Abstract：
:Guidelines for pain management in adult sickle cell patients with vaso-occlusive crises suggest prompt, frequent administration of parenteral opioids. Neither the ability to implement these guidelines in a busy urban emergency department nor opioid dose requirements in uncomplicated vaso-occlusive crisis have been previously documented. Thus, a retrospective review of vaso-occlusive crisis treated in an urban medical center emergency department in 2005 was performed to define opioid requirements and barriers to guideline implementation. Fifty-seven visits by 19 patients were evaluable. Opioid treatment was not initiated for more than 2 hours during 30% of visits; the interval between the first and second opioid doses exceeded 1 hour in 26% of visits and increased with subsequent doses; and total treatment time was less than 1 hour during 21% of visits (median, 2.2 hours). Opioid doses (as intravenous morphine equivalents) ranged from 4 to 26.7 mg (0.05-0.50 mg/kg) and exceeded 10 mg during 40 visits (70%) and in 10 patients (53%). Hospitalization occurred on 25 occasions with 48% of patients admitted after 3 or fewer opioid doses and 50% of patients admitted after less than 3 hours of treatment. Moreover, return emergency department visits occurred within 3 days after 9 of 32 home discharges (28%) with treatment times uniformly less than 3 hours during the preceding visit. It is concluded that: (1) opioid dose requirements vary widely, often exceeding guideline recommendations; and (2) treatment time and timely opioid administration are often compromised, resulting in delayed pain control and premature decisions on disposition with early return visits and possibly avoidable hospital admissions.
journal_name
J Natl Med Assocjournal_title
Journal of the National Medical Associationauthors
Solomon LRdoi
10.1016/s0027-9684(15)30729-xsubject
Has Abstractpub_date
2010-11-01 00:00:00pages
1025-32issue
11eissn
0027-9684issn
1943-4693pii
S0027-9684(15)30729-Xjournal_volume
102pub_type
杂志文章abstract：BACKGROUND:Hypertension is associated with left ventricular diastolic function abnormalities. There have been few studies evaluating left ventricular diastolic function in an African populace. MATERIALS AND METHODS:Ninety-eight hypertensives (52 females, 46 males) and 99 normal controls (49 females, 50 males) were rec...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2005-01-01 00:00:00
abstract：:Opioid use disorder (OUD) constitutes a significant public health burden as opioid overdose deaths have continued to rise in the United States. Although treatment modalities are available to manage OUD, some patients experience challenges achieving their OUD management goals. Some of these challenges may be attributab...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/j.jnma.2019.09.006
更新日期：2019-12-01 00:00:00
abstract：:Painful palmar and plantar erythema is an uncommon systemic complication of chemotherapy and has been reported in association with methotrexate, cystosine arabinoside, doxorubicin, and 5-fluorouracil. The authors report a case in which the syndrome was precipitated by hepatic artery infusion of 5-FUdR. The previous re...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1987-06-01 00:00:00
abstract：BACKGROUND:Physician diversity is linked to improved quality of care of diverse patient populations. The transition from medical school to residency is an opportunity to improve and increase workforce diversity in all specialties. However, there is limited published literature on the factors contributing to the ranking...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/j.jnma.2019.09.002
更新日期：2019-12-01 00:00:00
abstract：:This study examined the clinical characteristics and outcome of pulmonary tuberculosis in African Americans hospitalized in a teaching hospital in south-central Los Angeles from May 1992 through April 1994. The charts of 41 African Americans with culture-positive Mycobacterium tuberculosis were reviewed. Predisposing ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1998-02-01 00:00:00
abstract：:Loss of integrity of the thoracic duct will produce a chylous thoracic effusion. latrogenic chylothorax occurring during an intrathoracic surgical procedure in the vicinity of the thoracic duct is an omnipresent reality. The fluid is characteristically milky in appearance, sterile, and high in fat content.There seems ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:This article examines the validity of the National Institute of Mental Health Diagnostic Interview Schedule (DIS) relative to three of its measures: alcoholism, depression, and schizophrenia when compared with the clinical interview. Preliminary results indicate that greater diagnostic agreement was observed for alcoh...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：:Radiation therapy has been used for the management of breast cancer for many years. Traditionally, it has been an adjunct to the radical mastectomy, but in recent decades major centers have initiated studies replacing the mastectomy with a more limited surgical procedure and, at the same time, have increased the irrad...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1987-05-01 00:00:00
abstract：:The surgeon's responsibility to patients with colorectal cancer does not end with resection of the primary locoregional disease. The surgeon has a role to play in (1) designing and implementing strategies aimed at preventing recurrence, (2) early detection of recurrent disease, and (3) resective therapy of recurrent d...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章,评审
doi：
更新日期：1988-05-01 00:00:00
abstract：OBJECTIVES:To assess the prevalence of vitamin D deficiency among patients in an inner-city practice with a large African American population, and to evaluate the efficacy of vitamin D replacement as part of routine care. METHODS:A chart review was undertaken to identify patients aged 18 years and more with at least o...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/s0027-9684(15)30337-0
更新日期：2011-05-01 00:00:00
abstract：:An efficient, reliable, and immediate method of treating full-thickness skin avulsions of fingertips in an Emergency Room is presented. A series of patients are discussed. ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1978-04-01 00:00:00
abstract：:Relatively high serum albumin levels compared to low levels have been associated with reduced cardiovascular mortality and coronary heart disease and stroke incidence. The nature of these associations remains undefined. Therefore, widely accepted criteria of Bradford Hill were used to assess the likelihood that the as...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章,评审
doi：
更新日期：2000-01-01 00:00:00
abstract：BACKGROUND:While dramatic progress has been made lowering in-hospital mortality for coronary artery bypass graft surgery (CABG), few comprehensive studies have been done that include Caucasian, African-American, Hispanic and Asian-American/Pacific-Islander CABG inpatients and simultaneously evaluate the influence of ge...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2006-11-01 00:00:00
