Abstract:
:Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient.
journal_name
Emerg Med Clin North Amjournal_title
Emergency medicine clinics of North Americaauthors
Harwood-Nuss AL,Benrubi GI,Nuss RCsubject
Has Abstractpub_date
1987-08-01 00:00:00pages
577-99issue
3eissn
0733-8627issn
1558-0539journal_volume
5pub_type
杂志文章,评审abstract::Ultrasound has rapidly become an essential tool in the emergency department, specifically in procedural guidance. Its use has been demonstrated to improve the success rate of procedures, while decreasing complications. In this article, we explore some of these specific procedures involving needle guidance and structur...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:10.1016/j.emc.2012.09.008
更新日期:2013-02-01 00:00:00
abstract::Adverse cardiovascular events comprise a large portion of the morbidity and mortality in drug overdose emergencies. Adverse cardiovascular events encountered by emergency physicians treating poisoned patients include myocardial injury, hemodynamic compromise with shock, tachydysrhythmias, and cardiac arrest. Early sig...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2013.10.003
更新日期:2014-02-01 00:00:00
abstract::The general concepts of defibrillation are reviewed. Research continues in the area of implanted defibrillators, new circuiting, and more effective current transfer. ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1983-12-01 00:00:00
abstract::Because of the altered physiology of the elderly population, either as a result of aging or as a result of other disease processes, many illnesses may present with features that are either atypical or nonspecific in nature. Difficult and nonspecific complaints such as weakness in an elderly patient must be handled in ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70056-0
更新日期:1999-02-01 00:00:00
abstract::Emergency medical services for children require the integration of many community resources to operate optimally. In both urban and rural areas, the abilities of the receiving hospitals and medical staffs must be defined to develop a system that considers severity of injury and illness as well as transport times. ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract::Disruption of cerebral blood flow may influence brain energy metabolism to produce reversible or irreversible neurologic deficits. The emergency physician is in a unique position to provide timely treatment during the first few hours of an acute stroke. He or she must be facile with unique pharmacologic and non-pharma...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70245-5
更新日期:1996-02-01 00:00:00
abstract::Few presentations to the emergency department are as critical or dramatic as the patient in shock. Cardiovascular disasters that commonly present with shock include massive pulmonary embolism, cardiac tamponade, aortic dissection and aneurysm, and cardiogenic shock associated with acute myocardial infarction. Because ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract::Sepsis and septic shock remain all too frequent syndromes in modern medicine with unacceptably high mortality rates. Physicians must be aware of the many ways in which sepsis and septic shock may present and the multiple differential diagnoses. Early recognition and prompt institution of empiric therapy are of utmost ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1986-11-01 00:00:00
abstract::Diseases do not always show the usual or "classic" signs and symptoms in the elderly. Physiologic changes over the years of a long life seem to be responsible for impairment of regulation or function of many organ systems. Since function often is measured in clinical medicine by laboratory testing, physicians frequent...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-05-01 00:00:00
abstract::The history, effectiveness, and services of regional poison control centers are reviewed. In addition, the American Association of Poison Control Centers criteria for designation as a regional poison control center are presented. ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract::Although emergency departments (ED's) vary in shape, size, and technology, similarities in responsibilities exist. The primary responsibility is to provide quality health care to the communities served. The (ED) constitutes a substantial business in any hospital. Because of changing acuity levels, patient volume, and ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/S0733-8627(03)00099-3
更新日期:2004-02-01 00:00:00
abstract::Neurologic and myopathic complications of alcoholism are multiple and diverse, affecting both the central and peripheral nervous systems. In the ED, initial concern is for diagnosing readily reversible causes and ruling out possible life- or limb-threatening etiologies. A rapid assessment of the ABCs, a fingerstick bl...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-11-01 00:00:00
abstract::This article reviews out-of-hospital cardiac arrest from a public health perspective. Case definitions are discussed. Incidence, outcome, and fixed and modifiable risk factors for cardiac arrest are described. There is a large variation in survival between communities that is not explained by patient or community fact...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:10.1016/j.emc.2011.09.003
更新日期:2012-02-01 00:00:00
abstract::Earache, a common emergency department presentation, may be caused by a variety of conditions, some distant from the ear. This article discusses the diagnosis and treatment of acute otitis media, otitis media with effusion, otitis externa, otitis media with ruptured tympanic membrane or tympanostomy tubes, malignant o...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2013.02.001
更新日期:2013-05-01 00:00:00
abstract::Although there are complications associated with cardioversion, they are relatively infrequent and usually of small magnitude compared with the primary disease. Cardioversion is an invaluable part of the emergency physician's armamentarium. ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:
