Showing papers in "Canadian Family Physician in 1973"

Family therapy and the family physician.

Abstract: The purpose of this research paper is to look at family therapy as a technique for dealing with emotional problems in family medicine. It consisted of a non-randomized cohort study utilizing the patients at McMaster University Clinic. There were 42 families involved in the study group and they were matched with a control group. The results indicated that patients treated by means of family therapy placed 50 percent fewer demands on the physician and clinic than patients in the control groups treated with medication and/or psychotherapy. It also revealed little difference in the mix of complaints and diagnoses before and after family therapy. The study looks at complaints before and after diagnosis, before and after treatment, and the frequency of visits as a means of indicating whether there has been some improvement in the patient. It is hoped by this technique to provide a very easy method of researching this type of problem in an active community practice.

A family approach to emotional problems of children.

Abstract: Children are much more aware of and responsive to changes or distortions in family relationships and feelings than parents realize. An emotional problem in a particular child is frequently a reflection of emotional problems elsewhere in the family system. The simple act of bringing together the entire family to discuss these problems openly has significant therapeutic impact. An understanding of the systems model and familiarity with a few basic techniques greatly enhance the effectiveness of the family interview.

High dose oral isosorbide dinitrate and ischemic heart pain: a preliminary report.

Abstract: During the past two years, the author has treated 50 patients with angina pectoris, acute coronary insufficiency and acute myocardial infarction with high-dose oral isosorbide dinitrate. The daily dosage used varied between 120 and 360 mg daily, in contrast to the very small doses (10 mg tid and hs), usually recommended by the manufacturer and by many physicians. Previous articles in the literature suggest that oral isosorbide dinitrate is not effective in the prophylaxis of anginal pain. However, there are strong differences of opinion on this point, and our experience suggests that the lack of effect has been the result of the small dosage recommended. A double-blind cross-over study with placebo control and objective measurements of the degree of myocardial ischemia, is under way and will be reported in due course.

The burlington experience: a study of nurse practitioners in family practice.

Abstract: Two family practitioners in a suburban area measured the effects of introducing nurse practitioners into their established practices. The manner in which the two practicing physicians, without special research training, became involved in such a study is presented, showing that family doctors have a unique contribution to make in studies on health care delivery. The attitudes and changing roles of the health professionals involved are discussed.

Exercise versus hypnotherapy in coronary rehabilitation.

Abstract: Over a two year period a group of 31 post-myocardial infarction patients were subjected to an exercise rehabilitation program of gradually increasing intensity and duration. At the same time a group of 14 similar patients were given a non-active program utilizing the teaching of autohypnosis to achieve a more relaxed lifestyle. Individuals were randomly allocated to each group. Only those exercisers capable of achieving and maintaining a heavy training program showed tangible gains of cardiorespiratory fitness in all parameters measured. Those who achieved a moderate level of training showed improvement in some indices, but regressed in others; their overall improvement was no better than the inactive group.

Drug-related problems and the physician: the calgary experience.

Abstract: Experiences of a sample of Calgary physicians treating drug-related problems are described. Family physicians and specialists are compared on number of cases seen, by type of drug problems. Difficulties in treating or managing people with such problems, suggestions for overcoming difficulties, suggestions for improving treatment and prevention of drug-related problems in Calgary, and attitudes toward such problems are also reported.

A study of children with cerebral palsy.

Abstract: The Ontario Crippled Children's Centre was opened in 1962 to provide rehabilitation services for children with any type of physical disability. During 1970, 451 children with cerebral palsy were registered at the Centre and this paper reports the results of a survey of their charts.

Exercise prescription and the risk of sudden death.

Abstract: Sudden and unaccustomed physical activity may precipitate ventricular fibrillation, myocardial infarction, and sudden death. Evidence supporting this contention is drawn from a review of physiopathology, reported antecedents of infarction and death, and the experience of exercise test centres and gymnasia. The risk of precipitating ventricular fibrillation in a coronary-prone population may be as high as two episodes per 1,000 man hours of physical activity. Such an incidence has important medico-legal implications for fitness test centres and gymnasia. Despite the challenge of devising an exercise prescription that will avoid these hazards, current evidence suggests the long term effects of increased physical activity improve the prognosis of the coronary-prone individual.

