Obesity is a chronic condition, and long-term treatment will most likely be needed. Approved prescription medications for weight loss appear to have similar efficacy in controlled studies. No predictors of responsiveness in an individual patient or class of patients have been established. The choice of a medication is based on ...

With today's medically complex population of ambulatory patients, it is essential that the dental clinician possess a working knowledge of those medical issues that may impact a practice. This is most critical in those patients who present with a bleeding risk. Acquiring a thorough history with necessary medical information and ...

Acutely ill general medical patients are at moderate-to-high risk of venous thromboembolism (VTE); approximately 10-30% may develop deep vein thrombosis or pulmonary embolism, the latter being a leading contributor to deaths in hospital. Medical conditions associated with a high risk of VTE include cardiac disease, cancer, respiratory disease, inflammatory bowel ...

INTRODUCTION: The dispensing of drugs in medical care systems is, in most countries, strictly regulated, and nurses are responsible for distributing drugs to in-patients. AIM: To describe the perceptions of patients with rheumatic diseases regarding traditional drug dispensing during in-patient care and rehabilitation in a specialized rheumatological care unit. METHOD: ...

OBJECTIVE: Exposure to natural sunlight has been associated with improvement in mood, reduced mortality among patients with cancer, and reduced length of hospitalization for patients who have experienced myocardial infarction. Our aim was to evaluate whether the amount of sunlight in a hospital room modifies a patient's psychosocial health, the ...

Venous thromboembolism (VTE) is a condition that has multiple causes but few warning signs. Consequently, the 2 manifestations of VTE-pulmonary embolism and deep vein thrombosis-often go unpredicted. This is especially true for medical patients. Treatment guidelines indicate that most hospitalized patients should receive prophylaxis for VTE. This report discusses these ...

Using a sample of 200 medical technologists over a 4-year period, this study investigated whether peer, supervisor, and patient communication satisfaction facets were related but distinct referents. Confirmatory factor analyses on the medical technologist sample and a second independent sample of 85 medical/health professionals supported the distinctiveness of these three ...

Venous thromboembolism (VTE) is a serious disorder and a major cause of morbidity and mortality among acutely ill medical patients. However, despite the growing number of patients with acute medical illnesses who have an associated risk of VTE, the widespread use of VTE prophylaxis does not yet occur for both ...

In a two year retrospective analysis (January 2002 and December 2003) there were 364 cases of Caesarean section out of 1796 deliverers at Federal medical Centre, Birnin Kebbi giving a caesarean section rate of 20.3%. One thousand five hundred and twenty-three patients (84.8%) were unbooked while two hundred and seventy ...

Given the increased number of patients hospitalized for acute medical illnesses and the associated risk of venous thromboembolism (VTE), the use of prophylaxis has become a public health matter. Thromboprophylaxis is not widely practiced in acutely ill medical patients, due in part to the heterogeneity of this group and the ...

BACKGROUND/AIMS: Although medical information is often communicated in writing, little attention is given as to whether patients can read it--for example, the miniscule writing on the side of the medication bottles (equivalent to 6/6 reduced Snellen). The authors wished to determine a distance visual acuity threshold, using routine assessments of ...

Venous thromboembolism (VTE), which includes both deep vein thrombosis and pulmonary embolism, is a well-known risk in surgical patients, but it is also a significant and often unrecognized source of mortality and morbidity in hospitalized medical patients. The need for routine prophylaxis in the general medical population is increasingly supported.

BACKGROUND: While extensive data support the clinical benefit and cost-effectiveness of routine thromboprophylaxis in surgical patients, the use of this approach in medical patients has been controversial. However, recent data, mainly from the MEDENOX trial, support routine thromboprophylaxis in acutely ill medical patients. AIM: To determine attitudes towards VTE prevention ...

To investigate the difficulties doctors face in discussing treatment options with patients with acute, life threatening illness and major comorbidities. Observational study of doctor-patient interviews based on a standardised clinical scenario involving high risk surgery in a hypothetical patient (played by an actor) with serious comorbidities. 30 trainee doctors 3-5 ...

Background: The observation of the frequency with which patients presented at the outreach clinic at Giwa General hospital with complications resulting from intervention by traditional healers led to an investigation regarding their preference for western or traditional solutions to eye ailments alongside the distance necessary to travel from home to ...

OBJECTIVE: To assess the use of medical honey on healing times and complications in patients with venous leg ulcers after split-skin grafting. METHOD: Healing time and morbidity were evaluated in six patients with chronic venous leg ulcers who underwent split-skin grafting followed by the application of medical honey at the ...

Previous research on echocardiography in patients with acute stroke has focused on identifying possible cardioembolic etiologies of the stroke, but physicians might also obtain echocardiography to guide the management of heart disease in stroke patients. The objectives of this study were to determine how frequently echocardiography is used in acute ...

