Detecting and treating bulimia nervosa: how involved are family physicians?

BACKGROUND: Relatively little is known about bulimia nervosa in the primary care setting. Existing medical literature suggests that primary care physicians have limited experience with bulimia nervosa. METHODS: Experiences of family physicians with bulimia nervosa specifically and eating disorders in general were assessed by a questionnaire mailed to a representative sample (596 subjects) of Ohio family physicians. The response rate was 52.6 percent. RESULTS: Approximately 30 percent of the respondents had never diagnosed bulimia in a patient; 60 percent had no bulimic patients at the time of the survey. The mean career total of bulimic patients per physician was 5.3 (SD = 5.6). Younger physicians and female physicians were more likely to have bulimic patients. Having bulimic patients correlated significantly with having contact with bulimic and with anorexic persons in nonoffice settings. CONCLUSIONS: Despite a general prevalence rate of about 1 percent for bulimia (much greater for the female population, particularly in adolescents and athletes), nearly one third of Ohio family physicians have never diagnosed bulimia in a patient, and nearly two thirds are not currently providing care for bulimic patients. Because screening is quick, inexpensive, and straightforward, all at-risk patients--athletes or those who have concerns related to paucity of menstruation, gastrointestinal symptoms, dieting or weight concerns, and depression--should be screened for bulimia.

Effects of an aerobic exercise program on community-based adults with mental retardation.

Effects of a 10-week aerobic exercise program on maximal oxygen consumption (VO2max), oxygen pulse (O2 pulse), maximum ventilation (max vent), exercise stress test duration (max time), flexibility, weight and body composition (percentage body fat, percentage lean mass, and percentage body water) were investigated in 14 community-based adults with mental retardation. Supervised optional training sessions were held 4 days per week. Subjects were assessed for VO2 max, O2 pulse, max vent, and max time before and after the training program. Flexibility, weight, and body composition changes were assessed before, midway through, and after the training program. Subjects had a 91.3% attendance rate, and all safely completed the program. The treatment produced significant increases in VO2 max, O2 pulse, max vent, max time, and flexibility. However, no significant change was observed in weight or body composition changes.

Case presentation as a teaching tool: making a good thing better.

Formal lectures have generally replaced case presentations as teaching tools for group learning in internship and residency programs. This article discusses two forms of case presentations--"traditional" and "chunked." Best used to convey medical information, the traditional approach proves less than optimal as a tool in teaching problem-solving skills. The "chunked" method, on the other hand, is an excellent format for formal small- and large-group instruction. An overview and suggested approach for each type is outlined herein. Properly used, each type can be a more efficient, effective tool than lectures when it comes to teaching medical problem-solving skills.

Comparison of two office tests for determining blood theophylline levels.

The blood theophylline level determination is an important therapeutic tool, but reference laboratories can take from 1 to 3 days before giving results. Several quicker in-office methods for testing blood theophylline levels are currently available. Two methods were compared for reliability and accuracy. Both proved to be accurate, but the Acculevel method was more reliable than the Seralyzer method. The Acculevel appears to be a preferable method for in-office testing of serum theophylline levels.