The Journal of family practice
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Randomized Controlled Trial Comparative Study Clinical Trial
Does acetaminophen affect liver function in alcoholic patients?
Acetaminophen in doses of 4 g/d did not affect liver function of alcoholic patients in this randomized study. These results do not rule out the possibility of acetaminophen-induced liver failure in alcoholic patients, especially patients with pre-existing liver disease or those who continue to drink. Patient-oriented outcomes (ie, studying chronic acetaminophen use in alcoholics to determine the incidence of developing hepatic failure) ultimately would resolve this controversy. However, these data do cast doubt on the medical myth (based on case reports) that acetaminophen use in alcoholics causes hepatotoxicity.
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To describe the management of after-hours calls to primary care physicians and identify potential errors that might delay evaluation and treatment. ⋯ After-hours call systems in most primary care offices impose barriers that may delay care. All clinical patient calls should be sent to appropriately trained medical personnel for triage decisions. We urge all clinicians that use an answering service to examine their policies and procedures for possible sources of medical error.
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To compare the care provided by family practice primary care physicians with that provided by 2 hospitalist models: critical care hospitalists and rotating residency faculty family physician hospitalists. ⋯ Claims of better and cheaper care by hospitalists need further investigation. Meanwhile, the use of hospitalists should not be mandated, and the use of family physicians as hospitalists should be considered a good alternative to the use of subspecialists.
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Comparative Study
Delayed antibiotic prescriptions: what are the experiences and attitudes of physicians and patients?
To explore the experiences and opinions of family physicians and patients regarding the delay of antibiotic prescriptions, to be dispensed if symptoms persist or worsen over time, in treating upper respiratory tract infections. ⋯ Although delayed antibiotic prescriptions are effective in decreasing antibiotic use for conditions not clinically warranting antibiotics, neither patients nor physicians universally endorsed this strategy. Research to establish formalized recommendations for patient suitability and instructions for use would be of value.