Abstract:
:Grief and depression present similarly in patients who are dying. Conventional symptoms (e.g., frequent crying, weight loss, thoughts of death) used to assess for depression in these patients may be imprecise because these symptoms are also present in preparatory grief and as a part of the normal dying process. Preparatory grief is experienced by virtually all patients who are dying and can be facilitated with psychosocial support and counseling. Ongoing pharmacotherapy is generally not beneficial and may even be harmful to patients who are grieving. Evidence of disturbed self-esteem, hopelessness, an active desire to die and ruminative thoughts about death and suicide are indicative of depression in patients who are dying. Physicians should have a low threshold for treating depression in patients nearing the end of life because depression is associated with tremendous suffering and poor quality of life.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Periyakoil VS,Hallenbeck Jsubject
Has Abstractpub_date
2002-03-01 00:00:00pages
883-90issue
5eissn
0002-838Xissn
1532-0650journal_volume
65pub_type
杂志文章abstract::Primary dysmenorrhea is menstrual pain that is not associated with pelvis pathology. It usually begins with the onset of ovulatory cycles, characteristically appearing in the year after menarche and increasing with time. The pain is associated with increased myometrial activity. Oral contraceptives and prostaglandin s...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00
abstract::AIDS dementia complex is a major source of disability for many AIDS patients. Less commonly, the spinal cord or peripheral nerves are affected by HIV infection. Physicians working with AIDS patients must differentiate these manifestations from those caused by the infectious, neoplastic and vascular complications. ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract::Otitis externa, green nail syndrome, toe web infections, hot tub folliculitis, superinfections in chronic antibiotic-treated acne and infectious eczematoid dermatitis are examples of mild cutaneous infections due to Pseudomonas aeruginosa. These may occur in otherwise healthy persons. In persons with lowered resistanc...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Osteoporosis is the most common bone disorder in the United States. Bone mass is decreased, and porosity and fragility are increased. Dual-beam photon absorptiometry is currently considered the best detection technique. Prevention involves increased calcium intake and avoidance of diets high in protein and phosphates,...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00
abstract::Parathyroid hyperplasia is second only to adenoma as the most common cause of hyperparathyroidism. Symptoms are most likely to result from elevated serum calcium levels. Symptoms include nephrocalcinosis and nephrolithiasis. Studies that may help confirm a suspected diagnosis include ultrasonography, computed tomograp...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::Atrial fibrillation is associated with potentially life-threatening strokes. Anticoagulation with warfarin or aspirin reduces the risk of embolic events in patients with chronic atrial fibrillation and mitral valve stenosis or other underlying heart disease. In patients with acute onset of atrial fibrillation, anticoa...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, for diagnosis, and suspected atria...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2016-09-15 00:00:00
abstract::Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages,...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2013-03-01 00:00:00
abstract::Acute diarrhea in adults is a common problem encountered by family physicians. The most common etiology is viral gastroenteritis, a self-limited disease. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. A history and physical examination evaluating for ri...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2014-02-01 00:00:00
abstract::Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease pain and improve function. Acet...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2011-06-01 00:00:00
abstract::Pressure sore are caused by multiple mechanisms. Preventive management requires relief of pressure, skin care, control of spasms, release of contractures and treatment of infection. Conservative treatment succeeds only when pressure on the ulcer site is relieved. Surgical treatment involves primary, secondary and tert...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1982-02-01 00:00:00
abstract::The incidence of skin cancer is increasing by epidemic proportions. Basal cell cancer remains the most common skin neoplasm, and simple excision is generally curative. Squamous cell cancers may be preceded by actinic keratoses-premalignant lesions that are treated with cryotherapy, excision, curettage or topical 5-flu...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-15 00:00:00
abstract::Poisoning is a common cause of morbidity and mortality in the United States, with several million episodes reported annually. Acute medication poisonings account for nearly one half of all poisonings reported in the United States and should be considered in persons with an acute change in mental status. The initial ap...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2010-02-01 00:00:00
