The field of cystic fibrosis (CF) is changing dramatically as the scientific knowledge accumulated since the cloning of the cystic fibrosis transmembrane conductance regulator (CFTR) gene is being translated into effective therapies to correct the basic defect and provide better disease models and in-depth understanding of the basic mechanisms of ...

Our objective was to better understand UK-wide practice in managing sialorrhoea in motor neuron disease among specialist clinicians. We used a survey of neurologists in the UK with a special interest in motor neuron disease designed to establish clinicians' attitudes towards treatment options and resources for sialorrhoea management. Twenty-three clinicians ...

OBJECTIVE: To assess self-management in patients receiving glucocorticoid replacement therapy for primary or secondary adrenal failure before and 6 months after a glucocorticoid education group meeting. METHODS: All patients with primary or secondary adrenal insufficiency, treated at the department of Medicine, Division of Endocrinology were invited by their endocrinologist to ...

SUMMARY:: The Practice Advisory on Liposuction published by the American Society of Plastic Surgeons provides a thorough review of anesthetic techniques and guidelines for surgeons who perform liposuction. However, there is evidence to support several changes to the anesthetic infiltrate guidelines that will improve patient safety. These proposed recommendations will ...

The purpose of this study was to describe the prevalence, importance, and challenges of complementary and alternative medicine (CAM) utilization in Texas hospices. Mail surveys were sent to 369 hospices in Texas, and 110 useful surveys were returned. Results showed that a majority (n = 62, 56.4%) of hospices offer ...

Neurology is currently recognized as an independent clinical and academic specialty in Hungary, but the early history of Hungarian neurology was intertwined with the development of internal medicine and psychiatry. Up to the end of the 19th century, neurologic patients were mostly treated at internal medicine departments.

Hyperglycaemic patients admitted to hospital have worse clinical outcomes with higher operational costs than normoglycaemic patients. Identifying, defining and treating hyperglycaemia promptly and appropriately is essential during hospitalisation; adequate 'continuity of care' must be assured after discharge. This requires a multidisciplinary clinical collaboration between the internist and the diabetes team, ...

This paper encapsulates the history of Reiki, an ancient healing art, from its origins in Japan to current practice in the United States. It defines Reiki therapy and discusses the development of a new Reiki method called Temari Reiki and the use of two additional chakras. Lastly, sample clients scenarios ...

The practice of appropriate evidence-based medicine should be a goal for all physicians. By using protocols in areas where strong evidence-based medicine exists, physicians have reliably shown they can improve patient outcomes while reducing complications, cost, and hospital stay. Evidence-based protocols in complex spinal care are rare. At Northwestern University ...

This systematic review aimed to estimate the prevalence of use of complementary and alternative medicine (CAM) in the UK. Five databases were searched for English language, peer-reviewed surveys published between 1 January 2000 and 7 October 2011. In addition, relevant book chapters and files from our own departmental records were ...

The increased demand for medical diagnosis procedures has been recognized as one of the contributors to the rise of health care costs in the U.S. in the last few years. Nuclear medicine is a subspecialty of radiology that uses advanced technology and radiopharmaceuticals for the diagnosis and treatment of medical ...

Safety is one of our primary professional obligations to our patients. Vigilant application of basic principles allows the electrodiagnostic (EDX) medicine consultant to maintain a safe environment for the patients as well as office staff. Nerve stimulator use in close proximity to the path of wires or catheters that enter ...

BACKGROUND: Health policy-makers and pharmacy's representative bodies seek to better utilize the skill of community pharmacists so as to support patients' use of medicines and associated health care outcomes. The English Medicines Use Review (MUR) is an NHS-funded community pharmacy service that aims to improve patients' knowledge of medicines and ...

Synchronized Direct Current Cardioversion (SDC) is an established therapy for the termination of supraventricular tachycardia (SVT - either atrio-ventricular nodal reentry tachycardia (AVNRT) or atrio-ventricular reentrant tachycardia (AVRT)) with poor perfusion. The evidence is extremely limited with regard to the safety and effectiveness of this therapy. In Australia, half of ...

Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. This article provides simple ways to practice everyday EBM by (1) asking patient-specific clinical questions, (2) finding the most relevant, best evidence, (3) critically appraising evidence to ...

The new world of safe aesthetic injectables has become increasingly popular with patients. Not only is there less risk than with surgery, but there is also significantly less downtime to interfere with patients' normal work and social schedules. Botulinum toxin (BoNT) type A (BoNTA) is an indispensable tool used in ...

The use of standardized patient assessments (SPAs) in psychiatry is an emerging best practice. This column describes a survey of resident and faculty supervisors at a large academic department examining current practices, attitudes, and perceived barriers to incorporating SPAs into clinical practice. Although the study found that SPAs were not ...

