Abstract:
OBJECTIVE:To determine the frequency with which an acute confusional state is caused by a stroke and to evaluate the usefulness of obtaining computed tomography scans in this setting. DESIGN:Retrospective analysis. SETTING:Tertiary referral center. PATIENTS:The authors reviewed 127 neurology consultations requested for patients presenting with acute and apparently isolated mental status changes. The mean age was 62 years. RESULTS:Nine (7%) of the 127 patients were thought to have suffered mental status changes as a result of an acute stroke: one subarachnoid hemorrhage, and eight ischemic strokes. There was no intracerebral hemorrhage. The locations of the infarcts were: right frontoparietal (four patients), bilateral occipital (two patients), bilateral frontal (two patients), and right pontine (one patient, for whom the causality of the stroke was uncertain). Of those nine stroke patients presenting with isolated mental symptoms, six (66%) had some focal abnormality on neurologic examination. Only three (2.7%) of the 109 patients with no focal findings were ultimately diagnosed as having strokes, and one of these had a subarachnoid hemorrhage. CONCLUSIONS:Stroke was a relatively rare cause of acute confusional syndrome. The neurologic examination had a very high negative predictive value (97%) and was reliable in selecting patients who should undergo an imaging study.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Benbadis SR,Sila CA,Cristea RLdoi
10.1007/BF02599217subject
Has Abstractpub_date
1994-09-01 00:00:00pages
485-7issue
9eissn
0884-8734issn
1525-1497journal_volume
9pub_type
杂志文章abstract:BACKGROUND:The shortage of primary care providers and the provisions of the Affordable Care Act (ACA) have spurred discussion about expanding the number, scope of practice (SOP), and independence of primary care nurse practitioners (NPs). Such discussions in the media and among professional organizations may insinuate ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3896-7
更新日期:2017-03-01 00:00:00
abstract::Nicotine meets all critical criteria for an addictive drug. Furthermore, there is no evidence that there would be widespread compulsive use of tobacco without nicotine. These findings have led to consideration of the cigarette as a contaminated vehicle for an addictive drug (nicotine). Nevertheless, nicotine itself ma...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02600847
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Residents have a major role in teaching students, yet little has been written about the effects of resident work hour restrictions on medical student education. OBJECTIVE:Our objective was to determine the effects of resident work hour restrictions on medical student education. DESIGN:We compared student r...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0196-2
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Palliative care interventions in the ED capture high-risk patients at a time of crisis and can dramatically improve patient-centered outcomes. OBJECTIVE:To understand the facilitators that contributed to the success of the Primary Palliative Care for Emergency Medicine (PRIM-ER) quality improvement pilot in...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06302-2
更新日期:2020-10-27 00:00:00
abstract:OBJECTIVE:To determine the impact of an episode of serious cardiovascular disease on smoking behavior and to identify factors associated with smoking cessation in this setting. DESIGN:Prospective observational study in which smokers admitted to a coronary care unit (CCU) were followed for one year after hospital disch...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02597426
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Rates of substance use in rural areas are close to those of urban areas. While recent efforts have emphasized integrated care as a promising model for addressing workforce shortages in providing behavioral health services to those living in medically underserved regions, little is known on how substance use ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-015-3488-y
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Despite advances in pharmacologic therapy and invasive management strategies for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), these patients still suffer substantial morbidity and mortality. OBJECTIVE:The objective of this study was to analyze independent predictors of 1-year ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-007-0498-4
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Primary care providers (PCPs) have few tools for enhancing patient self-efficacy, a key mediator of myriad health-influencing behaviors. OBJECTIVE:To examine whether brief standardized patient instructor (SPI)-delivered training increases PCPs' use of self-efficacy-enhancing interviewing techniques (SEE IT)...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-016-3644-z
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Numerous interventions are available to boost medication adherence, but the targeting of these interventions often relies on crude measures of poor adherence. Group-based trajectory models identify individuals with similar longitudinal prescription filling patterns. Identifying distinct adherence trajectorie...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3747-6
更新日期:2016-09-01 00:00:00
abstract::Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-011-1641-9
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To examine suicidal behavior and depression prevalence among a group of Medicare patients under age 65 with functional impairment and recent significant health care services use. DESIGN:An observational study of baseline characteristics of participants in a randomized controlled trial. SETTING:A Medicare de...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2005.40244.x
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the accuracy of a preliminary diagnosis based solely on patient history and physical examination in medical outpatients with abdominal or chest pain. DESIGN:Prospective observational study. SETTING:General medical outpatient clinic in a university teaching hospital. PARTICIPANTS:One hundred nin...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1997.00083.x
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To determine time allocation and the perceived value to education and patient care of the weekday activities of internal medicine housestaff on inpatient rotations and to compare the work activities of interns and residents. DESIGN:An observational study. We classified activities along five dimensions (assoc...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00164.x
更新日期:1998-08-01 00:00:00
