关键词： depression   general hospital   prevalence   rate of recognition   China  

摘要： Background: One important approach to increasing recognition and treatment rates for depression in urban China is to identify persons with depression who have contact with primary health care services, most of which are provided in the outpatient departments of general hospitals. We aim to assess the prevalence, risk factors and rates of recognition of depressive disorders in internal medicine outpatient departments of general hospitals. Methods: Outpatients with depression among 5312 consecutive attendees at outpatient internal medicine departments of 23 randomly selected general hospitals in Shenyang are identified by a two-stage screening process using the General Health Questionnaire and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Charts of subjects with DSM-IV depressive disorders are reviewed to determine if treating clinicians made a diagnosis of depression or prescribed anti-depressant medications. Results: The current prevalence of any type of depressive disorder was 11.0% (95% CI: 10.1%-12.1%);and those of major depressive disorder, dysthymia, and depression not otherwise specified were 3.6% (3.1%-4.2%), 2.8% (2.4%-3.4%), and 4.1% (3.5%-4.8%) respectively. Only 4.0% (2.5%-6.1%) of the depressed patients were identified by the treating clinician and only 3.0% (1.6%-4.9%) were provided with antidepressant medication. Older age, female gender, reporting religious beliefs, low educational level, low income level and widowhood were independently associated with the occurrence of depression. Conclusions: The prevalence of depression in primary care settings in urban China is lower than that reported in most western countries but the risk factors for depression are similar. The very low rates of recognition and treatment are related both to the low rates of care seeking for psychological problems and to the high-volume collective model of hospital-based primary care delivery. Increasing the recognition and treatment of depression in Chinese

关键词： Fever of unknown origin   Infection   Neoplasm   Collagen vascular disease   Follow-up  

摘要： Despite the availability of all advanced diagnostic tools, fever of unknown origin (FUO) remains a diagnostic challenge for physicians. The objective was to define, through a retrospective study, the categories of the diseases of Sicilian patients admitted at the Department of Clinical Medicine and Emerging Diseases, University of Palermo, Italy, for classical FUO. Using the registration system for patients admitted from 1991 to 2002, 508 charts of patients admitted because of fever were reviewed. Of these, only 91 patients fulfilled the criteria for classical FUO. The origin of FUO was diagnosed in 62 (68.1%) patients. Infection was the most common cause of FUO with 29 cases (31.8% of total of FUO), neoplasms accounted for 13 cases (14.2%), collagen vascular disease for 11 cases (12.0%), and miscellaneous for 9 cases (9.8%). Undiagnosed FUO were 29 (31.8%) and, of them, 22 cases were followed-up for 2 years. A definite diagnosis could be established only in 8 cases, 13 subjects completely recovered and 4 of them died. In the 73.4% of cases, the FUO have been the result of misleading factors in the diagnostic approaches as made by the physician. The results of our study are similar to those already reported by other authors in other populations, with infections as first, neoplasm as second, and collagen vascular diseases as third most important causes of FUO. In our study the prognosis for undiagnosed FUO cases was good, but a definite diagnosis could be established only in few cases. Therefore, further multicentric, prospective studies of good design are required.

关键词： hospitalist   hospital medicine   medical education   hospitalist education   hospitalist training   internal medicine   internal medicine training   residency redesign  

摘要： The promise of the hospital medicine movement is that the hospitalist model of care will provide better outcomes than the system it replaced. This means improving the quality and processes of care, reducing inefficiencies and lowering costs. Despite some documented improvements in these areas hospitalists have yet to achieve their pinnacle. These shortfalls likely result from training providers in residencies that have yet to evolve to address the specific needs of hospitalists. While most internal medicine residency training programs stress inpatient care they underemphasize key components of a Successful hospitalist career. This paper overviews the state of the hospitalist movement, the Current educational training deficiencies and the methods to deliver hospitalist-focused training. Mt Sinai J Med 75:436-441, 2008. (C) 2008 Mount Sinai School of Medicine

