Journal of general internal medicine
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A profound and moving spirituality provided emotional and psychological support for most terminally ill patients at Grady Memorial Hospital. The authors were able to trace the roots of these patients' spirituality to core beliefs described by African-American theologians. ⋯ Importantly, almost all patients were willing to share their beliefs with the authors in long bedside interviews. This willingness to share indicates that physicians can learn about and validate such patients' spiritual sources of support.
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Multicenter Study Comparative Study
Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes.
The persistence of depressive symptoms after hospitalization is a strong risk factor for mortality after acute coronary syndromes (ACS). Poor adherence to secondary prevention behaviors may be a mediator of the relationship between depression and increased mortality. ⋯ Persistently depressed patients were less likely to adhere to behaviors that reduce the risk of recurrent ACS. Differences in adherence to these behaviors may explain in part why depression predicts mortality after ACS.
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Comparative Study
Prevalence of basic information technology use by U.S. physicians.
Information technology (IT) has been advocated as an important means to improve the practice of clinical medicine. ⋯ In early 2004, the majority of physicians did not regularly use basic, inexpensive, and widely available IT tools in clinical practice. Efforts to increase the use of IT in medicine should focus on practice-level barriers to adoption.
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A woman developed a prolonged QT interval and torsade de pointes while on methadone treatment for heroin addiction. We think methadone, or its impaired metabolism, was the major cause for her prolonged QT interval and progression to torsade. However, torsade is often multifactorial, as was likely so in this case. We advise physicians treating patients taking methadone to obtain careful medication and drug-use histories, screen for risk factors associated with long QT syndrome, counsel patients about potential drug interactions, and measure the QT interval before and during methadone treatment in high-risk patients.
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Comparative Study
Four physician communication styles in routine Japanese outpatient medical encounters.
Few studies have explored how physicians approach medical encounters in Japan. ⋯ Results suggest the need for a multiprovider-patient model of medical communication among physician, nurse, and patient. Further research is needed to establish the applicability of this model to the communication styles of physicians in other countries.