Journal of general internal medicine
-
Very little is known about complementary and alternative medicine (CAM) use in Asian Americans (AA), especially on a national level. To compare CAM use, reasons for use, and disclosure rates between Asian and non-Hispanic white Americans (NHW), and examine ethnic variations among AA. Data on CAM use in the past year (excluding prayer) were used from the 2002 National Health Interview Survey for 917 AA and 20,442 NHW. ⋯ Among AA, CAM use was associated with being female, having higher education, and having a chronic medical condition; foreign-birth was not associated with CAM use. Complementary and alternative medicine use is common among AA, and there are important ethnic variations in use. Asian Americans are less likely than NHW to disclose CAM use to conventional healthcare providers, suggesting that it is particularly important that physicians query AA patients about CAM use.
-
Oral anticoagulants (OAC) are effective and safe if the international normalized ratio (INR) is maintained within a narrow therapeutic range. Hospitalization is independently associated with poor anticoagulation control. The objective of this study is to describe how anticoagulation control changes in the peri-hospitalization period. ⋯ Following other hospitalization types, the proportion of patients with INR < 1.5 was significantly increased (daily increase 0.19%, P = .02). Patients admitted to the hospital for a variety of indications have significantly worse anticoagulation control in the peri-hospitalization period. Anticoagulated patients discharged after medical hospitalizations could be targeted for improved anticoagulation control.
-
Parvovirus B19 is a common infection in adults and children. There are reports of secondary parvovirus infection in immunocompromised persons, but no reports of symptomatic secondary infection in healthy persons. We describe a healthy 39-year-old woman who presented with fever, rash, and arthralgia. ⋯ Testing revealed both elevated IgG and IgM antibodies for parvovirus B19; previously, the patient was positive only for IgG. On a subsequent visit she related that a community outbreak of parvovirus developed in her town and church group. We believe this case demonstrates that a symptomatic secondary infection with parvovirus can occur in healthy persons, and that prior positive antibody test does not preclude the development of acute infection.