ABSTRACT: Traditionally, the medical management of concussion has involved close observation as well as physical and cognitive rest. Most post-concussive symptoms resolve spontaneously and require only conservative treatment. However, some patients do have prolonged recoveries and may benefit from treatment with medications. Some naturally occurring compounds demonstrate multi-mechanistic neuroprotective properties ...

Acromegaly is a rare disease characterized by excessive growth hormone secretion, usually from a pituitary tumor. Treatment options include surgery, medical therapy, and in some cases, radiation therapy. Current medical therapy consists of treatment with somatostatin analog medications or a growth hormone receptor antagonist. There are two somatostatin analogs currently ...

Medication overuse headache (MOH) is refractory headache with continuous and large amount use of drugs (analgesics, non-steroidal anti-inflammatory drugs, and triptans etc.) For treatment of MOH, overused drugs must be stopped as soon as possible. And preventive medication should be started at the same time. Also, the history of the ...

Cardiac caregivers may represent a novel low-cost strategy to improve patient adherence to medical follow-up and guidelines and, ultimately, patient outcomes. Prior work on caregiving has been conducted primarily in mental health and cancer research; few data have systematically evaluated caregivers of cardiac patients. The purpose of this study was ...

: In this article, the authors present a microeconomic analysis of the effects of the administrative status on plastic surgery units within academic medical centers, comparing the departmental versus subdepartmental status. The objectives are to introduce decision-making tools of microeconomics and use them to explore the potential effects of administrative ...

This article presents a comparison of the effectiveness of traditional clinical education toward skill acquisition goals versus simulation-based medical education (SBME) with deliberate practice (DP). This is a quantitative meta-analysis that spans 20 years, 1990 to 2010. A search strategy involving three literature databases, 12 search terms, and four inclusion ...

Professionalism is understood differently by members of different professions and within the medical profession itself. In its broadest sense, medical professionalism encompasses all of the aspects of the higher attributes of being a physician. This article explores some of the characteristics of being a professional, some of its challenges, and ...

Purpose The impact of an emergency department (ED) procedure requiring pharmacist review of all culture results as a way to improve use of antimicrobial therapies was evaluated. Methods Rates of antimicrobial regimen modifications before and after implementation of a pharmacist-managed ED culture review procedure at Carolinas Medical Center-Northeast were determined ...

Objective. To estimate the incidence of adverse drug events (ADEs) associated with health care visits among U.S. adults across all ambulatory settings. Data Source. We analyzed data from two nationally representative probability sample surveys: the National Ambulatory Medical Care Survey and the National Hospital and Ambulatory Medical Care Survey. From ...

Introduction: Inflammatory bowel diseases (IBDs) require maintenance medication to sustain remission and as a prophylaxis against the development of colorectal dysplasia. Non-adherence can compromise the effectiveness of treatment plans. Areas covered: Depending on study cohort and country, 7 - 72% of IBD patients do not adhere to maintenance medication plans. ...

The purpose of this study was to collect information on the utilization of physician assistants (PAs) and nurse practitioners (NPs) in academic health centers. Data were gathered from a national sample of University HealthSystem Consortium member academic medical centers (AMCs). PAs and NPs have been integrated into most services of ...

Patients with chronic disease often take many medications multiple times per day. Such regimen complexity is associated with medication nonadherence. Other factors, including the number of pharmacy visits patients make to pick up their prescriptions, may also undermine adherence. Our objective was to estimate the extent of prescribing and filling ...

ABSTRACT: BACKGROUND: Patients' values and preferences are fundamental tenets of evidence-based practice, yet current osteoporosis (OP) clinical guidelines pay little attention to these issues in therapeutic decision making. This may be in part due to the fact that few studies have examined the factors that influence the initial decision to ...

Compared with younger adults, older adults consume a disproportionate percentage of pain and sleep medications. Some studies have reported that psychoactive medication misuse and abuse in older populations is a significant problem. The aim of this study was to understand the perspective of primary care providers (PCPs) regarding the extent ...

OBJECTIVE: To evaluate the problems experienced after implementing a computerized physician order entry (CPOE) system, their possible root causes, and the responses of providers in order to incorporate the system into daily workflow. METHODS: A qualitative study in the medication-use process after implementation of a CPOE system in an academic ...

wulff k., cummings g.g., marck p. & yurtseven o. (2011) Medication administration technologies and patient safety: a mixed-method systematic review. Journal of Advanced Nursing. doi: 10.1111/j.1365-2648.2011.05676.x ABSTRACT: Background.  Healthcare leaders need evidence-based information on nursing medication administration technologies to guide the design of improvements to patient safety. Aim.  The aim of ...

