Expectations of groups versus pairs of attendings and residents about phone communications and bedside evaluation of hospitalized patients.

Background: Residents covering attendings' patients must decide when to call the attending and when to evaluate patients at the bedside for new clinical events. Conflicts arise when residents and attendings disagree about these decisions.

Purpose: Our purpose was to determine differences in expectations between attendings and residents concerning the need for phone communication about, and bedside evaluation of, new patient problems in hospitalized patients.

Paroxetine to treat irritable bowel syndrome not responding to high-fiber diet: a double-blind, placebo-controlled trial.

Objectives: The purpose of the trial was to determine whether a high-fiber diet (HFD) alone or in combination with paroxetine or placebo was effective treatment for patients with irritable bowel syndrome (IBS).

Design: Trial of HFD alone (Group 1) followed by a randomized, double-blind trial of HFD with paroxetine or placebo (Group 2).

Setting: Gastroenterology office in a 524-bed university-affiliated community hospital in Pittsburgh.

Somatizing patients: part II. Practical management.

Somatization is the experiencing of physical symptoms in response to emotional distress. It is a common and costly disorder that is frustrating to patients and physicians. Successful treatment of somatization requires giving an acceptable explanation of the symptoms to the patient, avoiding unwarranted interventions and arranging brief but regular office visits so that the patient does not need to develop new symptoms in order to receive medical attention.

Somatizing patients: Part I. Practical diagnosis.

The phenomenon of somatization, which results in unexplained physical complaints, is ubiquitous in primary care settings although it often goes unrecognized. Medical training emphasizes the identification and treatment of organic problems and may leave physicians unprepared to recognize and address somatoform complaints. As a process, somatization ranges from mild stress-related symptoms to severe debilitation.

The somatizing patient.

Somatization is the experience of physical symptoms in response to emotional distress. It is common, costly, and frustrating to both the patient and physician. Successful treatment of somatization requires the physician to pursue a positive diagnosis rather than rely on a diagnosis of exclusion.