Articles: patients.
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Biography Historical Article
[Hahnemann's youngest patients - an analytic study of the first homeopathic treatments for children].
This article develops a fragmentary history of early homeopathic treatment of children. It begins with an outline of Samuel Hahnemann's perception and treatment of children during the "Medical Enlightenment". This is followed by an investigation of attitudes towards children in early homeopathic literature, in comparison to those of mainstream medicine of the period. ⋯ In response to Hahnemann's queries, many letters contain exact description of somatic and psychic symptoms. Unlike Hahnemann's brief style, many of the parents delve into each detail of the child's condition, and also express themselves emotionally on subjects such as their children, fears of sickness and death. It is also apparent that women, who bore the main responsibility for family life, had a good deal of authority over the course of treatment, as well as the choice of physician.
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The relation of procalcitonin (PCT) plasma concentrations compared with C-reactive protein (CRP) was analyzed in patients with different severity of multiple organ dysfunction syndrome (MODS) and systemic inflammation. PATIENTS AND ⋯ Measurement of PCT concentrations during multiple organ dysfunction syndrome provides more information about the severity and the course of the disease than that of CRP. Regarding the strong association of PCT and the respective score systems in future studies we recommend evaluation also of the severity of inflammation and MODS when PCT concentrations were compared between different types of disease.
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Health care delivery is undergoing a revolutionary change. It is focusing rapidly all over the world towards outpatient and home care. One of the most obvious results of these changes has been the relative explosion office-based surgery and anesthesia; however, these are not new concepts. ⋯ These guidelines should be based on the specific type of surgery, the level of anesthetic required and the design of the office. This way the provision of adequate quality of care is ensured. Office-based anesthesia and surgery will no doubt continue to evolve because it is safe, pleasing and convenient for the patient and of low cost.
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The debate regarding therapeutic use of cannabis is being confused by a lack of distinction between therapeutic and social use of cannabis. Separate consideration of therapeutic and social use would enable strategies to minimise any negative social impact of therapeutic use. For therapeutic use of cannabis to be considered on its own merits, greater emphasis needs to be placed on scientific evidence of therapeutic efficacy. ⋯ The most likely value of cannabis is as an adjunct, rather than a replacement for, current medical approaches. The potential therapeutic benefits of cannabis will be greatest for those conditions where long-term cannabis use, with its attendant health risks, is not an issue and where the patient has the capacity to titrate dose against symptoms. There is sufficient evidence of potential therapeutic benefit to justify the facilitation of further research.
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Considering three different bypass procedures now in use, (single indirect nonanastomotic bypass procedure, multiple combined indirect (MCI) nonanastomotic procedure and direct anastomosis), the authors attempted to identify the most appropriate bypass procedure for treating ischemic-type moyamoya disease in children. The authors performed three procedures (the original encephaloduroarteriosynangiosis [EDAS] alone, the frontotemporoparietal combined indirect bypass procedure, and the superficial temporal artery--middle cerebral artery [STA-MCA] anastomosis with encephalomyosynangiosis [EMS]) on 72 hemispheres in 50 patients with pediatric moyamoya disease. Analyses were then performed to compare postoperative collateral vessel formation found on angiograms, complications, and clinical improvements. ⋯ However, the single and multiple combined indirect nonanastomotic bypass procedures were found to be safer than direct anastomosis. Furthermore, the frontotemporoparietal combined indirect bypass procedure caused the formation of collateral circulation not only in the MCA but also in the ACA distribution. Based on analysis of these findings, the authors recommend the MCI procedure as the appropriate surgical procedure in the treatment of children with moyamoya disease, although the best treatment is the STA-MCA anastomosis with EMS when feasible.