see can be evidence for a Divine Creator. And Julian, deeply convicted socialist that he was, surprised us by his answer. 'I am closer than you think.' Julian Tudor Hart had a vast influence on others personally, medically, politically, and academically. He showed us how fruitful a dedicated life can be, even a mere practising GP.
PubMed, Jul 1, 1997
The Internet is rapidly expanding as an environment for electronic communication and resource sha... more The Internet is rapidly expanding as an environment for electronic communication and resource sharing. The World Wide Web, a relatively new service on the Internet, provides access to a wealth of information resources through a simple point-and-click interface. Available resources of interest to physicians include bibliographical and statistical databases, literature reviews, discussion groups, press releases, newsletters, drug information, self-assessment questionnaires, multimedia textbooks, patient simulations, clinical decision aids, educational software, and much more. Access to the Internet is widely available in universities and medical libraries; physicians working at home can gain access from a personal computer linked by a modem to a telephone line, by subscribing to an Internet service provider.
British Journal of General Practice, Apr 26, 2018
British Journal of General Practice, Jun 30, 2014
Springer eBooks, 1997
A study of innovative practice in medical education in Europe has been repeated in Canada. The re... more A study of innovative practice in medical education in Europe has been repeated in Canada. The results of the Canadian study compare very favourably with the overall results of the European study, and show a high level of innovation among the five medical schools participating in the study. Access to MEDLINE is available to students at all the participating Canadian medical schools and at the vast majority (94%) of European medical schools. Compulsory courses on literature searching by computer are provided by 60% of the Canadian medical schools compared with only 32% of European medical schools. Programs for computer-based learning are currently used in all the Canadian medical schools. In contrast, they are used in only 60% of European medical schools, though a further 22% are planning to introduce them in the future. All the Canadian medical schools have courses in evidencebased medicine, communication skills, and community-based medicine. The majority (80% in each case) have courses in cost-effective medicine, geriatric medicine and preventive medicine. Courses in each of these six topics are also provided by at least two thirds of European medical schools.
British Journal of General Practice, Jun 27, 2019
argues that we could lengthen our consultation times. 1 Changing surgery times would destabilise ... more argues that we could lengthen our consultation times. 1 Changing surgery times would destabilise practices already
British Journal of General Practice, Sep 29, 2016
Postgraduate Medical Journal, Mar 1, 1998
Fortbildungsthema oder Problem: Die Digitalisierung im Gesundheitswesen – eine Notwendigkeit fuer... more Fortbildungsthema oder Problem: Die Digitalisierung im Gesundheitswesen – eine Notwendigkeit fuer die Qualitätssicherung und Optimisierung der Patientenversorgung Inhalt und praktische Umsetzung: Die Digitalisierung und Forschungsergebnisse in der Medizin schreitet täglich voran. [zum vollständigen Text gelangen Sie über die oben angegebene URL]
Deutsche medizinische Wochenschrift (1946), Jan 21, 1997
Deutsche medizinische Wochenschrift (1946), Jan 17, 1993
Fortschritte der Medizin, Jan 20, 1994
Deutsche medizinische Wochenschrift (1946), Jan 10, 1995
Postgraduate Medical Journal, 1998
Self-assessment corner 185 leading to an excess of transmitter at postsynaptic receptor sites. Si... more Self-assessment corner 185 leading to an excess of transmitter at postsynaptic receptor sites. Signs and symptoms of acute cocaine intoxication include agitation, tachycardia, palpitations, hypertension, hyperthermia, confusion, disorientation, and hallucinations. Massive doses can result in arrhythmias, seizures, and metabolic acidosis, which is often fatal. Medical treatment is focused on treating complications as they arise. Propranolol 1 mg/min intravenously may specifically antagonise the sympathomimetic effects of cocaine. Diazepam 2.5-5.0 mg or high-dose chlorpro-mazine have been used to prevent seizures. Dantrolene 1 mg/kg intravenously over 10-15 min has variable success in treating refractory hyperthermia. Once the patient is stabilised, surgery may be indicated to prevent rupture of any remaining packets. Final diagnosis Intracorporeal cocaine-filled packets in a 'body-packer'
British Journal of General Practice, 2011
In the UK, there are a total of over 800 000 (prevalence 1.5%) people on general practice COPD re... more In the UK, there are a total of over 800 000 (prevalence 1.5%) people on general practice COPD registers (Quality and Outcomes Framework data). 4 However, cross-sectional studies and extrapolation of data indicate that the actual prevalence should be nearer to 4%. More than half of the people with COPD are currently not identified. 5,6 The main conclusion is that symptoms are unreliable and the availability of spirometry for all those at risk remains the only way to identify those missing millions. Until NICE comes fully into line within criteria for diagnosis and is prepared to ignore unreliable subjective symptom scoring, then these figures are unlikely to improve and a state of confusion and uncertainty will remain.
