Nigerian quarterly journal of hospital medicine最新文献

{"title":"Diverticulosis of the colon: a report of two cases.","authors":"A B Olokoba,&nbsp;O A Obateru,&nbsp;M O Bojuwoye,&nbsp;S A Olatoke","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Diverticula are bulging pouch-like herniations in the wall of the hollow organ anywhere in the gastrointestinal tract from the oesophagus to the colon. Diverticula are thought to occur more commonly in the colon than in any other segment of the gastrointestinal tract. It may be asymptomatic or complicated by diverticulitis (diverticular inflammation), bleeding, or perforation with peritonitis. It could be potentially life threatening. It was thought to be rare in this part of the world, but is increasingly diagnosed with the advent of modern imaging techniques and colonoscopy. Two cases of colonic diverticula discovered during colonoscopy were highlighted.</p><p><strong>Case reports: </strong>Case 1--This patient was a 79-year old traditional ruler who presented with 2 months history of progressive left- sided abdominal pain, dull in nature and sometimes colicky but non-radiating. There was no known aggravating or relieving factors. There was associated history of chronic constipation dating back to over 15 years relieved with use of laxatives. There was no diarrhoea, vomiting or haematochezia. He had no history of previous surgeries. Physical examination showed mild tenderness at the left iliac fossa. Digital rectal examination was normal. Plain abdominal x-ray and abdomino-pelvic ultrasound scan showed no abnormalities. Colonoscopy revealed multiple diverticula with diverticulitis at the descending and sigmoid colon 40 cm-60 cm from the anal verge. Case 2--This patient is a 64-year old retired military officer who presented with constipation of 5 years and rectal bleeding of 10 months. Pre-morbid bowel habit was 1-2 bowel motions per day but now once in 2 days. Constipation was characterized by recurrent passage of hard pellet-like stools. This became associated with passage of fresh blood in the stool 10 months ago, and anal pain. Volume of blood was about 5 mls per episode, and this occurred only when stool was hard. The anal pain was sometimes severe enough to prevent the patient from sitting comfortably on both buttocks. There was no weight loss or constipation alternating with diarrhoea. He had no history of any chronic medical illness. Colonoscopy revealed anal fissure, internal haemorrhoids, and multiple diverticula in the sigmoid and descending colon. Both patients are being managed conservatively with dietary advice and antibiotics, and still being followed up in the clinic.</p><p><strong>Conclusion: </strong>Reports of colonic diverticula with diverticulitis in this part of the world are few. This is the first report of colonic diverticulosis from Ilorin.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"62-4"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31068067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating adipokine levels in type 2 diabetes mellitus in Lagos, Nigeria.","authors":"Tope Oshodi,&nbsp;Osaretin A T Ebuehi,&nbsp;Oyesola Ojewunmi,&nbsp;Ifeoma Udenze,&nbsp;Tunji Soriyan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes remains a global concern with its numerical increase occurring in developing countries which include Nigeria. Adipose tissue-secreted factors called \"adipokines\" are involved in energy homeostasis and regulation of glucose and lipid metabolism.</p><p><strong>Objective: </strong>This study was undertaken with the aim of investigating adipokine levels in the Type 2 Diabetes Mellitus.</p><p><strong>Methods: </strong>This is a cross sectional study conducted in Lagos University Teaching Hospital (LUTH), a-700 bed tertiary hospital centre in Lagos, Nigeria. 53 diabetic subjects and 27 non-diabetic controls with mean age (56.72 +/- 10.44) and (38.67 +/- 9.63) years respectively, were recruited into the study. Fasting blood glucose, HbA1 C, leptin and resistin levels and body mass index (BMI) were assayed.</p><p><strong>Results: </strong>Mean BMI was higher but not statistically significant in diabetics than in non diabetics (diabetics 28.77 +/- 5.35; non diabetics 27.38 +/- 6.04; p > 0.05). Resistin level was significantly higher in diabetics (31.26 +/- 2.5) as compared with non diabetics (16.61 +/- 2.16) compared to non-diabetics. Leptin correlated very strongly with BMI (r = 0.620, p < 0.0001) and was significantly higher in females than males (female 9.72 +/- 1.70; male 1.79 +/- 0.54; p < 0.0001).</p><p><strong>Conclusion: </strong>The circulating adipokines have variable effect on the glucose and fat metabolism. BMI and resistin level were higher in diabetics. Leptin was found in this study to correlate very strongly with BMI (adiposity). There was also a strong gender dependence observed as leptin level was signficantly higher in females than males.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"25-8"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31069128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of conjunctival masses seen at Guinness Eye Centre Luth Idi-Araba.","authors":"F B Akinsola,&nbsp;C A Mbadugha,&nbsp;A O Onakoya,&nbsp;A O Adefule-Ositelu,&nbsp;O T Aribaba,&nbsp;A Rotimi-Samuel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Conjunctival masses are growth on the surface of the outer eye; which may represent benign or malignant transformations.