The Journal of family practice
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The emergency management of the agitated patient is a common medical problem. Agitated behavior is not a diagnosis but a descriptive term; the initial task of the physician involves determining the etiology of the behavioral disturbance and evaluating the possible contribution of organic factors. ⋯ Agitated patients will generally fall into one of four diagnostic categories: agitation precipitated by drug intoxication, agitation precipitated by drug withdrawal, agitation precipitated by an organic brain syndrome, or agitation precipitated by a functional disorder. Appropriate pharmacological and psychological management techniques for these situations are discussed.
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By judicious consideration of the clinical appearance, by direct examination with magnification, and by culture results, skin biopsy, and other laboratory results, the clinician is able to diagnose most pathological conditions of the scalp. The scalp participates in many systemic disorders and frequently is the chief site of involvement. Similarly, many generalized disorders limited to the skin exhibit their most typical manifestations in the scalp. ⋯ By utilizing follow-up examinations at appropriate intervals, the diagnosis can eventually be made. Once a diagnosis is made, appropriate treatment will generally produce satisfactory improvement or cure. Nevertheless, a few generally rare conditions will defy the physician's most enlightened and aggressive therapy.
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Continuity of care, one of the basic characteristics of family medicine, was studied over a 12-month period in a family practice residency program. Continuity was measured in three contact areas; office hours, after hours, and on the inpatient service. The intensity of continuity was defined at three levels, from encounters with the personal physician to those with physicians on other medical teams. ⋯ Residents from other years were noted to have lower levels of continuity. Similar figures were noted for family practice inpatients. Continuity of care in private practice occurs in about 80 percent of patient encounters and it seems reasonable and feasible to expect residency training programs to come close to this figure.