Total Number Of New Patients Research Articles

Use of A Nutrition Screening Questionnaire in Outpatient Cardiology Clinic

Medical Nutrition Therapy (MNT) is a cost effective intervention for heart disease. A total of 8,229 new patients were seen in Cardiology Clinic last year. A screening tool allows health care team members to assess their patients’ nutritional risks and need for MNT with a Registered Dietitian (RD). In summer 1998 a screening tool was developed for use in outpatient clinics. From August 1998 to February 1999 new patients in Cardiology Clinic completed the Nutrition Screening Questionnaire. The RD was consulted when one of the three identified questions was answered “yes.” Prior to use of the screening tool, an average of 1.5 new patients per month received MNT with an RD. While using the screening tool, the number increased to an average of 4.5 new patients per month. Further evaluation of the data revealed 35% of the new patients in Cardiology Clinic answered “yes” to at least one of the three questions. Based on this percentage and the total number of new patients seen in Cardiology Clinic in prior year, 240 new patients per month would be considered for MNT with an RD. The results indicate a screening tool will identify more patients who can benefit from MNT and increase the need for RD services. Clear communication between all health care team members is essential for any tool to be effective.

当科における開院以来23年間の外来患者の統計的観察(第一報)

A retrospective study of outpatient statistics for the Department of Otorhinolaryngology of Kawasaki Medical School between December 1973 and December 1996 was made.The total number of new patients was 72,359 and the number of diseases treated was 87,579. The number of outpatients had increased gradually, while the number of patients over 60 years of age had increased rapidly. Regarding the sites of these diseases,38.7% were in the ear,27.7%were in the nasal cavity and paranasal sinuses,16.8% were in the larynx,13.7% were in the oral cavity and pharynx,2.2% were in the neck, and 0.9% were in the trachea and esophagus. The number of patients with disorders of the larynx, neck, trachea, and esophagus had increased gradually, over the time period studied.

The oral medicine clinic--what is its role?

The total number of new patients seen over a period of 12 months in an oral medicine department was 963. Of these 587 were seen by an oral physician, 168 by a liaison psychiatrist, 137 by an oral immunologist and 71 by a dermatologist with a special interest in diseases of the mouth. The broad categories of disease seen were: 364 with orofacial pain of non-dental origin; 263 with benign diseases of the oral mucosa; 149 with potentially malignant lesions, six with frank carcinomas; 100 with oral manifestations of a systemic disease; and 81 patients with conditions considered to be normal.

Whole blood amino acid levels in the pregnant mare, fetal and newborn foal : Abigail L. Fowden and Marian Silver, Physiological Laboratory, Cambridge, CB2 3EG, U.K.

To determine whether the introduction of out-of-pocket expenses to medical center employees would lead to decreased use of sleep disorder services.We retrospectively analyzed and compared the clinical and medical accounting data from visits by Mayo Clinic employees to the Sleep Disorders Center from January 1 to March 31, 2003, with that of January 1 to March 31, 2004, ie, before and after a January 2004 increase in co-payments for evaluation and testing.The total number of new patients evaluated in the first quarters of 2003 and 2004 was similar (113 vs 119; P=.37). Snoring, restless legs symptoms, hypertension, atrial fibrillation, and prior overnight oximetry testing were more prevalent in 2004 than in 2003 (P=.05, P=.01, P<.001, P=.003, P=.02, respectively). In contrast, insomnia and parasomnia complaints were less common in 2004 (P<.001). The mean apnea-hypopnea index, minimum oxygen saturation, and percentage of time with oxygen saturation less than 90% were all more severe in 2004 (P=.01, P=.001, P<.001, respectively). Sleep-related breathing disorders were more commonly diagnosed in 2004 (83.2% vs 67.2%; P=.02), whereas the diagnoses of nonbreathing disorders declined.The insurance policy changes that resulted in larger empolyee co-payments shifted the spectrum of diagnoses seen at the Sleep Disorders Center toward more symptomatic patients, with more associated comorbidities, and patients who had more severe sleep-related breathing disorders. Total utilization did not decrease.

Multiple duodenal ulcer: natural history and pathophysiology.

It has not been established whether multiple duodenal ulcer is associated with a different natural history, pathophysiology, and therapeutic response than a single duodenal ulcer. A consecutive series of 96 patients with two or more duodenal ulcers at endoscopy, representing 9.6% of the total number of new patients with duodenal ulcer seen during the period 1980-1985, were compared with a random series of 200 patients with single duodenal ulcer seen in the middle years of this period. Multiple duodenal ulcer was associated with higher (p less than 0.02) male to female ratio, more (p less than 0.05) late onset patients (those with ulcer symptoms starting after age 30 years, more (p less than 0.05) chronic cigarette smokers, and more frequent (p less than 0.05) moderate to severe deformity of the duodenal bulb. More (p less than 0.05) patients with multiple duodenal ulcer had abnormally low D50 derived from pentagastrin dose response tests, indicating that they were more sensitive to gastrin stimulation. Furthermore, their mean fasting and meal stimulated serum gastrin concentrations were significantly higher than those of patients with single ulcer (p less than 0.005), or of controls (p less than 0.05). Compared with single duodenal ulcer, multiple ulcer had significantly lower placebo healing rate, and required a higher dose of misoprostol (1200 v 800 micrograms/day) to achieve a similar healing efficacy at four weeks. We conclude that multiple duodenal ulcer is associated with different clinical features, pathophysiology, and possibly therapeutic response from single duodenal ulcer, and appears to represent the more aggressive side of the ulcer spectrum.