</p><p><strong>Objective: </strong>To determine the pattern of presentation of conjunctival masses at the Guinness Eye Centre (GEC), Lagos University Teaching Hospital (LUTH) Idi-Araba over a 13 year period (Jan 1995-Dec 2007).</p><p><strong>Method: </strong>A retrospective review of the clinical notes of all patients that presented to GEC with conjunctival masses during the study period was carried out. The bio-data, clinical features, stage, laterality and associated features of the masses were noted. The diagnosis, treatment and complications of treatment were also recorded.</p><p><strong>Results: </strong>Case notes of 612 eyes of 393 patients were included in the study. There were 219 (55.7%) males, 174 (44.3%) females with ages ranging from 4-85 years with a male to female ratio of 1.26: 1. Three hundred and eighty-eight patients (98.7%) presented as elective cases to the outpatient department while 5 (1.3%) presented as emergencies on account of associated ocular inflammation. There were 220 (56%) bilateral masses while 44% were uniocular. Pterygium was the leading conjunctival mass affecting 548 eyes (89.5%) of 329 patients. Pingueculae occurred in 53 eyes (8.7%), conjunctival cysts in 5 (0.8%) eyes, neoplastic growths in 3 (0.5%) eyes, conjunctival granulomas in 2 (0.3%) eyes and limbal teratoma in 1 (0.2%) eye. Most of these patients defaulted from surgery as only 141 eyes (23%) of 121 patients had surgery. Post-operative complications occurred in 33 eyes (5.4%) of 30 patients. The commonest postoperative complication was pterygium recurrence which occurred in 18 eyes of 15 patients.</p><p><strong>Conclusion: </strong>Pterygium was the commonest conjunctival mass and preventive strategies need to be advocated. Prevention of recurrence remains a challenge in the management of pterygium as recurrence after surgical excision occurred in 13.2% of eyes. Our study however did not confirm outdoor occupations as a risk factor for pterygium.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31068064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular findings in acquired immunodeficiency syndrome patients in Lagos, Nigeria.","authors":"A O Onakoya,&nbsp;M G Odeyemi,&nbsp;O T Aribaba,&nbsp;F B Akinsola","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There is paucity of studies on the prevalence and pattern of ocular complication in HIV patients in developing countries where 90% of all HIV sufferers live. Most studies were carried out in industrialized countries and are not representative of the spectrum of ocular complication of HIV and it's prevalence in developing countries.</p><p><strong>Objective: </strong>To determine the prevalence of ocular disorders in adult (> 15 years ) AIDS patients at PEPFAR clinic in Lagos, Nigeria.</p><p><strong>Material and methods: </strong>All consecutive adult Seropositive HIV/AIDS patients of PEPFAR Clinic at the Lagos University Teaching Hospital between February 1st-March 15th 2008 were enrolled into the study Cross sectional and non randomized, convenient study was used. Biodata and medical history were recorded on interviewer administered questionnaire. Participants were examined according to standard protocol comprising visual acuity, intraocular pressure, anterior segment examination with slit lamp biomicroscopy, dilated fundoscopy and fundus photograph where necessary. PCV, CD4+ count, viral load at diagnosis, stage of HIV disease were extracted from patients' records. Details of drug were regimen also recorded. Data analysis was performed with EPI-lnfo 6.04 version; Chi square and student t test used to describe statistical association.</p><p><strong>Results: </strong>A total of 400 patients were studied. Male:female ratio was 1.7 and mean age was 40 years (S.D. + 9.12). Ocular disorders seen in 78.5% of patients; HIV related ocular disorders occurred in 45 (11.3) patients. Conjunctival microvasculopathy 166 patients (41.5%), pingueculum in 114 (28.5%), pterygium in 76 (19.0%), refractive error in 93 (23.3%), cataract in 12 (3.0%), and 22 (5.5%) Glaucoma suspects. HIV retinopathy and allergic eye disease in one patient each (0.3%). Presumed Cytomegalovirus retinitis 7 (1.8%), 14 (3.5%) Toxoplasmosis, 8 (2.0%) HZO, and 15 (3.8%) Presumed Squamous cell carcinoma. Eighty six (21.5%) of the patients had no abnormality. 91.4% of eyes examined had visual acuity with best correction of > 6/18. CD4+ in 79.3% of the patients was > 200 cells/ul and < 5% had counts < 50 cells with an overall mean of 406 cell/ul. 375 (93.8%) patients were on Highly Active Antiretroviral therapy (HAART), and 25 (6.2%) were not.</p><p><strong>Conclusion: </strong>Study revealed low prevalence of HIV related ocular disorders. This could be due to few patients at low level of immunosuppresion where the infections occur.