Use of complementary and alternative medicine by males with Duchenne or Becker muscular dystrophy was examined using interview reports from caregivers enrolled in the population-based Muscular Dystrophy Surveillance, Tracking, and Research Network. Of the 200 caregivers interviewed, 160 (80%) reported "ever" using complementary and alternative medicine for their affected children. ...

As physician practices face stealthy marketplace competition, decreasing reimbursements, and increasing costs, it is crucial that they take a proactive approach toward strategic planning for their business. Merely accepting today's rocky business environment as the status quo and allowing it to dictate the direction of the practice can be a ...

INTRODUCTION: Good literary fiction has the potential to move us, extend our sense of life, transform our prospective views and help us in the face of adversity. A neurological disorder is one (if not the) most challenging experience a human being may have to confront in a lifetime. In this ...

Gout is the result of hyperuricemia, from either the body's overproduction or underexcretion. It can result in joint deterioration and destruction when improperly managed. Because primary care providers diagnose and treat the vast majority of patients with gout, it is important that they understand current guidelines and evidence-based practice.

PRACTICAL RELEVANCE: Cats commonly present with pelvic trauma following road traffic accidents (RTAs). A logical step-wise approach to diagnostics and subsequent management can significantly improve the prognosis in the majority of cases. This article provides a practical guide to assist decision-making and optimise management of these cats. CLINICAL CHALLENGES: Affected ...

Transesophageal echocardiography (TEE) has become a critical diagnostic and perioperative management tool for patients with congenital heart disease (CHD) undergoing cardiac and noncardiac surgical procedures. This review highlights the role of TEE in routine management of pediatric cardiac patient population with focus on indications, views, applications and technological advances.

Head injury is a common condition with a high morbidity and mortality. Serious intracranial haematomas require early recognition and evacuation to maximise chances of independent outcomes. Recent organisational changes have promoted the development of trauma units and major trauma centres where patients can go through triage and be managed in ...

Objective. To investigate the prevalence of complementary and alternative medicine (CAM) use among patients being investigated for thyroid nodules in a head and neck oncology practice. Subsequently, to determine whether the common therapies used were likely to interfere with the planned patient's care and whether the predominance was significant to ...

Objective: To investigate factors that influence beliefs about medicines in patients of South Asian origin with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods: Qualitative methodology was used to explore the health beliefs of South Asian patients and in particular the factors that influenced their beliefs about medicines and ...

Electroconvulsive therapy (ECT) is a treatment for affective catatonia and requires multiple general anesthetics. Morbid obesity is an increasingly prevalent condition that may complicate the standard anesthetic management of a patient undergoing ECT. We report the successful airway management of a morbidly obese ECT patient via elective tracheostomy.

OBJECTIVE: General practice-based case management is effective in improving symptoms, adherence, and the perceived process of care of patients living with major depression. The aim was to explore the patients' perceptions of practice-based depression case management, their satisfaction with it and how living with depression contextualizes case management. METHODS: This ...

This article reviews the pathophysiology, prevalence, incidence, and consequences of delirium, focusing on the evaluation of delirium, the published models of care for prevention in patients at risk of delirium, and management of patients for whom delirium is not preventable. Evidence on why physical restraints should not be used for ...

Changes in the 2010 American Joint Commission on Cancer melanoma staging guidelines include the evaluation of primary tumor mitotic index (mitogenicity) and the recognized prognostic significance of a single melanoma cell in a sentinel lymph node. These revised criteria have important practice implications for dermatopathologists as well as for dermatologists, ...

PRACTICAL RELEVANCE: Although a relatively uncommon condition, the investigation, diagnosis and initial medical management of feline congenital portosystemic shunts is often undertaken within general practice. Early recognition and appropriate treatment are important to ensure a good outcome. CLINICAL CHALLENGES: Clinical signs associated with CPSSs in cats are extremely variable and ...

Ureteroscopy continues to improve as a method for management of intrarenal stone disease. The development of new technologies and enhanced application of existing therapies is expanding the indications of ureteroscopy for the management of renal calculi. Improvements in image quality have been achieved with the adoption of digital ureteroscopes. Modifications ...

In Modern Medicine the ability to communicate represents a true and unique operative methodology which is the basis of Narrative Medicine. This type of approach does not represent an alternative to the traditional model, but rather expands its boundaries while preserving its scientific base; where the feelings, expectations, and desires ...

The emergency treatment of small ruminant patients can be overwhelming for clinicians with limited experience with these species. This article outlines the diseases most frequently encountered in veterinary practice. Each section discusses clinical signs, causes, and treatment and/or procedures associated with small ruminant emergencies. Emphasis is placed on the treatment ...

