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Electronic Prescription

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7661. Amblyopia

is compliance. [ ] This may also be the greatest challenge. [ ] It is worth noting that, although it is unpleasant for both child and parent, standard psychological assessments have detected no significant psychological distress. However, prescriptions should take the difficulty of following treatment into account and minimise the amount of hours of patching prescribed. Parents need good information and education, as do children when they are old enough to understand. [ ] Whilst both patching (...) . It is known that the amount of patching is often far less than prescribed, due to poor patient concordance. The age at which occlusion should be prescribed is also under review. Most studies suggest that children are unlikely to benefit over the age of 7, although there is some evidence of partial benefit up to the age of 12. The duration of treatment is variable but tends to be in the order of months. Most improvement is obtained in the first six weeks. [ ] Attention is paid to the healthy eye, due

2008 Mentor

7662. HRT - follow-up assessments

[ ] . There is only one currently available to prescribe in the UK. Micronised progesterone can be prescribed with oral or transdermal oestrogen. It is commonly prescribed at a dose of 200 micrograms a day for two weeks followed by a two-week break for those women who are still having periods. For a continuous combined use, it should be prescribed as 100 micrograms daily. It is usually taken at night. Weight gain This is often given as a major reason for why women discontinue HRT but there is no randomised (...) element of the HRT regimen. Switching from cyclical HRT to continuous combined HRT Women should be prescribed cyclical/sequential combined HRT if their last menstrual period was less than one year previously, or if they are significantly symptomatic but still having periods. Cyclical HRT can be changed to continuous combined HRT when the woman is considered to be postmenopausal. This is advantageous to the woman as it removes the risk of endometrial hyperplasia. The woman may also no longer want

2008 Mentor

7663. History and Physical Examination

patient may be taking co-codamol. The computer will record if medication is overused or underused and the date of last issue. Enquire about over-the-counter (OTC) remedies and possible herbal or other treatments. The latter are just as likely as prescription-only medicines (POMs) to have toxic effects or drug interactions, perhaps more so as they have not been so thoroughly tested. Family history Patients also assume that their family doctor is aware of their family history. Many conditions do have (...) apparent. The doctor should have a protocol for each system. Many forms of examination have their own article covering appropriate topics listed below. All general practitioners should have competence in: , including . . . Checking for and . . . Competence at orthopaedic examination, which should include , , , and assessment of . Examination of tender, . . . . . . . Management In the 1980s, handing over a prescription indicated the end of the consultation. It is now recognised that educating

2008 Mentor

7664. Head Lice

) detection comb should be used. This is different to a nit removal comb, which has narrower gaps. Some nit combs can be prescribed on an FP10; the Bug Buster® comb is the only one of these which has been assessed through clinical trials. Wet combing takes 10-15 minutes per head; lice are immobilised by hair conditioner, so are easy to see on the comb. Dry combing takes at least 3-5 minutes per head. Using a comb on dry hair may produce static electricity; when a louse is spotted on the comb, placing (...) should be continued until no full-grown lice have been seen for three consecutive sessions. 50-60% cure rates have been reported. Generally wet combing is thought to be less effective than insecticides. There are no contra-indications or safety precautions but it is time-consuming. Other mechanical devices such as electronic combs are not recommended, as there is no evidence of their efficacy and there may be safety concerns. Confirming treatment success [ ] Insecticide treatment: Advise people

2008 Mentor

7665. Ill and Feverish Child

, breathing, circulation and consciousness. Consider sepsis . Always consider the possibility of sepsis and refer as an emergency if sepsis is suspected. See also the separate article and the NICE guidelines 'Sepsis: recognition, diagnosis and early management' [ ] . Measure body temperature : Infants <4 weeks: measure with an electronic thermometer in the axilla. A child aged 4 weeks to 5 years: measure with either an electronic thermometer in the axilla, a chemical dot thermometer in the axilla (...) a specific diagnosis has not been made, should either be referred to urgent paediatric care or the carers of the child should be given a 'safety net', either detailing exactly when to seek further help (ie specific warning symptoms or signs) or arranging a further follow-up assessment. Children with only green features can be managed at home with advice for parents and carers, including advice on when to seek further help. Oral antibiotics should not be prescribed if there is no identifiable source

