Abstract:
:Delirium is characterized by a sudden deterioration in cognitive function and an inability to sustain attention. It is a medical emergency that occurs in more than 20 percent of hospitalized elderly patients. Misdiagnosis is common and contributes to high morbidity and mortality. Patients may present in hypoactive, hyperactive or mixed states. Frail elderly patients are at greatest risk of delirium, especially those with dementia and multiple medical problems. Clinical history, physical examination and laboratory testing determine the most likely etiologies, such as medications (especially drugs with anticholinergic potential), infections and electrolyte disturbances. Effective management requires prompt treatment of the underlying pathology and maintenance of a supportive environment. It is often necessary to control agitation and prevent the complications of immobility in elderly patients with delirium. Although the long-term prognosis is guarded in elderly patients with delirium, sound geriatric care and a high index of suspicion can minimize the impact of delirium.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Bross MH,Tatum NOsubject
Has Abstractpub_date
1994-11-01 00:00:00pages
1325-32issue
6eissn
0002-838Xissn
1532-0650journal_volume
50pub_type
杂志文章,评审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 ...
journal_title:American family physician
pub_type: 杂志文章,已发布勘误,评审
doi:
更新日期:2014-08-01 00:00:00
abstract::Thyroid function tests, radioiodine uptake and scintiscanning, and antithyroid antibody titers are the main laboratory tests useful in the management of goiter. Scintiscanning and ultrasonography aid in differentiating a functioning adenoma from a "cold" solid nodule--a crucial distinction since the incidence of cance...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::Skin laceration repair is an important skill in family medicine. Sutures, tissue adhesives, staples, and skin-closure tapes are options in the outpatient setting. Physicians should be familiar with various suturing techniques, including simple, running, and half-buried mattress (corner) sutures. Although suturing is t...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2008-10-15 00:00:00
abstract::Eczematous dermatitis is a common condition that can interfere with social function, sleep and employment. Its persistence and accompanying pruritus may be stressful and frustrating for patients. The most common and best characterized type of eczema, atopic dermatitis, appears to be increasing in incidence. Other comm...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-09-15 00:00:00
abstract::More women, men and children receive medical care each month in the offices of primary care physicians than any other professional setting. There is an urgent need for health policies that encourage further innovation and implementation ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2001-09-15 00:00:00
abstract::Patients commonly present to family physicians with low back pain. Because the majority of patients fully or partially recover within six weeks, imaging studies are generally not recommended in the first month of acute low back pain. Exceptions include patients with suspected cauda equina syndrome, infection, tumor, f...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2002-06-01 00:00:00
abstract::Many normal children have heart murmurs, but most children do not have heart disease. An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonar...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::Joint and soft tissue injection of the ankle and foot region is a useful diagnostic and therapeutic tool for the family physician. This article reviews the injection procedure for the plantar fascia, ankle joint, tarsal tunnel, interdigital space, and first metatarsophalangeal joint. Indications for plantar fascia inj...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2003-10-01 00:00:00
abstract::Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonergic activity in the nervous system. It is characterized by mental status changes, autonomic instability, and neuromuscular hyperactivity. Most reported cases of serotonin syndrome are in patients using multiple serotonergic dru...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2010-05-01 00:00:00
abstract::Genetic testing may be applied in a variety of clinical situations, including preconception counseling, prenatal diagnosis and postnatal determination of genetic predisposition to disease. The family physician needs to become familiar with the full range of genetic testing possibilities in all phases of the human life...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00
abstract::Pharmacologic agents that attenuate the influence of the renin-angiotensin-aldosterone system are known to reduce systemic arterial blood pressure through vasodilatory action and enhanced renal clearance of sodium and water. Angiotensin-converting enzyme inhibitors are known to antagonize the renin-angiotensin-aldoste...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-02-01 00:00:00
abstract::Hearing conservation programs have not kept pace with changes in the workplace and in the work force. Heavy industry and noisy factories have yielded to quiet computers and high technology. Chemicals, self-administered or prescribed, may replace noise as a chief source of hearing loss. The aging working population and...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract::Alzheimer's disease accounts for about 60 percent of dementia cases. Misdiagnosis of the treatable dementias can have devastating results. Pseudodementia accompanying major depression and chronic cognitive dysfunction due to psychoactive drugs are among the most commonly missed diagnoses. Although cortical atrophy is ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::In many cases, the family physician will set the tone for rehabilitation of the stroke patient. It is imperative that the physician understand the recovery process, as well as the nature, benefits and limitations of rehabilitation. Since there are no precise predictors of individual outcome, no patient should be exclu...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::Rheumatic complaints secondary to viral infections are usually brief, self-limited and nondestructive. They may accompany almost any type of viral illness, and the arthritic presentation is nonspecific. These manifestations are protean, ranging from arthralgia to vasculitis. Often the cause of the rheumatic complaint ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
