ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Pervasive developmental disorder, not otherwise specified (PDD, NOS), a developmental-neurologic spectrum disorder, occurs in 10 to 12 of every 10,000 children. PDD, NOS is characterized by a spectrum of significant problems that may vary substantially in range and expression. These may include visual/spatial, kinesthetic, verbal/linguistic, and musical/ rhythmic problems. Social skill deficits are also common, as are restricted, repetitive patterns of behavior, interests, and activities. Symptoms of PDD, NOS are often expressed differently among children with the disorder and can be mistakenly attributed to other problems such as attention deficits, oppositional behavior, or stress reactions. Clinicians may encounter children in their practice who exhibit symptoms of PDD, NOS and must be familiar with this disorder so that appropriate diagnosis and treatment can be provided. Families also need on-going, anticipatory guidance to help them cope with the behavioral aspects of the disorder.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Cases of long-standing (6 months or longer) fatigue that are not explained by an existing medical or psychiatric diagnosis are referred to as chronic fatigue syndrome (CFS). CFS is a condition of unknown etiology that presents with a complex array of symptoms in patients with diverse health histories. A diagnosis of CFS is largely dependent upon ruling out other organic and psychologic causes of fatigue. CFS can present the clinician with a unique set of challenges in terms of diagnosis and treatment. A review of recent research suggests that the management of CFS requires an individualized approach for each patient. An historic overview of the condition is presented along with current theories of causation, diagnosis considerations, symptom management, and health promotion strategies.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Acute low back pain will affect more than 80% of the population, with more than 28% of the industrial workforce suffering from lost work. Acute low back pain is recognized as the third most common illness presenting to private practice groups. The psychosocial overtones of depression and anxiety that often coexist or predate the episode of acute low back pain add to its complexity and cost. Diagnosis and treatment options are reviewed based on the Agency for Health Care Policy and Research recommendations of 1994. This article reviews details of the history and physical with emphasis on the importance of a thorough neurologic and psychologic evaluation. “Red flags” that should warn the clinician of the presence of a more acute illness are discussed with recommendations for referral. The treatment of acute low back pain now centers on increasing mobility and functional use of the spine as soon as possible. Nonsteroidal anti-inflammatory agents as well as aspirin and acetaminophen are recommended as first-line drug treatments; they have been found to be equally as effective as muscle relaxants and opioids for the control of pain without the burden of dependence and potential for abuse.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Parkinson's disease (PD) is a slowly progressing neurologic movement disorder affecting nearly 1% of the population over age 65. PD is the fourth most common neurodegenerative disease of patients. Incidence is greater in men with a ratio of 3:2-men to women. Because PD is so complex, diagnosis and treatment are often very challenging. While the cause of PD is unknown, research has concentrated on genetics, exogenous toxins, and endogenous toxins from cellular oxldative reactions. The presenting symptoms of a patient with PD include muscle rigidity, tremors, bradykinesia, and postural Instability. Treatment for PD has been primarily pharmacologic: levoidopa, carbldopa, anticholinergics, and selegiline (a monoamine oxidiase inhibitor to reestablish an equilibrium between dopamine and acetyl-choline). Surgical procedures (e.g., pallidotomy, thalamotomy, and tissue implants) are a possible choice of treatment for patients who have failed to respond satisfactorily to drugs.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

While emphasis is justifiably placed on the importance of detecting breast masses during breast examination, the equally important need for accurate assessment of nipple discharge is often overlooked. Inspection and palpation for nipple discharge should be a part of every breast examination. When detected, a critical analysis should be made of every nipple discharge, with the ultimate objective being differentiation between benign and malignant discharges. All nipple discharges can be defined by the physical characteristics of lateraliy, spontaneity, color, consistency, number of ducts involved, and duration. By correlating these characteristics with certain historical features (e.g., age, pregnancy, trauma, drugs), accurate determination of etiology can be made. A four-step approach is presented that offers a logical method for making the essential correlations. The sequence of the four relevant questions proposed gives the examiner a logical basis from which to assign clinical importance to each discharge. An algorithm is outlined that correlates diagnostic considerations with therapeutic actions.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Ovarian cancer is more likely to be cured when diagnosed in the early stages, but the vagueness of presenting symptoms, which are easily attributed to benign conditions, is a major barrier to early diagnosis. The goal of this research was to further delineate these vague presenting symptoms. A convenience sample of 50 women aged 35 to 70 years who had been diagnosed with ovarian cancer was obtained through the Internet. Data were obtained by means of a one-time questionnaire consisting of a symptom checklist, narrative descriptions of symptoms, and demographic questions. Overall, 94% (n=47) of the participants reported experiencing at least one symptom prior to their ovarian cancer diagnosis. Six gastrointestinal symptoms were reported by greater than 50% of the sample. The mean number of symptoms per woman was 8.6 (SD=4.3, range 1–19). The mean total number of symptoms reported by the women that they retrospectively attributed to cancer was 5.9 (SD=4.5, range 0–16). Narratively, the women reported menstrual cycle changes most frequently (22% of the sample). This study highlights the need for education of health care professionals on the symptomatology of this disease. Education of women should focus on the known signs and symptoms of ovarian cancer and what defines normal age-related physiologic changes.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID