BACKGROUND: Several studies have shown that most patients with heart failure are not investigated and treated according to published guidelines. More effective management could reduce both mortality and morbidity from heart failure. AIM: To identify the reasons for gaps between recommended and actual management of heart failure in general practice. ...

Today in developed countries the majority of paediatric patients in hospital units suffer from conditions which will continue into adult life, and paediatric nephrology is no exception to this. Despite its obvious importance, the problem of the transition of these children with continuing renal diseases from paediatric to adult clinics ...

Management Case Studies describe approaches to real-life management problems in health systems. Each installment is a brief description of a problem and how it was dealt with. The cases are intended to help readers deal with similar experiences in their own work sites. Problem solving, not hypothesis testing, is emphasized. ...

The failure of management is largely a failure to bring our whole selves to it. What parts of your self do you bring to your work? Do you bring only the management mind, only logic, only the company guidelines? Or do you bring your passions, your values, your soul, your ...

BACKGROUND: Chronic heart failure is an increasingly common problem in Australia and most management occurs in the outpatient setting. OBJECTIVE: To review the options available in the management of chronic heart failure. DISCUSSION: Appropriate management can dramatically improve the prognosis, symptoms and quality of life of chronic heart failure patients.

The ELITE-II, BEST and CHAMP Trials were reported for the first time at the American Heart Association in November 1999. These trials provide valuable new information to guide clinical practice in the management of heart failure and of myocardial infarction, although none mandate a major change from current clinical practice. ...

Involuntary termination of employment is the final step in the human resource management life cycle. It often is viewed negatively because it may connote failure on the part of the employee. In some circumstances, however, it may indicate management's failure to turn a situation around. Although you may never expect ...

Conservation, harvesting and pest control are three aspects of the same general problem: population management. All three involve intervention with the aim of regulating population size and growth in some way, yet the dissociation of these disciplines is pervasive. Recent developments and a comparison of approaches show the potential of ...

Localized juvenile periodontitis (LJP) is not commonly encountered in dental practice. Yet, when it is encountered, prompt and effective therapy is required to combat the severity of disease and its rapid progression. Failure to understand its diagnosis and etiology leads to failures in management of LJP. The clinical features, etiology, ...

In a recent survey, CEOs and CFOs expressed concern regarding the effectiveness of their materials management departments. Both groups of executives would like to see more improvement in their materials managers' supply expense reduction efforts and leadership skills. More than a third of CFOs are even considering outsourcing the materials ...

Evanston (IL) Hospital's continuum-focused clinical pathway for congestive heart failure (CHF) has racked up some impressive numbers since its implementation in 1995: Length of stay has dropped from 6.2 days to four days--three less than the national average--while direct treatment costs have dropped by 60%. At the same time, the ...

Drowning and near drowning remain a common cause of childhood death and disability. Toddlers aged one through four drown in private swimming pools. Submersions greater than 10 minutes and lack of CPR at the scene or the need for greater than 20 minutes of resuscitation portends a poor prognosis. Management ...

The evaluation of the anatomical dissemination of lung cancer has a pivotal role in the choice of the most appropriate treatment modality. The techniques of nuclear medicine are founded on the use of different radiopharmaceuticals capable of exploiting the specific characteristics of malignant tissues. They may recognise diverse cell densities, ...

The dilemma of the high cost of quality health care in a managed care environment for chronic disease populations has led to the development of a nurse-managed chronic care clinic that focuses on outpatient case management of chronic diseases beginning with chronic heart failure patients. The clinic provides advanced practice ...

The torsional monotonic structural material properties of equine metacarpi with or without, either a 5/16 inch or 3/8 inch diameter bicortical lateromedial middiaphyseal hole were assessed to determine the effect of a hole on metacarpal strength. Torsional stiffness was not significantly effected by the presence of a bicortical hole, whereas ...

Rheumatoid arthritis frequently involves the foot and ankle, resulting in pain, deformity, and difficulty with ambulation. This article outlines clinical, radiographic, and gait evaluation in the management of foot and ankle problems in rheumatoid arthritis. Conservative nonsurgical management of foot deformities is presented including available shoewear and orthotic options. Surgical ...

