Tools and Resources: Web Sites of Interest

2001 ◽  
Vol 6 (2) ◽  
pp. 6-8
Author(s):  
Christopher R. Brigham
Keyword(s):  
Informed Consent ◽  
Physical Examination ◽  
Functional Status ◽  
Web Sites ◽  
Satisfaction Survey ◽  
High Quality ◽  
Diagnostic Studies ◽  
Physician Relationship ◽  
Complete History

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, explains that independent medical evaluations (IMEs) are not the same as impairment evaluations, and the evaluation must be designed to provide the data to answer the questions asked by the requesting client. This article continues discussions from the September/October issue of The Guides Newsletter and examines what occurs after the examinee arrives in the physician's office. First are orientation and obtaining informed consent, and the examinee must understand that there is no patient–physician relationship and the physician will not provide treatment bur rather will send a report to the client who requested the IME. Many physicians ask the examinee to complete a questionnaire and a series of pain inventories before the interview. Typical elements of a complete history are shown in a table. An equally detailed physical examination follows a meticulous history, and standardized forms for reporting these findings are useful. Pain and functional status inventories may supplement the evaluation, and the examining physician examines radiographic and diagnostic studies. The physician informs the interviewee when the evaluation is complete and, without discussing the findings, asks the examinee to complete a satisfaction survey and reviews the latter to identify and rectify any issues before the examinee leaves. A future article will discuss high-quality IME reports.

The Medical History and Physical Examination of the HIV-Infected Patient

2017 ◽  
Author(s):  
Jose Martagon-Villamil ◽  
Daniel J. Skiest
Keyword(s):  
Physical Examination ◽  
Risk Behaviors ◽  
Infected Individual ◽  
Provider Communication ◽  
Sexual Diversity ◽  
Medication History ◽  
Current State ◽  
Patient Provider Communication ◽  
Physician Relationship ◽  
Complete History

Fostering a strong and empathetic patient–physician relationship is essential for the success of the HIV therapeutic plan. A comprehensive understanding of all medical and psychiatric comorbidities, medication history, exposures, risk behaviors, and current state of health is fundamental in caring for the HIV-infected individual. All patients with HIV newly in care need a complete history and physical examination. The physical exam needs to be comprehensive both for the assessment of current complaints and for baseline comparison with future findings. Providers must be aware of the cultural, social, and sexual diversity of their patient population to help foster patient–provider communication.

Severe Postural Hypotension Due to Imipramine Therapy

PEDIATRICS ◽  
1971 ◽  
Vol 47 (1) ◽  
pp. 132-134
Author(s):  
George W. Koehl ◽  
James E. Wenzel
Keyword(s):  
Blood Pressure ◽  
Physical Examination ◽  
Postural Hypotension ◽  
Toilet Training ◽  
Toxic Effects ◽  
Wide Acceptance ◽  
Complete History ◽  
Caucasian Female

The use of imipramine in the treatment of childhood enuresis has recently gained wide acceptance. The drug is known to be quite toxic to children who accidentally ingest it.1-4 Instances of incapacitating toxic effects caused by therapeutic dosages of the drug have not, to the best of our knowledge, been reported in children. It is our purpose to report a case of severe postural hypotension associated with therapeutic dosages of this drug. Report of a Case A 9-year-old Caucasian female was evaluated because of enuresis which had been present since toilet training was begun at age 2 years. A complete history and physical examination were nonrevealing; her pulse was 82 beats per minute and blood pressure was 110/75 mm Hg.

Irritability

2015 ◽  
Keyword(s):  
Physical Examination ◽  
Key Points ◽  
Life Threatening ◽  
Complete History

Key Points Irritability has a wide variety of causes, from life-threatening ones to trivial ones. In an ill-appearing child, stabilization is the priority, followed by a search for the cause. In a child who appears well, an organized approach to diagnosis is based on findings from a complete history and thorough physical examination.

