Postgraduate medicine
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Postgraduate medicine · Sep 2010
Migraine, tension-type headache, and attention-deficit/hyperactivity disorder in childhood: a population-based study.
Primary headache syndromes (eg, migraine and tension-type headache [TTH]) and attention-deficit/hyperactivity disorder (ADHD) are prevalent in childhood and may cause impairment in social and academic functioning. We tested if ADHD or its symptoms are associated with specific headache syndromes or with headache frequency. ⋯ Migraine and TTH are not comorbid to ADHD overall, but are comorbid to hyperactive-impulsive behavior. Providers and educators should be aware of the association.
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Postgraduate medicine · Sep 2010
Chronic hepatitis B: perceptions in Asian American communities and diagnosis and management practices among primary care physicians.
Asian Americans exhibit a high prevalence of chronic hepatitis B (CHB) compared with the general population in the United States. However, there are specific barriers to appropriate health care in the Asian American population, and CHB awareness is low. The aim of this study was to examine CHB awareness among the Asian American population and to assess the role and attitudes of primary care physicians in CHB diagnosis and treatment, particularly in relation to Asian American communities. ⋯ Improved education regarding CHB disease progression, prevention, and treatment is needed among both the Asian American community and primary care physicians to increase awareness of the seriousness of the disease and ultimately reduce the burden of CHB in the United States.
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Postgraduate medicine · Jul 2010
Randomized Controlled Trial Multicenter StudyMorphine sulfate and naltrexone hydrochloride extended release capsules in patients with chronic osteoarthritis pain.
To assess the efficacy and safety of morphine sulfate and naltrexone hydrochloride extended release capsules (EMBEDA; MS-sNT), which contain morphine sulfate pellets with a sequestered naltrexone core, in treating patients with chronic, moderate-to-severe osteoarthritis (hip or knee) pain. ⋯ MS-sNT provided effective analgesia in patients with chronic, moderate-to-severe osteoarthritis pain, with a safety profile typical of morphine-containing products. Naltrexone sequestered in MS-sNT had no clinically relevant effect when MS-sNT was taken as directed.
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Postgraduate medicine · May 2010
ReviewThe potential role of colesevelam in the management of prediabetes and type 2 diabetes mellitus.
Successful management of prediabetes and type 2 diabetes mellitus (T2DM) requires a multifaceted, multidisciplinary approach that involves patient education and support, lifestyle modification, and appropriate use of pharmacologic interventions with frequent monitoring and adjustment to ensure that target goals for hyperglycemia, dyslipidemia, and hypertension are achieved and maintained. Studies have shown that the bile acid sequestrant colesevelam HCl reduces hemoglobin A1c and low-density lipoprotein-cholesterol levels in patients with prediabetes and T2DM. This article briefly reviews current treatment guidelines for patients with prediabetes and T2DM and the potential role of colesevelam in the management of prediabetes and T2DM with oral antidiabetes agents.
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Caring for critically ill patients requires rapid and accurate diagnosis followed by prompt interventions. The physical examination remains an important part of the assessment of such patients, but it has been shown to have a low sensitivity and specificity in judging left ventricular function and intravascular volume. Invasive hemodynamic monitoring has similarly been shown to have significant limitations and has failed to demonstrate a mortality benefit in several recent studies. ⋯ Focused TTE can be used as a screening and monitoring tool. Studies have shown that clinicians can be trained to determine left ventricular function, detect pericardial effusions, predict intravenous fluid responsiveness, and identify important valvular defects in a relatively short period. This article describes the indications for focused TTE, provides evidence that clinicians can be rapidly taught the technique, reviews how the focused studies affect management, and discusses the advantages and limitations of this tool.