Southern medical journal
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Southern medical journal · Jul 2008
Physician discussion about social activities in primary care encounters with older adults.
Involvement in social activities is linked to positive health outcomes. This study focused on the prevalence of social activity discussions during the primary care medical encounter, and examined how patient, physician, and contextual factors were associated with discussions between physicians and older patients. ⋯ Results support the inclusion of discussion and counseling about social activities in medical encounters with older patients. Family physicians will likely experience improved patient satisfaction, and geriatric patients can potentially reap health benefits that improve both quality of life and medical outcomes. Additional research is needed to understand more fully the correlates and benefits of social activity discussion during the medical encounter.
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Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder that can lead to serious central nervous system complications including hemorrhage, ischemia, and infection. Symptoms can be mild, making diagnosis problematic. ⋯ Early recognition of HHT is important because screening in these patients and affected family members may help prevent complications. In addition, advancements in imaging, surgical techniques, antibiotics, and genetic testing may improve outcomes.
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Southern medical journal · Jun 2008
Percutaneous cholecystostomy without interval cholecystectomy as definitive treatment of acute cholecystitis in elderly and critically ill patients.
The aim of this study was to evaluate the safety and effectiveness of percutaneous cholecystostomy without interval cholecystectomy as definitive treatment for acute cholecystitis in elderly or critically ill patients with various coexisting diseases who were unfit for surgery under general anesthesia. ⋯ For the subgroup of extremely high-risk and unfit for surgery patients, percutaneous cholecystostomy might be considered as the definitive treatment since it controls the local symptoms and the systemic inflammatory response.
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Southern medical journal · May 2008
Case ReportsA primary tracheal carcinoid tumor masquerading as chronic obstructive pulmonary disease.
Primary tumors of the trachea are rare and can be missed because of the paucity of symptoms and findings and the difficulty in detecting them with chest radiographs. A 31-year-old male patient was admitted with complaints of shortness of breath, coughing, phlegm, and blood in the sputum. He stated that he was being treated for chronic obstructive pulmonary disease. ⋯ Postoperative histopathological examination revealed a typical carcinoid tumor. In patients with an unexplained cough, dyspnea, infrequent hemoptysis, and normal pulmonary imaging findings, tracheal carcinoma should be suspected. In such cases, early thoracic computed tomography and bronchoscopic examination can provide a rapid diagnosis and treatment options and prevent a false diagnosis.