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| New
York Academic
Minerva Web
Journal |
| January
2002 Volume 2,
Number 01 |
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Paper
0201:
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Evaluating
the Effectiveness of
Acupuncture in the
treatment of Chronic
Low Back Pain.
Chan, Y. and Xu,
X.,
Department of Family
Practice and
Community Medicine,
SVCMC, Jamaica, NY.
BACKGROUND:
Acupuncture is a
traditional Chinese
medicine, which uses
fine needles that
are inserted into
certain points of
the body call
‘acupoints’ to
control the ‘vital
energy' or ‘qi’.
In 1979, the
World Health
Organization cited
more than 40
conditions for which
acupuncture may be
indicated.
In November
1997, the National
Institute of Health
(NIH) provided a
limited endorsement
for acupuncture in
the use of certain
types of pain
management. Although
acupuncture is
widely used in many
different countries
for pain management,
it is under utilized
here.
This may be
due to the fact that
acupuncture is not
well studied in the
United States.
METHODS:
Patients with
low back pain were
randomly selected
from Family Practice
Center, Saint
Vincent Catholic
Medical Center. All
patients are
evaluated pre and
post treatment for
any improvement of
pain control by
acupuncture. Each
patient is received
1 to 2 sessions per
week, with total of
8 to 10 sessions for
the completion of
one treatment
course. Data will be
collected and
analyzed at the end
of the study for the
evaluation of the
effectiveness of
acupuncture on
chronic low back
pain.
RESULTS:
The
project is still on
going.
However, the
preliminary results
are encouraging for
the use of
acupuncture as
alternative
treatment for low
back pain.
CONCLUSION:
Although many people
are aware of
‘acupuncture’,
there is still
overall lack of
knowledge about the
use of acupuncture
for treatment of
chronic low back
pain.
NYAMWJ
2002,
2:Abstract
0201
Presented
to the First BWAFP Research
Forum
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| Paper
0202: |
Medication Compliance Among Elderly Patients
De Williams, J. and
Enubuzor, H.
Department of Family Practice and Community Medicine,
SVCMC, Brooklyn, NY
While patients over the age of 65 account for
12% of the general population, they use 30% of prescription
medications. Ambulatory elderly patients take an average
of 7.9 drugs per person per day. In light of these
statistics, it is not surprising that there are difficulties
with medication compliance, either by overuse (related to
forgetfulness or attempts to speed recovery) or underuse (the
most common type of non-compliance) which can be linked with
memory deficits, drug side effects, or costs.
A confidential survey consisting of 18 questions was conducted
for two weeks at the Theodora Jackson Senior Center in
Jamaica, Queens. It assessed different factors influencing
compliance in following prescribed medications. The
participants consisted of men and women older than 65 years
old, mainly Hispanics and blacks. Eighty-one survey forms (51
women, 30 men) were compiled and analyzed. Ages ranged from 65
to 83.
The result of this study revealed that the main barriers to
medication compliance are: polypharmacy, drug side-effects,
cost of medication, lack of proper information, cognitive
disfunction (memory deficit is the most common cause of
inappropriate use), and functional disabilities (such as
impaired hearing or vision). Several factors interfere with
achieving the goal of good compliance when talking about the
elderly population. Poor compliance results in inadequate or
incomplete treatment, prolonging the course of the disease and
the length of therapy, resulting in increasing cost and
consequently decreasing compliance. The approach has to be
multi-faceted. Multiple strategies are needed to improve
medication compliance in elderly patients. Among them are:
holding seminars with medical professionals emphasizing clear
information, including written instructions to the patients,
establishing clear treatment goals, eliminating polypharmacy
and simplify dosing regimens, considering the financial
resources of the patient, and assisting the patient in
organizing a system for taking medications.
NYAMWJ
2002,
2:Abstract
0202
Presented to the
First
BWAFP Research
Forum
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| Paper 0203:
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Cholesterol
and Diabetes, Windows of Opportunity Lost?
Ashita Chandra, MD , Mary Costello, RN, Laura Corsello, MD, and Abraham
Hamaoui, MD
SUNY Stony Brook Family Medicine, Stony Brook, NY
OBJECTIVE:
To
investigate the proportion of inpatients with diabetes who were screened for
cholesterol as a risk factor for heart disease.
DESIGN:
Observational
cross-sectional survey study of inpatient charts of diabetic patients..
METHODS:
Seventy
sequential charts from our inpatient service of patients were reviewed over a
five-week period, during their hospital stay. The patients included in the
study were 18 years and older, and had in their problem list the diagnosis of
Diabetes Mellitus and did not have specifically any diagnosis stating heart
disease.
RESULTS:
On
reviewing the inpatient charts of diabetic patients, 24.62% of the charts had
cholesterol and risk factors documented, compared to 40% of HbA1c data. This
is well below the documentation of hemoglobin and hematocrit (100%) and
creatinine (96.92%) values. Hypertension was a secondary diagnosis in 64.61%
of this group. Looking at management, ace inhibitors were a part of the
management protocol in 40.48% of the diabetic patients with hypertension and
in 26.15% of the diabetic patients overall.
Finally, looking at patient education, it was documented in 58.46% of
the charts.
CONCLUSIONS:
Primary
and secondary preventive programs may need to be incremented further and
primary care residents may need to more aggressive in taking the “window of
opportunity” when patients are admitted, to reinforce diabetic management
and prevention of co-morbid risk factors, given the prevalence of silent
cardiovascular disease in that subset of patients.
NYAMWJ
2002,
2:Abstract
0203
Presented to the
First
BWAFP Research
Forum
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Paper 0204:
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Cholesterol
Prevention And Awareness In Inpatients
Saul Maslavi, MD, Evelina Tsarik, DO Lilia Gehkman, DO, and Abraham Hamaoui, MD
Department of Family Medicine, Wyckoff Heights Medical Center, Brooklyn, NY
NYAMWJ
2002,
2:Abstract
0204
Presented to the
First
BWAFP Research
Forum
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Paper 0205:
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Awareness
of Cholesterol
Abraham Hamaoui, MD, Lisa Miller, and Chuwuma Okoroji, MD
Department of Family Medicine, New York Medical College, Valhalla, NY and St
Joseph's Medical Center, Yonkers, NY,
Background.
Atherosclerosis leading to cardiovascular damage begins early in life with
the utmost consequences occurring many years later as coronary heart disease and
ischemic cerebrovascular disease. For these diseases major advances have been
achieved in acute interventional management, but effective primary prevention
for the atherosclerosing progression has been mostly elusive, even though
information has accumulated heavily in the last decades. Of the many reasons for
this, the survey looked to assess the perception of cardiovascular risk by two
distinct populations, young and mature adults, and to determine the current
awareness of the pathological process by these distinct groups.
Methods.
An observational cross-sectional study was undertaken by a survey of
patients of a family health center (FHC). The Center is located in Yonkers, NY,
and serves mainly an inner-city low-income population. A standardized
questionnaire was filled out for each individual before a visit. One hundred and
forty participants, 18 years and older, were enrolled sequentially, before their
visit. Attrition was less than two percent.
Results.
Looking specifically at cholesterol levels, the results showed that although
cholesterol testing and patient education was similar to both populations,
awareness of cholesterol values are very much limited in the younger group,
where most of the preventive impact should have been achieved.
Conclusions.
This project underlines the need for effective primary preventive programs
by renovating the message to appeal to a younger audience, if we are to achieve
long term reduction in prevalence of cardiovascular disease.
NYAMWJ
2002,
2:Abstract
0205
Presented to the
First
BWAFP Research
Forum
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