ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;Insomnia is a common complaint. Transient and short‐term insomnias usually result from stress or the use of certain pharmaceuticals or drugs and may be managed by reduced caffeine use, behavioral means, and/or pharmacologic treatment. Long‐term insomnia is often a symptom of a medical or psychiatric condition or a primary sleep disorder. A diagnostic workup is expected; treatment should focus on the causative condition, as well as addressing the sleep problem itself. Established medications for the symptomatic treatment of insomnia include benzodiazepines, zolpidem, zaleplon, and certain antidepressant or occasionally antihistaminic drugs.

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Background.Sleep disorders are common, but the frequency of sleep history documentation in hospitalized patients is unknown.Methods.We reviewed 442 initial histories and physical examinations recorded by 122 house officers and 47 medical students in 208 consecutive general medicine ward patients.Results.Any reference to sleep was recorded in only 18 patients (9%), including 12 of 141 (9%) with conditions associated with obstructive sleep apnea. Sleep histories were recorded more often in women (13% vs 4%) and less often than histories of cigarette smoking or alcohol use. Medical students recorded such histories more often than did house officers. Patients with sleep histories more often had pulse oximetry (78% vs 37%), pulmonary function testing (11% vs 1%), arterial blood gas analysis (67% vs 30%), or electrocardiograms (78% vs 49%).Conclusions.Sleep histories are documented infrequently in hospitalized patients. Patients with a recorded sleep history more often have tests that suggest increased concerns about cardiorespiratory risk and/or a different process of care.

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;Anal melanoma is a devastating malignancy easily confused with benign hemorrhoids. Physician unfamiliarity with this bleeding rectal lesion can lead to delays in diagnosis and therapy. Four cases of anal melanoma, all initially mistaken for hemorrhoids, have been documented in the past 4 years at our institution. Despite surgical intervention and chemoimmunotherapy, each patient succumbed to widely metastatic disease. Average survival was 15.2 months. The clinical, pathologic, surgical, and oncologic features of anal melanoma are reviewed to enhance physician recognition of this unusual anorectal disorder.

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;We describe a 32‐year‐old woman who had temperatures increasing over 7 days from 100.7°F to 104.0°F. She had an upper respiratory infection and swelling of the left side of the neck. She was diagnosed with Lemierre's syndrome.

ISSN:0038-4348    

出版商:OVID    

年代:2001

数据来源: OVID