An essential understanding of physician-patient communication. Part I.

The first of two parts, this article explores the question, "Is there a communication problem between patients and physicians?" It reviews both available literature on the topic of physician-patient communication and survey results that indicate a high degree of patient dissatisfaction with their relationships with physicians. One view of how to understand the relationship focuses on the patient as a consumer who must have the ability to choose a care provider and the information necessary to make informed choices. Other models embracing the scientific paradigm are also described.

An essential understanding of physician-patient communication. Part II.

Part I of this article, which appeared in the July/August (15:1) issue of this journal, explored the question of whether a communication or relational problem exists between patient and physicians. The answer was a resounding, "Yes." Part 2 explores why effective patient-physician relationships should be important to physicians, health care administrators, and managed care organizations and what can be done to improve patient-physician communication and relationships. It describes the results of improved communication, which include increased patient satisfaction, enhanced patient compliance with medication and treatment regimens, and improved clinical outcomes. It outlines the major research and training organizations active in the area of patient-physician interaction and describes the courses offered by each.

In vitro mechanism of inhibition of bacterial cell growth by allicin.

Diallyl thiosulfinate (allicin) is the agent found in garlic which is responsible for the antibacterial and antifungal activity of extracts of this plant. The effect of bacteriostatic concentrations of allicin (0.2 to 0.5 mM) on the growth of Salmonella typhimurium revealed a pattern of inhibition characterized by: (i) a lag of approximately 15 min between addition of allicin and onset of inhibition, (ii) a transitory inhibition phase whose duration was proportional to allicin concentration and inversely proportional to culture density, (iii) a resumed growth phase which showed a lower rate of growth than in uninhibited controls, and (iv) an entry into stationary phase at a lower culture density. Whereas DNA and protein syntheses showed a delayed and partial inhibition by allicin, inhibition of RNA synthesis was immediate and total, suggesting that this is the primary target of allicin action.