Injury prevention in primary care

Article Abstract:

Injuries, including unintentional trauma and deliberate acts of violence, are the leading cause of death in persons up to the age of 45. Across all age groups, injuries are the fourth leading cause of death, and almost $39 billion was spent in 1985 for the treatment and rehabilitation of injury victims. In contrast to accidents that are unforseen events, most injuries are predictable and preventable. For example, the use of seat belts greatly diminishes the chances of serious injury in car accidents, but only 35 percent of adults routinely wear them. Recent evidence suggests that patients who are instructed by their physician to wear seat belts are almost four times more likely to do so than people who are not so instructed. An important strategy for curbing injuries is the screening, counseling, and treatment of patients with alcohol problems. Physicians should urge their patients not to drink and drive or be the passenger in a car where the driver has ingested alcohol. Additionally, clinicians should always ask patients about episodes of severe depression or if they have had suicidal thoughts. Most injuries, including those that are self-inflicted, are preventable and primary care physicians should take a leading role in trying to educate the public about injury prevention. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Causes of, Accidents, Wounds and injuries, Injuries, editorial

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Hepatic injury during propylthiouracil therapy in patients with hyperthyroidism: a cohort study

Article Abstract:

Some patients treated with propylthiouracil may develop asymptomatic liver damage that is reversible. Propylthiouracil is a drug used to treat patients with hyperthyroidism. Fifty-four patients with hyperthyroidism were treated with 300 milligrams (mg) of propylthiouracil per day for two months, followed by treatment with 100 to 150 mg per day for three months, followed by a maintenance dosage of 100 mg per day. Fifteen patients (28%) developed elevated levels of alanine aminotransferase (ALT) - a sign of mild liver damage - two months after beginning treatment. None of these patients had symptoms of liver disease or hyperbilirubinemia. ALT levels returned to normal in 13 of these patients within three months of continuing treatment with propylthiouracil. A liver biopsy revealed different types of tissue damage in three patients.

Complications and side effects, Drug therapy, Liver, Hyperthyroidism, Propylthiouracil

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Homelessness: care, prevention, and public policy

Article Abstract:

The health care community needs to commit itself to addressing the health and underlying social needs of the growing homeless population. Growing numbers of homeless people of every age and gender are acquiring preventable diseases and dying early. Existing barriers to providing basic health care to the homeless population and those at-risk of becoming homeless need to be removed, revised, or addressed. Reasons for gaps in health care include other more immediate priorities on the patient's part and lack of available, consistent, and affordable health care.

Health aspects, Homeless persons

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