2008 Mentor

7666. Ezetimibe

Ezetimibe Ezetimibe tablets for high cholesterol. Ezetimibe info | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Ezetimibe tablets Ezetrol Authored by , Reviewed by | Last edited 28 Feb 2017 | Certified by Ezetimibe has been prescribed to help lower your cholesterol levels. Take one 10 mg tablet daily. Some lifestyle changes will also help to reduce your cholesterol level - eat healthy food, do not smoke, gently (...) of a number of heart and blood vessel diseases, such as heart attack and stroke. Ezetimibe works by reducing the amount of cholesterol you absorb from food. This in turn, reduces your risk of long-term heart and circulation problems. Your treatment will be more successful if you also follow the healthy lifestyle advice given by your doctor. Ezetimibe is prescribed alongside a cholesterol-lowering diet. In addition, you could also be prescribed another medicine to take which lowers cholesterol

2008 Mentor

7667. Obesity in Adults

weight after stopping treatment but trials suggest it takes three years to gain weight lost in one year on the drug. Indications - individuals with a BMI of 28 kg/m 2 or more in the presence of significant comorbidities (eg, type 2 diabetes, high blood pressure, hyperlipidaemia) OR a BMI of 30 kg/m 2 or more with no associated comorbidities. [ ] These individuals should be on a mildly hypocaloric, low-fat diet. Prescription : Availability: this is now available over-the-counter (OTC) to individuals (...) with the above criteria. The recommended OTC dose is 60 mg three times a day and treatment under pharmacist care should not exceed six months. Pharmacists should check the patient's BMI on each occasion a request is made. Cautions: absorption of fat-soluble vitamins may be impaired. If on long-term therapy, monitor A, D, E and beta-carotene levels and prescribe supplementation if appropriate. If vitamin supplements are required, these should be taken at least two hours after an orlistat dose, or at bedtime

2008 Mentor

7668. Pain and Pain Relief

pathways. There are fewer of the typical opioid side-effects (notably, less respiratory depression, less constipation and less addiction potential). Psychiatric reactions have been reported. In June 2014 the prescribing regulations concerning tramadol were changed. It is now listed as a Schedule 3 drug which means it cannot be issued as an electronic prescription or prescribed in a quantity exceeding 30 days' supply. [ ] An increasing number of reports have appeared in the literature in recent years (...) for moderate-to-severe pain, particularly of visceral origin. Long-term prescribing is most common for palliative care in malignant disease but also may be appropriate for chronic non-malignant conditions, in conjunction with specialist advice. One of the main reasons patients in severe pain do not receive adequate analgesia is fear of addiction. If the condition is terminal cancer, this is not an appropriate concern. The main side-effects of all opioids are nausea, vomiting, constipation, drowsiness

2008 Mentor

7669. Oral Anticoagulants

etexilate, rivaroxaban and apixaban have all been associated with lower rates of intracranial haemorrhage but also a possible increase in gastrointestinal bleeding. Editor's note November 2017 - Dr Hayley Willacy has recently read a study comparing the safety of direct oral anticoagulants (DOACs) and warfarin in the treatment of venous thromboembolism [ ] . The study identified 59,525 adults (12,489 DOAC users and 47,036 warfarin users) with a new diagnosis of venous thromboembolism and a prescription (...) as a hospital clinic. Patients should be assessed for capability - only patients able to follow the same total quality management procedures as hospitals should undertake NPT ± PSM. Patients should be audited regularly for comparison with laboratory results, proportion of INRs in range and adverse events. Patient advice Patients should be advised to: Take the prescribed dose at the same time, daily. Report any bruising or bleeding immediately. Attend for blood tests as advised. Avoid pregnancy - ensure

2008 Mentor

7670. Opioid Analgesics

(DH) reduced the maximum permissible duration of Schedule 2, 3 and 4 drug prescriptions to 30 days in June 2006. The DH has withdrawn the requirement that all prescriptions for controlled drugs should be handwritten since 2007. More recently, amendments to regulations allow the signature on a prescription for a controlled drug to be electronic if the Electronic Prescribing Service (EPS) is used. A recent update to the DH guidance on supervision and management of the use of controlled drugs (...) and codeine and dihydrocodeine come under Schedule 5. Prescriptions for need to include: The patient's full name, address and age, where appropriate. Name and form of the drug, even if only one form exists. The strength of a preparation, where appropriate. The dose to be taken. The total quantity to be supplied, in words and figures. The prescriber's signature and the date of the prescription. No repeat ordering: prescriptions ordering repeats on the same form are not permitted. The Department of Health

2008 Mentor

7671. Osteoporosis Case Finding in Primary Care

with enormous morbidity and mortality. Treatment for osteoporosis should include not only drug treatment but also advice on lifestyle, nutrition, exercise and measures to reduce falls. Advise on smoking cessation where indicated, and moderation of alcohol intake. Advise regular weight-bearing exercise. Evidence suggests this has a modest but significant effect in improving bone density [ ] . Ensure adequate calcium intake and vitamin D status, prescribing supplements if required [ ] . Dietary calcium may (...) be assessed by one of a number of online tools [ , ] . Elderly people who are housebound or living in a nursing home may be assumed to require vitamin D supplementation. If there is adequate dietary calcium intake of more than 1000 mg/day but a lack of vitamin D, consider prescribing 10 micrograms (400 units) of vitamin D without a full replacement dose of calcium. For people who have a dietary calcium intake of less than 1000 mg/day, prescribe 10 micrograms (400 units) of vitamin D with at least 1000 mg

