Archives of family medicine
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To test the effectiveness of unattended home monitoring along with automatic titrating continuous positive airway pressure (auto-CPAP) as an acceptable method for diagnosing and prescribing proper CPAP pressure for treatment of patients presenting with classic symptoms of obstructive sleep apnea (OSA). ⋯ Unattended monitoring plus auto-CPAP allows cost-effective diagnosis and CPAP titration of most patients with OSA with straightforward symptoms.
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Cervical ectopic pregnancy is the implantation of a pregnancy in the endocervical canal. Diagnosis and treatment of cervical ectopic pregnancy has changed dramatically in the last 15 years. Before 1980, the diagnosis commonly was made when dilation and curettage for presumed incomplete abortion resulted in unexpected hemorrhage. ⋯ The family physician practicing obstetrics must consider the diagnosis of cervical ectopic pregnancy in women with first-trimester vaginal bleeding or pelvic pain to permit early diagnosis and fertility-saving treatment. A case report of diagnosis and successful medical management of a cervical ectopic pregnancy is presented. The literature on the epidemiology, causes, diagnosis, and treatment of cervical ectopic pregnancy is reviewed.
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In June 1997, the US Supreme Court unanimously decided that competent, terminally ill patients have no general constitutional right to commit suicide or to obtain assistance in committing suicide. Thus, the broad prohibitions against any kind of suicide assistance that almost every state has enacted do not violate the constitution. ⋯ For example, the Court concluded that a physician's intent can distinguish permissible acts of aggressive pain relief from impermissible acts of hastening death. This distinction has clinical uses and can help physicians develop ethical guidelines and practice standards to improve palliative care near the end of life.
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Randomized Controlled Trial Clinical Trial
Loperamide-simethicone vs loperamide alone, simethicone alone, and placebo in the treatment of acute diarrhea with gas-related abdominal discomfort. A randomized controlled trial.
Acute diarrhea with gas-related abdominal discomfort is a common, usually self-limited disorder with substantial social and economic impact. ⋯ The loperamide-simethicone combination chewable product provides faster and more complete relief of acute nonspecific diarrhea and associated gas-related abdominal discomfort (gas pain, cramps, gas pressure, and bloating) than either of its components or placebo. The combination is well tolerated.