Migraine, an underrecognized and undertreated neurologic disorder, has a prevalence of 15% to 17% in women, 5% in men, 5% in children, and 10% in adolescents. It is characterized by episodic, unilateral, pulsating or throbbing headaches that are often accompanied by nausea, vomiting, photophobia, and phonophobia (also olfactophobia), and is aggravated by physical activity (Table [...]
Continue reading " Delivery systems for acute migraine medications "
Repetitive strain injuries (RSI) can be defined as injuries caused or aggravated by repetitive or sustained submaximal exertion of the body’s soft tissue structures including muscles, tendons, ligaments, and nerves. Of particular concern is the increasing prevalence of RSI in the workplace. Not only are these injuries associated with personal morbidity and direct costs to [...]
Continue reading " Chronic occupational repetitive strain injury "
The 1996-1997 Annual Report of the South Central Health District of Saskatchewan indicates that the average length of stay in hospital for newborns has decreased over the past 5 years. This reflects both Canadian and American trends. Few studies consider rural areas, however, and national data are likely skewed by the large proportion of urban [...]
Continue reading " Reducing length of hospital stay for newborns in Saskatchewan "
Your face is full of attention, full of listening. How I remember that face!…. How you trusted your power of listening, your state of attention…. I know now that this is why you devoted yourself to medicine…. —Jacob Needleman … well, interesting that you should ask, but, yes, there have been several such incidents that [...]
The idea of andropause (“male menopause”) has received widespread attention in the popular and medical press in the last few years. As men age, total testosterone levels decline gradually and concentrations of free and bioavailable testosterone decline sharply with each decade beyond the 30s. Aging men often begin to experience symptoms such as sexual dysfunction [...]
Continue reading " Andropause. Testosterone replacement therapy for aging men "
Level I evidence shows that continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) are effective for preventing intubation and saving the lives of carefully selected patients with acute respiratory failure. This article attempts to review this evidence. We began by searching the literature, using OVID, looking for all randomized studies of congestive [...]
Continue reading " Use of CPAP and BiPAP in acute respiratory failure "
In 1991, Frank A. Lederle identified highdose oral vitamin B12 (cobalamin) treatment for pernicious anemia as “medicine’s best kept secret.” Lederle noted that only mg of cobalamin is required for daily metabolic functions. Because 2.0% of oral vitamin B12 is absorbed by small bowel mucosa independent of intrinsic factor or the terminal ileum, a daily [...]
Continue reading " Vitamin B12 injections versus oral supplements "