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"52-7"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31068066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and proctosigmoidoscopic findings in patients with anorectal sepsis in a private health facility in Lagos, Nigeria.","authors":"E A Jeje,&nbsp;B O Mofikoya,&nbsp;S A Osunkoya,&nbsp;T G Olajide,&nbsp;A O Osinowo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Anorectal sepsis is a distressing condition which is sometimes inadequatelytreated.</p><p><strong>Objectives: </strong>To determine the clinical and prostosigmoidoscopic findings in patients with anorectal sepsis seen by the authors over a 5 year period as well as identifying the commonly performed procedures.</p><p><strong>Method: </strong>A review of all the records of patients seen by the authors over a 5 year period was carried out. The demographic pattern was determined including the age, sex, mode of presentation, and associated co-morbidities. The detailed perianal and protosigmoidoscopic findings were also noted</p><p><strong>Results: </strong>45 males and 10 females were seen during the study period. The mean age incidence was 43.4 years. The commonest mode of presentation was perianal discharge and pain in over 85% of the patients seen. The low anal fistula was the commonest pathology on proctosigmoidoscopy while abscesses and external haemorrhoids were the other commonly occurring lesions found . Fistulotomy was the most commonly perfomed procedure while diabetes was the most common comorbidity.</p><p><strong>Conclusion: </strong>Anorectal sepsis most commonly affects males in the fifth decade of life. Thorough evaluation and adequate operative treatment appear to result in satisfactory early outcome.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"14-7"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31069125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution and characteristics of non carious cervical lesions in an adult Nigerian population.","authors":"A O Afolabi,&nbsp;O P Shaba,&nbsp;I C Adegbulugbe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Controversies rages in the literature as to the characteristics of non carious cervical lesions (NCCLs) in terms of the location and its severity.</p><p><strong>Objective: </strong>The study is to investigate the characteristics of NCCLs in adult patients who had a high incidence in them and to see if there are any association with the findings. Methods : The author examined 356 teeth with NCCLs in 34 subjects (male and female aged 22-75 years). The characteristics were based on the location of the lesion and the size (shape, extensiveness and depth).</p><p><strong>Results: </strong>In terms of the location, 61.2% were located on the posterior teeth, and 55.9% on the maxillary teeth. The first premolars (25.8%) and canines (19.4%) were affected most often, followed by the first molars (16.9%) and second premolars (13.8%). There was slight right side preponderance (50.3%) and more lesions in the male subjects (67.4%). Patients tended to be older, with 76.4% in the 40 years and older age group. In terms of the size of the lesion, 75.0% of the lesion had angular shape of < 135 (wedge), 70.2% had axial depth of 1-2 mm, and 51.7% had occlusogingival width (extensiveness) of 2-3.9mm (small). There was association between gender and the severity (extensiveness) of the lesion. The severity (shape and extensiveness) of NCCL was associated with age. There was strong association between the severity of NCCL and site of the lesion (jaws).</p><p><strong>Conclusion: </strong>The authors found that NCCLs were significantly related to age. The posterior maxillary teeth especially the first premolars followed by the canines were the teeth commonly involved. No great difference in incidence was found between the right and left sides as a result of right or left hand dexterity. Awareness of a multifactorial etiology in noncarious cervical lesions may help the clinician to formulate an appropriate treatment plan for the patient. In addition, these characteristics help identify which teeth and patients that are more susceptible.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31070324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrum of endoscopic findings in Nigerians with dyspepsia.","authors":"A B Olokoba,&nbsp;F K Salawu,&nbsp;A Danburam,&nbsp;S A Aderibigbe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Dyspepsia is a common gastrointestinal disorder originating from the gastroduodenal region, and is the most common indication for upper gastrointestinal tract endoscopy. There are differing information on the commonest endoscopic findings in patients with dyspepsia from Nigeria.</p><p><strong>Objective: </strong>The aim of this study was to determine the spectrum of endoscopic findings in patients with dyspepsia.</p><p><strong>Patients and methods: </strong>This is a hospital-based prospective study carried out at the Endoscopy Unit of Federal Medical Centre, Yola from November, 2006 to May, 2010. Patients with clinical features of dyspepsia who underwent upper gastrointestinal tract endoscopy as part of their workup were recruited. Their biodata, history and duration of dyspepsia were noted on a proforma. The spectrum of endoscopic findings was also noted.