OBJECTIVES: The purpose of this study was to compare the efficacy of medical treatment with percutaneous closure of patent foramen ovale (PFO). BACKGROUND: Patients with cryptogenic stroke and PFO are at risk for recurrent cerebrovascular events. METHODS: We compared the risk of recurrence in 308 patients with cryptogenic stroke and ...

Venous thromboembolism (VTE) is a clinically silent and potentially fatal disease that manifests as deep vein thrombosis (DVT) and pulmonary embolism. Venous thromboembolism remains a serious public health challenge, with an ever-increasing odds ratio of occurrence given the aging population in the United States. This article reviews the epidemiology of ...

This prospective study assessed the influence of resistance to antidepressant pharmacotherapy on the short-term response to subsequent electroconvulsive therapy (ECT). Previous research has shown that patients with medication resistance were less likely to respond to ECT. This finding may be applicable to the population of depressed inpatients in The Netherlands, ...

AIMS AND BACKGROUND: Amputation surgery in pediatric patients suffering from malignant tumors is less common than in the past, but has a great emotional impact on patients and their families as well as on the medical team. Studies addressing the psychological aspects of limb amputation in childhood cancer are still ...

Many hospitalised medical patients are at increased risk of venous thromboembolism (VTE). Consensus statements recommend that such patients be assessed for risk of VTE on admission to hospital and receive thromboprophylaxis where appropriate. However, VTE prophylaxis is not widely used in medical patients. One explanation is that assessing medical patients' ...

To answer questions from clinical-evidence texts, we identify occurrences of the semantic classes --- disease, medication, patient outcome --- that are candidate elements of the answer, and the relations among them. Additionally, we determine whether an outcome is positive or negative.

BACKGROUND: There is limited information about risk factors for venous thromboembolism (VTE) in acutely ill hospitalized general medical patients. METHODS: An international, randomized, double-masked, placebo-controlled trial (MEDENOX) has previously been conducted in 1102 acutely ill, immobilized general medical patients and has shown the efficacy of using a low-molecular-weight heparin, enoxaparin ...

Clinicians often encounter patients with dementia and urge incontinence who might benefit from both an anticholinergic medication and a cholinesterase inhibitor. At first glance, this combination would seem to violate basic principles of geriatric pharmacology, as the drugs appear to be working at cross-purposes and anticholinergic medications are notorious for ...

A retrospective review of the against medical advice (AMA) discharges revealed that the majority of the patients left AMA for personal reasons, i.e., sickness or death in the family; reconciliation with spouse, girl friend, or family members; financial problems; and legal issues such as a court date. Strategies to reduce ...

IT IS VITAL for perioperative team members to assess the effects of increasingly used herbal and nontraditional medications on a patient's surgical course. THIS LITERATURE REVIEW provides a knowledge base so nurses can appropriately assess the possible effects of herbal medication use by perioperative patients. THE HISTORY OF HERBAL REMEDY ...

Macrophages, lymphocytes and their products, may be involved in the pathophysiology of psychiatric disorders. The cell-mediated immune activation response of manic patients during pre-medication and medication stages remains unclear. The purpose of this case-control study was to investigate the plasma levels of immunologic variables, including interleukin (IL)-1 receptor antagonist (IL-1RA), ...

Studies have shown equivalent or improved outcomes with once-daily antiretroviral (ARV) regimens, but have failed to quantify the true daily dosing frequency and pill burden of HIV-infected patients, by not considering concomitant medications. This study was conducted to describe the total daily number (pill burden) and dosing frequency for all ...

In 2002, the Italian guidelines for eligibility of patients for intestinal transplantation (ITx) were defined as: life-threatening complications of home parenteral nutrition (HPN), lack of venous access for HPN, locally invasive tumors of the abdomen, Chronic intestinal failure (CIF) with a high risk of mortality, primary disease-related poor quality of ...

BACKGROUND: Little information is available about patients' perspectives on self- or nurse-related administration of medication. AIM: The aim of the study was to determine patients' perspectives about self-medication in the acute care setting. METHODS: A qualitative approach, using in-depth semi-structured interviews, was taken. Ten patients with a chronic medical illness ...

Venous thromboembolism accounts for a large number of preventable deaths. The majority of these events occur in medical patients, but medical thromboprophylaxis remains underutilised in this population. The purpose of this review is to examine the results of recent clinical trials of low molecular weight heparins in the prevention of ...

This study's objectives were twofold: to identify pain assessment methods used by caregivers of cognitively impaired older adults in long-term care, and to identify medications ordered and administered to them. Over 60% of RNs, with fewer LPNs and CNAs, used formal pain assessment tools. Patient records identified that 77.5% of ...

BACKGROUND: Clinical trials have demonstrated that prophylaxis with low-molecular-weight heparin reduces the occurrence of venous thromboembolism (VTE) among acutely ill medical inpatients in the experimental setting. OBJECTIVE: The goal of this retrospective database analysis was to examine the outcomes of low-molecular-weight heparin thromboprophylaxis among acutely ill medical inpatients in community ...