Technology-Based Marketing in the Healthcare Industry

2011 ◽  
pp. 30-44 ◽  
Author(s):  
Grace Johnson ◽  
Anand Kumar ◽  
Arkalgud Ramaprasad ◽  
Madhusudhan Reddy
Keyword(s):  
Information Technology ◽  
Web Sites ◽  
Hospital Setting ◽  
Healthcare Industry ◽  
Web Based ◽  
Registration Desk ◽  
Physician Relationship ◽  
The Relationship ◽  
Clinic Hospital ◽  
The Way

The past few years have seen Web-based technology diffusing into a wide cross-section of industries, cutting across various barriers, and changing the way many companies do business. The healthcare industry, though relatively slow to adopt information technology (Eder and Darter, 1998), is no exception. Information technology is transforming the healthcare environment in ways that go beyond simple consumer health information Web sites (Hagland, 1997). Increasingly, the industry is leveraging information technology effectively to manage its business and address issues affecting patient care (Lankford, 1999). At the heart of the healthcare industry lies the patient-physician relationship. The interaction between these two players usually occurs in a clinic/hospital setting. It is generally believed that the relationship between the patient and the physician is influenced not only by this interaction, but also by other interactions that a patient may have inside a clinic/hospital setting, such as interactions with nurses, staff, the registration desk, etc. However, changes brought about by information technology (a) allow players outside the clinic/hospital setting to influence the patient-physician relationship and (b) affect the way in which players and processes inside a clinic/hospital setting influence the patient-physician relationship. This chapter examines how Web technology affects the patient-physician relationship through its impact on players and processes both outside and inside a clinic/hospital setting.

scholarly journals Are health workers reduced to being drug dispensers of antiretroviral treatment? A randomized cross-sectional assessment of the quality of health care for HIV patients in northern Uganda

2019 ◽  
Vol 34 (8) ◽  
pp. 559-565
Author(s):  
Ulrike G Seeberger ◽  
Joseph J Valadez
Keyword(s):  
Physical Examination ◽  
Health Facility ◽  
Antiretroviral Treatment ◽  
Treatment Guidelines ◽  
Health Workers ◽  
Northern Uganda ◽  
High Quality ◽  
Cross Sectional ◽  
Sub Saharan

Abstract High quality of care (QoC) for antiretroviral treatment (ART) is essential to prevent treatment failure. Uganda, as many sub-Saharan African countries, increased access to ART by decentralizing provision to districts. However, little is known whether this rapid scale-up maintained high-quality clinical services. We assess the quality of ART in the Acholi and Lango sub-regions of northern Uganda to identify whether the technical quality of critical ART sub-system needs improvement. We conducted a randomized cross-sectional survey among health facilities (HF) in Acholi (n = 11) and Lango (n = 10). Applying lot quality assurance sampling principles with a rapid health facility assessment tool, we assessed ART services vis-à-vis national treatment guidelines using 37 indicators. We interviewed health workers (n = 21) using structured questionnaires, directly observed clinical consultations (n = 126) and assessed HF infrastructure, human resources, medical supplies and patient records in each health facility (n = 21). The district QoC performance standard was 80% of HF had to comply with each guideline. Neither sub-region complied with treatment guidelines. No HF displayed adequate: patient monitoring, physical examination, training, supervision and regular monitoring of patients’ immunology. The full range of first and second line antiretroviral (ARV) medication was not available in Acholi while Lango had sufficient stocks. Clinicians dispensed available ARVs without benefit of physical examination or immunological monitoring. Patients reported compliance with drug use (>80%). Patients’ knowledge of preventing HIV/AIDS transmission concentrated on condom use; otherwise it was poor. The poor ART QoC in northern Uganda raises major questions about ART quality although ARVs were dispensed. Poor clinical care renders patients’ reports of treatment compliance as insufficient evidence that it takes place. Further studies need to test patients’ immunological status and QoC in more regions of Uganda and elsewhere in sub-Saharan Africa to identify topical and geographical areas which are priorities for improving HIV care.

