PubMed Health⌕ Search

Biomedical subjects

R C Forbes

Publications and source records attributed to R C Forbes.

7 recordsLinked to original sources
PubMed1995

Initial management of the patient with newly diagnosed diabetes.

A family physician is often the one who makes an initial diagnosis of diabetes. The physician must consider the impact of this diagnosis on both the patient and the patient's family members. Outpatient management is less costly and less traumatic for the patient than inpatient care. Initial management goals are control of hyperglycemia, correction of fluid and electrolyte imbalances, and avoidance of hypoglycemia. For patients with type I (insulin-dependent) diabetes, the initial insulin dosage ranges from 0.25 to 1.0 U per kg per day. For patients with type II (non-insulin-dependent) diabetes, standard therapy begins with dietary modifications, exercise and an oral hypoglycemic agent, if needed. Insulin is indicated in patients with type II diabetes during times of acute stress, infection, surgery and pregnancy, and if the patient is allergic to sulfonylureas. Initially, patients only need to have a basic understanding of glucose monitoring, medications, diet and symptoms of hypoglycemia. Simple instructions can help the patient achieve glycemic control without being overwhelmed with information. As the patient learns more about diabetes and the treatment regimen, therapy can become more intensive.

Adolescent↗
PubMed1995

Allergic rhinitis.

Allergic rhinitis commonly manifests for the first time in childhood or adolescence with seasonal or perennial sneezing, rhinorrhea, nasal congestion, and pruritus of the nose, eyes and throat. The nasal mucosa are pale blue and boggy, with a clear discharge. Patients should be instructed to avoid breathing tobacco smoke, to remove bedroom carpeting, to use foam pillows, to enclose mattresses and box springs in plastic covers, to keep house windows closed and to reduce indoor humidity by using air conditioning. If these avoidance procedures, together with oral and ocular antihistamines and/or decongestants, do not provide relief of symptoms, intranasal corticosteroids and cromolyn may be prescribed. Pharmacotherapy is more effective if it is used prophylactically. Second-generation antihistamines may reduce sedative and anticholinergic side effects. Intranasal decongestants should be used for only three to four days. Immunotherapy is appropriate for patients who remain unresponsive to therapy. Intranasal cromolyn should be the first drug considered in the treatment of pregnant women.

Diagnosis, Differential↗
PubMed1994

Efficacy of sliding-scale insulin therapy: a comparison with prospective regimens.

OBJECTIVE: To compare the efficacy of retroactive sliding-scale insulin therapy, proactive therapy, and a combination of the two methods in establishing glycemic control in hospitalized diabetic patients. METHODS: Medical records of 47 diabetic ketoacidosis inpatients were reviewed retrospectively. RESULTS: The sliding-scale insulin therapy group's glucose deviation score (167.4) was significantly higher than the deviation for the proactive (112.9) and combination (121.3) groups. The sliding-scale insulin therapy group also had a significantly higher median glucose value (262.5) than the proactive (199.9) and combination (221.2) groups as well as a significantly higher number of nursing shifts (0.70) in which a glucose of 250 mg/dl or greater was recorded than in the proactive (0.37) and combination (0.40) groups. The proactive group was on their treatment regimen significantly less time than the combination group (5.5 vs 10.4 nursing shifts, respectively). The proactive group was hospitalized significantly fewer days (4.4) than the combination (6.3) and sliding-scale insulin therapy (6.3) groups. CONCLUSIONS: The present study lends support to previous concerns that sliding-scale insulin therapy is less effective than preventive therapy in the management of hospitalized diabetic patients.

Acid-Base Equilibrium↗
PubMed1994

Mississippi: who's staffing our emergency departments?

Emergency services in Mississippi have come under scrutiny over the past few years. As part of a summer research project, we surveyed all 88 Mississippi emergency departments available to the public to determine physician staffing characteristics. At four times during one week (10 a.m. and 10 p.m. on a Tuesday and a Saturday), we determined whether a physician was present, their specialty, board certification/resident status, and whether they were from the community. Our paper presents and discusses the findings.

Emergency Service, Hospital↗
PubMed1992

Graduate follow-up in the University of Mississippi family practice residency program.

Practice profiles in 120 University Medical Center Department of Family Medicine residency graduates were assessed by questionnaire and follow-up telephone calls. Physician credentials, career satisfaction, and evaluation of residency training were also addressed. Findings include some preferences for partnership or group practice settings and practices in communities of less than 25,000. Eighty percent of graduates remain in Mississippi, and most are satisfied with their careers and the residency training they received. Changing patterns in areas such as obstetrical care provided and Medicare/Medicaid acceptance suggest new surveys may be needed to provide the department with information that will assist in meeting its goals.

Adult↗
PubMed1988

Immunization of the elderly. A vital part of routine healthcare.

The vaccines recommended for routine use in healthy elderly persons (influenza vaccine, pneumococcal vaccine, tetanus-diphtheria toxoid) have benefits far outweighing any risks, yet they are under-utilized. Every patient visit to a healthcare provider presents an opportunity for assessment of the patient's immune status, but preventive care for the elderly is often neglected. Elderly patients are willing to change their habits to maintain good health. The success of any program aimed at protecting this age-group is dependent on a change in habit by the physicians and institutions that provide their healthcare.

Adult↗