Annals of Internal Medicine, 1971
British Journal of General Practice, 2016
PubMed, 1997
Computer access to the medical literature has become more convenient than ever with MEDLINE and o... more Computer access to the medical literature has become more convenient than ever with MEDLINE and other bibliographical databases available on CD-ROM. The benefits of literature searching by computer include improvements in the quality of medical decision making and cost effectiveness of patient care. However, the results obtained by physicians with amateur searching skills are often inferior to those obtained through the traditional service mediated by a skilled librarian. To ensure that future physicians develop the skills necessary for effective use of the medical literature, it is essential to provide training in literature searching by computer at medical school.
British Journal of General Practice, Apr 1, 2011
(AF), the most common arrhythmia, increases the risk of stroke. OBJECTIVE To review the evidence ... more (AF), the most common arrhythmia, increases the risk of stroke. OBJECTIVE To review the evidence on screening for AF in adults without prior stroke to inform the US Preventive Services Task Force.
British Journal of General Practice, Aug 30, 2018
One sunny April day in 2014 we knocked on the cottage door. We had arranged to see Julian Tudor H... more One sunny April day in 2014 we knocked on the cottage door. We had arranged to see Julian Tudor Hart but his wife Mary told us he was not well. 'But wait a minute', she said. 'Yes', it was OK to come in. Julian was in pain from sciatica and rather fed up. However, he roused himself and within moments the conversation was flowing. As it then did over lunch and all afternoon. He was then 87 and had spent most of his working life at Glyncorrwg Health Centre, in a former mining valley in South Wales. His leftwing lay deep and he stood unsuccessfully for parliament three times as a Communist Party candidate. Although personally charming, considerate, and hospitable, he still was fiercely opposed to politicians whom he thought were betraying ordinary people. We ranged over his considerable research, the 'Inverse Care Law' being the prime example. By his life he showed that it was possible to combine daily practice with substantial academic work. In 2006, he was awarded the inaugural Discovery Prize by the RCGP as 'a general practitioner who has captured the imagination of generations of GPs with his groundbreaking research'. He was respected by those who held very different views from his own, and in turn freely admitted learning from those who opposed him. Retirement for Julian was clearly not inactivity and his passion never faltered as we talked. Inevitably the time to leave drew near and we admired the view over the Gower from his window. We broached the question of why the glorious creation we see can be evidence for a Divine Creator. And Julian, deeply convicted socialist that he was, surprised us by his answer. 'I am closer than you think.' Julian Tudor Hart had a vast influence on others personally, medically, politically, and academically. He showed us how fruitful a dedicated life can be, even a mere practising GP.
PubMed, Jul 1, 1997
The Internet is rapidly expanding as an environment for electronic communication and resource sha... more The Internet is rapidly expanding as an environment for electronic communication and resource sharing. The World Wide Web, a relatively new service on the Internet, provides access to a wealth of information resources through a simple point-and-click interface. Available resources of interest to physicians include bibliographical and statistical databases, literature reviews, discussion groups, press releases, newsletters, drug information, self-assessment questionnaires, multimedia textbooks, patient simulations, clinical decision aids, educational software, and much more. Access to the Internet is widely available in universities and medical libraries; physicians working at home can gain access from a personal computer linked by a modem to a telephone line, by subscribing to an Internet service provider.
