Ongoing continuing medical education is an essential component of life-long learning and can have a positive influence on patient outcomes. However, some evidence suggests that continuing medical education has not fulfilled its potential as a performance improvement (PI) tool, in part due to a paradigm of CME that has focused ...

Objective  This study aimed to investigate inpatients' and outpatients' need for information about medication, to what extent those needs were addressed and patient attitudes regarding pharmaceutical services. Method  Self-administered questionnaires were distributed to a sample of outpatients and inpatients in a UK district general hospital. Themes included satisfaction with information ...

Medical and lifestyle secondary prevention strategies are essential components for reducing cardiovascular risk, irrespective of whether revascularization is performed. In patients with coronary artery disease (CAD), recent clinical trials have further clarified the management of lipid optimization, renin-angiotensin-aldosterone system inhibition, antiplatelet therapy, and diabetes. Still, many questions remain with regard ...

Introduction: Several antiplatelets have been used in the prevention of secondary ischemic strokes with limited success and some carried a high risk of bleeding. Cilostazol is a relatively new antiplatelet that has been thoroughly investigated in Japan with promising outcome in secondary stroke prevention. Areas covered: In this paper, the ...

PURPOSE: To compare outcomes of selective laser trabeculoplasty (SLT) with drug therapy for glaucoma patients in a prospective randomized clinical trial. PATIENTS AND METHODS: Sixty-nine patients (127 eyes) with open-angle glaucoma or ocular hypertension were randomized to SLT or medical therapy. Target intraocular pressure (IOP) was determined using the Collaborative ...

Purpose The development, implementation, and evaluation of an i.v. interoperability program to advance medication safety at the bedside are described. Summary I.V. interoperability integrates intelligent infusion devices (IIDs), the bar-code-assisted medication administration system, and the electronic medication administration record system into a bar-code-driven workflow that populates provider-ordered, pharmacist-validated infusion parameters ...

Previous studies examining discrete movements of Parkinson's disease (PD) patients have found that in addition to performing movements that were slower than those of control participants, they exhibit specific deficits in movement coordination and in sensorimotor integration required to accurately guide movements. With medication, movement speed was normalized, but the ...

Summary.  For a long time, physical activities have been contraindicated in haemophiliacs or were restricted to few activities. Sports are nowadays advocated for haemophiliacs. Although various lists of physical activities have been proposed, scuba diving is never mentioned. Thus, with a group of haemophilic volunteers, a study was launched on ...

ADHD is a common neuropsychiatric disorder with a strong persistence over time. Medication is frequently used in the clinical management of ADHD. After response, medication is typically prescribed for months to years. It is unclear whether extended medication treatment provides long-term benefits and how long it should be continued. Furthermore, ...

Chronic migraine patients are at risk of developing a medication overuse. Brain functional studies in these patients have demonstrated an orbitofrontal hypometabolism, persistent after overuse cessation. Orbitofrontal dysfunction is also present in addiction and thus could predispose migraineurs to medication overuse. The aim of this study was to investigate if ...

Self-reporting seems more appropriate than medical-based surveillance to estimate true incidence of diarrhea during deployment of military troops. Most soldiers self-reported multiple episodes, 42% leading to medical care, mainly the first episode, resulting in a threefold higher incidence. Mathematical models integrating self-reported data should better predict outbreaks during military deployments ...

Abstract Objective: With the development of information technology, real-time telemetry has been invented for checking patients' physiologic parameters during their transport, via an Emergency Medical Service (EMS) system. We developed a Real-Time Telemetry System (RTS), which sends physiologic parameters including electrocardiogram (ECG), vital signs, and pulse oxymetry in real-time from ...

Most patients diagnosed with asthma maintain control reasonably well and do not experience asthma exacerbations; however, on average, 30% of patients achieve suboptimal control, have severe or difficult-to-treat asthma, and are relatively nonresponsive to the same medications that achieve and maintain asthma control for most patients. This small patient population ...

Background: The SUNCT syndrome (short-unilateral neuralgiform headache with conjunctival injection and tearing) can be very disabling for affected patients and is often refractory to medical management. We report the first case of SUNCT with a successful response to stereotactic radiosurgery without any adverse effect. Case: After failing optimal medical treatment, ...

Ulcerative colitis (UC) is a chronic inflammatory condition of the mucosa affecting the rectum and extending up the colon in a continuous manner. Its etiology is unknown, but is most probably the result of the interaction of genetic and environmental factors. Approximately 30% of UC patients will need to undergo ...

Mortality in congestive heart failure (CHF) usually occurs from either progressive worsening of cardiac pump failure or sudden cardiac death (SCD). Medical interventions that counter neurohormonal changes slow the progression of CHF and also prevent SCD. The benefits of medical therapy on SCD prevention have been variable, depending on the ...

