Archives of family medicine
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To design and implement an individualized program of evaluation and education to provide remedial experiences to physicians. ⋯ A comprehensive evaluation program can identify areas amenable to education and target individualized remedial educational experiences that may enable physicians to become contributing members of the medical community.
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Comparative Study
A pilot project in office-based diagnostic esophagogastroduodenoscopy comparing two nonintravenous methods of sedation and anesthesia.
To evaluate the performance and findings of diagnostic esophagogastroduodenoscopy (EGD) procedures in a primary care office setting, comparing two nonintravenous methods of sedation and anesthesia. ⋯ Two alternative methods to intravenous sedation and anesthesia appear to create adequate comfort and satisfaction for patients undergoing EGD and merit future study and consideration.
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Seriously or terminally ill patients are frequently incapacitated and unable to express their preferences regarding cardiopulmonary resuscitation (CPR). In this situation, family members or other surrogate decision makers are often asked whether they believe the patient would want to be resuscitated. We evaluated the concordance of patient CPR preferences and surrogate perceptions of the patient preferences in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT), a large, multicenter study of seriously ill hospitalized patients. ⋯ Surrogates' perceptions of patient CPR preferences are often inaccurate, particularly for those patients who do not want to be resuscitated. Methods to improve communication between patients and surrogates on CPR preferences should be developed and evaluated.
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This article identifies the importance of delirium in general medical practice. Recent revisions in the diagnostic criteria for delirium are discussed, and the epidemiology of delirium is summarized, including the incidence and prevalence, risk factors, origins, course, and outcomes. Studies of the pathophysiological features of delirium are reviewed and recommendations are made for treatment of patients with delirium and future research.