Southern medical journal
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Southern medical journal · Aug 2010
Pain management by primary care physicians, pain physicians, chiropractors, and acupuncturists: a national survey.
Chronic pain is a serious public health problem and is treated by diverse health care providers. In order to enhance policies and programs to improve pain care, we collected information about the distribution of pain patients among four major groups of pain management providers: primary care physicians (PCPs), pain physicians, chiropractors, and acupuncturists, and the variation in the attitudes and practices of these providers with respect to some common strategies used for pain. ⋯ There is substantial variation in attitudes and practices of the various disciplines that treat chronic pain. This information may be useful in interpreting differences in patient access to pain care, planning studies to clarify patient outcomes in relation to different providers and treatment strategies, and designing a system that matches chronic pain patients to appropriate practitioners and treatments.
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Southern medical journal · Aug 2010
Comparative StudyRacial differences in general health, suicidal thoughts, physical and sexual abuse in African-Americans and Caucasians with irritable bowel syndrome.
Knowledge of the contribution of race to irritable bowel syndrome (IBS)-associated morbidity helps not only with health care policy decisions but also may provide important clues to the pathophysiologic interactions involved. ⋯ Substantial similarities as well as differences in IBS patients of the two races support the concept that, while there is an important role for a biological component to the pathogenesis of IBS, it by itself may not be an exclusive determinant.
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Southern medical journal · Aug 2010
Case ReportsA unique case of recurrent takotsubo cardiomyopathy.
Takotsubo (stress induced) cardiomyopathy is also known as broken heart syndrome or transient left ventricular apical ballooning syndrome. The clinical presentation, which mimics acute myocardial infarction, is preceded by intense emotional or physical stress. ⋯ There was full recovery with conservative management. This suggests that there are presently unknown patient-specific characteristics that predispose patients to takotsubo cardiomyopathy.
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Southern medical journal · Aug 2010
Editorial CommentA role for extracorporeal treatment in severe influenza?
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Southern medical journal · Aug 2010
Review Case ReportsClinical pathological characteristics and management of acute respiratory distress syndrome resulting from influenza A (H1N1) virus.
Young adults, especially pregnant woman and patients with pre-existing medical conditions, appear to be at risk for the development of severe acute respiratory distress syndrome (ARDS) from influenza A (H1N1) infection, leading to critical hypoxemia. This may require high ventilator settings, the use of nonconventional modes, and extracorporeal membrane oxygenation in some cases. This severe ARDS may be related to prolonged and virulent viral infection, inducing ongoing aberrant immune responses and leading to extensive lung damage. Duration of antiviral therapy, the timing of steroid introduction, and moving away from standard ventilation techniques in ARDS may be key points in disease management.