BACKGROUND: Adherence to medication in inflammatory bowel disease (IBD) improves outcomes. Current practices of screening for adherence to IBD medications are unknown. The goal of this study was to determine current practice and perception of screening for medication adherence among US-based gastroenterologists. METHODS: A survey was mailed electronically to gastroenterologists ...

AIMS: Some individuals have a preference for the present rather than for the future. We investigated the impact of this impatient relationship to temporality on adherence to medication and HbA(1c) level in type 2 diabetic patients. METHODS: An observational, cross-sectional monocenter study in 90 patients consulting for a health check-up ...

BACKGROUND: Racial/ethnic minority patients are more likely to report experiences with discrimination in the healthcare setting, potentially leading to reduced access to appropriate care; however, few studies evaluate reports of discrimination with objectively measured quality of care indicators. OBJECTIVE: To evaluate whether patient-reported racial/ethnic discrimination by healthcare providers was associated ...

BACKGROUND: Despite increasing knowledge about the limited effectiveness and severe adverse effects, the prescription rate of psychotropic medications in frail elderly persons remains high. Prescriptions are mainly made to control behavioral and psychological symptoms of dementia, although factors associated with prescriptions are rarely reported. However, such information is a prerequisite ...

Aim.  This article aims to explore caregivers' knowledge of acetaminophen and comprehension of written medication instructions about acetaminophen syrup when administered to febrile children. Background.  Fever is one of the most common problems about which primary caregivers seek medical advice for their children. Administration of acetaminophen is the most common ...

OBJECTIVE: To assess the extent to which patients feel they have received enough information on cardiovascular drugs and experienced counseling at the pharmacy. In addition, to identify factors that are predictors for patient satisfaction with the information received. METHODS: Fifteen community pharmacies participated. New and chronic users of cardiovascular medication ...

BACKGROUND: Blood transfusion is the most common procedure performed in American hospitals, and transfusions are commonly ordered by physicians without formal training in transfusion medicine. Several transfusion medicine curricula have been proposed, including those developed through the Transfusion Medicine Academic Awards (TMAA). To our knowledge, no comprehensive study has assessed ...

Abstract The clinical provision of medical care by emergency medical services (EMS) providers in the out-of-hospital environment and the operation of EMS systems to provide that care are unique in the medical arena. There is a substantive difference in the experience of individuals who provide medical care in the out-of-hospital ...

Objectives.  To understand the extent to which medication adherence was related to diversion of prescription analgesics. Design.  Cross-sectional analyses of data from the College Life Study, a prospective study of young adults. Setting.  Participants were originally sampled as incoming first-time first-year college students from one large public university in the ...

This issue provides a clinical overview of celiac disease focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In the Clinic. Non-subscribers who wish to access this ...

The aim of this paper is to outline a current trend in inpatient medical rehabilitation in Germany, i.e. vocationally oriented medical rehabilitation (VOMR). Since employment-related demands and challenges pose a potential source of strain regarding employees' health and work ability, rehabilitative treatment in Germany is increasingly geared towards including work-related ...

Scholars of the medicalization of social problems have paid inadequate attention to medicalization's multiple dimensions - discourses, practices and identities - and to the multiple levels of analysis at which it occurs - macro, meso and micro. As a result, scholars of a given social problem typically examine only a ...

To estimate the effect of the introduction of a new smoking cessation medication, varenicline, and the publication of guidance related to its use, on trends in prescribing of smoking cessation medications in England. Interrupted time series analysis of primary care data on prescribing of smoking cessation medication using autoregressive integrated ...

Cultural competency is gaining recognition as an essential strategy by which to address health care disparities. A closer examination of medical school curriculums was undertaken to determine how the need for cultural competency and humility (CCH) training in medical education is being addressed. A MEDLINE review of published literature regarding ...

Several web-based resources recommend effective intervention strategies to promote use of mammography but there is limited information on whether the strategies are used, particularly by organizations that serve medically underserved women. In 2010, data collected by the Avon Breast Health Outreach Program (BHOP) were analyzed to examine the diffusion of ...

The increase in oral anticancer medications with complex regimens creates a need to assure that patients are taking therapeutic dosages as prescribed. This article reviews the assessment and measurement of adherence to oral antineoplastic agents. Research and journal articles from CINAHL and PubMed. Assessing and measuring adherence to oral antineoplastics ...

(Headache 2011;51:693-706) Objective.- To estimate the prevalence of chronic migraine (CM) among adolescents and to describe the epidemiologic profile, headache characteristics, disability, and healthcare utilization of adolescents with CM in the USA. Background.- Chronic daily headache (CDH) and CM occur in children and adolescents, but are poorly understood in these ...

