Primary care
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This article is intended as an overview of emergencies that could and often do present to the physician's office, especially when a hospital emergency department may not be nearby. It is not intended as an in-depth view of every problem but should be considered as a presentation of essential management in the emergency phase of treatment. The reader is directed to the references for more in-depth information on these topics.
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The preceding discussion is an attempt to stress anatomy in the diagnosis of coma. By localizing the offending lesion, the physician can apply the appropriate diagnostic and therapeutic measures more adeptly. Because physicians are also frequently asked to prognosticate, I have tried to summarize the work of Plum and Posner in their study of the outcome of patients presenting in coma. The primary care physician is encouraged to plan at least for the basics in case he or she is faced with a comatose patient.
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Careful telephone triage of women with significant obstetric and gynecologic emergencies is the optimal way to avoid devastating complications in the office. With practical knowledge and some specialized office equipment and medications, most obstetric and gynecologic emergencies can be managed effectively in the office or stabilized while arranging transport to a hospital. Management of the most common complications likely to be encountered is outlined in this article.
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The author provides a comprehensive overview of online medical information services that can be accessed by personal computer users over telephone lines. The article encompasses the reasons for online database access, equipment considerations, and structure and sources of database information. Tips on search strategy and resources for increasing database search proficiency are also included.
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The magnitude of the smoking problem is overwhelming. The annual mortality and expense are staggering. ⋯ A consistent attitude of nonacceptance of the smoking habit with recommendations and support for discontinuation can make a significant impact on the problem. Extension of this attitude into community affairs and regional and national politics will result in increased public awareness and eventually in the majority rejecting this costly habit.