Articles: patients.
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The aim of the study is an investigation of the psychometric characteristics of the Italian translation of the Multidimensional Pain Inventory and a comparison with the American, German, Swedish and Dutch versions of the MPI. ⋯ After making appropriate changes in all 3 sections of the inventory, the MPI is substantially suitable for use in cross-cultural and international research.
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Recent evidence indicates that physicians are at high risk for patient-perpetrated violence. The objectives of this article, in association with case reports of patients with chronic pain (PWCP), are the following: to review the literature and determine if pain physicians could be at risk for PWCP-perpetrated violence; to review the current evaluation and management procedures for potentially violent patients; and to identify some situations specific to PWCPs that can heighten the risk of PWCP-perpetrated violence. ⋯ In the evaluation for risk of violence against physicians or institutions by PWCPs, one needs to understand PWCP-specific situations. Management of potential violent behavior cannot be effective without this understanding.
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Curr Opin Anaesthesiol · Jun 2000
Perioperative considerations in the management of the patient taking herbal medicines.
The use of herbal products has recently increased dramatically in the United States. Patients are flocking to use these and many other complementary or alternative therapies. ⋯ The following review will discuss the limitations of Food and Drug Administration protection, and will review as well as provide an outline of the potential adverse reactions and side-effects that might affect anesthesia administration. To date, no double-blind, placebo-controlled studies have been carried out that specifically address herbal-anesthetic interactions or outcomes.
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Cost concerns may inhibit emergency medical services (EMS) use. Novel tax-based and subscription prepayment programs indemnify patients against the cost of EMS treatment and transport. We determine whether the presence of (or enrollment in) prepayment plans increase EMS use among patients with acute chest discomfort, particularly those residing in low-income areas, those lacking private insurance, or both. ⋯ Economic considerations may affect EMS system utilization among underinsured and low-income patients experiencing a cardiac event. Prepayment systems may increase EMS utilization among these groups. [Seipmann DB, Mann NC, Hedges JR, Daya MR, for the Rapid Early Action for Coronary Treatment (REACT) Study. Association between prepayment systems and emergency medical services use among patients with acute chest discomfort syndrome. Ann Emerg Med. June 2000;35:573-578.].
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Curr Opin Anaesthesiol · Jun 2000
Patient-controlled epidural analgesia or continuous infusion: advantages and disadvantages of different modes of delivering epidural analgesia for labour.
Patient-controlled epidural analgesia, intermittent top-up and continuous infusion are equally effective in providing epidural pain relief during labour. Patient-controlled epidural analgesia is associated with a significant reduction in hourly dose requirements when compared with continuous infusion, and by transferring the responsibility for epidural top-up, it offers the parturient the psychological benefit of being in control. ⋯ However, the safety of the method needs to be documented more extensively, and the advantage of a reduction in hourly dose requirements needs to be visualized in terms of an improvement in labour or neonatal outcome. Moreover, the optimal dose, drug combination and settings still remain to be determined.