Biomedical subjects

E Kligman

Publications and source records attributed to E Kligman.

6 recordsLinked to original sources

PubMed1997

Effects of nicotine dose and administration method on withdrawal symptoms and side effects during short-term smoking abstinence.

The effects of using several nicotine replacement treatments on self-reported withdrawal symptoms and side effects during 2-day periods of smoking cessation, with 5 days of ad lib smoking between cessation days, were evaluated. Participants (N = 18) experienced the following conditions: nicotine gum, 24-hr patch, 16-hr patch, 24-hr patch plus gum, double 24-hr patch, and no nicotine replacement. The present study found morning urge to smoke was greater during the 16-hr than during the 24-hr patch condition. Double-patch use resulted in significantly greater insomnia than the smoking baseline and 16-hr patch conditions. The no medication and gum alone conditions resulted in similar withdrawal symptoms, and both tended to result in greater reported withdrawal symptoms than the smoking baseline condition. There were no significant withdrawal symptom differences between the 24-hr, patch-gum, and double-patch conditions. The 24-hr and double-patch conditions were preferred by two thirds of the participants (6 each).

Administration, Cutaneous↗

PubMed1991

Preoperative screening for perioperative cardiac risk.

Preoperative screening for potential cardiac complications is crucial in making rational decisions about surgery. A number of classification schemes are available to aid the primary care physician in assessing a patient's perioperative cardiac risk. In general, these schemes enable the physician to place patients in low-risk, moderate-risk and high-risk categories. Patients at low risk can often be safely referred for surgery with minimal preoperative evaluation, while those at potentially high risk frequently need further assessment and medical or surgical treatment of cardiac disease prior to surgery. The classification schemes are most accurate in identifying patients at high risk for perioperative cardiac complications. However, patients with silent underlying cardiac disease are often underclassified with respect to potential risk. For those patients, accurate prediction of perioperative cardiac complications can be challenging.

Health Status↗

PubMedDate not supplied

Primary polycythaemia vera in the elderly.

At presentation the history of an 87-year-old woman included progressive memory loss, repeated transient ischaemic attack, increasing fatigue, dizziness, palpitations and frequent falls. Investigations revealed erythrocytosis, leukocytosis, thrombocytosis, normal arterial oxygen concentration and an increased red cell volume. Polycythaemia vera was diagnosed and was successfully managed by phlebotomy with half a unit twice a week and rechecks of her haematocrit, initially; she reported marked improvement after 2 weeks of treatment. The alternative treatments for polycythaemia vera are discussed; in addition to venesection, conventional treatments include bone-marrow depressive agents such as phosphorus-32 and chemotherapy with agents such as hydroxyurea. More recent developments include isovolumic erythrocytophoresis, alpha-interferon and ticlopidine. All of the treatments are associated with complications, or other disadvantages, thrombotic complications in the case of phlebotomy, malignancies in the case of most myelosuppressive treatments, and problems of compliance in others. The optimal treatment for polycythaemia vera is a judicious combination of the alternatives, depending on the phase of the disease, the age of the patient, and other prognostic factors.

Aged↗

PubMedDate not supplied

Friedreich's ataxia in the elderly.

Friedreich's ataxia is one of the best defined and most common forms of hereditary ataxia of unknown aetiology. It is transmitted in an autosomal recessive manner, appearing sporadically, usually in childhood or adolescence. The case of an elderly patient with a possible diagnosis of late-onset Friedreich's ataxia is reported; this is thought to be the only such case in the literature. The 91-year-old Anglo female presented with ataxia that had been progressive over the last 5 years. Magnetic resonance imaging scans of the head revealed mild peripheral cerebellar atrophy and moderate cerebral atrophy. The patient's parents were unaffected but two of her six siblings had had Friedreich's ataxia starting in childhood, and four of her grandfather's siblings had had an undiagnosed illness that left them in wheelchairs early in life. Friedreich's ataxia was diagnosed in view of the strong family history and non-revealing magnetic resonance imaging of the brain.

Age of Onset↗

PubMedDate not supplied

Meanwhile back at the ranch: training residents in clinical preventive medicine.

In view of the current growing interest in prevention as an integral part of health care, it is timely to consider clinical preventive medicine (CPM) training approaches that best prepare physicians to deliver appropriate and effective preventive services. During CPM training, skills residents most need to acquire include methods of counseling on health promotion and techniques for advising patients on reducing health risks by changing disease-promoting behavior. University of Arizona residents in the General Preventive Medicine program receive this training focus at Canyon Ranch, a Tucson health resort and university training site. This training is an important component of the CPM area of emphasis in the residency program. Training emphasizes risk reduction and health promotion with a large volume of patients whose aim is to effect lifestyle changes. Emphasis is placed on acquiring skills in clinical prevention. Counseling and patient education are the primary foci. Evaluation data indicate that residents' perception of the rotation's benefit to their education is high, and interest in considering practice in a similar setting is reinforced as a result of the experience. Medical educators in preventive medicine and primary care need to turn their attention to finding appropriate training sites with suitable role models to teach counseling and patient education skills.

Arizona↗

PubMedDate not supplied

Alternative medicine.

Much attention is given to alternative and complementary therapies by the media and our patients. Well over 40% of the US population uses some form of unconventional (not allopathic or osteopathic) medical care. This feature focuses on the role of spirituality and other mind-body therapies in healing.

Complementary Therapies↗