</p><p><strong>Results: </strong>A total of 259 patients with dyspepsia had upper gastrointestinal tract endoscopy. Ninety-nine (38.2%) were males while 160 (61.8%) were females, giving a male to female ratio of 1:1.6. Clinically significant endoscopic findings were seen in 241 (93.1%) patients while gastroduodenitis was the commonest finding. One hundred and two (39.4%) patients had two endoscopic findings, and 7 (2.7%) had three findings.</p><p><strong>Conclusion: </strong>Majority of patients with dyspepsia had clinically significant endoscopic findings. Gastroduodenitis was the commonest endoscopic finding.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"58-61"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31068069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Principles of chest tube insertion.","authors":"E O Ogunleye","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chest tube insertion is often times a life saving procedure which is well within the scope of a trained physician. It is a simple therapeutic manoevre but prone to complications if the principles of thoracic drainage are not complied with strictly. This article aims to highlight the indications and contraindications associated with chest tube insertion and also the technique of thoracostomy tube drainage and its associated complications.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"65-8"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31068068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of periodontal treatments performed at the periodontology clinic of the Lagos University Teaching Hospital: 22 months review.","authors":"K A Umeizudike,&nbsp;P O Ayanbadejo,&nbsp;K O Savage,&nbsp;O A Taiwo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A critical evaluation of the pattern of periodontal procedures performed is important in providing useful data to the administrator for proper planning and budgeting for dental health service.</p><p><strong>Objective: </strong>To assess the pattern of periodontal treatments performed over a given period of time at the Periodontology clinic of the Lagos University Teaching Hospital, Lagos, Nigeria.</p><p><strong>Methods: </strong>This was a twenty two months retrospective study of all periodontal procedures performed on patients seen at the periodontology clinic of the Lagos University Teaching Hospital between January 2006 and October 2007. The periodontology treatment record was used to retrieve information which included the patient's age, gender, diagnosis and periodontal procedures given. The procedures were further categorized into surgical and nonsurgical groups. The information obtained was then analyzed using Epi Info 2007 statistical software.</p><p><strong>Results: </strong>A total of 1,938 patients were seen during this period. Females were 1009 (52.1%) and males were 929 (47.9%). (F/M, 1.1:1). A total of 2,110 periodontal treatments were performed. Majority of the patients received non-surgical periodontal therapy which constituted the bulk (96.3%) of the therapies. Scaling and polishing was the most frequently performed non-surgical procedure accounting for 1261 (62.1%) with slightly more males receiving the treatment. Of the surgical treatment modalities, operculectomy accounted for 65.4% and was carried out on more females than males. Regenerative procedures were the least performed surgical treatments.</p><p><strong>Conclusion: </strong>This study highlighted that non-surgical periodontal therapy, particularly scaling and polishing was the most frequently utilized periodontal procedure. Operculectomy was the predominant surgical procedure performed. The low percentage of regenerative surgical procedures was however below the desired expectation.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"22 1","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31069123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing the new WHO guidelines for the early detection of sensorineural hearing loss in newborns and infants in Nigeria.","authors":"B O Olusanya,&nbsp;A L Okhakhu,&nbsp;A O Somefun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This brief educational update examines the key recommendations in the new report of the World Health Organisation on newborn and infant hearing screening within the Nigerian context. While acknowledging the goal of universal newborn hearing screening as desirable, the authors highlight the need for all tertiary hospitals in the country to be appropriately equipped to provide at the minimum early hearing detection services for all high-risk newborns including those delivered by consanguineous parents, those with maternal hypertensive disorders, nonelective caesarean section and unskilled birth attendants. In addition to conventional risk factors for infant hearing loss, microcephalic and undernourished infants should be tested based on evidence from local pilot studies. Primary and secondary-level hospitals should maintain an active referral system to the tertiary centres within a multidisciplinary framework to assure the best of care for the affected infants.</p>","PeriodicalId":19202,"journal":{"name":"Nigerian quarterly journal of hospital medicine","volume":"21 4","pages":"324-6"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31068456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}