A 14 month old child was referred for management of acute respiratory distress syndrome after aspiration of paraffin lamp oil. Initial management with conventional ventilation and subsequent management with high frequency oscillatory ventilation produced pulmonary air leaks, further compromising clinical management. After initiating extracorporeal life support and low pressure ventilation, ...

PURPOSE: This study assesses the clinical performance of 92 resin-bonded fixed partial dentures (FPDs) placed at four private practices in Karachi, Pakistan, between 1982 and 1991. MATERIALS AND METHODS: The distribution of the FPDs was 9 perforated, 45 electrolytically etched, and 38 silicoated. Twenty-five FPDs replaced anterior teeth and 67 ...

The oral and maxillofacial surgeon is aware of the need to evaluate and treat the entire facial complex. To gain maximum esthetic results, excessive ear prominence occasionally needs to be addressed. Excessive ear prominence can be the result of failure of scapha folding, conchal hypertrophy, conchal malposition, or a combination ...

OBJECTIVE: To develop a questionnaire for measuring patients' knowledge about arthritis and its self-management. METHODS: An initial item pool of 175 multiple-choice questions was developed, based on the Stanford Arthritis Self-Management Program and on basic medical knowledge about arthritis and its management. A rheumatologist, psychologist, physiotherapist, and several lay individuals ...

Siddha system is the ancient Dravidian system of medicine presently practiced predominantly in South India. In practice, generally the plants used are often in the compound form to which either herbs, metals, minerals and animals products are added. This paper attempts to describe the need for standardizing the drugs since ...

The literature was reviewed for evidence of digoxin efficacy and for indicators of positive digoxin response in chronic congestive heart failure with normal sinus rhythm. Practice in a family medicine teaching unit was audited based on this review. Most patients in this study were treated appropriately. Several (22% to 36%), ...

The purpose of this article is not to set out definitive management protocols for breeding flocks. These protocols must be individually designed and executed by the aviculturalist and attending veterinarian. The success of an avicultural medical management effort depends on the enthusiasm and competence of the veterinarian, the management expertise ...

Positioned as they are between administration and staff, hospital middle managers are especially vulnerable to risks, failures, and the emotions and stress that accompany them. "Failure," however, is a relative term, and turning failure into success chiefly entails a change in perspective and an acceptance of the manager's right to ...

Arthroscopic surgical techniques are well suited for the removal of diseased tissue. This article illustrates anecdotally some of the feasible arthroscopic "-ectomy" procedures of the wrist: centrum excision of the triangular fibrocartilage complex following injury; synovectomy in the management of wrist rheumatoid arthritis; proximal row carpectomy for degenerative arthritis; and ...

Tremors occur in a significant percentage of the adult population. They are quite variable and can be best seen under special conditions. All tremors cease during sleep. Tremors may represent adverse effects of certain drugs, or they may indicate the presence of systemic disturbances or diseases affecting the central nervous ...

The use of episiotomy emerged with the advent of "modern obstetrics". Few of the benefits attributed to it have been sustained by scientific study. The author of this article explores the interrelationship between episiotomy and other interventions in the second stage of labour and makes a plea for a reassessment ...

Forty-seven patients entered this comparison of frusemide-amiloride and cyclopenthiazide-potassium chloride in the treatment of congestive cardiac failure in general practice. Frusemide-amiloride was 'very satisfactory' in 92% of the patients compared to only 55% who took cyclopenthiazide-potassium chloride. Significantly more patients were free of paroxysmal nocturnal dyspnoea and orthopnoea after taking ...

The relative stress of participation in wheelchair basketball, volleyball, tennis, and racquetball were determined by monitoring the heart rates of wheelchair athletes. Heart rates were recorded for 5 seconds every 30 seconds during monitoring sessions of 10 min or longer under game or practice conditions. Subjects were volunteer paraplegic athletes ...

The physician who looks after children and teenagers is often confronted with the problem of short stature or growth failure. A major concern is when, and how extensively, to investigate the problem. From a practical standpoint, assessment can be related to height percentiles. The aims of treatment are to identify ...

This fourth and final installment on Salmon's monograph on procidentia concludes with further case reports. Upon his death the Committee on Management of St. Mark's Hospital commented: Thus has passed from this world a man whose kindness of heart induced, and whose indomitable perseverence enabled him to found an institution ...

