Abstract:
:Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Assessment for and prevention of delirium should occur at admission and continue throughout a hospital stay. Caregivers should be educated on preventive measures, as well as signs and symptoms of delirium and conditions that would indicate the need for immediate evaluation. Certain medications, sensory impairments, cognitive impairment, and various medical conditions are a few of the risk factors associated with delirium. Preventive interventions such as frequent reorientation, early and recurrent mobilization, pain management, adequate nutrition and hydration, reducing sensory impairments, and ensuring proper sleep patterns have all been shown to reduce the incidence of delirium, regardless of the care environment. Treatment of delirium should focus on identifying and managing the causative medical conditions, providing supportive care, preventing complications, and reinforcing preventive interventions. Pharmacologic interventions should be reserved for patients who are a threat to their own safety or the safety of others and those patients nearing death. In older persons, delirium increases the risk of functional decline, institutionalization, and death.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Kalish VB,Gillham JE,Unwin BKsubject
Has Abstractpub_date
2014-08-01 00:00:00pages
150-8issue
3eissn
0002-838Xissn
1532-0650pii
d10939journal_volume
90pub_type
杂志文章,已发布勘误,评审abstract::Medical problems associated with prematurity are frequently complex, and a multidisciplinary approach is often required. Some common problems include the following: (1) anemia, which can be reduced by iron supplementation, (2) cerebral palsy or mental retardation as a result of intraventricular hemorrhage or periventr...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-15 00:00:00
abstract::Women experience depression twice as often as men. The diagnostic criteria for depression are the same for both sexes, but women with depression more frequently experience guilt, anxiety, increased appetite and sleep, weight gain and comorbid eating disorders. Women may achieve higher plasma concentrations of antidepr...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-07-01 00:00:00
abstract::If current trends continue, U.S. health insurance costs will consume the average household's annual income by 2025. As health care becomes unaffordable for most people in the United States, it will be necessary to implement innovative models to move the system in a more equitable and sustainable direction. ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2005-11-15 00:00:00
abstract::The safety of vaginal birth after cesarean (VBAC) delivery has been documented. Fetal and neonatal morbidity is not increased, and the mortality rate is less than one in 2,000 deliveries. Maternal morbidity and mortality rates for VBAC delivery are significantly lower than those for repeat cesarean section. Family phy...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1988-06-01 00:00:00
abstract::Delayed hypersensitivity skin tests, when properly planned and performed, are both practical and sensitive in determining the status of cell-mediated immunity. They can be diagnostic of specific exposure, such as tuberculosis, or they can rule out anergy. Pitfalls include poor selection of antigens, inappropriate appl...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::Bone loss coincides with the reduced physical activity of both sexes in later years, vigorously aggravated by age-associated hormonal changes in women and chronic inadequate intake of calcium. In the absence of preventive dietary measures, osteoporosis may become a major health problem for America's fastgrowing senior...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
abstract::Acute ankle injury, a common musculoskeletal injury, can cause ankle sprains. Some evidence suggests that previous injuries or limited joint flexibility may contribute to ankle sprains. The initial assessment of an acute ankle injury should include questions about the timing and mechanism of the injury. The Ottawa Ank...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-11-15 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::Oral administration of xanthine compounds represents the first line of therapy in most patients with asthma. Establishment and maintenance of a therapeutic blood level of the medication requires regular dosgae. Oral sympathomimetic agents with predominantly beta-2 adrenergic activity, if tolerated, are often useful ad...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::Coronary angioplasty is an accepted method of revascularization in selected patients with coronary artery disease. Immediately after a successful angioplasty, initial management concentrates on the detection and treatment of coronary artery spasm and acute vessel closure, should these complications occur. Once the pat...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::Progestational agents have many important functions, including regulation of the menstrual cycle, treatment of dysfunctional uterine bleeding, prevention of endometrial cancer and hyperplastic precursor lesions, and contraception. Because of the reported side effects of synthetic analogs called "progestins," there has...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-10-15 00:00:00
abstract::Group B streptococci and Escherichia coli are the most frequently isolated etiologic agents in neonatal septicemia. Neonatal infection that is caused by Pseudomonas aeruginosa is usually late in onset, nosocomial in origin and epidemic in pattern. However, P. aeruginosa must be considered in all neonatal infections, r...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::Chlamydial cervicitis has the potential for serious gynecologic complications, including pelvic inflammatory disease, infertility and ectopic pregnancy. In the pregnant patient, this infection is associated with premature rupture of membranes and increased fetal morbidity and mortality. In addition, infants infected b...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 00:00:00