The aims of this study were firstly to examine patient demographics, lesion types and referral sources to Cork University Dental School and Hospital (CUDSH) for oral medicine services and secondly, to indicate factors that could improve the efficiency of the service provided. A retrospective analysis of the clinical records for ...

ABSTRAC: The therapeutic course of an aciclovir-induced acute renal dysfunctional patients was summarized. This had been relieved through a 15-day treatment with Western medicine but with a two-week protracted low fever that was cured by the authors using Chinese medicinal herbs for supplementing qi to support essence, nourishing yin to ...

OBJECTIVE: Current NICE guidelines for Osteoarthritis (OA) identify several core self-management recommendations (exercise and weight loss if overweight/obese) to be supported by Healthcare Professionals. Contemporary research stresses that a patient-centred model of self-management that builds upon existing patient action and belief is essential. The lay beliefs regarding self-management for OA ...

Summary.  Acute haemarthrosis is a frequent type of bleeding in individuals with haemophilia. Delayed and/or inadequate treatment can trigger a series of pathological changes within the joint, leading to a painful and disabling arthropathy. The early management of intra-articular bleeding has the potential to prevent chronic joint disease and may ...

The aim of this study is to evaluate the factors affecting the use and frequency of use of complementary and alternative medicine among chronic renal failure patients. The use of complementary and alternative medicine in the general population and patients with chronic renal failure has increased significantly. Despite this, there ...

Familial Mediterranean fever is an autosomal recessive genetic disorder characterized by recurrent febrile polyserositis, especially prevalent in individuals of Mediterranean descent. Familial Mediterranean fever can have nonspecific manifestations that mimic many common acquired disorders such as infections, acute appendicitis, cholecystitis, and arthritis, which can delay diagnosis for many years and ...

OBJECTIVES: We aimed to investigate clinical practice patterns for the outpatient management of acute deep vein thrombosis (DVT). METHODS: In the prospective Outpatient Treatment of Deep Vein Thrombosis in Switzerland (OTIS-DVT) registry, 534 consecutive outpatients with acute DVT (49% proximal, 24% recurrent, and 12% cancer-associated) were enrolled: 41% patients were ...

OBJECTIVES: To design, implement, and assess an educational intervention for providers focused on osteoporosis screening and management in older patients with chronic obstructive pulmonary disease or asthma who have been prescribed prolonged courses of oral or high-dose inhaled corticosteroids or both and are therefore at high risk for bone loss ...

In the orthopedic community, there is controversy regarding the management of articular cartilage defects of the knee. Nonoperative treatment is indicated for initial management. Surgical options include autologous chondrocyte implantation, osteochodral autograft transfer, osteoarticular allografts, and microfracture. More than 70% of patients who have surgery using these techniques have reported ...

Hyperglycemia is frequent in patients with cerebrovascular disease. This review article aims to summarize the recent evidence from observational studies that examined the adverse cerebrovascular effects of dysglycemic states as well as interventional studies assessing intensive management strategies for hyperglycemia. In recent years, diabetes, prediabetic states and insulin resistance and ...

Objective To discuss the presentation, diagnosis, and management of primary hyperparathyroidism (PHPT) in family medicine. Quality of evidence MEDLINE was searched from 2002 to 2009 using the terms presentation, diagnosis, and treatment of PHPT. Proceedings and guidelines from the Third International Workshop on Primary Hyperparathyroidism in May 2008 were reviewed ...

Complementary and alternative medical (CAM) treatments are considered nonmainstream therapies. The popularity and widespread usage of CAM reflects the inadequacies of the current understanding and management of rheumatic and musculoskeletal (and other) diseases despite significant progress. Better science in the future will relegate certain CAM therapies to the margins of ...

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS). Growing evidence indicates that ADMA plays an important role in the initiation and progression of a variety of adulthood diseases, especially in the cardiovascular and renal systems. However, the study of ADMA in pediatric diseases has just begun. ...

The purpose of this study was to determine the percentage of patients referred to an interventional radiology (IR) practice who need palliative care and to examine the training required for a diplomate of the American Board of Radiology (ABR) to qualify for the hospice and palliative medicine certifying examination. This ...

Access to echocardiography remains suboptimal for many older patients; hand-held echocardiography may improve access to this investigation. New methods of service provision may, however, not always result in appropriate use by clinicians. The aim of this study was to test whether the provision of hand-held echocardiography in a geriatric medicine ...

Cameron AP, Wallner LP, Forchheimer MB, Clemens JQ, Dunn RL, Rodriguez G, Chen D, Horton J III, Tate DG. Medical and psychosocial complications associated with method of bladder management after traumatic spinal cord injury. OBJECTIVES:: To determine the relationships between bladder management method and medical complications (renal calculi or decubitus ...

