Characteristics of non-cobalamin deficient patients who receive regular cyanocobalamin injections.

Abstract:

:For decades Vitamin B12 injections have been administered to patients with no documented deficiency. A previous study identified a cohort of patients who described vitamin B12-responsive symptoms despite lack of cobalamin deficiency as measured by conventional laboratory tests. These patients have been studied further and, when compared with controls, were found to have had more prescriptions for psychoactive drugs (P less than .001) and to have had more hospitalizations related to symptoms suggestive of neuropsychiatric problems (P less than .01). To confirm these findings and to determine national estimates for vitamin B12 use, an analysis of the 1985 National Ambulatory Medical Care Survey (NAMCS) was conducted. This analysis supports a significantly higher frequency of neuropsychiatric complaints among patients who received vitamin B12 injections (P less than .001). In addition, the NAMCS analysis indicates that of the calculated 2,516,564 vitamin B12 injections given in 1985, only 376,488 were for a diagnosis compatible with a cobalamin deficiency state (a 7:1 observed over expected ratio). According to the national data set analysis, vitamin B12 injections are given most frequently in the rural south by a doctor of osteopathy in solo practice.

journal_name

Fam Med

journal_title

Family medicine

authors

Lawhorne LW,Wright H,Cragen D

subject

Has Abstract

pub_date

1991-09-01 00:00:00

pages

506-9

issue

7

eissn

0742-3225

issn

1938-3800

journal_volume

23

pub_type

杂志文章
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    abstract:BACKGROUND AND OBJECTIVES:In 1993, the University of California, Los Angeles introduced an interdisciplinary course called ¿Doctoring¿ for all first-year medical students in which students visited family physicians' offices once a month for a total of four visits. The study's objectives were to ascertain preceptors' at...

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    authors: Usatine RP,Hodgson CS,Marshall ET,Whitman DW,Slavin SJ,Wilkes MS

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  • Introduction of a Motivational Interviewing Curriculum for Family Medicine Residents.

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  • Results of the 2010 national resident matching program: family medicine.

    abstract::The results of the 2010 National Resident Matching Program (NRMP) reflect a small but promising increased level of student interest in family medicine residency training in the United States. Compared with the 2009 Match, 75 more positions (with 101 more US seniors) were filled in family medicine residency programs th...

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    authors: Pugno PA,McGaha AL,Schmittling GT,DeVilbiss Bieck AD,Crosley PW,Ostergaard DJ

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  • Comments heard by US medical students about family practice.

    abstract:BACKGROUND AND OBJECTIVES:This study was conducted to explore the hypothesis that negative comments from faculty and residents about family practice are related to the recent decline in student selection of this specialty. METHODS:A questionnaire was sent to all family physicians and an equal number of other primary c...

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    authors: Campos-Outcalt D,Senf J,Kutob R

    更新日期:2003-09-01 00:00:00

  • Electrocardiography teaching in Canadian family medicine residency programs: a national survey.

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    authors: Paul B,Baranchuk A

    更新日期:2011-04-01 00:00:00

  • Motivational interviewing workshop in a virtual world: learning as avatars.

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    authors: Shershneva M,Kim JH,Kear C,Heyden R,Heyden N,Lee J,Mitchell S

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  • Experiences of a support group for interns in the setting of war and political turmoil.

    abstract:BACKGROUND AND OBJECTIVES:Intern support groups have been instituted in many residency programs to improve resident well-being. In this article, we discuss the themes that emerged in intern support group meetings in a family medicine program operating in a setting of war and political instability. METHODS:We held supp...

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    authors: El Jamil F,Hamadeh GN,Osman H

    更新日期:2007-10-01 00:00:00

  • Dialogues in the exam room: medical interviewing by resident family physicians.

    abstract:BACKGROUND:Limited information exists about the application of the biopsychosocial model in medical practice. This study expanded our knowledge about the extent to which psychosocial content is included in medical interviews conducted by resident family physicians. METHODS:Interviews of 180 patients conducted by six s...

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    authors: Marvel K,Major G,Jones K,Pfaffly C

    更新日期:2000-10-01 00:00:00

  • Entry of U.S. medical school graduates into family practice residencies: 1988-1989 and eight-year summary.

    abstract::This study continues a series of reports from the American Academy of Family Physicians on the percentage of each medical school's graduates who enter family practice residency programs. Approximately 10.7% of the 15,947 graduates of United States medical schools between July 1987 and June 1988 were first-year residen...

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    authors: Schmittling G,Graham R

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  • Patient preferences in discussing sexual dysfunctions in primary care.

    abstract:BACKGROUND AND OBJECTIVES:There are multiple barriers that limit patients and primary care physicians (PCPs) from discussing sexual dysfunctions (SDs) during medical appointments. Exploring patient preferences in discussing SDs with PCPs may help address some barriers, which can improve doctor-patient communication abo...