abstract::Seizure patterns usually reflect known functions of the involved areas of the brain. The causes of epilepsy vary with the age at onset. For the purposes of determining drug therapy, seizures are divided into three groups. Focal and tonic-clonic seizures respond to one group of drugs, and absence seizures respond to an...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2014-07-01 00:00:00
abstract::Hearing loss is a common problem that can occur at any age and makes verbal communication difficult. The ear is divided anatomically into three sections (external, middle, and inner), and pathology contributing to hearing loss may strike one or more sections. Hearing loss can be categorized as conductive, sensorineura...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2003-09-15 00:00:00
abstract::Thyroiditis is a spectrum of diseases that includes acute, subacute and chronic thyroiditis, all of which demonstrate the histologic findings of inflammation, fibrosis or lymphocytic infiltration. Acute thyroiditis is an infectious disease characterized by the abrupt onset of anterior neck pain and swelling. Subacute ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-15 00:00:00
abstract::Apophyseal injuries, which are unique in the adolescent athlete, cause inflammation at the site of a major tendinous insertion onto a growing bony prominence. These injuries typically occur in active adolescents between the ages of eight and 15 years and usually present as periarticular pain associated with growth, sk...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-06-01 00:00:00
abstract::The classic modes of heat loss affecting the newborn are conduction, convection, radiation and evaporation. The disproportionate ratio of surface area to body weight (SA/BW) of the premature infant is the basis of inefficient heat conservation, combined with a blunted metabolic response. Hypothermia leads to hypoxemia...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1977-11-01 00:00:00
abstract::Outpatient intravenous antibiotic therapy is a cost-effective modality to shorten hospital stays and provide continued care to patients with infections. The recent availability of tamper-proof pumps that can deliver multiple antibiotics on independently timed regimens will further expand the use of home intravenous an...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract::The principle of confidentiality is one of the clearest and firmest rules of professional ethics. However, situations can arise in which confidentiality ought to be abridged in favor of other, weightier values. In the case of a teenager who asks a family physician to prescribe birth control pills for her without infor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1982-01-01 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::New beta lactams and the quinolone class of antibiotics represent major improvements in the therapy of moderate to severe infections. These newer antibiotics have an extended spectrum of antimicrobial activity, excellent pharmacokinetic properties and low toxicity. The beta lactams include carbapenems, represented by ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1988-10-01 00:00:00
abstract::Healing by primary intention is a threefold process, consisting of an initial phase in which red and white blood cells bind the wound; epithelialization and fibroplasia, and a maturation phase involving collagen synthesis. The appearance of the wound reflects its maturation. Skillful wound management is based on biolo...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract::The acute and chronic effects of alcohol on bone, muscle and peripheral nerves are not well appreciated. Bone complications include traumatic fractures, osteoporosis and osteonecrosis. In muscle, a sustained bout of heavy drinking may cause rhabdomyolysis, while chronic alcohol abuse may produce proximal myopathy. In ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Persons whose experienced or expressed gender differs from their sex assigned at birth may identify as transgender. Transgender and gender-diverse persons may have gender dysphoria (i.e., distress related to this incongruence) and often face substantial health care disparities and barriers to care. Gender identity is ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2018-12-01 00:00:00
abstract::The specific type of epilepsy must be identified. The history and the EEG provide the evidence. Drug selection is then based on the classification of the patient's epilepsy. Major drugs used in the management of epilepsy are phenytoin, phenobarbital, primidone, carbamazepine, ethosuximide and valproic acid. The physic...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
abstract::Analgesic and sedative needs depend on the type of procedure, the child's age and the degree of cooperation from the child and parents. Local anesthesia, which may be administered subcutaneously or in topical gel form, generally is sufficient for common procedures such as lumbar puncture and laceration repair. Frequen...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-02-15 00:00:00
abstract::Celiac disease is a genetic, immunologically mediated small bowel enteropathy that causes malabsorption. The immune inflammatory response to gluten frequently causes damage to many other tissues of the body. The condition is frequently underdiagnosed because of its protean presentations. New prevalence data indicate t...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-03-01 00:00:00
abstract::Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocatio...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-03-01 00:00:00