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Evolving colonoscopy skills in a rural family practice: the first 293 cases. 农村家庭实践中结肠镜检查技术的发展:前293例。
Family practice research journal Pub Date : 1993-03-01
W M Rodney, G Dabov, C Cronin
{"title":"Evolving colonoscopy skills in a rural family practice: the first 293 cases.","authors":"W M Rodney,&nbsp;G Dabov,&nbsp;C Cronin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>During the 1980s, many family physicians acquired flexible sigmoidoscopy skills for the early detection and secondary prevention of colorectal cancer. As these skills have matured, some family physicians have advanced from flexible sigmoidoscopy to the performance of colonoscopy. This is a descriptive report of this phenomenon from the private practice of one family physician. The first five years of total colonoscopy experience (293 procedures) were analyzed. No complications were encountered. A learning effect (measured in terms of scope depth and anatomical depth) was present during the first 50 procedures; an improvement in examination depth between the 25th and 50th procedure was present. Previous abdominal surgery had an effect on limiting scope-insertion depths. There were no complications, and among sedated patients, 137/253 (54%) of procedures reached the cecum. Important findings included cancer, polyps, and colitis. Twenty-seven percent (9/34) of important pathological findings were located beyond the reach of the 60 cm sigmoidoscope. This study of full colonoscopy in private family practice suggests it is safe, and the diagnostic yield is substantial. Additional studies by family physicians are needed regarding technique, quality assurance, and patient satisfaction.</p>","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 1","pages":"43-52"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19466721","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
Diabetic limb infections: identification of microorganisms and selection of treatment. 糖尿病肢体感染:微生物鉴定和治疗选择。
Family practice research journal Pub Date : 1993-03-01
A T Taylor
{"title":"Diabetic limb infections: identification of microorganisms and selection of treatment.","authors":"A T Taylor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Polymicrobial lower limb infections are common complications among diabetic patients, yet their antimicrobial management remains mostly empiric. A retrospective study of the clinical circumstances of 74 patients accounting for 101 hospital admissions was performed. Risks for vascular disease, clinical and microbiologic evidence for infection, as well as antimicrobial drug selection in these patients, were compiled. Culture materials were obtained from either swab or incision and drainage techniques in 65 (64.4%) patients. Eighty-two (81.2%) patients received antimicrobial therapies. Of the 172 antimicrobial agents prescribed, cephalosporins were utilized 83 times. Twenty-nine (28.7%) patients received amputations. Average total hospital charges were $7,368 per hospital stay, $485 per day.</p>","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 1","pages":"53-61"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19466722","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
Measurement of subjective phenomena in primary care research: the Visual Analogue Scale. 初级保健研究中主观现象的测量:视觉模拟量表。
Family practice research journal Pub Date : 1993-03-01
M D Miller, D G Ferris
{"title":"Measurement of subjective phenomena in primary care research: the Visual Analogue Scale.","authors":"M D Miller,&nbsp;D G Ferris","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The visual analogue scale is a technique used to measure subjective phenomena. It is a self-reporting device consisting of a line of predetermined length that separates extreme boundaries of the phenomenon being measured. The purpose of this review is to report on the characteristics of the visual analogue scale technique, including its reliability, validity, accuracy, and scale value. This review presents several examples of the usefulness of the visual analogue scale technique in primary care research projects, describes its advantages and limitations, and presents suggestions for constructing visual analogue scales.</p>","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 1","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19466128","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
Provider confidence in breast examination. 医生对乳房检查的信心。
Family practice research journal Pub Date : 1993-03-01
J M Wiecha, P Gann
{"title":"Provider confidence in breast examination.","authors":"J M Wiecha,&nbsp;P Gann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many physicians have reported interest in further training in clinical breast examination, and it has been speculated that health care providers may lack confidence in their breast examination skills. At a multisite family practice residency, we surveyed a group of physicians and nurse practitioners about confidence in clinical breast examination. Forty-three percent of respondents reported impairment of the clinical breast examination by lack of confidence in skills, and 50% reported feeling only \"somewhat\" or \"moderately\" confident in their clinical breast examination skills. Residents often reported encountering few patients with breast lumps; experience with breast lumps was associated with reported confidence in the clinical breast examination. To improve and maintain breast palpation confidence and skills, residents and practicing physicians need longitudinal educational programs.</p>","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 1","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19466129","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
Transurethral prostatectomy versus transurethral dilatation of the prostatic urethra for benign prostatic hyperplasia: a cost-utility analysis. 经尿道前列腺切除术与经尿道前列腺尿道扩张治疗良性前列腺增生:成本-效用分析。
Family practice research journal Pub Date : 1993-03-01
R S Bisonni, F H Lawler, D R Holtgrave
