The management of primary pulmonary hypertension

Article Abstract:

Primary pulmonary hypertension (PPH) is a syndrome of high blood pressure within the lungs, which rapidly progresses to cor pulmonale, the enlargement or failure of the right heart ventricle in the absence of heart or lung disease. The criteria for diagnosis of PPH include: (1) symptoms of pulmonary hypertension, such as hypertrophy, or enlargement and dilation of the heart ventricle; (2) increased pressures in the pulmonary artery, the major blood vessel supplying the lungs, and increased resistance to blood flow; and (3) absence of a cause of pulmonary hypertension. Most cases of PPH are diagnosed by excluding other possible causes, and PPH implies that a cause for pulmonary hypertension cannot be identified by clinical or laboratory studies. Treatment of PPH is directed at alleviating the symptoms resulting from disturbances in the lung circulation. The provision of oxygen, treatment of heart failure with the digoxin (to increase heart muscle contractility) and diuretics (to eliminate body water), and anticoagulation therapy have been used in managing PPH. However, vasodilator therapy, or the use of agents that dilate blood vessels, has become important in the treatment of PPH. Other new approaches to treating PPH include the use of high-dose calcium channel blocking agents and intravenously administered prostacyclin, a vasodilator. Heart-lung or lung transplantation may be the most effective treatment of PPH for selected patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Pulmonary hypertension, Vasodilators, Vasodilator agents

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Attitudes of primary care physicians toward corporal punishment

Article Abstract:

Many family physicians and pediatricians agree that children should be spanked if they misbehave, even though research has shown that corporal punishment is not always effective and may teach children that violence is acceptable. Of 619 family physicians and pediatricians surveyed, 67% supported corporal punishment. Seventy percent of the family physicians supported it, and 59% of the pediatricians did so. Seventy-two percent of the doctors under the age of 40 supported corporal punishment, compared to 63% of those over 40. Of those who supported corporal punishment, 42% said children should be spanked only when they are engaging in dangerous behavior, such as running into the street. Ninety percent of the pediatricians discussed corporal punishment with parents, but only 52% of family physicians did so. Doctors can teach parents alternative techniques for dealing with children who misbehave.

Beliefs, opinions and attitudes, Public opinion, Physicians (General practice), General practitioners, Corporal punishment

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Management Changes in Primary Hyperparathyroidism

Article Abstract:

Innovations in the care and treatment of hyperparathyroidism are presented. This condition is caused by excessive amounts of parathyroid hormone in the blood.

Hyperparathyroidism

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