The Medical clinics of North America
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This review summarizes the current approach to the diagnosis and treatment of sleep disorders. Classification of sleep disorders, basic sleep physiology, use of the sleep laboratory, and management of patients are discussed.
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This article considers the rapid assessment and initial management of several neurologic emergencies--altered consciousness, increased intracranial pressure, stroke, status epilepticus, acute neurogenic respiratory failure, acute autonomic instability, the neuroleptic malignant syndrome, and spinal cord compression.
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Psychiatric disorders are common in medical inpatient and outpatient populations. As a result, internists commonly are the first to see psychiatric emergencies. As with all medical problems, a good history, including a collateral history from relatives and friends, physical and mental status examination, and appropriate laboratory tests help establish a preliminary diagnosis and treatment plan. ⋯ Haloperidol (Haldol) is the safest neuroleptic. Chlorpromazine (Thorazine), perphenazine (Trilafon), and, in the elderly, thiothixene (Navane) can also be useful if haloperidol (Haldol) is not effective and more sedation is needed; these drugs, however, produce more side effects. Violent patients need to be physically restrained and then given antipsychotic medication or, in the case of drug abuse or alcohol withdrawal, the appropriate drug management.(ABSTRACT TRUNCATED AT 250 WORDS)
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Endocrine emergencies are relatively infrequent events in clinical practice. Correct management requires prompt recognition and treatment, frequent without supporting laboratory studies. An understanding of the pathophysiology of these acute states of hormone excess or deficiency assists in establishing the correct diagnosis and initiating the proper therapy.
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This article describes the many metabolic complications encountered in the management of cancer patients. Pathogenetic mechanisms and therapy are discussed, with special emphasis on hypercalcemia, the most common of these disorders.