American family physician
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Arterial blood gases are useful in establishing acid-base status, determining the degree of impairment of the lungs as a gas exchanger, diagnosing such important phenomena as pulmonary emboli and implementing or adjusting oxygen therapy. The balance among H+, HCO3- and CO2 is represented by the equation H+ + HCO3- in equilibrium CO2 + H2O. Primary alterations of either component of the left-hand side of the equation result in metabolic acid-base balance disturbances; primary alterations of CO2 result in respiratory acid-base balance disturbances.
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Adult respiratory distress syndrome is a type of acute respiratory insufficiency which is preceded by a variety of serious illnesses. The radiologic appearance ranges from scattered densities early in the course to complete consolidation later. ⋯ Treatment generally includes intubation, suctioning, oxygen and mechanical ventilation with positive end-expiratory pressure. Diuretics and methylprednisolone may also be used.
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Most of the elderly with psychiatric disorders are unknown to mental health facilities and untreated by psychiatrists. Many of this population may be under the care of family physicians. ⋯ Physicians' attitude and training create the possibility that treatable illnesses are misdiagnosed as irreversible dementia. A more optimistic approach to the treatment and prognosis of mental disorders in the aged is warranted.
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This is the common "tension" or "nervous" headache. It is extracranial in origin, and is often precipitated by anxiety or depression. The headache is usually bilateral, nonpulsatile and of longer duration than migraine, with no focal signs or symptoms. While aspirin remains the most practical and useful analgesic for head pain of low intensity, combination agents are useful and drugs to control anxiety associated with headache are appropriate.