What is Wrong With the Current Psychiatric Medication

Abstract: Some common aspects of the misuse of psychotropic drugs are discussed against the background of disparate development of psychiatric and medical sciences Particular attention is granted the anxiolytic agents, antidepressants, and neuroleptic drugs, and the related psychiatric conditions are considered correspondingly Popular errors in applying psychiatric medication are thus discussed with their adverse consequences

The Family Physician's Role in Treating Strabismus.

Abstract: If the practitioner notices that a baby's eyes have started to turn in, or that they do not focus properly, the condition should be investigated. It might be a tumor or some other pathological condition and early diagnosis and treatment are important. If the child blinks, closes one eye in the sun, the eyes become red, or he appears to have difficulty in seeing, he should be referred for thorough examination and treatment.

Sterilization and abortion counselling for retarded patients.

Abstract: The family physician encounters an incredible number of psychosocial problems in his practice. One of the most sensitive and difficult is providing counselling in the areas of sterilization and therapeutic abortions. It is even more difficult when the patient is mentally retarded or when you are working with a family which has a retarded member. This article will attempt to provide some basic guidelines for the family physician who has to meet this challenge.

The role of hypnotic suggestion in acupuncture.

Abstract: Any form of treatment has some degree of psychosomatic component. A study of the role of hypnotic suggestion in acupuncture was done in a double-blind study setting, which revealed there were minimal effects of hypnosis and/or power of suggestion. Two cases are reported for further illustration.

Child abuse is a family social disease.

Abstract: Child maltreatment is a social disease due to a breakdown in family dynamics and parent child relationships. The family doctor is closest to the family. As such he is the most suitable and effective professional for the prevention and management of the syndrome. This article outlines the types of injury common to this syndrome, with frequently heard complaints from parents.

Beyond the Scribbled Note

Abstract: A good record system is fundamental to good care. The problem-oriented approach provides a scientific format for identifying and recording the course of a patient's problems. Starting with a defined data base, the physician formulates a complete problem list and initial plans of management. The progress notes record the feedback and revised decisions on each problem. This system has profound implications for improved care, medical education and research.

Psychoactive drug prescribing in clinic and private practice.

Abstract: Privately practicing physicians, mainly family practitioners, were found in 1966 to prescribe psychoactive drugs somewhat differently from various types of outpatient clinic. Differences could be accounted for in part by differences in clientele, which are described. At that time, psychiatric clinics were considerably more wary of barbiturates and amphetamines than the private physician, or the medical or other outpatient clinics. There are indications of a current trend in private prescribing away from sedatives and hypnotics, and toward the minor tranquilizers and antidepressants. Prescription of amphetamine-containing drugs has also decreased, though not of phenmetrazines. Private physicians (and even more so the outpatient clinics) prescribed barbiturates, antidepressants and meprobamate in quantities far beyond the massive dose. A cost-benefit analysis is suggested.

Recognizing Bell's Palsy: What the Family Physician Should Know.

Abstract: This article discusses the etiology, diagnosis and management of Bell's Palsy, stressing the beneficial results of steroid therapy with large doses of Prednisalone. Differential diagnosis, investigative procedures, and indications for surgery are outlined.

Caring for the pregnant diabetic.

Abstract: The perinatal mortality and morbidity associated with diabetes is too high. The importance of history and glucose tolerance test in making the diagnosis is stressed. Once the diagnosis is made an expert team should tend the mother and child. Particular attention should be directed towards a good diet and vigorous insulin therapy.

Hepatitis - an occupational hazard in health-care personnel.

Abstract: Viral hepatitis represents an increasing risk for health care personnel, largely due to the spread of parenteral drug abuse. While regular monitoring of high risk health care workers is a good research project, there is little evidence to show whether it is of practical value. General prophylactic and hygienic measures are still the best methods of preventing the spread of the disease.

The coronary patient: a psychosocial glimpse.

Abstract: At a time when great emphasis is being placed on revolutionary treatments and preventive techniques in the area of coronary and heart disease, the human perspective of the patient may tend to be blurred. The family physician has a unique position via an increased knowledge of psychosocial aspects to be a bridge for his patient between technological advance and the human aspect of medicine.

The unhappy fat woman.

Abstract: Obesity is a psychosomatic illness; treating the emotional illness first gives a much better chance of success in weight reduction. In this study, older, fatter, calmer and happier, more realistic patients with fewer associated illnesses did best of all (37 lb. weight loss).