New B-lactams: new problems for the internist

Article Abstract:

Some bacteria possess the capacity to develop resistance to antibiotics. When a bacterial infection is identified and an antibiotic that might be expected to cure it is given, those strains of the bacterium in question that can avoid destruction by the antibiotic survive and multiply. Not surprisingly, this can prove fatal to the person infected by that bacterium. Ironically, some of the newer, more powerful antibiotics that were developed precisely to treat resistant bacteria now produce resistance. Among the drugs associated with this phenomenon are those in the category of cephalosporins, particularly the newer ones (third-generation cephalosporins). The fact that some of these newer cephalosporins are now available orally raises the possibility that resistant bacteria will be produced in ambulatory patients, and that the incidence of resistance will be far higher in the human population than studies of hospitalized patients will suggest. Use of the newer cephalosporins should be reserved for those cases in which they are truly needed, to try to prevent the emergence of resistance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Drug resistance in microorganisms, Microbial drug resistance, Dosage and administration, Cephalosporins

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Violence in intimate relationships and the practicing internist: new "disease" or new agenda?

Article Abstract:

Primary care physicians may need to prepare themselves to take a more active and compassionate role in identifying domestically abused patients and directing them to appropriate assistance. Researchers summarized some of the characteristics of domestically abused patients, suggested skills to effectively intervene for these patients, and identified potential obstacles that the patients and physicians may face in pursuing treatment. Doctors need to familiarize themselves with the physical and emotional signs of domestic abuse, routinely question patients about domestic abuse history, and convey an atmosphere of support and assurance of confidentiality to their patients. Establishing a network of social workers, nurses, and legal counsel can be helpful in directing patients to safe and appropriate support. Complete documentation of suspicious findings may be important for future legal intervention. It may also be advisable to train clinic support staff in domestic violence awareness.

Care and treatment, Diagnosis, Abused women, Family violence, Domestic violence

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Literature, humanities, and the internist

Article Abstract:

Literature has much to offer physicians who can overcome their reluctance to become involved in literary study. Physicians may need to forget past unpleasant experiences in school literature courses, and they should discard the notion that scientific minds cannot relate to the humanities. Physicians should try to make time for reading and for discussing what they have read, perhaps even in a reading group. Short story anthologies are a good starting point for busy physicians. The pleasure of reading is a reward unto itself, but also, literature that encompasses medical themes can provide physicians with new perspectives on their relations with patients and the practice of medicine.

Medicine, Study and teaching, Literature, Literature and medicine

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