Assuntos
Metformina/efeitos adversos , Neoplasias/induzido quimicamente , Nitrosaminas/efeitos adversos , Padrões de Prática Médica , Preparações de Ação Retardada/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Indústria Farmacêutica/ética , Indústria Farmacêutica/legislação & jurisprudência , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Humanos , Hipoglicemiantes/uso terapêutico , Metformina/administração & dosagem , Nitrosaminas/administração & dosagem , Segurança do Paciente/legislação & jurisprudência , Relações Médico-Paciente , Padrões de Prática Médica/ética , Padrões de Prática Médica/legislação & jurisprudência , Reino Unido , Estados UnidosRESUMO
A questionnaire survey, combined with an observational study, evaluated the knowledge of doctors in training grades on the practical aspects of blood pressure measurement. Eighty (non-consultant) junior hospital doctors, graduates from 30 separate medical schools, participated in the study. The results show that 27 (33%) doctors acknowledged no formal education on how to measure blood pressure. This lack of precise theoretical knowledge was matched by an observed poor clinical technique in over one third of the study group. The precision and accuracy of blood pressure recording is fundamental to the clinical examination of patients, and crucial in their management in both hospital and community settings. The findings of this study support the urgent need for further training and assessment of blood pressure measurement at undergraduate, and postgraduate level.
Assuntos
Determinação da Pressão Arterial/normas , Competência Clínica , Corpo Clínico Hospitalar/normas , Humanos , Corpo Clínico Hospitalar/economia , Inquéritos e Questionários , Reino UnidoRESUMO
To evaluate how steroid trials are currently used in the assessment of reversibility of air flow limitation, a postal questionnaire was sent to 355 consultant members of the British Thoracic Society working in England and Wales; 253 questionnaires were returned (71% response rate). Two respondents did not undertake steroid trials; of the remaining 251, 75% prescribed 30-40 mg oral prednisolone, with the commonest treatment period being 2 weeks. A high dose steroid inhaler was sometimes used as an alternative by 31% of respondents. Although 71% of respondents made lung function measurements on several occasions before starting steroids and 76% made measurements during treatment, 78% assessed patients on only one occasion at the end of the trials to ascertain its outcome. Weight, blood pressure and glycosuria were measured less frequently after the steroid treatment compared to the pre-trial period. Blood glucose and serum electrolytes were infrequently measured both before and after treatment. Wide variations exist in steroid trial regimens and current practice may neither provide definitive evidence of treatment benefit nor an adequate safeguard for patients against potential side-effects.