Subfertility is common. Its management is almost invariably stressful. With the aid of an Upjohn Travelling Fellowship, it was hoped that a more structured role for the general practitioner could be developed, which would be adaptable for use in different areas and which would improve the management of subfertile couples. ...

Ischaemic heart disease is the most important cause of death in our society. Knowledge of the natural history of the various ischaemic syndromes leads to better management, with emphasis on prevention of cardiac necrosis rather than management of its sequelae. This article is from the Department of Cardiology, Royal Melbourne ...

The term 'discipline', as applied to family medicine, is widely used, yet poorly understood. The dictionary definitions of discipline as "a branch of knowledge or learning; training that develops self-control, character, or orderliness and efficiency" are related in this article to the personal discipline of family physicians. This discipline requires ...

This case report documents the antepartum detection of congenital complete heart block in the fetus of an adolescent primigravida. Management utilizing direct fetal electrocardiogram and fetal scalp sampling is discussed. The report illustrates the appropriate management of a fetus in utero with congenital complete heart block and suggests procedures to ...

Hair loss may not be as serious as cancer or heart disease, but when patients lose one of their most treasured possessions, the psychological trauma can be extremely severe. Although the pathogenesis of alopecia may seem complicated, if one understands the basic physiology and the normal hair growth cycle and ...

Faculty development, particularly that aspect of it concerned with increasing the educational and teaching skills of faculty members, is currently a major issue for medicine in general-and family medicine in particular. This article presents the author's views about what might be aspects of the guiding philosophy and content of such ...

An analysis of large tears treated over a decade revealed that while dialyses responded well to circumferential buckling, horseshoe tears responded poorly. A circumferential intrusion of the globe augmented the redundancy of the posterior edge of long tears and predisposed to leaking radical folds. Tears up to 70 degrees responded ...

Lumbar epidural block for the relief of pain in labour has been reported as having a variable frequency of success. Analysis of a personal series of 1544 epidurals carried out with the close co-operation of midwives shows that, with attention to details of management, satisfactory analgesia can be assured in ...

A double-blind cross-over trial of feprazone 450 mg daily and indomethacin 75 mg daily was carried out in fourteen patients with rheumatoid arthritis. The analgesic and anti-inflammatory activity was indistinguishable from that of indomethacin under the conditions of the trial. Seven patients expressed a preference for feprazone and four for ...

In double-blind cross-over studies in 46 patients with rheumatoid arthritis and in 42 patients with osteoarthrosis of the hip, Orudis-a new non-steroidal anti-inflammatory agent-has been shown to be well tolerated and to have comparable therapeutic efficacy with indomethacin when given in equal dosage. Side effects were less severe with Orudis. ...

As congestive heart failure (CHF) is a potentially life-threatening disease with increasing incidence and prevalence, guidelines for its diagnosis and treatment have been developed. In this study we examined the management of patients with CHF by general practitioners (GPs) in the province of Styria, Austria. Questionnaires designed to examine the ...

Background. In Italy the majority of patients with heart failure are admitted lo Internal Medicine Divisions, where diagnostics and therapeutic procedures, suggested by guidelines, are less utilized than in Cardiology Divisions. In order to provide a better assistance to patients with heart failure, a Cardiovascular Medicine Unit was founded with ...

Within the EUFP6 project HEARTFAID, an integrated platform of services is being developed to assist chronic heart failure stakeholders in their routine workflow and to provide an optimal management of heart failure patients, by exploiting the most advanced technologies, compliant to medical standards, advanced instruments for diagnostic data processing, and ...

This is a one hour audio broadcast on National Public Radio (NPR) Talk of the Nation, which took place in April 2004. Discussed is injecting stem cells from the patient’s own bone marrow into the heart, to improve blood flow and heart function. The broadcast is by Dr Amit Patel, ...

Sickness absence continues to be an economic burden to the NHS. Managers are faced with employees' sickness episodes and may have some challenges in managing this issue. This article draws on sickness absence statistics to highlight the extent of the problem in the NHS in England. It focuses on some ...

A method was devised for estimtaing the electrical resistance between the cytoplasm of adjacent cells of the red marine alga Griffithsia globulifera. A very high resistance was found, which argues strongly against the existence of protoplasmic continuity in this species.