ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Although alchol-related problems are a significant source of morbidity and mortality in the United States, denial and resistance to treatment by patients and their families make detection challenging. Primary care providers may find it difficult to confront the patient who drinks excessively; however, early intervention can lower morbidity and prevent progressive damage to family and social relationships. Routine alcohol screening of all patients may assist the primary care provider in effectively identifying and treating alcohol abuse. Although abstinence is the primary goal for patients with alcohol-related problems, decreasing intake is also beneficial and may be accomplished with brief primary care interventions. The management of outpatient alcohol detoxification is increasingly provided by primary care providers in managed care environments, but requires careful assessment of the patient's support system, close provider supervision, and appropriate pharmacologic support.

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Appendicitis is one of the most common causes of acute abdominal pain in the industrialized world. Appendicitis must be considered in the differential diagnosis of any patient presenting with abdominal pain. Workup may include blood tests, abdominal radiographs, abdominal ultrasound, and focused appendix computed tomography. Unfortunately, none of these provides definitive results. Although several signs and symptoms are associated with appendicitis, their inconsistent presentation, especially among the young and the elderly, can lead to an erroneous diagnosis. The classic sequence of symptoms includes the onset of vague epigastric or periumbilical pain; associated nausea, anorexia, or unsustained vomiting; and pain migrating to the right lower quadrant. In uncomplicated cases, the treatment of appendicitis is appendectomy. However, less definitive presentations merit further diagnostic testing and close follow-up.

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Lower-extremity amputation is a much feared complication of diabetes mellitus; however, 40% to 50% of these amputations are preventable. Peripheral neuropathy has been implicated as a cause in some 82% of diabetic amputations. Patient education on foot care is often not enough to prevent foot ulceration and potential amputation. Health care providers can lower the incidence of lower extremity amputation by using a Semmes-Weinstein monofilament to identify protective sensation loss and quickly taking measures to prevent ulceration. Diabetes patients who have a history of foot deformity, ulceration, or amputation of any part of the foot should be referred for special shoes or orthotics. This article reviews the methods for identifying those patients with diabetes that are at high risk for amputation and preventive interventions.

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1999

数据来源: OVID