abstract::At least three models have been used to project the future physician workforce, and each produces different results. No physician workforce predictions can be relied on until there is more consideration of and agreement on desired health outcomes and what physicians must do to achieve them. ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2005-11-01 00:00:00
abstract::Because of the increasing popularity of recreational scuba diving, primary care physicians should be familiar with common diving injuries. One form of barotrauma, middle ear squeeze, is the most common diving injury. Other important diving injuries include inner ear barotrauma and pulmonary barotrauma. Arterial gas em...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-04-01 00:00:00
abstract::Caring for the problem drinker in the perioperative period is a challenging task. If alcohol abuse is suspected, a careful assessment is indicated before surgery is performed. Both the CAGE and SMAST questionnaires are good screening tools for alcoholism. Preoperative evaluation of alcohol-dependent patients should in...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1995-12-01 00:00:00
abstract::The records of 1,381 patients with gonorrhea were examined by the Massachusetts Department of Public Health to determine the efficacy of their treatment schedules. Urethritis, cervicitis and pharyngitis were treated with 4.8 million u. of aqueous procaine penicillin G intramuscularly, without probenecid. Cure rates we...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract::A throat culture is necessary for accurate diagnosis of group A beta-hemolytic streptococcal tonsillopharyngitis. The use of penicillin therapy in every patient with sore throat results in overtreatment of 85 percent of children and 95 percent of adults presenting to family physicians with the complaint of sore throat...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::New recommendations for the classification and diagnosis of diabetes mellitus include the preferred use of the terms "type 1" and "type 2" instead of "IDDM" and "NIDDM" to designate the two major types of diabetes mellitus; simplification of the diagnostic criteria for diabetes mellitus to two abnormal fasting plasma ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-10-15 00:00:00
abstract::The best condoms are made of latex, are lubricated and coated with a spermicide, and have a reservoir tip. Condoms can protect against conception and sexually transmitted diseases, including acquired immunodeficiency syndrome. When condoms are used properly and in combination with vaginal spermicidal foam, the contrac...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::This is a minimally invasive imaging technique designed to evaluate patients for suspected coronary artery disease. It is usually performed in conjunction with stress ECG testing. It can accurately determine the presence and extent of coronary artery disease and help determine whether cardiac catheterization is necess...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract::Peptic ulcer disease is strongly associated with infection by Helicobacter pylori, a spiral-shaped, flagellated organism found predominantly in the gastric antrum. More than 90 percent of duodenal ulcers and adenocarcinomas of the distal stomach are associated with H. pylori infection. Eradication of the organism effe...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-06-01 00:00:00
abstract::Gallstone disease is a major health problem in the United States and in most Western countries. During the past century, cholecystectomy has been the treatment of choice. Recently, new modalities of treatment have been developed, including oral dissolution therapy, extracorporeal shock-wave lithotripsy, percutaneous t...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-10-01 00:00:00
abstract::Respiratory difficulty is a common presenting complaint in the outpatient primary care setting. Because patients may first seek care by calling their physician's office, telephone triage plays a role in the early management of dyspnea. Once the patient is in the office, the initial goal of assessment is to determine t...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2003-11-01 00:00:00
abstract::Contrast sensitivity vision testing is the new technology in visual screening. Easy to administer and quick to perform, contrast sensitivity vision testing appears to be cost-effective for use by family physicians. It is a more sensitive indicator of ocular disease than traditional Snellen acuity testing and may detec...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::New evaluation and management codes were created by the Current Procedural Terminology (CPT) Editorial Panel to ensure more accurate and consistent reporting of physician services. The new hospital inpatient codes describe three levels of service for both initial and subsequent care. Critical care services are reporte...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract::Cat-scratch disease is a common infection that usually presents as tender lymphadenopathy. It should be included in the differential diagnosis of fever of unknown origin and any lymphadenopathy syndrome. Asymptomatic, bacteremic cats with Bartonella henselae in their saliva serve as vectors by biting and clawing the s...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-15 00:00:00
abstract::Systemic lupus erythematosus, chronic cutaneous lupus erythematosus and subacute and acute cutaneous lupus erythematosus are associated with distinct cutaneous manifestations, and each disease has a particular clinical course and prognosis. Dermatomyositis, an immune-mediated disorder of unknown etiology that is often...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-04-01 00:00:00