abstract::Primary carcinoma of the fallopian tube is a rare disease and has traditionally been managed in the same manner as epithelial ovarian cancer. However, unlike ovarian cancer, fallopian tube cancer is not routinely suspected and treatment may be delayed. The clinical presentations of seven cases of fallopian tube cancer...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract::Senile dementia of the Binswanger's type is a term used to describe a dementia syndrome characterized by onset in the sixth or seventh decade of life, subcortical neurologic deficits, psychiatric disorders and evidence of hypertension or systemic vascular disease. The status of senile dementia of the Binswanger's type...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::Esophagogastroduodenoscopy is most commonly performed for evaluation of epigastric pain, severe heartburn, chronic nausea and other dyspepsia syndromes that are not relieved by medical therapy. It should not be performed as an in-office procedure in patients with unstable angina, respiratory failure, active upper gast...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract::House calls can still serve many functions in the overall care of the patient. By improving the relationship between physician and patient, providing the physician with important information that can only be gained from a home visit and allowing the physician to remain active in the care of the homebound patient, hous...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-11-01 00:00:00
abstract::Use of a diaphragm plus spermicide provides effective protection against pregnancy in motivated women and decreases the risk for some sexually transmitted diseases. Potential risks of this contraceptive method include the development of urinary tract infections and the possible teratogenic effects of nonoxynol-9, the ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract::Substantial advances have been made in the management of inflammatory bowel disease. Mesalamine and olsalazine are new anti-inflammatory agents that may serve as alternatives to corticosteroids and sulfasalazine, which have been the mainstays of medical therapy. These new agents are available in oral, enema and suppos...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::Gout is a disease resulting from the deposition of urate crystals caused by the overproduction or underexcretion of uric acid. The disease is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute and chronic arthritis, tophi, interstitial renal disease and uric a...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-04-01 00:00:00
abstract::Rosacea is a common, but often overlooked, skin condition of uncertain etiology that can lead to significant facial disfigurement, ocular complications, and severe emotional distress. The progression of rosacea is variable; however, typical stages include: (1) facial flushing, (2) erythema and/or edema and ocular symp...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2002-08-01 00:00:00
abstract::Gas, bloating, and belching are associated with a variety of conditions but are most commonly caused by functional gastrointestinal disorders. These disorders are characterized by disordered motility and visceral hypersensitivity that are often worsened by psychological distress. An organized approach to the evaluatio...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2019-03-01 00:00:00
abstract::Careful examination of a fresh, properly collected urine specimen can indicate the presence of urinary tract disease or uncover unsuspected local or systemic pathology. Urinalysis also can lead to a more complete understanding of a systemic disorder or can assure both the patient and the physician that urinary tract d...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, an...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2014-09-15 00:00:00
abstract::Microscopic hematuria, a common finding on routine urinalysis of adults, is clinically significant when three to five red blood cells per high-power field are visible. Etiologies of microscopic hematuria range from incidental causes to life-threatening urinary tract neoplasm. The lack of evidence-based imaging guideli...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2006-05-15 00:00:00
abstract::Endometrial biopsy is an office procedure that serves as a helpful tool in diagnosing various uterine abnormalities. The technique is fairly easy to learn and may be performed without assistance. The biopsy is obtained through the use of an endometrial suction catheter that is inserted through the cervix into the uter...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2001-03-15 00:00:00
abstract::Spinal cord compression from metastatic cancer is a medical emergency. Prompt intervention affords the best chance for successful recovery, while delay may result in devastating neurologic impairment. In the appropriate clinical setting, emergency myelography should be done to confirm the diagnosis of metastatic disea...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::Post-traumatic stress disorder evolved from the concepts of shell shock and traumatic war neurosis. In Vietnam veterans, the disorder is associated with unemployment, marital discord, alcoholism and increased autonomic system response to perceived symbols of war trauma. A combination of psychotherapy and pharmacothera...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1988-02-01 00:00:00
abstract::As effective antipsychotic pharmacotherapy has become available, patients with schizophrenia are increasingly managed in an outpatient setting by primary care physicians. Pharmacotherapy is generally effective in treating "positive," or psychotic, symptoms and lessening the risks of relapse, but ineffective in improvi...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::Historically, osteopathic physicians have made an important contribution to the primary care workforce. More than one half of osteopathic physicians are primary care physicians, and most of these are family physicians. However, the proportion of osteopathic students choosing family medicine, like that of their allopat...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2005-08-15 00:00:00