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    更新日期:2014-02-01 00:00:00

  • Electronic Health Record Impacts on Family Medicine Teachers: Survey of Third-Year Medical Student Clerkship Preceptors at an Academic Medical Center.

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  • Heart failure in Vietnam.

    abstract:BACKGROUND:Students are increasingly participating in international health experiences during their medical training. This essay explores one student's perspective on the importance of relationship development with both patients and health care systems in global settings. The essay also reflects on the unique learning ...

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  • Strengthening the Community College Pathway to Medical School: A Study of Latino Students in California.

    abstract:BACKGROUND AND OBJECTIVES:One third of Latino medical students begin their premedical undergraduate education at a community college (CC) or 2-year college, compared to a 4-year university. This study explored the academic and personal experiences Latino premedical students commonly encounter at the CC. METHODS:In 201...

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  • Psychosocial problem assessment: to counsel or not to counsel.

    abstract::A pragmatic method for assisting family practice residents in deciding whether or not to counsel patients with psychosocial problems is described. Called "the problem assessment framework," this seven-step method uses a process of sequential analysis to guide the resident through problem identification, goal setting, ...

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  • Enhancing procedural training in a family practice residency.

    abstract:BACKGROUND AND OBJECTIVES:Teaching outpatient procedures is a major responsibility of family practice residencies. This requires equipment, faculty expertise, and curricula. This report documents one residency program's attempt to enhance the teaching of outpatient procedures. METHODS:We tabulated all office procedure...

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    更新日期:1997-09-01 00:00:00

  • Pilot test of family medicine faculty development fellowship accreditation guidelines.

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    更新日期:2000-11-01 00:00:00

  • Outcomes of Embedded Care Management in a Family Medicine Residency Patient-Centered Medical Home.

    abstract:BACKGROUND AND OBJECTIVES:Much attention is devoted nationally to preventing hospital readmissions and emergency department (ED) use, given the high cost of this care. There is a growing body of evidence from the Patient Centered Primary Care Collaborative that a patient-centered medical home (PCMH) model successfully ...

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    authors: Newman RJ,Bikowski R,Nakayama K,Cunningham T,Acker P,Bradshaw D

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  • Migraine in students of a US medical school.

    abstract:BACKGROUND AND OBJECTIVES:The study's aim was to determine migraine prevalence, severity, and educational impact in medical students. METHODS:A 23-item survey of all medical students of one US medical school addressed migraine frequency, triggers, pattern and severity of symptoms, medication use, impact on educational...

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    authors: Johnson H,Guhl G,Arora J,Walling A

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  • Use of symptoms, signs, and blood tests to diagnose acute sinus infections in primary care: comparison with computed tomography.

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  • Early pregnancy failure management among family physicians.

    abstract:BACKGROUND AND OBJECTIVES:Family physicians, as primary care providers for reproductive-aged women, frequently initiate or refer patients for management of early pregnancy failure (EPF). Safe and effective options for EPF treatment include expectant management, medical management with misoprostol, and aspiration in the...

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  • Measuring self-reported comfort with general family practice skills during a required third-year family practice clerkship.

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  • Financial and clinical relationships between family practice and the academic medical center.

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    authors: Schwenk TL,Davies TC

    更新日期:1987-03-01 00:00:00

  • A school-based intervention to increase the use of bicycle helmets.

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    journal_title:Family medicine

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    authors: Towner P,Marvel MK

    更新日期:1992-02-01 00:00:00

  • The use of household surveys in community-oriented primary care health needs assessments.

    abstract:OBJECTIVE:This study demonstrates the use of a community household survey and how it can provide information beyond that obtained with secondary epidemiologic data alone. METHODS:Adults in 215 randomly selected households in an inner-city neighborhood in Bronx, NY, were assessed by in-person interviews in homes of nei...

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    doi:

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    更新日期:1996-06-01 00:00:00

  • The effects of learners on waiting times and patient satisfaction in an ambulatory teaching practice.

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    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Bestvater D,Dunn EV,Nelson W,Townsend C

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  • 2011 ACGME duty hour week proposal--a national survey of family medicine residents.

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    abstract:BACKGROUND AND OBJECTIVES:Medical schools are increasingly challenged to recruit and retain community-based preceptors. Physicians experience various incentives and deterrents to teaching medical students while providing patient care. Self-determination theory (SDT) posits people act in response to internal and externa...

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    pub_type: 杂志文章

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    更新日期:1993-04-01 00:00:00