Podiatric Medical Resources on the Internet

2006 ◽  
Vol 96 (2) ◽  
pp. 162-166 ◽  
Author(s):  
Charles R. Fikar
Keyword(s):  
Medical Students ◽  
Web Sites ◽  
Medical Practitioner ◽  
The Internet ◽  
High Quality ◽  
Medical Resources ◽  
Reference Guide ◽  
Internet Resources ◽  
Potential Use ◽  
Selection Of

An updated selection of high-quality Internet resources of potential use to the podiatric medical practitioner, educator, resident, and student is presented. Internet search tools and general Internet reference sources are briefly covered, including methods of locating material residing on the “invisible” Web. General medical and podiatric medical resources are emphasized. These Web sites were judged on the basis of their potential to enhance the practice of podiatric medicine in addition to their contribution to education. Podiatric medical students, educators, residents, and practitioners who require a quick reference guide to the Internet may find this article useful. (J Am Podiatr Med Assoc 96(2): 162–166, 2006)

scholarly journals Bruxism in children: Effectiveness of bite splints

2014 ◽  
Vol 2 (1) ◽  
pp. 22
Author(s):  
Marcelo Tomas de Oliveira ◽  
Talita Bressan ◽  
Saulo Pamato ◽  
Ana Carolina Niehues ◽  
Nara Farias Niehues ◽  
...  
Keyword(s):  
Informed Consent ◽  
Physical Examination ◽  
Pediatric Dentistry ◽  
Ethics Committee ◽  
Parental Informed Consent ◽  
Wear And Tear ◽  
Dental Appliance ◽  
Effective Use ◽  
The University

Purpose: The aim of this study was to evaluate the effectiveness of bite splints in the treatment of children with bruxism, reduction or elimination of symptoms and effective use of the dental appliance by patients. Methods: The sample consisted of 30 children with bruxism, aged 7 to 10 years, attending the Pediatric Dentistry Clinic of the University of Southern Santa Catarina. After approval by the ethics committee and parental informed consent agreement, children underwent anamnesis, physical examination, and alginate molding for fabrication of acrylic bite splints. The children were reassessed after 15 days and after 4, 8 and 12 months of splinting use through new clinical examination and questionnaires. Results: The use rate of bite splints shows that there was a positive correlation (rP=0.9961) between the decrease in use and time elapsed. The parafunctional habit of bruxism was no longer observed in 76.7% of the sample. It was observed that both symptoms evaluated, headache and muscular discomfort, showed a behavior that, if present at the beginning of treatment, declined during follow-up. No splint wear and tear was observed. Conclusion: There was a significant reduction in parafunctional activity, headache and muscular discomfort with the use of bite splints. The higher the persistence of patients, the higher the use rate of bite splints.

Minimally Invasive Navigated Foraminal Discectomy via Contralateral Approach Using a 3-Dimensional 4K High-Definition Exoscope: 2-Dimensional Operative Video

2019 ◽  
Vol 19 (2) ◽  
pp. E188-E188
Author(s):  
Jonathan Oren ◽  
Kevin Kwan ◽  
Julia Schneider ◽  
Mitchell Levine ◽  
David Langer
Keyword(s):  
Informed Consent ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
High Definition ◽  
High Quality ◽  
Tubular Retractor ◽  
3 Dimensional ◽  
Intraoperative Fluoroscopy ◽  
Disc Herniations ◽  
Operative Microscope

Abstract This surgical video is the first to demonstrate a novel minimally invasive technique of utilization of surgically navigated foraminal discectomy using a 3-dimensional 4k high-definition exoscope (Sony Olympus). Typical approaches for foraminal disc herniations may involve violation of the facet resulting in subsequent destabilization requiring fusion.1 Although minimally invasive facet-sparing contralateral techniques have previously been described,2 there is continued limitations stemming from rudimentary localization with standard fluoroscopy and impaired visualization with the bulky traditional operative microscope.3 We demonstrate that high-quality real-time navigation is possible using standard Iso-C intraoperative fluoroscopy for 3-dimensional reconstructions, allowing for intraoperative routing. Navigation is particularly advantageous for adjustments in the trajectory of the tubular retractor and for confirmation of complete foraminal decompression. Visualization from the 4k high-definition exoscope also allows for an unparalleled view of the narrow operative corridor and allows for participation from the operative team. Informed consent was obtained from the patient for the surgery in its entirety.

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