Your CE topic (No. 47). Therapeutic fiber: its role in disease treatment and prevention.
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Biomedical subjects
Publications and source records attributed to H M Silverman.
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Emergency department patients are believed to have high rates of noncompliance with instructions to obtain follow-up care. A study of emergency department patients at a medium-sized community hospital without clinics showed that compliance is better than rates previously published for hospital follow-up clinics. There was significantly less compliance by patients referred to an unknown on-call physician (59.4%) compared with patients referred to their own private physicians (83.7%) or back to the emergency department (73.2%). Compliance improved (79.2%), however, when the emergency physician discussed the case with the on-call physician and the patient was so informed. This phone call significantly increased the likelihood of compliance by one third. The phone call served as an introduction and a liaison between the patient and the on-call physician. The major reason for noncompliance with advised follow-up was that the patients "felt better" or didn't "feel it was necessary" (36%), rather than "expense" or "inability to get appointment in time" (8%).
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Four patients who had experienced a cimetidine-theophylline interaction are reported. All patients displayed decreases in theophylline elimination after the introduction of cimetidine. Clearances approached baseline values when cimetidine was discontinued. Patients on this drug combination should be monitored closely for signs of theophylline toxicity. When indicated, a beta agonist may be a better choice of a bronchodilator for peptic ulcer patients.
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Chloramphenicol, introduced over 30 years ago, enjoyed instant popularity due to antimicrobial effectiveness. However, serious blood dyscrasias soon became apparent.
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A computerized pharmacy system dealing with drug distribution, clinical services and administrative services is described. Present systems, implemented for 50% of the institution's beds, are discussed fully. Future applications of the system are outlined.
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