Epidemiological Survey of Vestibular Disorders

In 1980, the Vestibular Disorders Research Committee of Japan, which is supported by the Ministry of Health and Welfare, was founded by 24 doctors, who come from various districts or areas of Japan. First of all, the Committee drafted the diagnostic criteria of several peripheral vestibular disorders, such as benign paroxysmal vertigo, vestibular neuronitis, bilateral loss of labyrinthine function, inner ear syphilis. In the epidemiological survey, 783 cases of vestibular disorders were collected from the Committee members. The proportion of vestibular disorders in the total number of patient treated during the same period was 3.2-3.8% for new patients. The male: female ratio was 3.6:4.7. Among these cases, the proportion of definite casses of Ménière's disease in the total number of new patients was 0.79%, and this figure is very close to the proportion obtained from the epidemiological survey by the Ménière's disease Research Committee of Japan in 1977, and the prevalence of Ménière's disease estimated from the survey was 160 per million. The prevalence of each type of vestibular disorders estimated from the data of Ménière's disease were as follows: benign paroxysmal positional vertigo 107, sudden deafness with vestibular disturbance 85, vestibular neuronitis 35, traumatic vestibular disorders 18, bilateral loss of vestibular function 16, inner ear syphilis 11 (per million). However, as these estimations are based on the second hand data, further investigation will be necessary.

CHRONIC DACRYOCYSTITIS: ITS CAUSATION AND TREATMENT

With an auspicious and a drooping eye.—Hamlet, Act 1, Scene 2. The present material supplements the cases already referred to in a paper1on external dacryocystorhinostomy read before the Ophthalmological Society of the United Kingdom in 1932, which dealt with the period from 1929 to 1931. During the years 1932 to 1939 inclusive, 1,073 patients were seen in the ophthalmic clinic of the Royal Infirmary, Edinburgh, under my charge, whose complaint was watering of one or both eyes. This number represents 2.7 per cent of the total number of new patients attending during these years. Of these, 548, or almost exactly 50 per cent, were adults with dacryocystitis. Patients appearing for the first time with acute dacryocystitis were included in the group with watering of the eyes, as they gave that history. Fifty cases of congenital dacryocystitis were collected in two and a half years. This is equal

CHRONIC DACRYOCYSTITIS

With an auspicious and a drooping eye.—Hamlet, Act 1, Scene 2. The present material supplements the cases already referred to in a paper1on external dacryocystorhinostomy read before the Ophthalmological Society of the United Kingdom in 1932, which dealt with the period from 1929 to 1931. During the years 1932 to 1939 inclusive, 1,073 patients were seen in the ophthalmic clinic of the Royal Infirmary, Edinburgh, under my charge, whose complaint was watering of one or both eyes. This number represents 2.7 per cent of the total number of new patients attending during these years. Of these, 548, or almost exactly 50 per cent, were adults with dacryocystitis. Patients appearing for the first time with acute dacryocystitis were included in the group with watering of the eyes, as they gave that history. Fifty cases of congenital dacryocystitis were collected in two and a half years. This is equal

HERPES CORNEAE

In New England dendritic keratitis appears to be the most frequent corneal infection recognizable on an etiologic or morphologic basis. During the past forty-two months 221 patients with this disease have been observed and treated personally by me. These patients comprise the majority of all those with corneal infection seen during this period in the outpatient department of the Massachusetts Eye and Ear Infirmary. The frequency of dendritic keratitis in comparison with that of other well recognized conditions of the cornea is shown in table 1. Table1.— Incidence of Various Types of Keratitis During Forty-Two Months Total number of new patients in the outpatient department. 41,733 Dendritic keratitis . 221 Interstitial keratitis (syphilitic and nonsyphilitic). 184 Serpent ulcer . 97 Sclerokeratitis. 80 Phlyctenular keratitis . 52 Gonorrheal ulcer (all ages). 27 Disciform keratitis . 18 Trophic or senile marginal ulcers and those attributable to rosacea have been omitted from consideration, since their classification

DIABETES

The statistical study of 1,000 cases of diabetes1which I reported a year ago was an attempt to correlate my data with those of other authors and to offer evidence of the different factors involved in the study of this disease. The present statistical study in a larger series is but a continuation of my previous presentation. During the period which this study covers, March 1, 1921, to Nov. 1, 1927, the total number of new patients admitted to the clinic was 87,449. Thus the incidence of diabetes among our patients during this period was 2.28 per cent; while in the first series, among the 55,939 patients seen in the clinic during the period covered by that series, March 1, 1921, to Aug. 31, 1925, the diabetic incidence was 1.8 per cent. AGE AND SEX INCIDENCE The distribution of these cases in each series according to sex and to the