A new model of care for the management of patients with delirium was developed and evaluated. A four-bedded Close Observation Unit (COU) was introduced. The model comprised education for assistants in nursing (AINs), environmental adaptations and AIN-to-patient ratio of 1:4. Outcomes in all patients with delirium before and after introduction ...

The objective of this survey was to determine the level of experience OB/GYN (Obstetrics & Gynecology) physicians in the state of Arkansas have in seeing and managing patients with vulvar pain, commonly known as vulvodynia. The 8 question, anonymous survey was mailed to Arkansas OB/GYN physicians. The survey assessed the ...

Thromboprophylaxis in arthroscopy is controversial. Recent literature has shown variable rates of deep vein thrombosis following routine arthroscopic knee surgery; however, it is unknown if current practice reflects the literature. We have conducted a cross sectional survey to provide insight into the practice patterns perceived risks, benefits and barrier in ...

OBJECTIVE: The objective was to explore perspectives on reasons for psychotropic medication use in prisons. METHOD: We recruited a purposive sample of healthcare staff and patients prescribed psychotropic medicines from four East of England prisons. Participants took part in qualitative, semistructured interviews, which were recorded, transcribed and analyzed thematically. RESULTS: ...

PURPOSE:: Our goal is to investigate the opinion and practice pattern of Canadian ophthalmologists regarding the use of and recommendations for complementary and alternative medicine (CAM) for their glaucoma patients. METHODS:: Institutional review board approval for this prospective, cross-sectional survey was obtained from the Research Ethics Board of Sunnybrook Health ...

The Japanese Society of Hypertension (JSH) updated its hypertension management guidelines in 2009. One of the most significant changes with respect to the 2004 version was the stance towards the use of diuretics: in 2004, their use was cautioned against, but in 2009, it was actively promoted. The purpose of ...

: The clinical use of medicines outside the conditions authorized in their Summary of Product Characteristics (SPC) (off-label use) is a common practice in pediatrics. The aim of the present study was to describe and quantify the medicines received by children attended in the pediatric gastroenterology department, their off-label use, ...

Growing evidence supports the inclusion of patient empowerment as a key ingredient of care for patients with chronic conditions. In recent years, several studies based on patient empowerment, have been carried out in different European countries in the context of general practice and primary care to improve management of chronic ...

This article is a systematic review of complementary and alternative medicine use for pediatric and adult asthma self-management. The aim of the review was to summarize the existing body of research regarding the types and patterns of, adverse events and risky behaviors associated with, and patient-provider communication about complementary therapies ...

This systematic review is aimed at estimating the prevalence of complementary and alternative medicine (CAM)-use by paediatric populations in the United Kingdom (UK). AMED, CINAHL, COCHRANE, EMBASE and MEDLINE were searched for English language peer-reviewed surveys published between 01 January 2000 and September 2011. Additionally, relevant book chapters and our ...

ABSTRACT: BACKGROUND: Patient-centered medicine is developing alongside the concepts of personalized medicine and tailored therapeutics. The main objective of patient-centered medicine is to improve health outcomes of individual patients in everyday clinical practice, taking into account the patient's objectives, preferences, values and available economic resources. DISCUSSION: Patient-centered medicine implies a ...

Multiple medications are recommended for the management of ischaemic heart disease. Unfortunately, increasing the number of medicines reduces adherence to medicines therapy. The concept of a polypill with a fixed dose combination of the common cardiovascular medicines (aspirin, statin, two blood pressure-lowering medicines) has been promoted. Patient perceptions about this ...

Marcel Proust (1875-1922), the son and brother of famous physicians, had close and continuous contact with medicine and doctors in connection with chronic asthma, neurasthenia, medical 'tourism', and self-medication. This proximity to medical issues is obvious in his work, particularly his novel In Search of Lost Time, which today is ...

This article provides an update for the anesthesiology community on the mechanisms and limitations of common modalities used to assess the early hemodynamic status in patients with trauma. Figures are provided to illustrate important concepts through the use of computer simulation and real-world examples. This article is of value to ...

Background:Along with patient history, the physical examination is the key component for any patient encounter. Determining what should be included in the nasal examination is critical. Practicing evidenced-based medicine calls for an integration of the clinical/surgical expertise of the provider, the individual patient's needs and preferences, and the application of ...

The aim of this study descriptive study was to evaluate concordance with medication and those factors that affect the use of medicine in patients with hypertension. Data were collected using a questionnaire completed by 750 patients with hypertension between December 25, 2003, and April 30, 2004, in an outpatient hypertension ...

People aged more than 65 years take more medicines than any other group, with over 90% taking at least one prescription medicine, and nearly half using five or more drugs (polypharmacy). Medicines in older patients have the potential to provide great gains as well as significant harms. To provide an ...

