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Biomedical subjects

G N Fox

Publications and source records attributed to G N Fox.

At least 19 recordsLinked to original sources
PubMed1998

Chromium picolinate supplementation for diabetes mellitus.

Chromium picolinate is a widely available nutritional supplement marketed for a plethora of afflictions. There is some evidence, including results from human studies, that it has a role in glucose homeostasis. We report the case of a 28-year-old woman with an 18-year history of type 1 diabetes mellitus whose glycosylated hemoglobin (Hb A1c) declined from 11.3% to 7.9% 3 months after initiation of chromium picolinate, 200 micrograms 3 times daily. Chromium picolinate continues to fall squarely within the scope of "alternative medicine," with both unproven benefits and unknown risks. It deserves closer scrutiny with additional prospective, randomized, double-blind, placebo-controlled trials to evaluate its efficacy in improving outcomes in patients with diabetes. A brief review of the literature was done to assist physicians who are being called upon to counsel and treat patients who are engaging in alternative therapies.

Adult↗
PubMed1996

Minimizing prescribing errors in infants and children.

Family physicians frequently prescribe medications for children. The high volume of pediatric prescribing, particularly of antibiotics, means that even a low rate of prescription error would result in adverse consequences for a substantial number of children. Errors may be attributed to factors associated with drug names, packaging or formulation, particularly when a liquid preparation is marketed in several concentrations, as well as to human error in selecting and prescribing medications. A systematic approach that minimizes distractions during the prescribing process, provides a safety-checking mechanism by office staff and encourages the consistent use of standard techniques for calculating pediatric dosages is recommended. In the interest of clarity, prescriptions should be written legibly, abbreviations should be avoided, the indication for the medication should be specified and the times of day and number of times each day the medication is to be taken should be clearly stated.

Adolescent↗
PubMed1994

Cruising the information highway: online services and electronic mail for physicians and families.

Commercial online service providers, bulletin board services, and the Internet make up the rapidly expanding "information highway." Physicians and their families can use these services for professional and personal communication, for recreation and commerce, and to obtain reference information and computer software. Commercial providers include America Online, CompuServe, GEnie, and MCIMail. Internet access can be obtained indirectly through America Online or directly through specialized access providers. Today's online services are destined to evolve into a National Information Infrastructure that will change the way we work and play.

Computer Communication Networks↗
PubMed1993

Resource use by younger versus older patients.

OBJECTIVE: Compared to younger persons, the elderly use disproportionately greater health care resources. We wondered if this difference persisted when care of both older and younger patients was managed by physicians of a single specialty, family practice. METHODS: The design was a retrospective analysis of a family practice clinical database. The setting was a 622-bed suburban teaching hospital. The subjects were all acute-care patients (112 short-stay unit and 232 hospitalized patients) cared for by a family practice residency service during a one-year period. The main outcome measures were site of care (inpatient versus short-stay unit), hospital length of stay, and in-hospital consultant use. RESULTS: When cared for by the same physicians, the elderly are more likely to be admitted to the hospital rather than be successfully cared for in a short-stay unit (p = 0.001), to stay in the hospital longer (mean days: less than age 20 years, 5.1; age 80 and older, 8.5; p = 0.004), and to have a greater number of consultants (mean number of consultants: less than age 60 years, 0.80; age 60 and older, 1.16; p = 0.001). CONCLUSIONS: Our study, in which patient care for patients of all ages was provided by one group of family practice residency physicians, indicated greater relative health care resource consumption by the elderly. We cannot exclude the possibility that age was simply a surrogate for unexplored factors, such as insurance status. The generalizability of a study from one group in one institution is limited.

Adolescent↗
PubMed1992

The computer-based medical record: current status.

At the turn of the century, neither hospitals nor physicians routinely kept clinical records. Since then, the medical record has gradually evolved. More recently, as society and medicine have become more complex and sophisticated, inadequacies of the paper medical record have become increasingly apparent. The computer-based medical record addresses many of the deficiencies of the paper record. Meanwhile, barriers to computer-based records have decreased; hardware has become more affordable, powerful, and compact, and software has been refined. Socially, the major payers for health care are demanding verification of the effectiveness and quality of care, information that involves data-intensive research. The electronic medical record promises to improve quality of care by providing point-of-care reminder and decision support tools as well as a database for substantiating the effectiveness of care. In conjunction with the growing integration of computers into all facets of life, government agencies, computer giants, and medical organizations are currently laying the groundwork for the development of standardized elements and formats for computer-based medical information systems. As part of the continuing evolution of the medical record, we foresee these forces culminating in the computerization of the clinical record. In this review, we briefly describe the developments that led us to this conclusion and describe computer-based clinical record systems in use in two family practice settings.

Decision Support Techniques↗
PubMed1991

Drug interactions software programs.

The value of a computer application is usually dependent on the program's ability to store, rearrange, and retrieve information in a format that is useful to the computer user. Based on a list of drugs (input), drug interactions programs search their databases for possible interactions between each drug pair in the input list. An output list specifies pairs of drugs that potentially interact. Since each program uses its own information database, results may differ slightly among programs. In general, however, the screen menus, appearance of the programs, and the "extras" included in each program differ more than the programs' drug interactions output. The software programs tested are all easy to use. Each of the three drug interactions programs reviewed has unique features that may appeal to certain users. The Medical Letter Drug Interactions Program is the least costly and provides the most academic output, allowing users to view citations for each specific interaction. The PDR Drug Interactions and Side Effects software includes a side effects index that allows either searching of a drug, which produces a list of the drug's side effects, or searching of a specific side effect, which produces a list of drugs associated with that side effect. Drug Interactions III is the only program that allows users to add drug interactions to its database.

Databases, Factual↗