: To estimate current trends in continuing medical education among obstetrician-gynecologists in relation to the Maintenance of Certification program. : A validated questionnaire was mailed to 1,030 randomly selected physicians of the American College of Obstetricians and Gynecologists in the United States, Puerto Rico, and Canada. Participants were asked about ...

With the increasing use of oral antineoplastic agents in cancer management, patients and family members need to understand of how to obtain, safely handle, and store the medication, how and when the medications should be taken, and when to report toxic side effects to accomplish efficacious treatment. Research-based articles and ...

Objective. To outline methods for deriving and validating intensive care unit (ICU) antimicrobial utilization (AU) measures from computerized data and to describe programming problems that emerged. Design. Retrospective evaluation of computerized pharmacy and administrative data. Setting. ICUs from 4 academic medical centers over 36 months. Interventions. Investigators separately developed and validated programming code to ...

The advent of oral therapies has dramatically changed the landscape of cancer therapy. Yet the degree to which patients actually take the prescribed agents as ordered remains unknown. This article outlines the challenges that oral chemotherapy agents present to both patients and providers and suggests interventions for promoting adherence. Published ...

Chronic headaches have increasingly become a focus within the field of head pain. Most of the patients with frequent headache eventually overuse their medications, and if it happens [the percentage is approximately 4%], the diagnosis of chronic migraine with medication-overuse headache is clinically important, because patients rarely respond to preventive ...

Serious medication errors occur commonly in the period after hospital discharge. Medication reconciliation in the postdischarge ambulatory setting may be one way to reduce the frequency of these errors. The authors describe the design and implementation of a novel tool built into an ambulatory electronic medical record (EMR) to facilitate ...

Purpose: To study the health profiles and behavioral differences between primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients. Methods: Confidential mail survey of ICD-9 defined POAG (n = 277) and NTG (n = 116) patients was carried out to collect information regarding age, gender, height, weight, waist circumference, blood pressure (BP), ...

To identify regional and specialty differences in the medical treatment of chronic rhinosinusitis (CRS). Cross-sectional analysis of a national database. Ambulatory visits for CRS were extracted from the National Ambulatory Medical Care Survey (NAMCS) for years 2005 to 2006. Medication utilization associated with CRS (antibiotics, antihistamines, nasal steroids, and oral ...

The aims of the present study were to evaluate physicians' satisfaction with medication services delivered by a clinical pharmacist (CP); to investigate and document to which extent a CP could improve the medication quality and reduce medication costs at an intensive care unit (ICU); and to explore which types of ...

Hoping to reduce medication errors and contain health care costs, policy makers are promoting electronic prescribing through Medicare and Medicaid financial incentives. Many e-prescribing systems provide electronic access to important information--for example, medications prescribed by physicians in other practices, patient formularies and generic alternatives--when physicians are deciding what medications to ...

Gastrointestinal endoscopy started in the early 1970s in Malaysia with the help of Japanese doctors. It has evolved over the past 30 years. The gastrointestinal endoscopy unit at the University of Malaya Medical Centre has been in the forefront in providing endoscopy services to patients as well as training doctors in ...

In medical interactions, it may seem straightforward to identify 'small talk' as casual or social talk superfluous to the institutional work of dealing with patients' medical concerns. Such a broad characterisation is, however, extremely difficult to apply to actual talk, and more specificity is necessary to pursue analyses of how ...

This report describes the prosthodontic rehabilitation of a partially edentulous patient by means of a maxillary implant-supported removable dental prosthesis and mandibular telescopic crown prosthesis. Due to the patient's contributory medical history for epilepsy and deep vein thrombosis, clinical management considerations are outlined along with an evidence-based, medically oriented treatment ...

Physicians are urged to communicate more openly following medical errors, but little is known about pathologists' attitudes about reporting errors to their institution and disclosing them to patients. We undertook a survey to characterize pathologists' and laboratory medical directors' attitudes and experience regarding the communication of errors with hospitals, treating ...

Shared medical appointments (SMAs) are 90-minute group appointments for patients with similar medical complaints. SMAs include components of a traditional office visit but provide further emphasis on health education. The effectiveness of SMAs on weight-loss in an outpatient setting has not been studied. Weight-loss SMAs were offered by one physician ...

Changes in global population and demography, and advances in medicine have led to elderly population growth, creating aging societies from which elderly medical care has evolved. In addition, with the elderly susceptible to chronic diseases, this together with the changing lifestyles of young adults have not only pushed up patient ...

Objectives To determine the frequency, types and severity of medications use-related problems among medical outpatients in a tertiary care setting in southwestern Nigeria. Setting Medical outpatient clinics of a 900-bed Teaching Hospital located in Ibadan, Southwestern Nigeria. Methods A prospective cross-sectional medication use review was conducted by ten pharmacists for ...