2008 Mentor

7672. Effects of Tape and Exercise on Dynamic Ankle Inversion Full Text available with Trip Pro

). The dependent variables were average inversion velocity, total inversion, maximum inversion velocity, and time to maximum inversion.Thirty college-age male and female students (17 males, 13 females; mean age = 24.9 +/- 4.3 years, range, 19 to 39 years) were tested. Subjects were excluded from the study if they exhibited a painful gait or painful range of motion or had a past history of ankle surgery or an ankle sprain within the past 4 weeks.We collected data using electronic goniometers while subjects (...) balanced on the right leg on an inversion platform tilted about the medial-lateral axis to produce 15 degrees of plantar flexion. Sudden ankle inversion was induced by pulling the inversion platform support, allowing the platform support base to rotate 37 degrees . Ten satisfactory trials were recorded on the inversion platform before and after a prescribed exercise bout. We calculated total inversion, time to maximum inversion, average inversion velocity, and maximum inversion velocity after sudden

2000 Journal of athletic training Controlled trial quality: uncertain

7673. Adherence in Clinical Trials-Induction Strategies

. Unfortunately, the failure of a large percentage of patients to adhere to prescribed medical regimens is a widely recognized and well documented phenomenon. It has been estimated that as many as 50 percent of patients do not take their prescribed medications, and of those remaining, less than two-thirds take their medication as prescribed. The interventions, implemented at the outset of pharmacologic intervention within the clinical trial, were timed to yield maximum effectiveness. Such randomized induction (...) as members of the Clinical Applications and Prevention Advisory Committee Behavioral Medicine and Prevention Working Groups. The initiative was released in September, 1991 and awarded in September, 1992. DESIGN NARRATIVE: Randomized, double-blind, two-group design. Within each of the groups, half of the subjects were on lovastatin and half on placebo. The main outcome measure was medication intake monitored daily and unobtrusively with the MEMS electronic monitor. For each subject, event time series

2000 Clinical Trials

7674. Safety and Efficacy of Xenical in Children and Adolescents With Obesity-Related Diseases

on the medication, subjects who have continued to take prescription medication for at least 3 months prior to study entry may be eligible; Recent use (within six months) of anorexiant medications for the purpose of weight reduction; Inability to undergo MRI (e.g., volunteers with metal within their bodies including cardiac pacemakers, neural pacemakers, aneurysmal clips, shrapnel, ocular foreign bodies, cochlear implants, non-detachable electronic or electromechanical devices such as infusion pumps, nerve (...) or a psychiatric disorder or other condition which, in the opinion of the investigators, would impede competence or compliance or possibly hinder completion of the study; Subjects who regularly use prescription medications unrelated to the complications of obesity. Oral contraceptive use will be permitted, provided the contraceptive has been used for at least two months before starting study medication. The use of over-the-counter and prescription medications will be reviewed on a case-by-case basis; depending

1999 Clinical Trials

7675. A Phase II Efficacy Study of Roferon-A in Hairy Cell Leukemia

the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: Child, Adult, Older Adult Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Age 18-70. Patients must have morphologically identifiable hairy cells in peripheral blood and bone marrow, or tissue biopsies with at least one of the following: 1) Positive stain for the tartrate-resistant acid phosphatase 2) Electron microscopy compatible with hairy cells. Patients must (...) be ambulatory with an expected survival greater than 16 weeks and be willing and able to give written informed consent. Patients must have a disease that is assessable, defined by: 1) Pancytopenia 2) Bone marrow leukemic infiltrate 3) Lymphadenopathy, splenomegaly, or hepatomegaly. Patients must not require palliative chemotherapy, immunotherapy or hormonal therapy other than the treatment prescribed in this protocol. Patients must be tested for Hepatitis B surface antigen within one week of entry

1999 Clinical Trials

7676. Endocrine Studies of Healthy Children

have, or whose parent or guardians have, current substance abuse or a psychiatric disorder or other condition which, in the opinion of the investigators, would impede the ability to give informed consent or possibly hinder completion of the study; Subjects who regularly use prescription medications are not eligible. The use of over-the-counter medications will be reviewed on a case-by-case basis; For those sub-studies involving MRI, inability to undergo MRI (e.g., volunteers with metal within (...) their bodies including cardiac pacemakers, neural pacemakers, aneurysmal clips, shrapnel, ocular foreign bodies, cochlear implants, non-detachable electronic or electromechanical devices such as infusion pumps, nerve stimulators, bone growth stimulators, etc. that are contraindications). Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor

