ABSTRACT
The use of stress-testing modalities after angioplasty or bypass has been an area of discussion and research since the advent of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG). Issues of when to do which test, and if any, in asymptomatic or symptomatic patients, are not resolved. Stress imaging ETT plays a larger role in this population, but task forces stop short of coming out with any frequency of testing. Cost-effective strategies have not been explored. This article attempts to summarize the results in the literature.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Artery Bypass , Exercise Test/methods , Humans , Postoperative Care , Practice Guidelines as Topic , Primary Health CareABSTRACT
BACKGROUND: Acute low back pain is the fifth most common reason for physician visits. Multiple treatment options are available, but not all physicians and patients are satisfied with the results. This study evaluated treatment outcomes from patients' perspectives using standardized measures. METHODS: 368 patients with acute low back pain were enrolled in the study. Only 128 participants (35%) completed all 4 health outcome questionnaires (administered at baseline, 6 weeks, 3 months, and 1 year). RESULTS: Most participants reported improved health at 1-year follow-up,, with the most significant gains achieved by 3 months. However, 40% were not satisfied with their outcome. Patients with radicular low back pain scored lower on health outcome measures than patients without radicular symptoms. CONCLUSION: A sizeable percentage of patients with acute low back pain progress to chronic pain despite therapeutic intervention. Patients with radiculopathy may require nonstandard treatment to avoid unfavorable outcomes.
Subject(s)
Low Back Pain/therapy , Outcome Assessment, Health Care , Acute Disease , Adult , Female , Health Status Indicators , Humans , Male , Patient Satisfaction , Societies, Medical , Surveys and Questionnaires , WisconsinSubject(s)
HIV Infections , Pregnancy Complications, Infectious , Anti-HIV Agents/therapeutic use , Female , HIV Infections/diagnosis , HIV Infections/drug therapy , Humans , Mass Screening , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/drug therapy , Risk Factors , Zidovudine/therapeutic useABSTRACT
More than ever before, exercise stress testing (EST) has become a focus for primary care physicians. But there are definite indications and contraindications for EST administration. Criteria may include when cardiology referrals should be made and what role the family physician should play in follow-up with coronary artery disease patients. There also are considerations for using EST for individuals with atypical chest pain or with patients after bypass surgery, angioplasty, or the coronary artery disease diagnosis. There even are distinct criteria for administering EST to women. This article will attempt to examine the numerous factors surrounding EST's growing use by primary care physicians.
Subject(s)
Coronary Disease/diagnosis , Exercise Test , Family Practice , Contraindications , Coronary Disease/prevention & control , Exercise Test/statistics & numerical data , Family Practice/standards , Family Practice/trends , Female , Humans , MaleABSTRACT
The potential toxicity of theophylline preparations are well known, yet little attention has been paid to over-the-counter medications containing theophylline. We report the case of a 44-year-old woman who presented with toxic effects of theophylline secondary to the use of an over-the-counter product for asthma. Many physicians may be unaware of the over-the-counter products that contain theophylline and may not be counseling their patients about potential risks associated with these medications.
