The Internet Journal of Family Practice最新文献

Options for Intensification with Biphasic Insulins in Patients with Type 2 Diabetes Not Achieving Glycemic Control 未达到血糖控制的2型糖尿病患者双相胰岛素强化治疗的选择

The Internet Journal of Family Practice Pub Date : 2013-01-03 DOI: 10.5580/2ccf

M. Warren

{"title":"Options for Intensification with Biphasic Insulins in Patients with Type 2 Diabetes Not Achieving Glycemic Control","authors":"M. Warren","doi":"10.5580/2ccf","DOIUrl":"https://doi.org/10.5580/2ccf","url":null,"abstract":"Background: In type 2 diabetes, simple, convenient and effective regimens should encourage timely insulin initiation and improve outcomes. Longand rapid-acting insulin analogues more closely mimic endogenous basal/prandial insulin secretion than human equivalents. Premixed insulin analogues deliver prandial and basal insulin in one formulation and can be administered 1-3 times daily. Premixed insulin may, therefore, provide an alternative to basal–bolus regimens for intensification of insulin therapy.Objectives: The aim of this commentary was to show how biphasic insulin therapy may offer a simple and effective intensification option for patients with type 2 diabetes who do not achieve adequate control with existing insulin therapies.Methods: A literature search using the PubMed database (years: January 1997September 2010) was carried out using the search terms diabetes AND ([(biphasic OR bi-phasic) AND (insulin OR insulins]) OR ([premix OR pre-mix) AND (insulin OR insulins)]). Clinical trials, systematic reviews, case reports or clinical practice guidelines that addressed topics of interest with regard to premixed insulin analogues/analogue regimens and intensification strategies were identified and included.Results: Clinical data show that premixed insulin analogues reduce hemoglobin A1C and fasting plasma glucose to a similar extent as premixed human insulin, but have advantages in terms of postprandial glucose control, incidence of hypoglycemia, and convenience. Premixed insulins may also provide benefits to glycemic control (reduced HbA1c, fasting and postprandial plasma glucose) in patients failing to achieve targets on basal insulin. In addition, premixed insulin analogue regimens generally compare well with basal–bolus regimens. Conclusions: Premixed insulin analogues offer a simple intensification option in patients with type 2 diabetes not achieving adequate control with existing insulin therapy. Premixed insulin analogues may offer a viable alternative to basal–bolus regimens and an improved physiologic profile compared with human equivalents.","PeriodicalId":440879,"journal":{"name":"The Internet Journal of Family Practice","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126134977","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}

引用次数: 0

Socioeconomic and Demographic Determinants of Mental Health across Canadian Communities 加拿大社区心理健康的社会经济和人口决定因素

The Internet Journal of Family Practice Pub Date : 2012-05-02 DOI: 10.5580/2c23

J. Safaei

{"title":"Socioeconomic and Demographic Determinants of Mental Health across Canadian Communities","authors":"J. Safaei","doi":"10.5580/2c23","DOIUrl":"https://doi.org/10.5580/2c23","url":null,"abstract":"Background Many factors contribute to health. This study uses community level data to estimate the impact of socioeconomic and demographic factors as well as physical health on community mental health outcomes. Method Multiple regression analysis was used to estimate the impact of determinants on community mental health outcomes for men and women using community level data from up to 113 health regions covering almost the entire population in Canada. Results Study findings indicate that communities with higher proportions of aboriginal people have greater mental illness hospitalization. Minorities have poorer perceived mental health but better objective measures of less mental illness hospitalization and self injury hospitalization. Also, communities with higher proportion of low income persons show poorer results for many objective mental health outcomes. Higher prevalence of lone parents in a community is associated with greater perceived life stress and greater mental illness hospitalizations for men. Poor physical health is also a predictor of poor mental health. Conclusion Improving the living conditions of aboriginal people and other low income people could reduce mental illness hospitalizations in a community, helping minorities the majority of whom are immigrants with their settlements in their host communities could improve perceived mental health and life stress, and helping lone parents who are men with counseling services to better cope with their situations could reduce their perceived life stress and mental illness hospitalization. Also, improving the physical health of individuals across communities could have a positive impact on mental health outcomes across communities.","PeriodicalId":440879,"journal":{"name":"The Internet Journal of Family Practice","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124403175","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}

