The Mount Sinai journal of medicine, New York
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Recent studies suggest that minorities may have higher plasma levels caused by ethnic variations in pharmacokinetics under standard neuroleptic treatment; they would be at increased risk for extrapyramidal side effects and more likely to be treatment noncompliant. This study examined the prescribing pattern of antipsychotic medication to minority schizophrenics in outpatient psychiatric programs developed to meet their treatment needs. A computer search was conducted of registered clients in a Hispanic and Asian outpatient clinic(s). ⋯ With regard to the former secondary analysis yielded significant differences between the clinic sample and the Hispanic (p < 0.05) and Asian (p < 0.05) samples, which did not differ significantly from each other but which received significantly less drugs than the other patient population. These results were similar to the standardized dose comparison. The findings replicate previous inpatient reports and have implications for cross-cultural treatment programs.
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International Medical Graduates (IMGs) have played an integral role in provision of medical services in the United States, representing 25% of physicians nationwide and up to 43% in some states. Because of the concern with the future physician surplus, several proposals have been advanced specifically targeting IMGs. Although the need to downsize our residency training programs is apparent, focusing specifically on the IMG who has met all requirements for entry into residency training is neither morally acceptable nor pragmatically effective. Downsizing can be accomplished independent of the need to single out a specific group without jeopardizing either quality of training or quality of care if all groups responsible for residency training work together.
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Neurocysticercosis (NCC), which is caused by the encysted larvae of the porcine tapeworm Taenia solium, is uncommon in developed countries. ⋯ NCC should be suspected in immigrants from Central and South America who have seizures; it may complicate the differential diagnosis of various central nervous system syndromes. Available therapies entail risks and uncertainties. The ultimate approach is prevention of infestation.
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Comparative Study
Personal emergency response systems: factors associated with use among older persons.
A descriptive survey was conducted to determine factors associated with the use of personal emergency response systems among older community-residing subscribers in the New York City metropolitan area. Subscribers who wore the portable help button when alone in the home were defined as being "compliant." The average length of time the 106 respondents (average age 83 +/- 9) had the system in their possession was 26 +/- 18 months. ⋯ Compliance was less common in users who had obtained the system at the request of a family member. The data suggest that disuse is a common problem that clinicians should assess regularly to assure the benefit of this intervention.