CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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In clinical trials, cholesterol-lowering medications have been proven to decrease mortality and morbidity and are strongly recommended as secondary prevention for patients with established coronary artery disease. Whether physicians and patients follow this recommendation is unknown. Our objective was to determine the rate at which patients fill at least one prescription for cholesterol-lowering medications after coronary revascularization. ⋯ In this population-based study of revascularized patients, we observed a substantial underutilization of cholesterol-lowering medications after revascularization. Our observations suggest an important role for continuity of care in the treatment of cardiovascular patients undergoing revascularization procedures.
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Review Case Reports
Rehabilitation medicine: 2. Diagnosis of dysphagia and its nutritional management for stroke patients.
Following stroke, patients may have reduced dietary intake, swallowing impairments (dysphagia) and other neurological deficits that could affect their nutritional and hydration status and lead to aspiration pneumonia. Impaired nutritional status is associated with reduced functional improvement, increased complication rates and prolonged hospital stays. ⋯ We discuss the need for assessing the nutritional status of stroke patients and provide strategies for the management of dysphagia and patients' food and fluid intakes. In addition, we review clinical and radiological options for the diagnosis of dysphagia as well as oral and enteral feeding alternatives.
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Information gaps occur when previously collected information is unavailable to a physician who is currently treating a patient. In this study we measured the prevalence of physician-reported information gaps for patients presenting to an emergency department at a teaching hospital. ⋯ Information gaps were present in almost one-third of the visits to our emergency department. They were more common in sicker patients and were independently associated with a prolonged stay in the emergency department.