{"title":"Transurethral prostatectomy versus transurethral dilatation of the prostatic urethra for benign prostatic hyperplasia: a cost-utility analysis.","authors":"R S Bisonni,&nbsp;F H Lawler,&nbsp;D R Holtgrave","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Transurethral prostatectomy is the treatment currently preferred for benign prostatic hyperplasia. A new procedure, transurethral dilatation of the prostatic urethra, has lower costs and mortality and complication rates but may be less effective. These two strategies were evaluated by using cost-utility analysis, a form of cost-effectiveness analysis in which the benefit is defined in terms of individual preferences. Under the model assumptions, the cost of transurethral dilatation is less than the cost of transurethral prostatectomy for patients with benign prostatic hyperplasia ($7084 versus $8647) and slightly more effective: 11.787 quality adjusted life years versus 11.766. Thus, transurethral prostatectomy is said to be dominated. Results indicate that if patients are rigorously selected, and if balloon catheters of 30-35mm in size are utilized, transurethral dilatation could be the initial treatment of choice for eligible patients with benign prostatic hyperplasia.</p>","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 1","pages":"25-36"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18687792","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
Differentiation of physical and psychological fatigue. 辨证生理和心理疲劳。
Family practice research journal Pub Date : 1993-03-01
D A Katerndahl
{"title":"Differentiation of physical and psychological fatigue.","authors":"D A Katerndahl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although chronic fatigue is a common complaint in family practice, little research has focused upon differentiating physical causes from psychological causes based upon historical information. This pilot study was conducted to determine whether psychological and fatigue scales could be used to identify potential causes, and to assess the utility of using fatigue characteristics to distinguish psychological from physical fatigue. Family health center patients were randomly selected and interviewed for the presence of fatigue. Those with significant fatigue were asked to participate in a structured, in-depth interview concerning fatigue characteristics, psychiatric conditions, and symptom checklists. Of 248 patients interviewed, 17 (6.9%) had fatigue. Fourteen patients had at least one psychiatric disorder. Fatigue severity correlated with depression severity in depressed patients (r = 0.83, p < 0.02) and with severity of phobic anxiety (r = 0.55, p < 0.1) in panic attack patients. However, fatigue characteristics generally did not differentiate between those with and without associated psychological disorders.</p>","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 1","pages":"81-91"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19466726","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
Family practice research in Spain. 西班牙家庭实践研究。
Family practice research journal Pub Date : 1993-03-01
J Gené-Badia, J Jimenez-Villa, A Martin-Zurro
{"title":"Family practice research in Spain.","authors":"J Gené-Badia,&nbsp;J Jimenez-Villa,&nbsp;A Martin-Zurro","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 1","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19466724","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
Ethnography and family medicine: issues and overview. 民族志和家庭医学:问题和概述。
Family practice research journal Pub Date : 1992-12-01
H R Searight, D C Campbell
{"title":"Ethnography and family medicine: issues and overview.","authors":"H R Searight,&nbsp;D C Campbell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ethnography is a qualitative research model generally associated with anthropology. Ethnographic methods include inductively oriented strategies such as participant observation, structured interviews, and open-ended interviews. Issues in family medicine such as patient compliance, doctor-patient relationships, and patients' subjective experience of illness may be optimally studied with ethnography. Because it is inductive, ethnography is cognitively similar to clinical reasoning. Making use of ethnography provides family physicians with a greater array of research methods compatible with clinical practice.</p>","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"12 4","pages":"369-82"},"PeriodicalIF":0.0,"publicationDate":"1992-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12651041","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
Effects of a six-week, low-fat diet on serum cholesterol, body weight, and body measurements. 六周低脂饮食对血清胆固醇、体重和身体测量的影响。
Family practice research journal Pub Date : 1992-12-01
H C Seim, K B Holtmeier
{"title":"Effects of a six-week, low-fat diet on serum cholesterol, body weight, and body measurements.","authors":"H C Seim,&nbsp;K B Holtmeier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study was done to determine if significant weight loss, decrease in body measurements, and lowering of serum lipids and blood pressure could be shown in people on a low-calorie, low-fat, high-fiber diet over a period of six weeks. Forty-one people (33 females and 8 males) between the ages of of 37 and 55 years old participated in a six-week calorie-controlled, low-fat, low-sodium, high-fiber diet using foods available in supermarkets. Participants also exercised moderately. The average weight loss was 10.3 pounds, or 5.8% of the original average weight. The body mass index decreased 1.7-a 6.0% decrease for women and a 5.3% decrease for men. The average of five body measurements decreased 4.9%. Total cholesterol decreased 16%, LDL-C decreased 12%, and HDL-C decreased 18%. All of these decreases were statistically significant at P < .001. No significant difference was noted in blood pressures at the start and completion of the study, as both values were in the normal range. This relatively short period of dieting using 1200 calories for women and 1500 calories for men, along with moderate exercise, shows that reasonable weight loss and a tendency toward lowering lipid values can be obtained. Weekly monitoring by physicians and their office staffs can enhance this process. Continued accountability and support for lifelong behavior changes are probably necessary to maintain reasonable body weight in these patients.</p>","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"12 4","pages":"411-9"},"PeriodicalIF":0.0,"publicationDate":"1992-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12509629","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
Caring for women with chest pain in hospital emergency departments. 在医院急诊科照顾胸痛的妇女。
Family practice research journal Pub Date : 1992-12-01
J Z Ayanian
{"title":"Caring for women with chest pain in hospital emergency departments.","authors":"J Z Ayanian","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"12 4","pages":"337-40"},"PeriodicalIF":0.0,"publicationDate":"1992-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12651038","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
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