To understand the decision-making processes involved in conventional medicine and complementary medicine cancer treatment, and the role that information plays, a cross-sectional survey of cancer patients was carried out at 2 Australian cancer centres. Data was obtained from 75 cancer patients. When asked about complementary medicine use, 36 (48%) patients ...

Background and AIMS: Suspected latent tuberculosis infection (LTBI) is a common reason for referral to TB clinics. Interferon-gamma release assays (IGRAs) are more specific than tuberculin skin tests (TSTs) for diagnosing LTBI. The aim of this study is to determine if IGRA changes practice in the management of cases referred ...

BACKGROUND: In North America and Europe ∼150 persons are killed by avalanches every year. METHODS: The International Commission for Mountain Emergency Medicine (ICAR MEDCOM) systematically developed evidence-based guidelines and an algorithm for the management of avalanche victims using a worksheet of 27 Population Intervention Comparator Outcome questions. Classification of recommendations ...

BACGROUND/AIM: Alternative medicine is a set of therapeutic procedures which are no part of official practice. At present, the use of alternative medicine among cancer patients is significant and the purpose of this study was to get more information on the methods and products of alternative medicine. Thus, the aim ...

OBJECTIVE: To determine the frequency with which hospital in-patients receive information about medicines and whether this varies dependent on patient characteristics or hospitals. METHODS: Cross-sectional survey of medical in-patients in six hospitals in North West England. RESULTS: 1218 questionnaires were completed sufficiently for analysis by medical in-patients. 534 (43.9%) respondents ...

Introduction/Problem A review of the mass-gathering medicine literature confirms that the research community currently lacks a standardized approach to data collection and reporting in relation to large-scale community events. This lack of consistency, particularly with regard to event characteristics, patient characteristics, acuity determination, and reporting of illness and injury rates ...

The recently published Clinical Practice Guideline raised issues related to the value and timing of laryngoscopy in patients with hoarseness. We sought to determine the extent to which these guidelines concur with clinical practice among members of the American Broncho-Esophagological Association (ABEA). A web-based survey was distributed to ABEA members, ...

Asthma patients often try some form of alternative medicine. This article questions whether this is good or bad. Systematic reviews fail to demonstrate that the treatments in question are demonstrably effective. Other data raise considerable concern over the safety of some forms of alternative medicine. Thus the risk-benefit balance fails ...

PURPOSE: The optimal management of renal replacement therapy (RRT) in critically ill patients remains a matter of debate, although insights have arisen from recent large trials. Nonetheless, little is known about the current practices and beliefs of intensivists. The goal of this study was to record current practices in RRT ...

Patients often have difficulty securing and positioning finger orthoses (splints). Using standard strapping materials molded directly into the orthotic device, this author describes an alternative strapping system for these small finger orthoses. -Victoria Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor.

Endocrine hypertension forms a small (< 5%) but curable subset of patients with hypertension. Common endocrine causes of hypertension include pheochromocytoma, Cushing's syndrome, primary hyperaldosteronism, and thyroid disorders. Nuclear medicine imaging plays an important role in evaluation of patients with endocrine hypertension. It has established role in patients of pheochromocytoma/paraganglioma, ...

Studies suggest older adults attending emergency departments(ED) benefit from specialist geriatric medicine evaluation. Findings from a pilot ED Geriatric Medicine(GM) liaison service in our 480-bed university hospital are presented. This is not a randomized controlled trial. Service comprised consultant geriatrician and senior trainee-led sessions during daytime working hours. Senior ED ...

Keeping phone lines open through the mid-day hours may seem commonplace to many practices; however, there are still some that close down entirely during these important hours when patient needs and potential new patient calls don't take a lunch break. This article addresses how many practices violate the best practice ...

Western integrative oncology (IO) combines conventional mainstream medicine with complementary and alternative medicine (CAM) for the care of cancer patients. Since it includes patient orientation and the holistic approach of many CAM options, IO offers not only preventive measures, but also a wide spectrum of treatment modalities for all stages ...

BACKGROUND: We performed an internal review of triage decisions and outcomes for all patients admitted for small bowel obstruction (SBO). Concern for potential delays in operation led to formalization of an institution-wide SBO management guideline. We hypothesized that use of the guideline would improve initial triage and patient outcomes. METHODS: ...

ETHNOPHARMACOLOGICAL RELEVANCE: Along with increase of herbal medicine use worldwide, the safety of traditional herbal medicines frequently becomes a medical issue. AIM OF THE STUDY: This study aimed to investigate the incidence of herbal medicine-induced adverse effects on liver functions. SUBJECTS AND METHODS: A prospective study was performed with 313 ...