引用次数: 4

Unhealthy Family Functioning As A Psychological Context Underlying Australian Children’s Emotional And Behavioural Problems 不健康的家庭功能作为澳大利亚儿童情绪和行为问题的心理背景

The Internet Journal of Family Practice Pub Date : 2012-05-02 DOI: 10.5580/2c24

Hisham M. Abu-Rayya, Baohui Yang

{"title":"Unhealthy Family Functioning As A Psychological Context Underlying Australian Children’s Emotional And Behavioural Problems","authors":"Hisham M. Abu-Rayya, Baohui Yang","doi":"10.5580/2c24","DOIUrl":"https://doi.org/10.5580/2c24","url":null,"abstract":"Objectives: Understanding the psychological reasons underlying childrens emotional and behavioural problems can guide appropriate interventions. This study examined emotional and behavioural problems in Australian children and unhealthy family functioning as a psychological factor associated with development of these emotional and behavioural problems. Methods: The study utilised stratified surveys conducted by the New South Wales, Ministry of Health, during the years 2005-2008. A computer assisted telephone interviewing method was employed. The surveys collected information on demographics, family functioning measured by the General Functioning Scale, and emotional and behavioural problems measured by the Strengths and Difficulties Questionnaire. Children aged 4-15 years (n=7,210 children) were included. Logistic regression analyses were used for the emotional and behavioural problem outcomes. Results: Analyses adjusting for demographics revealed that unhealthy family functioning increased substantially the risks of emotional symptoms (OR = 2.53; 95% CI = 1.36-4.69), peer problems (OR = 6.26; 95% CI = 4.43-11.42), conduct problems (OR = 3.83; 95% CI = 1.88-7.84), and the overall emotional and behavioural problems (OR = 5.06; 95% CI = 2.42-10.58). Conclusions: Children from unhealthy family functioning backgrounds have a potential risk factor for emotional and behavioural problems. Mental health interventions aiming at improving the quality of parent-child relationships may reduce this potential risk for emotional and behavioural problems among the children.","PeriodicalId":440879,"journal":{"name":"The Internet Journal of Family Practice","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127447633","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}

引用次数: 10

Prevalence of Diagnosed Mental Disorders Among Florida Adult Appendectomy Patients: Implications for Medical Cost Offset with Mental Health Treatment 佛罗里达州成年阑尾切除术患者中诊断为精神障碍的患病率:心理健康治疗对医疗费用抵消的影响

The Internet Journal of Family Practice Pub Date : 2012-05-02 DOI: 10.5580/2c49

M. Lo

{"title":"Prevalence of Diagnosed Mental Disorders Among Florida Adult Appendectomy Patients: Implications for Medical Cost Offset with Mental Health Treatment","authors":"M. Lo","doi":"10.5580/2c49","DOIUrl":"https://doi.org/10.5580/2c49","url":null,"abstract":"Background: This study analyzed the prevalence of mental disorders among appendectomy patients, comparing differences between patients with and without mental disorders to explore the potential for a psychiatric cost-offset effect. Methods: Records of 209,822 appendectomy patients age 18 and older were abstracted from 1994-2009 Florida hospital discharge data. Chisquare tests, t-tests, and logistic regression were performed. Results: Of the study population, 5.1% were diagnosed with a mental disorder. Odds for psychotic, schizophrenic, affective, neurotic, and depressive disorders were significantly greater above age 28. Females had significantly greater odds for affective, neurotic, and depressive disorders. Negative appendectomy was significantly positively associated with neurotic and other mental disorders. Irritable bowel syndrome and ill-defined rightlower abdominal pain were each independently significantly associated with neurotic, depressive, and other mental disorders. Psychotic and schizophrenic disorders were significantly associated with lengths of stay above two days, and other mental disorders above three days. Affective, neurotic, depressive, and other mental disorders were significantly associated with hospital charges totaling $18,941 or more, psychotic disorders totaling $26,860 or more, and schizophrenic disorders totaling $39,106 or more. Conclusions: Longer stays and higher charges incurred by appendectomy patients diagnosed with mental disorders raise the prospect of a potential psychiatric cost-offset effect. Improved diagnosis of mental disorders and irritable bowel syndrome in patients presenting with functional abdominal pain suspected to be psychogenic in origin is indicated, as are referrals to appropriate mental and/or physical health treatment professionals.","PeriodicalId":440879,"journal":{"name":"The Internet Journal of Family Practice","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117084112","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}

