Background: The purpose of this study was to evaluate the effectiveness of telephone call reminder on retention rate in obese patients. Methods: A total of 118 patients (85 first-time visitors, 33 re-visitors), who visited an obesity management clinic from May 2003 to May 2004, were divided into the intervention group (n=64) and the comparison group (n=54). The intervention was a telephone call reminder before the appointment date. The retention rate up to 7th visit and body mass index were compared between the two groups. Results: The retention rate was 64.4% at 4th visit (after 66.5+/-29.2 days from the first visit) and 36.4% at 7th visit (after 142.1+/-57.8 days from the first visit). For the first- time visitors, the retention rate at 3rd visit was significantly higher (85.1%) in the intervention group than those in the comparison group (67.6%, P=0.049). Otherwise, there were no significant differences in retention rate and body mass index at each visit between the two groups regardless of the visiting status. However, the body mass index at 4th and 7th visit was significantly lower in the intervention group than in the comparison group among the first-time visitors who completely attended 7 times (P=0.031). Conclusion: We could not find the telephone call reminder to be an effective method to improve retention rate in obesity management clinic. Further intensive approach is needed to promote attendance.
Body Mass Index ; Humans ; Obesity ; Telephone*

Zolpidem is a non-benzodiazepine drug that has selectivity for the gamma-aminobutyric acid (GABA) receptors. We experienced paradoxical effect of zolpidem in a 48-year-old male patient with hypoxic-ischemic brain injury after cardiac arrest. The patient was in stupor and could not communicate. His Glasgow Coma Scale (GCS) was E2M4V2 and Rancho Los Amigos (RLA) was grade III to IV. Zolpidem was prescribed to induce sedation but paradoxically, he became alert (GCS 15, RLA VII) and was able to communicate. The arousal lasted for 2 hours repeatedly following each administration of the medication. While he was alert, electroencephalogram showed the reversal of slow wave into beta range fast activity and F-18 flumazenil positron emission tomography (PET) showed increased GABAergic receptor activity in both frontoparietotemporal cortices. Single photon emission computed tomography (SPECT) also showed increased cerebral perfusion and reversal of cerebellar diaschisis.
Anoxia ; Arousal* ; Brain Injuries ; Electroencephalography ; Electrons* ; Flumazenil* ; gamma-Aminobutyric Acid ; Glasgow Coma Scale ; Heart Arrest ; Humans ; Male ; Middle Aged ; Perfusion ; Positron-Emission Tomography* ; Stupor ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: To investigate the usefulness of computed tomography venography (CTV) for evaluation of leg swelling, especially deep vein thrombosis (DVT), in rehabilitation patients. METHODS: A hundred twenty-three patients, who had performed CTV performed because of suspected DVT in our clinic, were enrolled. We performed chart reviews retrospectively and categorized CTV findings as follows: DVT distal to inguinal ligament and no compression lesion; DVT proximal to inguinal ligament and no compression lesion; DVT distal to inguinal ligament and anatomical variant (for example, May-Thurner syndrome); DVT due to compression of mass (cancer or cyst); DVT and other incidental abnormal finding; and no DVT and other possible causes of leg swelling. RESULTS: DVTs were found in 65 (53%) patients. DVTs were found at distal level (thigh or lower leg) to inguinal ligament in 47 patients. DVTs were found at proximal to inguinal ligament, usually undetectable with duplex ultrasonography, in 6 patients. DVTs caused by external compression, such as femoral vein and cancer mass, were found in 12 patients (10%), which are also not easily detected with duplex ultrasonography. Other various causes of leg edema without DVT were found in 22 (18%) patients. CONCLUSION: CTV can evaluate more extensively venous problems in the pelvis and abdomen and detect other possible causes of leg swelling. Therefore, CTV can be a useful tool not only for easy detection of DVT but also for evaluating differential diagnosis of leg edema in rehabilitation patients.
Abdomen ; Diagnosis, Differential ; Edema* ; Femoral Vein ; Humans ; Leg* ; Ligaments ; Pelvis ; Phlebography* ; Rehabilitation* ; Retrospective Studies ; Ultrasonography ; Venous Thrombosis*