Introduction.  Erectile dysfunction (ED) depression and ischemic heart disease (IHD) had long been classified as independent medical conditions managed by unrelated medical services. Recent studies have revealed the intimate associations among the three conditions. However, when a patient presents with one component of this triad, whether the physicians should also ...

Rising medical malpractice premiums have reached a crisis point in many areas of the United States. In 2003 the Texas legislature passed a comprehensive package of tort reform laws that included a cap at $250,000 on noneconomic damages in most medical malpractice cases. We hypothesized that tort reform laws significantly ...

Adverse medical events-medical interventions that cause harm or injury to a patient separate from the underlying medical condition-are unfortunately an all-too-frequent occurrence in US hospitals. They may cause as many as 187,000 deaths in hospitals each year, and 6.1 million injuries, both in and out of hospitals. We estimate the annual ...

To examine (1) arrest outcomes for adults with schizophrenia and bipolar disorder who were treated with first-generation antipsychotics (FGAs) or second-generation atypical antipsychotics (SGAs) and (2) the interaction between medication class and outpatient services in a Florida Medicaid program. In a secondary data analysis, Florida Medicaid data covering the period ...

Chronic non-terminal diseases, including postmenopausal osteoporosis, are associated with poor treatment compliance and persistence. The longer a patient with osteoporosis complies and persists with treatment, the lower the risk of fracture. Retrospective studies with emphasis on real-world data have led to a greater understanding of the factors affecting medication compliance ...

Several decades of research indicate that up to 20% of all patients do not fill a new prescription, and approximately one-half of those who do fill a new prescription discontinue therapy in the first 6 months.

Questions of patient autonomy have formed an important part of ethical debate in medicine from at least the post-war period onwards. Although initially important as a counterweight to widespread medical paternalism, recent years have seen a reaction against a widely perceived 'triumph of autonomy'. In particular, competent patients' refusal of ...

Introduction: Medication overuse headache (MOH) is a clinical concern in the management of migraine headache. MOH arises from the frequent use of medications used for the treatment of a primary headache. Medications that can cause MOH include opioid analgesics as well as formulations designed for the treatment of migraine, such ...

PURPOSE: To examine the circumstances of medical treatment for acute pancreatitis before publication of the new Japanese (JPN) guidelines using the Japanese administrative database associated with the Diagnosis Procedure Combination system. METHODS: We collected data from 7,193 patients with acute pancreatitis in 2008 and examined the recommended medical treatment in ...

Personalized genomic medicine and surgery (PGMS) represents a new approach to health care that customizes patients' medical treatment according to their own genetic information. This new approach is the result of increased knowledge of the human genome and ways this information can be applied by physicians in the medical and ...

BACKGROUND: Although recent studies suggest that medical treatment is appropriate for patients with aortic intramural hematoma (IMH), the outcomes of supportive medical treatment alone have not been satisfactory, and clear guidelines for medical treatment are not yet available. We assessed whether a management protocol of combined early aggressive medical treatment ...

Prenatal androgens have important organizing effects on the development and future behavior of the brain. The second-to-fourth digit length ratio (2D:4D) has been proposed as a marker of these prenatal androgen effects, with a relatively longer fourth finger indicating higher prenatal androgen exposure. 2D:4D has been shown to predict the ...

PURPOSE: This study aims to study death records mentioning epilepsy, epileptic seizures and/or status epilepticus, in order to survey the population demographics and associated medical conditions, making it possible to outline the patient's profile. METHODS: A qualitative analysis was performed on the data gathered from death certificates from the Curitiba ...

BACKGROUND: Brain tissue oxygen (PbtO(2)) monitoring is used in severe traumatic brain injury (TBI) patients. How brain reduced PbtO(2) should be treated and its response to treatment is not clearly defined. We examined which medical therapies restore normal PbtO(2) in TBI patients. METHODS: Forty-nine (mean age 40 ± 19 years) patients with severe ...

BACKGROUND AND PURPOSE: Intracranial atherosclerosis is especially prevalent in Asians, but intracranial stent placement and medical treatment for severe intracranial stenosis are controversial. Thus, we compared long-term outcomes of these 2 therapeutic approaches in an Asian population. MATERIALS AND METHODS: Patients with angiographically proved severe (≥70%) symptomatic intracranial atherosclerosis, with ...

Patients rely on their primary care physician to manage multiple, often chronic medical conditions that require prescription medications. Balancing the risk to benefit of treatments can be challenging and requires that the primary care physician stay abreast of new information regarding risks and benefits. The number of medications with reported ...

There are no controlled human studies to determine the efficacy of benzodiazepines or antipsychotic medications for prevention or treatment of acute cocaine toxicity. The only available controlled data are from animal models and these studies have reported inconsistent benefits. The objective of this study was to quantify the reported efficacy ...