1999 Clinical Trials

7677. Metabolism and Body Shape of Healthy Children and Children With Chronic Infections

INHIBITOR-NAIVE HIV-INFECTED CHILDREN ONLY). Data available concerning the start date of protease inhibitor treatment (HIV-INFECTED CHILDREN ON PROTEASE INHIBITOR-CONTAINING ANTIRETROVIRAL REGIMENS ONLY). HEALTHY PEDIATRIC VOLUNTEERS: Good general health. No significant hematologic, renal, hepatic, endocrinologic, or pulmonary disorders. No evidence of HIV infection by standard HIV antibody testing. Body mass index for age below 85th percentile. Not currently using prescription medications (...) MRI because of metal objects within their bodies that are contraindications for MRI. These include cardiac pacemakers, neural pacemakers, aneurysmal clips, schrapnel, ocular foreign bodies, cochlear implants, non-detachable electronic or electromechanical devices. No allergic reaction to heparin. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information

1999 Clinical Trials

7678. A Study to Compare Anti-HIV Drugs Given Twice a Day or Once a Day, With or Without Direct Observation

Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Information provided by (Responsible Party): National Institute of Allergy and Infectious Diseases (NIAID) Study Details Study Description Go to Brief Summary: Anti-HIV drug therapy works best when the drugs are taken exactly as prescribed by a doctor. Because anti-HIV therapy often involves multiple drugs, some people have difficulty taking them all correctly. The easier it is to take anti-HIV drugs, the more likely people (...) will take them as prescribed and get the best results. This study will see if people are more successful in taking anti-HIV drugs once a day or twice a day. It also will determine if having a health care professional oversee each weekday dose helps people control their HIV infection. The study will compare taking a three-drug combination twice a day versus taking a three-drug combination just once a day. The study will also compare patients taking the drugs on their own to patients taking the drugs

2002 Clinical Trials

7679. Depsipeptide to Treat Patients With Cutaneous T-Cell Lymphoma and Peripheral T-Cell Lymphoma

: Peripheral T-cell Lymphoma (PTCL) Participants received at least one protocol prescribed dose or higher of Romidepsin intravenously at 14mg/m^2 and at 17.5 mg/m^2 on days 1, 8, and 15 of a 28 day cycle. Drug: Romidepsin Experimental: Cutaneous T-cell Lymphoma (CTCL) Participants received at least one protocol prescribed dose or higher of Romidepsin intravenously at 14mg/m^2 and at 17.5 mg/m^2 on days 1, 8, and 15 of a 28 day cycle. Drug: Romidepsin Outcome Measures Go to Primary Outcome Measures : Number (...) -cells ascertained by flow cytometry. Secondary Outcome Measures : Number of Participants With Adverse Events [ Time Frame: 147 months and 5 days ] Here is the number of participants with adverse events. For a detailed list of adverse events, see the adverse event module. Median Number of Cycles of Depsipeptide Administered [ Time Frame: 83 cycles (i.e., each cycle is 21 days) ] Participants were administered Depsipeptide and cycles (each cycle is 21 days) were monitored from the prescribed dose

2000 Clinical Trials

7680. Radiation Therapy and Chemotherapy Before and After Surgery in Treating Patients With Esophageal Cancer

Procedure: conventional surgery The type of resection (lvor-Lewis, Transhiatal, etc.) was left to the discretion of the operating surgeon. One lymph node dissection was required. Radiation: radiation therapy The total dose to the prescription point was 4500 cGy given in 25 fractions. The patient was treated with one fraction per day with all fields treated per day. 180 cGy was delivered to the isocenter. If the dose to the supraclavicular fossa (SCF) was less than 4500 cGy, a localized photon (...) or electron boost was allowed in order to increase the SCF dose to 4500 cGy, specified at 3 cm depth from the anterior skin surface. Experimental: Paclitaxel / Cisplatin / Radiation therapy (Arm B) Days 1 - 35 : Concurrent radiation therapy (RT) and Paclitaxel/Cisplatin Chemotherapy. Radiotherapy 45 Gy administered at 1.8 Gy per day, 5 days a week for 5 weeks. Paclitaxel 50 mg/m² (1 hr) days 1, 8, 15, 22, 29. Cisplatin 30 mg/m² days 1, 8, 15, 22, 29. Chemotherapy should begin within 24 hours of start

2002 Clinical Trials

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