British Journal of General Practice, Apr 26, 2018
British Journal of General Practice, Jun 30, 2014
Springer eBooks, 1997
A study of innovative practice in medical education in Europe has been repeated in Canada. The re... more A study of innovative practice in medical education in Europe has been repeated in Canada. The results of the Canadian study compare very favourably with the overall results of the European study, and show a high level of innovation among the five medical schools participating in the study. Access to MEDLINE is available to students at all the participating Canadian medical schools and at the vast majority (94%) of European medical schools. Compulsory courses on literature searching by computer are provided by 60% of the Canadian medical schools compared with only 32% of European medical schools. Programs for computer-based learning are currently used in all the Canadian medical schools. In contrast, they are used in only 60% of European medical schools, though a further 22% are planning to introduce them in the future. All the Canadian medical schools have courses in evidencebased medicine, communication skills, and community-based medicine. The majority (80% in each case) have courses in cost-effective medicine, geriatric medicine and preventive medicine. Courses in each of these six topics are also provided by at least two thirds of European medical schools.
British Journal of General Practice, Jun 27, 2019
argues that we could lengthen our consultation times. 1 Changing surgery times would destabilise ... more argues that we could lengthen our consultation times. 1 Changing surgery times would destabilise practices already
British Journal of General Practice, Sep 29, 2016
Postgraduate Medical Journal, Mar 1, 1998
Fortbildungsthema oder Problem: Die Digitalisierung im Gesundheitswesen – eine Notwendigkeit fuer... more Fortbildungsthema oder Problem: Die Digitalisierung im Gesundheitswesen – eine Notwendigkeit fuer die Qualitätssicherung und Optimisierung der Patientenversorgung Inhalt und praktische Umsetzung: Die Digitalisierung und Forschungsergebnisse in der Medizin schreitet täglich voran. [zum vollständigen Text gelangen Sie über die oben angegebene URL]
Deutsche medizinische Wochenschrift (1946), Jan 21, 1997
Deutsche medizinische Wochenschrift (1946), Jan 17, 1993
Fortschritte der Medizin, Jan 20, 1994
Deutsche medizinische Wochenschrift (1946), Jan 10, 1995
Postgraduate Medical Journal, 1998
Self-assessment corner 185 leading to an excess of transmitter at postsynaptic receptor sites. Si... more Self-assessment corner 185 leading to an excess of transmitter at postsynaptic receptor sites. Signs and symptoms of acute cocaine intoxication include agitation, tachycardia, palpitations, hypertension, hyperthermia, confusion, disorientation, and hallucinations. Massive doses can result in arrhythmias, seizures, and metabolic acidosis, which is often fatal. Medical treatment is focused on treating complications as they arise. Propranolol 1 mg/min intravenously may specifically antagonise the sympathomimetic effects of cocaine. Diazepam 2.5-5.0 mg or high-dose chlorpro-mazine have been used to prevent seizures. Dantrolene 1 mg/kg intravenously over 10-15 min has variable success in treating refractory hyperthermia. Once the patient is stabilised, surgery may be indicated to prevent rupture of any remaining packets. Final diagnosis Intracorporeal cocaine-filled packets in a 'body-packer'
British Journal of General Practice, 2011
In the UK, there are a total of over 800 000 (prevalence 1.5%) people on general practice COPD re... more In the UK, there are a total of over 800 000 (prevalence 1.5%) people on general practice COPD registers (Quality and Outcomes Framework data). 4 However, cross-sectional studies and extrapolation of data indicate that the actual prevalence should be nearer to 4%. More than half of the people with COPD are currently not identified. 5,6 The main conclusion is that symptoms are unreliable and the availability of spirometry for all those at risk remains the only way to identify those missing millions. Until NICE comes fully into line within criteria for diagnosis and is prepared to ignore unreliable subjective symptom scoring, then these figures are unlikely to improve and a state of confusion and uncertainty will remain.
Annals of Internal Medicine, 1971
British Journal of General Practice, 2016