Browse Items (44 total)

Background: Computer-assisted instruction in medicine appears rofacilitare learning, but it has not been compared prospectively to more traditional reaching methods. Purpose: To compare the efficacy of computer-assisted instruction to a more…

Rationale, Aims and Objectives Doctor compliance with diabetic care guidelines is low and may be improved with system-wide changes that include patient involvement. The objective of this study was to determine if patients in an internal medicine…

In elderly individuals, serum creatinine may remain normal as glomerular filtration rate (gfr) declines. Therefore, the estimation of glomerular filtration utilizing mathematical models incorporates age as an important variable. In order to adjust…

The finding of eosinophils in the urine has been suggested to be useful in establishing the diagnosis of acute interstitial nephritis (AIN). The diagnostic accuracy of this test has not yet been defined. It is the purpose of this study to define the…

A systematic approach to the successful investigation and management of oliguria uses a reproducible method called the Rules of Three: consideration of three sources of olguria (postrenal, prerenal, and renal), three noninvasive tools for evaluation…

Detection of renal vascular disease offers the opportunity to cure a patient with hypertension as well as to avert severe renal damage and lifelong dependence on dialysis. The crucial first step is to suspect renovascular lesions. Clues include the…

Percutaneous transluminal angioplasty and renal artery bypass surgery are the most effective means of treating renal vascular disease and the hypertension it causes. Selection of the most appropriate treatment depends on the nature of the underlying…

Autosomal dominant polycystic kidney disease (ADPKD), the most common inherited disorder in this country, is more than just a renal disease. Major extrarenal sites are the cardiovascular system, liver, and GI tract. The most devastating…

Hypomagnesemia may be caused by renal losses (often related to drugs or diabetes), inadequate intake or inadequate intestinal absorption. Manifestations may include arrhythmias, particularly during myocardial ischemia or with digitalis use, and such…

Early detection and careful management of kidney disease can help slow or halt progression to renal failure. Early diagnosis is based on a history and physical examination, urinalysis (with dipstick testing for protein, blood, and pH), and…

Abnormalities that increase water reabsorption can lead to hyponatremia, and the resulting water retention presents the threat of CNS volume changes. Avoid overcorrection of hyponatremia, however, as this causes similar changes. Also, be aware of…

Four cases histories illustrate the process of defining the cause of hyponatremia: Categorize the patient's volume status; determine kidney function and kidney's response to volume stimulus; measure urine osmolality; consider other factors, including…

When a patient's total serum calcium level drops below 8.9 mg/dL, first determine whether the hypocalcemia is real. Measure the serum level of ionized calcium or (because 40% of calcium is bound to protein) adjust the total serum calcium level for…

The interpretation of acid-base data can be greatly facilitated by applying five rules: (1) use the blood gas to identify acidemia or alkalemia, (2) determine whether the underlying cause of acidemia or alkalemia is respiratory or metabolic, (3)…

Thorough investigation of complex cases of acid-base disturbances indudes verification of pH, determination of respiratory and metabolic components, calculation of the anion gap, assessment of the degree of compensation; and analysis of the…

Decisions which determine the duration and outcome of terminal care should be influenced by patient autonomy. Studies suggest, however, that end-of-life decision-making is more complex than a single principle and that physicians may be responsible…

This article demonstrated a systematic approach to acid-base problem solving through the application of the so-called "Rules of Five." This technique was compared with other options for acid-base problem solving, namely, clinicians' use of gestalt or…

Several recent studies have provided evidence that gonadal steroid hormones can exert acute (nongenomic) effects on both neural and vascular tissues. This study examines the acute effects of testosterone (T) on vascular reactivity of the rat thoracic…

The second most common cause of hypercalcemia is humoral hypercalcemia of malignancy (HHM), a condition associated with increased mortality. Although hypercalcemia is usually seen in squamous cell cancers, only 13 cases have been described in…

A controlled randomized double-blind study was done to determine the frequency and severity of leg cramps in 40 patients on dialysis with a history of leg cramps. All patients entered a 2 month placebo washout and were randomized into a 2 month…

PURPOSE: To evaluate chart review as a method of assessing residents' performances of physical examinations in an ambulatory care setting. METHOD: In 1992, nurse authors at the Affiliated Hospitals at Canton of the Northeastern Ohio Universities…

Enterovesical fistula is a rare complication of a variety of inflammatory and neoplastic diseases. It usually presents with pneumaturia, fecaluria, urinary tract infections, or irritable bladder symptoms in the setting of either diverticulitis or…
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