PURPOSE: The aim of this study was to determine the prevalence of herbal medication use in the pediatric surgical patient population, because herbal medications can cause major perioperative complications. METHODS: A questionnaire on all drug use before surgery was given to the parents of 1,100 consecutive pediatric surgical patients operated ...

OBJECTIVE: To evaluate the outcome of epilepsy and later reproductive endocrine health in girls who had epilepsy during puberty, using a population-based controlled study. METHODS: Sixty-nine patients (88%) and 51 control subjects (94%) of previously identified cohorts of 78 girls with epilepsy and 54 healthy control girls participated in this ...

OBJECTIVE: To report 4 cases of medication nonadherence due to presence of inert ingredients forbidden by the patients' religion. CASE SUMMARIES: We describe 4 cases in which religious concerns about prescribed medications' inert components led to discontinuation of these medications. These inert components are gelatin and stearic acid, which might ...

OBJECTIVE: To determine how frequently hospital discharge is delayed to administer intravenous heparin to patients with diverse indications for oral anticoagulation (OAC) medications and how often these delays are potentially avoidable, as assessed by the prevalence of contraindications to outpatient use of low-molecular-weight heparin (LMWH). PATIENTS AND METHODS: Records were ...

BACKGROUND: Prutitis or itching is a common complaint. It can be due to many dermatological and medical illnesses. This study was conducted to find out presence of pruritus in different diseases in patients admitted in a medical ward and to determine whether pruritus is more common due to medical causes ...

This paper draws on the PLEDGE research project (Patients with Limited English and Doctors in General Practice) 1 The Patients with Limited English and Doctors in General Practice (PLEDGE) project was funded by Sir Siegmund Warburg's Voluntary Settlement (2001-2003). The research team was: Celia Roberts, Roger Jones, Becky Moss, Srikant ...

We sought to determine Emergency Department (ED) patient preference for oral (p.o.), intramuscular (i.m.), or intravenous (i.v.) pain medication and patient expectations of time to medication effect by route. A prospective, observational study of 1276 patients presenting with painful illness or injury was performed in a university ED. Patient preferences ...

"The patient will need transportation." These simple words, frequently heard by case managers, identify a need that can require time-consuming research of possible providers and, in some instances, reveal very limited options, depending on the patient's medical needs, funding, and location. Patient transportation needs run the gamut from occasional local ...

Focal idiopathic excessive eccrine sweating presents most commonly as an affliction of three anatomically distinct area: the axillae, the palms and soles, and the upper face. The true incidence is not known, but about half of the patients referred to us with this condition have at least one first-degree relative ...

In this paper we introduce a shift in understanding patient-physician communication from the current individualistic, behavior-changing, patient-centered perspective, toward a more performative position. This postmodern shift reconstructs the collaborative doctor-patient plotline as involving a mutually-improvising ensemble performing an interweaving of biomedical and humanistic scripts in order to more effectively negotiate ...

BACKGROUND: Hemodialysis (HD) patients are at risk for medication-related problems (MRP). The MRP number, type, and appearance rate over time in ambulatory HD patients has not been investigated. METHODS: Randomly selected HD patients were enrolled to receive monthly pharmaceutical care visits. At each visit, MRP were identified through review of ...

OBJECTIVE: To determine the role of pyroglutamic acid (PGA) in the pathogenesis of unexplained metabolic acidosis in critically ill patients. DESIGN AND SETTING: Case series in the medical ICU of an urban hospital. PATIENTS: 23 patients admitted to the medical ICU with acidemia (pH <7.35 or HC0(3) < or = ...

BACKGROUND: While frequent or occasional symptomatic intradialytic hypotension (IDH) may influence patient well-being, its effects on survival-independent of comorbidities-has not previously been investigated. In this study, therefore, our objective was to assess the effect of frequent IDH (f-IDH) or occasional IDH (o-IDH) on survival. METHODS: During a 10 month run-in ...

OBJECTIVE: Our objective in the present study was to identify the medico-social problems in dialysis patients at the Department of Renal Medicine, RIPAS Hospital, Brunei Darussalam. Patients and METHODS: We retrospectively analyzed the social problems encountered by the patients in our dialysis program during the period January 2001 to June ...

BACKGROUND: Morphea and lichen sclerosus et atrophicus (LSA) are sclerotic skin lesions of unknown etiology involving connective tissue. The hypothesis of a borrelial origin of morphea and LSA is currently controversial. METHODS: Immunoglobulin G (IgG) immunoblot serologies against Borrelia burgdorferi in patients with morphea and LSA were analyzed and compared ...

Approximately 34,000 Iranians known to have sustained mustard agent exposure during the Iran-Iraq war of 1980-1988 and survived over a decade afterwards were screened for distribution of the most commonly occurring medical problems. In order of greatest incidence, these include lesions of the lungs (42.5%), eyes (39.3%), and skin (24.5%). ...