摘要:

Nongenital verruca Is a common ailment frequently encountered In the primary care setting. Although greater than half of verruca resolve spontaneously within a 2-year period, many have a propensity to spread and cause considerable discomfort if untreated. This characteristic makes it vital for the clinician to become competent In assessment and treatment of verruca. This article discusses etlologic and epidemiologic factors, diagnosis and prevention considerations, folk remedies, and common treatment options for the management of verruca. Included is a patient-teaching handout to offer the patient when dual office and home therapy Is chosen. This article also reviews the newest treatment option, Clmetldlne (Tagamet). Current research with this H2antagonist offers hope for easier and less costly management of recalcitrant verruca.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Patients' uses of herbal therapies warrant close scrutiny by providers. With the current proliferation of lay literature on herbal remedies and the wide availability of such products In health foods and other such stores, more people are relying on herbal and less conventional therapies for a wide variety of problems. Guidance In safe and effective use Is needed. Only nine herbs are approved by the Food and Drug Administration for selected applications, so that any lay press book or article that touts the benefits of an herbal remedy must be considered In light of the scientific literature for patient safety. Judging safety and efficacy becomes particularly difficult with the current lack of standardization and regulation of herbal products. German Commission E provides a review of some of the more than 1,400 herbal drugs; this review may be useful in evaluating such therapies. This article provides an overview of the current status of herbal therapies in the United States, a review of selected commonly used herbs by popular claims and scientific information, and relevant safety and efficacy data.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Changes in the law of death are being made. Nurse practitioners will be asked to help their patients commit suicide, and to help euthanize their patients. Currently most nurse practitioners have legal authority to prescribe the drugs that can potentially kill patients. NPs may be more likely than physicians to be asked for these drugs. Assisted suicide, euthanasia, and related terms are defined. The specific changes in the law of causing death are provided. Collective payment for illness care may be one reason that changes In the law are now being made. Society projects that dying people do not want to live; but that assumption is wrong. NPs in the future may choose to act at the lowest standard of behavior (the law) or they may behave in accord with a higher standard, their personal ethics. NPs should assert that their professional duty is to do good for the patient, not to help kill the patient.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Depression is a common clinical problem seen in primary care. Despite a high prevalence of depression in patients of all ages, it is underdiagnosed and undertreated by primary care and other nonpsychiatric health care providers—the practitioners most likely to see the patient initially, greater than 50% of the time. Differentiating depression and physical illness is difficult and often comorbidlty confounds, the problem. Diagnostic criteria for depression are presented along with tips for assessment of suicide risk. Laboratory screening should be done as part of the diagnostic process to document certain changes in physiological parameters related to depression. The choice of treatment for depression includes psychotherapy, medication, ECT, or combined treatment with medication and psychotherapy. The result of managed care is that primary providers are more often responsible for medication management of depression than they were in the past. An overview of antidepressant pharmacotherapeutics for primary care is presented.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This is the 23rd in a series of articles based on chapters excerpted from the Clinician's Handbook of Preventive Services, part of the Put Prevention Into Practice Program from the U.S. Public Health Service. This month's article, which contains updated recommendations, is taken from a draft of the second edition of the Clinician's Handbook, scheduled to be published in the fall. The draft Is awaiting final approval from the U.S. Department of Health and Human Services

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A B S T R A C TViolence In society Is reflected In aggressive acts within health care delivery systems. As health care reform continues to emphasize preventive health, primary health care settings will increasingly be used to deliver preventive care and may experience an Increase In episodes of aggressive behaviors. Verbal abuse is the most common form of aggression, with nurses being one of the most likely targets of all health care providers. Verbal abuse Is communication through words, tone, or manner that disparages, humiliates, Intimidates, patronizes, threatens, accuses, or Is disrespectful toward another. Verbally aggressive behaviors are generally not Isolated acts, but a part of a cycle Involving a sequence of escalating behaviors. Through verbal and nonverbal Interventions, health care providers can interrupt the cycle and de-escalate a situation. The etiology of verbal aggression, populations at risk, behavioral cues, the verbal aggression cycle, and Interventions are discussed.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

It is estimated that cholelithiasis occurs in 20. million people in the United States, and 500,000 people will undergo cholecystectomy annually. Furthermore, 5% of those who undergo surgery will have acalculous cholecystitis, an uncommon disease that can result in gallbladder perforation or death. Diagnosis of acalculous cholecystitis is frequently delayed due to a confusing clinical presentation and nonspecific diagnostic findings. The following case report describes the presentation of a 19-year-old female with a 12-month history of right upper quadrant pain, and the serologic and radiographic tests that led to a diagnosis of acalculous cholecystitis. Primary care providers should consider this disease a possibility in any patient who presents with right upper quadrant pain.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID