Hospital practice最新文献

{"title":"An Obese Man with Anxiety, Sweating, and Headache","authors":"John D. McCormick, Darron Diguilio, H. Adelman, E. Cutolo, R. P. Shah, B. Bognar, Pascal Bidot, Charlotte A. Truitt","doi":"10.1080/21548331.2001.11444141","DOIUrl":"https://doi.org/10.1080/21548331.2001.11444141","url":null,"abstract":"A 47-year-old man reported becoming confused, disoriented, and anxious while driving his car. He recalled sweating and having blurred vision, palpitations, and a diffuse headache shortly before pulling to the side of the road and losing consciousness. Emergency service personnel arrived about 15 minutes later and administered a 50% solution of dextrose intravenously. On regaining consciousness, the patient had no weakness,shortness of breath, chest pain, or loss of bowel or bladder function. He had experienced a similar episode one week earlier and several others in the distant past. Each time, symptoms had been alleviated by eating.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"36 1","pages":"21 - 22"},"PeriodicalIF":0.0,"publicationDate":"2001-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21548331.2001.11444141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071555","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":"Type 2 Diabetes: New Drugs, New Perspectives","authors":"A. Goldfine","doi":"10.1080/21548331.2001.11444143","DOIUrl":"https://doi.org/10.1080/21548331.2001.11444143","url":null,"abstract":"Detection at younger ages is rapidly increasing. Although diet and exercise remain the mainstays of therapy, physicians can now choose from among a variety of medications targeting different pathophysiologic facets of the disease. The newest drugs are the thiazolidinediones, a totally novel class of insulin sensitizers.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"36 1","pages":"29 - 36"},"PeriodicalIF":0.0,"publicationDate":"2001-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21548331.2001.11444143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071807","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":"The Home Hospital: An Alternative for Older Patients?","authors":"B. Leff","doi":"10.1080/21548331.2001.11444139","DOIUrl":"https://doi.org/10.1080/21548331.2001.11444139","url":null,"abstract":"Dr. Leff is Associate Professor of Medicine, ohns Hopkins University School of Medicine and School of Hygiene and Public Health. Baltimore. His studies are supported by a grant from the john A. Hartford Foundation of New York. T he acute-care hospital-the current paradigm and gold standard of care for acutely and seriously ill patients-may not always be an ideal environment for older patients, who are significantly at risk for adverse events in this setting. For example, they often experience functional decline, delirium, and incontinence in the acute-care hospital, increasing the risk of dependency and subsequent nursing-home care. In addition, iatrogenic complications are common and their incidence increases with patient age. Given such potential hazards, alternatives to traditional hospital care of the elderly have been developed. Hospital-based models such as Acute Care for the Elderly (ACE) units apply principles of clinical geriatrics to create a more friendly hospital experience that promotes functional recovery. Another model-the home hospital-allows patients to avoid the inpatient acutecare environment completely. Several types of home-hospital models have been developed. In some, all of the critical elements of acute-hospital care (e.g., physician and nursing care, medicines, appropriate diagnostic and therapeutic technologies) are brought to patients' homes. Other models facilitate early hospital discharge by providing in-home services that many in the United States would consider to be standard postacute-discharge care. Some home-hospital programs have focused solely on patients who have undergone surgery (e.g., hernia repair, total knee or hip replacement), others have targeted older patients with certain medical conditions, and still others have combined surgical and medical patients into a single program. Most home-hospital programs have been developed and studied in the United Kingdom and Australia, countries with national health insurance schemes. Before discussing the potential for the home hospital in the U.S. health-care system, I will review recent studies of home-hospital models that have substituted for inpatient hospital admissions and provided substantial physician input.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"36 1","pages":"11 - 16"},"PeriodicalIF":0.0,"publicationDate":"2001-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21548331.2001.11444139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071255","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":"Appropriate Use of Calcium Antagonists in Hypertension","authors":"M. Weir","doi":"10.1080/21548331.2001.11444145","DOIUrl":"https://doi.org/10.1080/21548331.2001.11444145","url":null,"abstract":"The paradigm for treating hypertension has shifted: Tighter control is the goal and a multidrug regimen is often the means. Calcium antagonists can play an important role in such regimens, given their demonstrated efficacy in controlling blood pressure.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"36 1","pages":"47 - 55"},"PeriodicalIF":0.0,"publicationDate":"2001-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21548331.2001.11444145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071980","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":"Neurodegenerative Disease and Cancer: Two Sides of a Coin?","authors":"D. Bredesen","doi":"10.1080/21548331.2001.11444144","DOIUrl":"https://doi.org/10.1080/21548331.2001.11444144","url":null,"abstract":"The mechanisms underlying disruption of physiologic cell-death programs are slowly being revealed. Information gleaned from genetic profiles soon may allow physicians to delay onset of many silent, age-related diseases. While development of actual cures could prove elusive, simply postponing clinical onset would have an impressive effect on the goal of healthy aging.