Articles: patients.
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Perioperative complications in obstructive sleep apnea (OSA) patients are described in a small series of case reports. No study to date systematically evaluates perioperative complications in a large number of OSA patients receiving surgeries other than those involving the pharynx. ⋯ The incidence of respiratory complications related to difficulties in airway management in OSA patients was higher than that reported in a recent study for all patients receiving general anesthesia (4%). The perioperative complications observed in these OSA patients are consistent with the underlying pathogenesis of OSA, pharyngeal obstruction. The absence of observed perioperative arrhythmias and myocardial ischemia is consistent with previous findings that sleep-related cardiac ischemia is uncommon in OSA patients. Our results suggest it is prudent to cautiously manage all OSA patients receiving surgeries involving general anesthesia.
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The aim of this study was to examine the relationship between information and views held by service users before obtaining help from a genitourinary medicine (GUM) service and the accessibility and use of the service, and to determine potential intervention measures for change. A structured questionnaire was completed by 292 first-time GUM service users in a large UK city in 1994. Overall 94 (57.7%) of 163 male service users and 59 (48.4%) of 122 female service users had some information about the service before seeking help, although this difference was not significant. ⋯ The results of this study show a clear need to project increased awareness and information about this GUM service so as to encourage use of the range of services available and promote more positive feelings about using the service. Information in written media as well as through other health professionals may be of benefit. Further work is needed to study the effect of information provision in influencing the large number of potential service users to make use of sexual health services.
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Studies using a multimodal approach in order to prognose therapeutic success in patients suffering from back pain were seen to have highly diverse results. However, in spite of various independent health care systems, a common interest prevails in identifying determinants of therapeutic success in order to improve therapy. ⋯ Predicting successful treatment is hardly possible without analyzing individual circumstances, focusing on sociodemographic variables, workplace-related conditions, and aspects of individual motivation. With regard to objective therapeutic success, subjective perceptions proved highly influential. Treatment proved successful only when the patient's perception of functional disability was minimized. Hence, individual perceptions and experiences were more important than physical capabilities.
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Acupuncture is being increasingly used as one of the most important non-pharmacological therapies in treatment of chronic pain. Chronic headache, especially migraine and tension headache are diseases frequently encountered. In their treatment acupuncture is a method with very few side effects and is a remarkable alternative or addition in the whole concept of treatment. ⋯ The concept of treatment depends on the basic rules of traditional Chinese medicine (TCM). Selection of the acupuncture points is primarily determined by the pain site. Long-term success could be confirmed by follow-up examinations six to eighteen months after end of the therapy.
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Comparative Study
Euthanasia and physician-assisted suicide: a comparative survey of physicians, terminally ill cancer patients, and the general population.
There is an ongoing debate about the legalization of euthanasia. The attitudes and beliefs of the general public and physicians appear to differ; the views of patients have not been adequately explored. During 1995, we conducted a simultaneous survey in the province of Alberta, Canada, of a random sample of 1,240 individuals from the general population, 179 physicians, and 62 consecutive patients with terminal cancer. The same instrument was administered to the public and physicians through telephone interview, and to patients in a face-to-face interview. Statements related to the legalization of euthanasia and physician-assisted suicide were scored using 1-to-7 Likert agreement scales. ⋯ In all groups, a marked polarization of attitudes was observed, with most individuals either strongly agreeing or strongly disagreeing with the statements in the survey. Although a slight majority of the public supported euthanasia, one third opposed it. Most physicians opposed these interventions and appeared not to be willing to perform these procedures if legalized. Our findings suggest that legalization at this time could be highly divisive and controversial from a societal perspective.