abstract::The objective of this study was to assess reasons for physicians' noncompliance with computer-generated preventive care reminders. In an academic general internal medicine practice, a survey of physicians' reasons for noncompliance found that 55% of reminders were not complied with. Reasons included "not applicable" i...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599049
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Whether patients' reports of gaps in care coordination reflect clinically significant problems is unclear. OBJECTIVE:To determine any association between patient-reported gaps in care coordination and patient-reported preventable adverse outcomes. DESIGN AND PARTICIPANTS:We administered a cross-sectional s...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06047-y
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively. OBJECTIVE:To determine whether adherence to national guidelines for outpatient preventive health services differs by year of residency training. DESIGN:Cross-sectional stu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.0158.x
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To describe a novel method of time analysis for health care settings by quantifying internal medicine housestaff's work activities and contacts. DESIGN:Observational work sampling study based on random sampling technique. SETTING:General medicine service in a university hospital. PARTICIPANTS:All housestaf...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599655
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:We compare preventive services utilization among privately insured African Americans and Hispanics in managed care organizations (MCOs) versus fee-for-service (FFS) plans. We also examine racial/ethnic disparities in the receipt of preventive services among enrollees in FFS or MCO plans. DESIGN:Analysis of t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2002.10512.x
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:The objective of the study is to examine the association between ambulatory care sensitive hospitalizations (ACSH) and dual Medicare/Veteran Health Administration use. PARTICIPANTS:A nationally representative sample of Medicare beneficiaries, who participated in the Medicare Current Beneficiary Survey (MCBS)...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1788-4
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To determine whether there are differences between men and women patients who have chronic fatigue syndrome (CFS) and, if so, to ascertain whether a gender-related pattern exists. DESIGN:A descriptive study of demographic, clinical, and psychosocial measures, the results of which were prospectively collected...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02629522
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Racial and ethnic disparities in opioid prescribing in the emergency department (ED) are well described, yet the influence of socioeconomic status (SES) remains unclear. OBJECTIVES:(1) To examine the effect of neighborhood SES on the prescribing of opioids for moderate to severe pain; and (2) to determine i...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-013-2516-z
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Domestic violence (DV) is prevalent across all racial and socioeconomic classes in the United States. Little is known about whether physicians differentially screen based on a patient's race or socioeconomic status (SES) or about resident physician screening attitudes and practices. OBJECTIVE:To assess the ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00494.x
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To determine whether selected socially rehabilitated former heroin addicts maintained on methadone can continue successful rehabilitation while maintained on methadone by primary care physicians rather than licensed clinics. This procedure has been termed "medical maintenance." DESIGN:Cohort study with 42-11...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600025
更新日期:1994-03-01 00:00:00
abstract::Our aim was to improve clinical reasoning skills by applying an established theory of memory, cognition, and decision making (fuzzy-trace theory) to instruction in evidence-based medicine. Decision-making tasks concerning chest pain evaluation in women were developed for medical students and internal medicine resident...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2001.00214.x
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relative...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3104-6
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To determine the overdose rate of drugs that require renal dose adjustment and factors related with overdose. SUBJECTS:Total of 23,635,210 records of prescriptions and laboratory data of inpatients at a tertiary teaching hospital for the period from January 2002 to December 2005. METHODS:A clinical data mar...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0336-8
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Doctor rating websites are a burgeoning trend, yet little is known about their content. OBJECTIVE:To explore the content of Internet reviews about primary care physicians. DESIGN:Qualitative content analysis of 712 online reviews from two rating websites. We purposively sampled reviews of 445 primary care ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1958-4
更新日期:2012-06-01 00:00:00
abstract::This study was designed to determine the clinical characteristics of hypertensive patients whose blood pressures are substantially higher in the medical office than in their natural environments. Thirty-nine percent of patients enrolled in a nonpharmacologic hypertension treatment program had systolic or diastolic off...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599528
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Network meta-analysis (NMA) is a popular tool to compare multiple treatments in medical research. It is frequently implemented via Bayesian methods. The prior choice of between-study heterogeneity is critical in Bayesian NMAs. This study evaluates the impact of different priors for heterogeneity on NMA resul...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06357-1
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:Racial and ethnic minority groups have lower levels of leisure-time physical activity (LTPA) than whites, but it is unclear how much of this is explained by differences in socioeconomic status and health. OBJECTIVE:To examine differences in LTPA, work-related physical activity (WRPA; heavy household chores ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.40198.x
更新日期:2005-03-01 00:00:00