Postgraduate medicine
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Postgraduate medicine · May 1995
ReviewNo ice, no butter. Advice on management of burns for primary care physicians.
It is often difficult to determine the true extent of a burn, but most small thermal burns can be easily evaluated and managed by primary care physicians. In this article, the authors review the characteristics of different types of burns, describe those that require treatment in a burn center, and discuss appropriate measures to hasten healing and promote a satisfactory cosmetic outcome.
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Postgraduate medicine · May 1995
ReviewBehavioral problems in nursing home residents. Safe ways to manage dementia.
Behavioral problems in nursing home residents are already common and are likely to increase in number with the "graying" of the population. Effective treatment is available, and a structured and logical approach to management is needed. ⋯ The best treatment of dementia-related behavioral problems includes nonpharmacologic measures (eg, environmental changes) and appropriate choice, dosing, and monitoring of pharmacologic agents. Long-term success with demented patients may depend on realistic expectations.
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Postgraduate medicine · Feb 1995
ReviewManagement of concussion in collision sports. Guidelines for the sidelines.
During high-risk sports events, it is important for team physicians to be alert to the possibility of concussion in athletes who may not realize they have been injured or may want to conceal their injury. If concussion is suspected and the player is conscious, history taking should include inquiries about loss of consciousness, loss of memory of events before and after the impact, headache, visual abnormalities, motor and sensory changes, and back, neck, and extremity pain. In an unconscious player, the airway, breathing, circulation, and cervical spine should be checked. ⋯ Athletes with such an injury and those who have lost consciousness require hospital evaluation. If there is no cervical spine injury, a complete neurologic evaluation should be carried out on the sidelines and the player checked for signs of skull fracture. The Colorado Medical Society guidelines for grading concussions and deciding when athletes may return to competition are an excellent aid to clinical judgment.
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Postgraduate medicine · Oct 1994
ReviewTwo ear problems you may not need to refer. Otitis externa and bullous myringitis.
Primary care physicians are being forced to broaden the scope of their practice because of the financial restraints placed on them by managed care. Common otologic conditions such as otitis externa and bullous myringitis, which are often referred to otolaryngologists, can be promptly diagnosed and treated by primary care physicians. Referral to a subspecialist is indicated when symptoms persist despite treatment and when the cause of ear pain remains unexplained after thorough evaluation.
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Postgraduate medicine · Jun 1994
ReviewDiagnosing obstructive lung disease. Why is differentiating COPD from asthma important?
Chronic obstructive pulmonary disease (COPD) and asthma are the main causes of obstructive lung disease, and mortality rates of both diseases are on the increase. Smoking is the major risk factor for COPD. ⋯ COPD and asthma can be diagnosed through careful history taking, physical examination, spirometry, and other ancillary tests. More widespread use of peak expiratory flow rates should aid in diagnosis and monitoring.