Canadian family physician Médecin de famille canadien
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To develop a typology of after-hours care (AHC) instructions and to examine physician and practice characteristics associated with each type of instruction. ⋯ Important issues identified included the recommendation to use an emergency department as the sole source of AHC, practices providing no specific AHC instructions to their patients, and physicians' lack of acceptance of Telehealth. To improve AHC, new initiatives should build upon the existing system, changes should be integrated, and there should be a range of AHC options for patients and physicians.
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Review Comparative Study
Single-dose intrathecal analgesia to control labour pain: is it a useful alternative to epidural analgesia?
To examine the safety and efficacy of single-dose spinal analgesia (intrathecal narcotics [ITN]) during labour. ⋯ Physicians practising modern obstetrics in rural and small urban centres might find single-dose ITN a useful alternative to parenteral or epidural analgesia for appropriately selected patients.
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To review the differences between physiologic and pathologic phimosis, review proper foreskin care, and discuss when it is appropriate to seek consultation regarding a phimotic foreskin. ⋯ Physiologic phimosis is often seen by family physicians. These patients and their parents require reassurance of normalcy and reinforcement of proper preputial hygiene. Consultation should be sought when evidence of pathologic phimosis is present, as this requires surgical management.