引用次数: 0

Early Insulin Initiation—A Review of the Literature and Case Studies 早期胰岛素启动-文献和案例研究综述

The Internet Journal of Family Practice Pub Date : 2012-01-24 DOI: 10.5580/2a69

Franklin C Coulter

{"title":"Early Insulin Initiation—A Review of the Literature and Case Studies","authors":"Franklin C Coulter","doi":"10.5580/2a69","DOIUrl":"https://doi.org/10.5580/2a69","url":null,"abstract":"The prevalence of type 2 diabetes (T2D) in the United States has increased in the last decade. Clinical guidelines direct patients with newly diagnosed T2D to a stepwise approach to glycemic management that includes diet, exercise, sequential oral antidiabetic drug (OAD) treatment (from monotherapy to combination therapy), and insulin treatment in order to help prevent microvascular and macrovascular complications. Studies have shown that patients with T2D benefit from early initiation of glycemic therapy to reduce glycated hemoglobin (A1C); however, OADs have been associated with limited A1C reductions leading to patients requiring insulin. Therefore, early initiation of insulin may help more patients to achieve and maintain longterm glycemic control. Insulin initiation is, however, frequently hindered by patient anxiety, clinician inertia, and patient and physician misconceptions about the role of insulin in glycemic control. This review examines the literature on insulin therapy in patients with T2D, focusing on the efficacy and advantages of early basal insulin analog therapy and real-life clinical experience that is illustrated in 3 case studies of patients with T2D. Early insulin initiation should be considered for a wide range of patients, from those with slightly elevated A1C to those with frank diabetic ketoacidosis.","PeriodicalId":440879,"journal":{"name":"The Internet Journal of Family Practice","volume":"355 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124479877","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}

引用次数: 1

Nasal Alar Cleft Deformity: A Rare Complication Of Nasogastric Tube 鼻翼裂畸形:鼻胃管的罕见并发症

The Internet Journal of Family Practice Pub Date : 2012-01-24 DOI: 10.5580/2bb6

S. Yadav, J. Gulia, K. Soni, A. Hooda

引用次数: 0

Atypical Early Presentation Of Orbital Pseudotumor: A Case Report 眼眶假瘤的不典型早期表现1例

The Internet Journal of Family Practice Pub Date : 2012-01-24 DOI: 10.5580/2bb7

Yi-Ting Chen, Yuan-Yu Cheng, C. Lui, Chih-Fang Huang, Wei-Hsi Chen

引用次数: 0

Unexpected Nasal Foreign Body Found During Adenoidectomy 腺样体切除术中意外发现鼻腔异物

The Internet Journal of Family Practice Pub Date : 2012-01-24 DOI: 10.5580/2bb8

J. Gulia, S. Yadav, A. Hooda

引用次数: 0

Button Battery in the Ear 按下耳内电池

The Internet Journal of Family Practice Pub Date : 2012-01-24 DOI: 10.5580/2bb5

J. Gulia, S. S. Yadav, K. Soni

引用次数: 1

Severe Aripiprazole-Induced Extrapyramidal Parkinsonian Features In A Patient With Psychotic Depression On Sertraline: A Case Report 重度阿立哌唑诱导的舍曲林精神病性抑郁患者的锥体外系帕金森特征:1例报告

The Internet Journal of Family Practice Pub Date : 2010-12-31 DOI: 10.5580/28a2

A. Rady, Heba Elwafa, O. Elkholy

引用次数: 1