关键词： Animals   Drug Toxicity   Female   Fetus   Humans   Internal Medicine   Pregnancy   动物   药物毒性   胎儿   内科学   妊娠   妊娠并发症   产前保健   Pharmaceutical Preparations   Drug Toxicity   Fetus   Case studies   Drug Prescribing   Pregnancy   Internal Medicine  

摘要： A large body of information about medications prescribed during pregnancy is readily available to internists and patients either online or through books and medical journals. Much of the evidence about many prescribed drugs is either anecdotal or presented with sufficient warnings about its use during pregnancy. This article discusses specific medications to set the risks and benefits into a more proper perspective, thereby alleviating certain fears and, when necessary, improving compliance.

关键词： Contraception   Female   Humans   Internal Medicine   Pregnancy   Unplanned   避孕   内科学   妊娠   性教育   Otolaryngologists   Pregnancy   Contraceptive Methods   unplanned pregnancy   Child Rearing   Internal Medicine  

摘要： The human costs of unintended pregnancy-abortion and parenting under difficult circumstances-are high. For this reason, all physicians who treat female patients should be knowledgeable about the basics of contraception-both its practical uses and its public health impact. This knowledge will make physicians, including internists, better able to counsel and provide contraceptives for individual patients and to advocate for availability and access. This article discusses the problem and determinants of unintended pregnancy and reviews contraceptive methods.

关键词： TEACHING methods   HOSPITALISTS   INTERNAL medicine education   MEDICAL education   MEDICAL students  

摘要： Academic hospitalists have grown in number and influence over the past decade. This has fueled concerns about the effect of hospitalists on resident and Student education. While the bulk of the literature favors the hospitalist teaching model to a more traditional model concerns remain that hospitalists may negatively impact housestaff autonomy and reduce exposure to subspeciality physicians. This paper will review the literature exploring the effect of the hospitalist teaching model on resident and student education. Mt Sinai J Med 75:430-435, 2008. (C) 2008 Mount Sinai School of Medicine

关键词： 医药、卫生   内科学   传染病  

关键词： 内科学   白细胞介素8   动脉粥样硬化   糖尿病  

摘要： 近年来研究发现白细胞介素8对单核细胞有趋化作用,能促使单核细胞黏附于血管内皮,募捐中性粒细胞和淋巴细胞进入内皮下间隙,促进平滑肌细胞增生以及增加斑块的不稳定性,参与动脉粥样硬化的形成,在糖尿病大血管病变的发生和发展中起着重要的作用。糖尿病时的糖脂代谢紊乱、氧化损伤、肿瘤坏死因子及同型半胱氨酸水平升高等多种因素可导致白细胞介素8水平上升。

关键词： PBL   内科学   教学  

摘要： PBL已经广泛用于西方的医学教育，也已成为中国医学教育的重要教学方法。在内科教学中应用PBL教学法。并与传统教学法相结合，取得了较好效果。PBL在提高学生的学习兴趣、提高分析问题与解决问题的能力、提高自学能力、促进临床思维形成等方面有明显的优势，但也存在学习系统性较差等方面的不足。由于中国医学生具有不同于西方国家的特点，如何将PBL引入内科学教学仍需要进行大量的研究。

关键词： 科学   精品课程   泌尿系统疾病   硕士研究生   临床医学   简介   省级   学院  

摘要： 1内科教研室基本情况 内科教研室于1983年组建，承担着《内科学》、《诊断学》、《心电图学》、《健康评估》、《急救医学》和《临床概论》的教学任务，面向临床医学、预防医学、医学检验、医学影像、护理学、药学等专业的学生。内科教研室经过25年的建设与发展，教师队伍不断发展壮大，学术水平不断提高，2006年获得“内科学硕士点”，2007年正式招收硕士研究生，研究生培养方向：循环系统疾病、冠心病基础与临床、心肌病基础与临床、高血压病基础与临床、泌尿系统疾病、肾脏病基础与临床、血压系统疾病、血压病基础与临床。