abstract：:The following is a review of the literature concerning hidradenitis suppurativa with emphasis on aspects of this disease which suggest that it may be a result of altered host-defense mechanisms.Deep fistula formation, anemia, and the development of carcinoma are complications seen only in disease affecting the periana...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1978-05-01 00:00:00
abstract：:Family medicine as a specialty has now "come of age." To maintain its new status, the specialty must be able to survive the vigorous assessment that is given other specialties by the public, the profession, and the academic community. One way of achieving this is for the family physician to do research of excellent qu...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1977-11-01 00:00:00
abstract：OBJECTIVES:Intimate partner violence (IPV)during pregnancy is a significant public health problem. Approximately 324,000 IPV victimizations occur during pregnancy each year. However, research on the impact of IPV on birth outcomes yields conflicting findings. This study examines the association of IPV with birth outcom...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/j.jnma.2017.06.017
更新日期：2017-01-01 00:00:00
abstract：:Pulmonary contusions following blunt trauma often are visible roentgenographically immediately after injury. The case presented illustrates the need for prompt x-ray studies of the chest following blunt injury. ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1984-04-01 00:00:00
abstract：:Seventy-eight patients with mediastinal abnormalities were imaged with magnetic resonance imaging (MRI) to evaluate mediastinal masses and associated lung, pleural, or chest wall disease. Magnetic resonance images were compared with computed tomography (CT) scans, which were available in 45 patients. While MRI and CT ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1991-11-01 00:00:00
abstract：:Women from Africa are a fast-growing population group in the United States; however, little is known about their breast cancer outcomes. There is minimal empirical data that describe the cancer practices, beliefs, and needs of African-born women. We conducted 2 focus groups with 20 African women to: (1) explore their ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/s0027-9684(15)30553-8
更新日期：2010-06-01 00:00:00
abstract：:An analysis of the articles published in 1992 in the Journal of the National Medical Association (JNMA) was performed to assess the content, statistical analysis, and the profile of its contributors. Seventy-six articles were reviewed. The majority of the articles focused on biomedical aspects of health; however, a si...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：:Growth standards specific to black boys and girls are necessary because genetically determined patterns of growth in black children are significantly different from those of white children. Such standards have only recently become available, and they need further refinement. The required improvements include: (1) adju...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1980-10-01 00:00:00
abstract：:In the past the study of the allocation of scarce medical resources centered around "high-tech" forms of health care, such as the use of the artificial heart and hemodialysis. The use of nonbiomedical criteria (ie, should the social worth or financial status of a particular patient dictate preferential treatment over ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1986-05-01 00:00:00
abstract：:The occurrence of multifocal rhabdomyoma is exceedingly rare with less than half a dozen cases collected in the literature. We present a case of multifocal rhabdomyoma of the head and neck that involves extension of the tumor to the vallecula, the glossoepiglottic fold, and the aeriepiglottic fold. ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1993-02-01 00:00:00
abstract：:The Keller resection arthroplasty was first described in 1904. Ninety years later, this operation continues to be useful to orthopaedic surgeons and their patients. This article presents the results of Keller bunionectomies in a private practice setting. Indications, surgical techniques, postoperative management, and ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
abstract：:African Americans are less likely than European Americans to participate in biomedical research. Researchers often attribute nonparticipation to the "Tuskegee effect." Using critical qualitative analysis of focus group data, we examined the public's use of the Tuskegee Study of Untreated Syphilis (TSUS) to discuss bio...
journal_title：Journal of the National Medical Association
pub_type： 历史文章,杂志文章
doi：
更新日期：2004-08-01 00:00:00
abstract：:To minimize the incidence of postoperative infections in patients undergoing open-heart surgery, antibiotics should maintain tissue concentrations greater than the minimal inhibitory concentration (MIC) for potential pathogens (eg, Staphylococcus) for the duration of the operation. The ability of cefonicid, a new β-la...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：INTRODUCTION:To determine the efficacy and safety of Kahook Dual Blade (KDB) goniotomy alone or combined with phacoemulsification cataract surgery to lower intraocular pressure and medication burden in Black and Afro-Latinx patients with open angle glaucoma (OAG). MATERIALS AND METHOD:A retrospective, single center ca...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/j.jnma.2020.09.147
更新日期：2020-11-03 00:00:00
abstract：:If minority students likely to score low on the Medical College Admissions Test (MCAT) can be identified in advance, they can be advised to take existing preparatory programs, or programs can be developed to meet their needs. Correlation coefficients for a number of available independent variables with MCAT scores wer...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1987-06-01 00:00:00
abstract：PURPOSE:This article highlights issues of misdiagnosis in an African-American, adult clinical population by doing point prevalence, record review study within a comprehensive community mental health center. METHOD:Psychiatric evaluations of 330 patients were reviewed and clinically identifiable variables of: a) childh...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/S0027-9684(15)30048-1
更新日期：2015-03-01 00:00:00
abstract：:Quit-rates for cigarette smokers in a lifestyle intervention program aimed at reducing coronary risk were 24 percent for all participants and 34 percent for non-dropouts. Recidivism remained very low during participation in the program. Half of the smokers who quit did so after being in the program more than two years...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1982-04-01 00:00:00