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"105 1","pages":"39 - 45"},"PeriodicalIF":0.0,"publicationDate":"2001-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21548331.2001.11444144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071940","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":"A Loss of Literacy?","authors":"A. B. Weisse","doi":"10.1080/21548331.2001.11444131","DOIUrl":"https://doi.org/10.1080/21548331.2001.11444131","url":null,"abstract":"","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"36 1","pages":"13 - 9"},"PeriodicalIF":0.0,"publicationDate":"2001-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21548331.2001.11444131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071159","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":"An unusual ECG after spinal surgery.","authors":"Hancock Ew","doi":"10.1080/21548331.2001.11444132","DOIUrl":"https://doi.org/10.1080/21548331.2001.11444132","url":null,"abstract":"Dr. Hancock is Professor of (Cardiovascular) Medicine Emeritus. Stanford University School of Medicine, Stanford. Calif. A 91-year-old man with leg weakness and pseudoclaudication of four months' duration underwent lumbar laminectomy for intervertebral disc disease and spinal stenosis. He did not have heart disease or cardiac symptoms-the preoperative cardiovascular examination and ECG were normal. The operation was uneventful, and the patient's initial recovery was satisfactory. However, his stay in the intensive care unit was prolonged because of cough, fever, and pulmonary infiltrates. Borderline respiratory failure and intermittent hypoxemia developed On the sixth postoperative day, an arrhythmia was noted on the monitor. The 12-lead ECG recorded at this time is shown. What explains the differing QRS complexes? What explains the intermittent pauses in rhythm? Is a cardiologic intervention indicated?","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"36 1","pages":"15-16"},"PeriodicalIF":0.0,"publicationDate":"2001-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21548331.2001.11444132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071164","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":"A Monthly Critical Overview of Current Medicine","authors":"G. Stollerman, A. Bisno","doi":"10.1080/21548331.2001.11444133","DOIUrl":"https://doi.org/10.1080/21548331.2001.11444133","url":null,"abstract":"Molecular Marker for Malignant Thyroid Nodules A n estimated 4o/o of Americans aged 30 to 60 years have palpable thyroid nodules. Fineneedle aspiration cytology, the established evaluation method, has inherent limitations related to sampling and the overlapping cytologic features of benign and malignant lesions. Most patients ultimately undergo surgery, even though less than lOo/o of lesions are definitively classified as carcinoma. There is thus a need for reliable markers that can identify malignant thyrocytes preoperatively. A six-center European group investigated the reliability of CD44v6 and galectin-3, two antigenic proteins expressed by malignant thyrocytes and involved in regulating interactions among cells and between cells and matrix. The two proteins were studied irnmunocytologically, both retrospectively in 1,009 samples of thyroid tissue taken from patients who had undergone surgical resection and prospectively in 226 preoperative fine-needle aspirates. Galectin-3 turned out to be the more useful. Its sensitivity and specificity in discriminating benign from malignant lesions were more than 99o/o and 98o/o, respectively. The positive predictive value and diagnostic accuracy were 92o/o and 99o/o, respectively. Galectin-3 irnmunostaining identified all true follicular malignancies, including five minimally invasive carcinomas.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"36 1","pages":"19 - 22"},"PeriodicalIF":0.0,"publicationDate":"2001-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21548331.2001.11444133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071178","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":"Treatment Strategies for Bronchial Asthma: An Update","authors":"G. Krishnaswamy","doi":"10.3810/hp.2001.08.245","DOIUrl":"https://doi.org/10.3810/hp.2001.08.245","url":null,"abstract":"Advances in understanding the biomolecular basis of the disease's inflammatory and remodeling responses are offering new therapeutic choices—and sometimes new drugdelivery system∼n categories such as B-agonists, glucocorticoids, and leukotriene blockers. Meanwhile, researchers are exploring novel targets, including intercellular signals and cell-adhesion and gene-activating molecules.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"50 34 1","pages":"25 - 35"},"PeriodicalIF":0.0,"publicationDate":"2001-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3810/hp.2001.08.245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70169051","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":"Erectile Dysfunction and Cardiovascular Risk Factors","authors":"R. Kloner","doi":"10.3810/hp.2001.08.246","DOIUrl":"https://doi.org/10.3810/hp.2001.08.246","url":null,"abstract":"Erectile dysfunction (ED) affects as many as 30 million men in the United States. Its risk factors are similar to those for atherosclerotic heart disease. Physicians should ask male patients—particularly those with cardiovascular disease-about ED and men with confirmed ED about cardiovascular risk factors. Oral sildenafil is an effective therapy for both organic and psychogenic ED; it is contraindicated in patients taking organic nitrates.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"36 1","pages":"41 - 51"},"PeriodicalIF":0.0,"publicationDate":"2001-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3810/hp.2001.08.246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70169098","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}