Object Subthalamic nucleus deep brain stimulation (STN DBS) improves cardinal motor symptoms of Parkinson disease (PD) and reduces antiparkinsonian medication. Therefore, STN DBS seems to be well indicated for patients suffering from medication-induced psychotic symptoms. However, there are few available data dealing with the effect of STN DBS in this ...

Is there a positive duty at law to prevent an athlete with a serious medical disability from performance, despite the player accepting the risk? Is high risk of serious injury or death in the athletic context equivalent to euthanasia? Euthanized death is a predictable consequence of deliberate action. Accepting high ...

The practice of pleurodesis for the management and prevention of spontaneous pneumothorax (SP) is uncertain. A retrospective multicentre analysis of patients admitted to 12 hospitals in Hong Kong with SP in 2004 and who subsequently underwent pleurodesis for the same episode. Pleurodesis was performed in 394 episodes. Initial medical chemical ...

: Medication-overuse headache is one of the most disabling headaches. Antiepileptic drugs have been considered a promising strategy as prophylactic treatment in these patients, even if their use often has been limited by low tolerability or safety. The objective of this study was to evaluate the efficacy and safety of ...

Background. Nutmeg is widely used as a household spice. Numerous citations in the medical literature report its abuse as a psychoactive agent, primarily for its purported hallucinogenic effects that are thought to be due to the compound myristicin; these are primarily limited to case reports. Methods. We performed a retrospective review of ...

Iran is presently designing a long-term plan for promoting science, technology and innovation in medicine. An important part of this plan will be a strategy for future planning for medical education considering the important trends affecting the future of health status and medical education in Iran. Here, we sought to ...

Brain death determinations have been challenged in courts, but no systematic study has been published in the medical literature. Court cases on brain death determination could provide some insights for the clinical practice of physicians. We reviewed legal cases between 1980 and 2010 involving neurologic criteria for death since adoption ...

Japan established the medical system in Taiwan during its 50 years of occupation, which evolved into the present National Taiwan University Hospital system. This paper summarizes the biographies of 97 Japanese leaders in various medical disciplines during the Japanese occupation of Taiwan. These leaders were among the elite of Japan, ...

On Saturday, March 27th, 2010, the Dutch Performing Arts Medicine Association (NVDMG) organized a scientific and artistic Jubilee symposium "Genees & Kunst 10" for its 5th anniversary and 10th member assembly, at the University Medical Centre Utrecht, The Netherlands. During his opening speech, dr. Rietveld, president of NVDMG, mentioned the ...

It is increasingly suggested that political advocacy is a core professional responsibility for physicians. The author argues that this is an error. Advocacy on behalf of societal goals, even those goals as unexceptionable as the betterment of human health, is inevitably political. Claims that political advocacy are a professional responsibility ...

An 89-year-old female resident in the assisted living section of a continuing care retirement community complained of dizziness and lightheadedness at 10 am daily and was experiencing frequent falls. The facility staff requested a consultant pharmacist perform an extensive review of her medications and medical conditions. Following a chart review ...

Understanding how medical malpractice occurs and is resolved is important to improving patient safety and preserving the viability of a physician's career in academic medicine. Every physician is likely to be sued by a patient, and how the physician responds can change his or her professional life. However, the principles ...

BACKGROUND: Anorexia nervosa (AN) is a serious eating disorder associated with numerous medical complications, including alterations in water balance and impaired osmoregulation. OBJECTIVE: The aim of this paper is to review the evidence-based literature and discuss the potential pathophysiological mechanisms of impaired osmoregulation observed in patients with AN. MAIN DATA: ...

Researchers have recently hypothesized that autism spectrum disorders (ASD) may be partly characterized by physiological over-arousal. One way to assess physiological arousal is through autonomic measures. Here heart period (HP) and parasympathetic activity measured by respiratory sinus arrhythmia (RSA) were examined in adults with ASD and matched controls at rest ...

To explore the positive and negative effects of medical tourism on the economy, health staff and medical costs in Thailand. The financial repercussions of medical tourism were estimated from commerce ministry data, with modifications and extrapolations. Survey data on 4755 foreign and Thai outpatients in two private hospitals were used ...

Quality-assurance initiatives encourage adherence to evidenced-based guidelines based on a consideration of treatment benefit. We examined older persons' willingness to take medication for primary cardiovascular disease prevention according to benefits and harms. In-person interviews were performed with 356 community-living older persons. Participants were asked about their willingness to take medication ...

INTRODUCTION:: Leadership is an important predictor of team performance in medical emergencies. There are no data on why some healthcare workers take the lead in emergencies while others do not. Accordingly, the aim of the study was to determine predictors of leadership in a medical emergency. METHODS:: Two hundred thirty-seven ...