The Mount Sinai journal of medicine, New York
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Methadone Medical Maintenance (MMM) was implemented in 1983 to enable socially rehabilitated methadone patients to be treated in the offices of private physicians rather than in the traditional clinic system. Over a period of 15 years, 158 methadone patients who fulfilled specific criteria within the clinic system entered this program in New York City. Participating patients reported to their physician once a month and received a one-month supply of methadone tablets rather than a one-day liquid dose in a bottle. ⋯ Stigma concerning enrollment in methadone treatment was a major social issue that patients faced. Many refused to inform employers, members of their families, friends, and other physicians who treated them for a various of conditions that they were methadone patients. The methadone medical maintenance physician, therefore, functions as a medical ombudsman for the patient, educating other physicians who treat the patient about methadone maintenance and its applicability to the patient. Our results can serve as a model for the expansion of office-based MMM treatment.
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Accumulating evidence suggests that partner violence may be associated with HIV risk behavior and drug use among women in methadone maintenance treatment programs (MMTPs), yet the mechanisms linking these overlapping problems remain unclear. The main purpose of this qualitative study is to explore in detail how drug-related activities and HIV risk behavior occur in the context of a recent episode of partner violence among women in MMTPs. ⋯ The multiple ways in which the use of mood-altering drugs are related to partner violence and the occurrence of coerced, unprotected sex underscore the need to design specific interventions for preventing drug relapse, and HIV and HCV infection among abused women in MMTPs. Treatment and policy implications of study findings are discussed.
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Comparative Study
Endoscopic carpal tunnel release: report of 146 cases.
The purpose of this study is to describe one type of surgical treatment of carpal tunnel syndrome, namely endoscopic carpal tunnel release. ⋯ Although overall long-term results of endoscopic carpal tunnel release appear similar to those of open release, patients who undergo endoscopic carpal tunnel release demonstrate a quicker functional recovery, less postoperative pain, and less scarring than open carpal tunnel release patients.
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Emergency medicine became the twenty-third specialty by the American Board of Medical Examiners in 1979. Emergency physicians are specialists in the stabilization and resuscitation of medical and surgical emergencies in patients of all ages; they are experts in triage and in prioritization of resources. Emergency physicians provide the "safety net" for the American health care system, and they are the facilitators between the community and health care systems, and between primary care physicians and specialists. ⋯ Emergency physicians possess a unique set of clinical and research skills that have made them valuable members of the medical school academic community. Presented is a historical perspective on the specialty of emergency medicine and its evolving role at the Mount Sinai School of Medicine. Included are discussions on innovations in teaching developed by the emergency medicine faculty, including applications of computer-assisted instruction and the Internet.
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Biography Historical Article Classical Article
The William Henry Welch Lectures: Some recent advances in the physiology of the anterior pituitary. 1934.