Medicine and Health Sciences Commons^™

A Patient With Aids, Susan Ball, Md, Stephen Hauptman, Do, Jean Helz, Md, Sheila Murphey, Md, Beth Shindell, Mss

Jefferson Journal of Psychiatry

Susan Ball , M.D.. Chief Resident: Mr. B, a thirty-five-year-old white male, was admitted to the medical service with chief complaints of fever, chills, and increasing shortness of breath. This was Mr. B's second admission. His first was six month s ago for pneumonia, leukopenia, and lymphadenopathy of unknown etiology. At that time he was treated with antibiotics; he improved and was discharged. Since that time Mr. B reported continuing to feel weak and lethargic. Two weeks before this admission he noted the onset of fever, chills, sore throat, and a nonproductive cough. He initially saw …

Resistant Thyrotoxicosis In A Patient With Graves Disease: A Case Report, Taimur Saleem, Aisha Sheikh, Qamar Masood

Section of Diabetes, Endocrinology and Metabolism

Background: Conventional management of thyrotoxicosis includes antithyroid drugs, radioactive iodine, and surgery while adjunctive treatment includes beta-blockers, corticosteroids, inorganic iodide and iopanoic acid. Very rarely, patients may be resistant to these modalities and require additional management.

Case Presentation: A 50-year-old lady presented with weight loss and palpitations diagnosed as atrial fibrillation. Her past history was significant for right thyroid lobectomy for thyrotoxicosis. Thyroid functions tests at this presentation showed free T4 of 6.63 ng/dl (normal range: 0.93-1.7) and TSH of <0.005 μIU/mL (normal range: 0.4-4.0). She was given aspirin, propranolol, heparin and carbimazole; however free T4 failed to normalize. Switching to propylthiouracil (PTU) did not prove successful. She was then given high doses of prednisolone (1 mg/kg/day) and lithium (400 mg twice daily) which prepared the patient for radioactive iodine treatment by reducing free T4 levels (2.82 ng/dl). Two doses of radioactive iodine were then administered 6 months apart. Subsequently she became hypothyroid and was started on thyroid replacement therapy.

Conclusion: This case highlights management options in patients with resistant thyrotoxicosis. Radioactive iodine and surgery are definitive modes …

Patient Perspectives Of Physicians' Compliance Gaining Strategies, Margaret Malinda Lambert

Theses, Dissertations and Capstones

This research examined strategies used by physicians for compliance gaining and patient responses to those strategies. Respondents were surveyed regarding their expectations about strategies physicians would use to gain compliance with requests related to changing lifestyle behaviors and how the respondents anticipated they would respond to physicians. Findings revealed that patients did anticipate specific persuasive strategies from physicians and anticipated responding in specific ways. Most respondents expect expertise strategies from physicians and plan to comply. Expertise strategies, however, were also linked with patients who planned to defy or ignore their physicians’ requests. Findings suggest that future research into why patients …

The Older Patient, The Doctor And The Trainee: Patients' Attitudes And Implications For Models Of Care, Andrew Bonney, Sandra Jones, Donald Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

Aims & rationale/Objectives Population ageing poses major challenges for health systems. Additionally, training future general practitioners in the management of older and chronically ill patients is potentially hampered by the reluctance of these patients to consult trainees for chronic care. This paper reports a cross-sectional study investigating the attitudes of older patients to trainees, to inform strategies to improve older patient-trainee interaction. Methods The survey instrument was distributed to 1900 patients aged 60 and over from 38 training practices from five Australian states using a stratified, randomised cluster sampling process. Generalised estimating equation models were used for analysis. Principal findings …