INTRODUCTION: Standard management guidelines for voiding dysfunction in patients with spinal cord injury (SCI) do not exist and these patients are managed on the basis of institutional protocols or individual judgment of managing physicians. OBJECTIVES: To notice general trends and improvements over a five year period, in the institutional practices ...

Background. Rheumatoid arthritis (RA) as a chronic systemic disease, commonly affects the feet, impacting negatively on patients' quality of life. Specialist podiatrists have a prime role to play in the assessment and management of foot and ankle problems within this patient group. However, it has been identified that in many ...

OBJECTIVES: /st> To develop evidence-based recommendations for management of calcium pyrophosphate deposition (CPPD). METHODS: /st> A multidisciplinary guideline development group of 15 experts, representing 10 European countries, generated key propositions for management of CPPD using a Delphi consensus approach. For each recommendation research evidence was searched systematically. Whenever possible, the ...

Bleeding and thrombosis are not infrequent problems in children receiving treatment for acute lymphoblastic leukaemia (ALL). The exact frequency varies with age, co-morbidity and treatment schedule, but the risk is highest in the first few weeks of treatment when disease and treatment-related haemostatic abnormalities prevail. Recommendations for prevention and management ...

Oral Diseases (2011) doi: 10.1111/j.1601-0825.2011.01787.x Wound healing is a complex biological process that affects multiple tissue types. Wounds in the oral cavity are particularly challenging given the variety of tissue types that exist in close proximity to one another. The goal of regenerative medicine is to facilitate the rapid replacement ...

BACKGROUND: Patient-physician interactions in the emergency department (ED) are unique in that prior relationships may not exist; interactions are brief, and the environment is hectic. OBJECTIVES: The research hypotheses were that patient satisfaction scores on a commonly used national satisfaction survey are associated with patient complaints and risk management file ...

Peritoneal dialysis is a modality of renal replacement therapy that is commonly used in human medicine for treatment of chronic kidney disease and end-stage kidney failure. Peritoneal dialysis uses the peritoneum as a membrane across which fluids and uremic solutes are exchanged. In this process, dialysate is instilled into the peritoneal ...

the impact of the 2007 American Heart Association endocarditis prophylaxis guidelines on clinician practice has not been well established. Our objective was to evaluate how the American Heart Association endocarditis guidelines changed the practice of cardiologists who manage congenital heart disease and to ascertain the degree of practice variation among ...

A focus often exists in dental practice on the maintenance and management of the dentition and the periodontium, however, conditions of the oral mucosa and orofacial pain can cause significant problems for older patients. Oral mucosal conditions are more prevalent in older patients and many orofacial pain disorders, such as ...

Reno vascular hypertension (RVH) is an important challenge for clinicians managing patients with hypertension. With recent advances in imaging techniques, the diagnosis and recognition of Renal artery stenosis (RAS) has increased resulting in a 3-4 fold increase in endovascular procedures. Recent prospective, randomized trials have demonstrated equivocal results for interventions ...

The Texas Medical Association is fending off attacks on the practice of medicine by nonphysician practitioners who want to expand their scope of practice and diagnose and treat patients without going to medical school. Most recently, TMA went to court to protect patients, filing another lawsuit against the Texas Board ...

This is the guideline for genital herpes simplex virus (HSV) management for the IUSTI/WHO Europe, 2010. They describe the epidemiology, diagnosis, clinical features, treatment and prevention of genital HSV infection. They include details on the management of HSV in pregnancy, those who are immunocompromised and the clinical investigation and management ...

Irritative voiding symptoms are to the urinary tract much as a cough is to the pulmonary system, that is, a nonspecific manifestation of multiple potential underlying causes. Key to the evaluation and management of patients with these symptoms is a clear understanding of the differential diagnosis, the diagnostic tests required ...

Myotonic dystrophy (DM1) is the most prevalent muscular dystrophy occurring in adulthood. DM1 is a multi-systemic disorder resulting in early-onset cataracts, cardiac rhythm problems, muscle weakness, ptosis, and cognitive and psychiatric manifestations. Dysphagia is one of the most problematic symptoms of DM1 because it may cause weight loss, aspiration pneumonias ...

The aim of this study is to determine the current trends in the management and surveillance of the NB population secondary to spinal cord injury (SCI) or myelomeningocele by certified urologist working in Saudi Arabia and to compare it to the current guidelines. A cross-sectional study was conducted using a ...

Raynaud's phenomenon (RP) and digital ulcers (DU) are the clinical manifestations of vasculopathy in systemic sclerosis. Both interfere with hand function and hold the possibility of severe complications, thus adversely influencing patients' quality of life. Managing RP and DU is often a challenge for the treating physician, who has to ...

Hemodialysis is a highly technical procedure that requires specialized equipment that is not used in other areas of veterinary medicine. Certain hemodialysis-specific monitoring equipment is also employed.