Primary care
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Flexible fiberoptic bronchoscopy continues to be an important tool in the diagnosis of pulmonary disease. This article reviews the history, technology, methodology, applications, and complications of this diagnostic tool.
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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.
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With the recent advances in radiographic medical technology, confusion about the appropriate use of this technology has developed. The major clinical benefits of these advances are reviewed.
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This article has emphasized a basic approach to coma. First, the patient must have airway, breathing, and circulation protected. If the etiology of coma is in doubt, a broad metabolic screen is necessary. ⋯ If history or neurologic examination suggests a structural cause for the coma, then a cranial CT scan is mandatory. An electroencephalogram is often helpful, particularly in metabolic coma, and at times may even show structural abnormalities not demonstrated by CT scan. Rapid assessment and treatment is critical because coma is the clinical manifestation of brain failure, and often irreversible injury will occur if treatment is slow or incorrect.
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Vasculitis is reviewed as a continuum of disease from asymptomatic to life-threatening. Therapeutic intervention predicated upon assessment of the significance of organ system involvement and the relative risks of the various forms of therapeutic intervention are discussed.