更新日期:1983-12-01 00:00:00
abstract::The spectrum of acute coronary syndromes (ACS) includes several clinical complexes that frequently cause critical instability in affected patients. This article focuses on several critical care aspects of these unstable ACS patients. The management of cardiogenic shock can be particularly challenging because the mecha...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2008.04.002
更新日期:2008-08-01 00:00:00
abstract::Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2016.08.006
更新日期:2017-02-01 00:00:00
abstract::This article is designed to review proper procedure by an emergency or primary care physician when evaluating a patient with decreased hearing. It will cover the anatomy and physiology of hearing, as well as the evaluation and initial management of conductive and sensorineural hearing loss. ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1987-05-01 00:00:00
abstract::Numerous surgical complications arise from parenteral drug use. Some complications have severe sequelae and most prove to be a diagnostic challenge. It is likely that these problems will remain a significant burden on the health care system as a result of continued widespread drug abuse. EPs must always maintain vigil...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(03)00068-3
更新日期:2003-11-01 00:00:00
abstract::Elderly trauma patients present unique challenges and face more significant obstacles to recovery than younger patients. Despite overall higher mortality, longer length of stay, increased resource use, and higher rates of discharge to rehabilitation, most elderly trauma patients return to independent or preinjury func...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2007.06.005
更新日期:2007-08-01 00:00:00
abstract::Although discussed much less than flexor tendon injuries, achievement of satisfactory function is difficult with these injuries. Under proper circumstances in clean wounds, and in a well equipped emergency department, they can be primarily repaired if the examining physician has the experience. If these conditions are...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00
abstract::Toxic overdose can present with various clinical signs and symptoms. These may be the only clues to diagnosis when the cause of toxicity is unknown at the time of initial assessment. The prognosis and clinical course of recovery of a patient poisoned by a specific agent depends largely on the quality of care delivered...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2007.02.004
更新日期:2007-05-01 00:00:00
abstract::Many systemic diseases have associated oral symptoms. Occasionally, patients with these diseases present with lesions that occur primarily in the mouth. Although few systemic diseases have strictly pathognomonic lesions of the oral mucosa, a careful examination of the oral cavity can often lend important clues to maki...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70144-9
更新日期:2000-08-01 00:00:00
abstract::PTV is an adjunct to airway management that can prove helpful in selected cases. Its speed and ease of performance are offset by the need for specialized equipment to accomplish it. This difficulty, combined with infrequent indications, makes PTV a rarely performed procedure. Nevertheless, it remains a viable airway m...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-11-01 00:00:00
abstract::A future challenge for international EM development is expanding the specialty to Africa, where it is non-existent. Another goal for international EM development is to assist in the peace process in the Middle East. There is increasing need for good EM development throughout the world. Development of international EM ...
journal_title:Emergency medicine clinics of North America
pub_type: 历史文章,杂志文章
doi:10.1016/j.emc.2004.09.013
更新日期:2005-02-01 00:00:00
abstract::Fever is the most common reason that children and infants are brought to emergency departments. Emergency physicians face the challenge of quickly distinguishing benign from life-threatening conditions. The management of fever in children is guided by the patient's age, immunization status, and immune status as well a...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2013.07.006
更新日期:2013-11-01 00:00:00
abstract::Adolescents are the victims, perpetrators, and witnesses of violent acts in the home, at school, and on the streets. Adolescent violence describes a dynamic, destructive, and repercussive process. This article discusses the unique aspects of adolescent violence and the involvement undertaken by the emergency departmen...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70084-5
更新日期:1999-08-01 00:00:00
abstract::The patient with severe head injury is a therapeutic challenge and demands all of the skills of the emergency medical specialist to manage traumatic injuries to the head, chest, abdomen, and limbs, as well as the specialized problems associated with respiratory care in a patient with raised ICP. The initial treatment ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::Respiratory failure is a frequent disease process encountered in the emergency department. There is significant need for improvement in the care of patients on mechanical ventilation. If not contraindicated, lung-protective ventilation strategies should be used. It is important to consider pathophysiology (shunting, d...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2014.07.012
更新日期:2014-11-01 00:00:00
abstract::Venomous aquatic animals are hazardous to swimmers, surfers, divers, and fishermen. Exposures include mild stings, bites, abrasions, and lacerations. Severe envenomations can be life threatening. This article reviews common marine envenomations, exploring causative species, clinical presentation, and current treatment...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2016.12.004
更新日期:2017-05-01 00:00:00