Archives of family medicine最新文献

{"title":"Costs of beta-lactam allergies: selection and costs of antibiotics for patients with a reported beta-lactam allergy.","authors":"E J MacLaughlin,&nbsp;J J Saseen,&nbsp;D C Malone","doi":"10.1001/archfami.9.8.722","DOIUrl":"https://doi.org/10.1001/archfami.9.8.722","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate antibiotic selection and the cost effect of reported beta-lactam allergies.</p><p><strong>Design: </strong>Retrospective medical records review comparing antimicrobial selection and costs in patients with a reported beta-lactam allergy with a group in which no such allergy had been documented.</p><p><strong>Setting: </strong>University-based family medicine clinic.</p><p><strong>Patients: </strong>Patients who were prescribed at least 1 antibiotic for an upper respiratory tract infection, otitis media, sinusitis, and/or a urinary tract infection were eligible. One thousand two hundred one patients were identified via ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes. Four hundred sixty-five patients were initially identified and an additional 195 family members were eligible for inclusion.</p><p><strong>Main outcome measures: </strong>Comparison of antimicrobial selection and costs (by average wholesale price) between patients with and without a reported beta-lactam allergy.</p><p><strong>Results: </strong>Of the 660 patients eligible for inclusion, 99 (15%) had a documented beta-lactam allergy. Of the patients with a documented allergy, only 33% had a description of their purported reaction. The mean antibiotic cost for patients with a beta-lactam allergy was significantly higher compared with those without a beta-lactam allergy ($26.81 vs $16.28, respectively; P =.004). Patients with a beta-lactam allergy were more likely to have received a cephalosporin, macrolide, or a miscellaneous agent (eg, quinolone, tetracycline, or nitrofurantoin) (P =.001).</p><p><strong>Conclusions: </strong>Patients with a beta-lactam allergy had higher antibiotic costs and were more likely to receive a broader-spectrum antibiotic. Most patients with a reported allergy did not have a description of their reaction. Skin testing may be of use in detecting true beta-lactam allergies; however, further study is needed to determine its cost-effectiveness.</p>","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"722-6"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766690","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":"Update on the management of hyperthyroidism and hypothyroidism.","authors":"K A Woeber","doi":"10.1001/archfami.9.8.743","DOIUrl":"https://doi.org/10.1001/archfami.9.8.743","url":null,"abstract":"","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"743-7"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766694","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":"Depression management programs.","authors":"A J Dietrich","doi":"10.1001/archfami.9.8.689","DOIUrl":"https://doi.org/10.1001/archfami.9.8.689","url":null,"abstract":"","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"689-70"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766825","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":"Health food store recommendations for breast cancer patients.","authors":"C C Gotay,&nbsp;D Dumitriu","doi":"10.1001/archfami.9.8.692","DOIUrl":"https://doi.org/10.1001/archfami.9.8.692","url":null,"abstract":"CONTEXT Despite cancer patients' widespread and growing use of complementary and alternative medicine, minimal attention has been paid to the role of health food stores in the \"supply side\" of this phenomenon. OBJECTIVE To gain a better understanding of health food store personnel's recommendations for breast cancer patient care. DESIGN Researcher posing as the daughter of a breast cancer patient and surveying health food store personnel on their product recommendations for cancer care. SETTING Oahu, Hawaii, summer 1998. PARTICIPANTS All health food stores (N = 40) offering products for cancer patients. MAIN OUTCOME MEASURES Recommended products and services, proposed mechanism of action, and costs. RESULTS Store personnel readily provided information and product recommendations, with shark cartilage being the most frequent. Suggested mechanisms of action drew on traditional healing, scientific, and pseudoscientific rationales. Costs for recommended dosages varied multifold across stores and brands. CONCLUSIONS Retailers supplying supplements can play an important role in the network of \"authorities\" for patients with breast and other cancers, as they readily provide advice and recommend products. The reasons why patients seek health food store remedies are useful in developing approaches to patient education. Physicians and other providers are in a key position to assist cancer patients in making informed choices when considering health store products.","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"692-9"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766684","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":"Improvement of outcomes in chronic illness.","authors":"W Katon","doi":"10.1001/archfami.9.8.709","DOIUrl":"https://doi.org/10.1001/archfami.9.8.709","url":null,"abstract":"","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"709-11"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766687","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":"Editor's comment: evaluation of Migraineurs' preferences for naratriptan over conventional first-line agents","authors":"Bowman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"758"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766616","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":"Author's comment","authors":"Dumitriu","doi":"10.1001/archfami.9.8.699","DOIUrl":"https://doi.org/10.1001/archfami.9.8.699","url":null,"abstract":"","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"699"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766685","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":"Editor's comment: is caffeine a flavoring agent in cola soft drinks?","authors":"Bowman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"734"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766691","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":"Special selection: minocycline-induced hyperpigmentation of the tongue.","authors":"E L Tanzi,&nbsp;M S Hecker","doi":"10.1001/archfami.9.8.687","DOIUrl":"https://doi.org/10.1001/archfami.9.8.687","url":null,"abstract":"","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"687-8"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766824","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":"Informed consent for postfertilization effects of hormonal and surgical forms of birth control for women.","authors":"M A Sherfey","doi":"10.1001/archfami.9.8.690","DOIUrl":"https://doi.org/10.1001/archfami.9.8.690","url":null,"abstract":"","PeriodicalId":8295,"journal":{"name":"Archives of family medicine","volume":"9 8","pages":"690-1"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21766682","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}