CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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To review reported cases of hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with the use of selective serotonin reuptake inhibitors (SSRIs). ⋯ Elderly people may be at increased risk for hyponatremia associated with SSRI use. Physicians caring for elderly patients should be aware of this potentially serious but reversible adverse effect. Further research is required to determine the incidence of this adverse effect, the relative risk of hyponatremia and SIADH in different age groups and the risk associated with different SSRI drugs.
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Comparative Study
Multicultural health care requires adjustments by doctors and patients.
Canada has become a multicultural society, and more physicians have patients who are immigrants or refugees from the Third World. While doctors are aware of the need for culturally sensitive health care, there is still room for improving the delivery of medical treatment to those of other cultures. Janice Hamilton spoke with physicians who have multicultural practices to get an idea of the challenges they have faced and the problems they have solved.
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In the context of patient consent, "disclosure" refers to the provision of relevant information by the clinician and its comprehension by the patient. Both elements are necessary for valid consent. ⋯ Therefore, clinicians may need to consider how the proposed treatment (and other options) might affect the patient's employment, finances, family life and other personal concerns. Clinicians may also need to be sensitive to cultural and religious beliefs that can affect disclosure.