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101.
Cognitive Rest and Graduated Return to Usual Activities Versus Usual Care for Mild Traumatic Brain Injury: A Randomized Controlled Trial of Emergency Department Discharge Instructions 下载免费PDF全文
102.
Bjug Borgundvaag PhD MD CCFP Fernanda Bellolio MD MSc Isabelle Miles MD Evan S. Schwarz MD Sameer Sharif MD MSc Mark K. Su MD MPH Kevin Baumgartner MD David B. Liss MD Hasan Sheikh MD MPA Jody Vogel MD MSc MSW Emily B. Austin MD Suneel Upadhye MD MSc Michelle Klaiman MD FRCPC DABAM Robert Vellend Anna Munkley Christopher R. Carpenter MD MSc 《Academic emergency medicine》2024,31(5):425-455
103.
Regular exercise and physical activity have many health benefits for both females and males. In particular, weight-bearing exercise has a protective effect on the skeleton, and can even be osteogenic (stimulating to bone formation). However, achievement of optimal bone mineral density and regulation of bone maintenance depend upon a combination of mechanical, hormonal and dietary factors. Adequate hormonal status (oestrogen and progesterone), and sufficient nutrition (calcium, protein, and other bone-building materials) are essential. For young women with components of the Female Athlete Triad (such as disordered eating, amenorrhea and other forms of menstrual dysfunction), one or more of these may be lacking, and decreased bone density can result. With an effort to maximize peak bone mineral density in the young athlete and to preserve or restore gonadal function during the reproductive years, the complications of altered bone mineral density and frank osteoporosis can be avoided. 相似文献
104.
BACKGROUND: Safe and effective use of local anesthesia is essential in hair transplantation. OBJECTIVE: To review the agents and techniques of local anesthesia as applied to hair transplantation. METHODS: Information was retrieved from texts, journal articles found by MEDLINE searches, and related references. RESULTS: Agents, vasoconstrictors, maximum dosages, toxicity, and techniques are discussed. CONCLUSION: Effective local anesthesia can be maintained throughout hair transplantation. Care must be exercised to minimize discomfort through proper technique and to minimize toxicity through judicious use of vasoconstrictors and nerve blocks and by monitoring total dosage. Constant monitoring for toxicity is required, as is early intervention in the unlikely event that warning signs should appear. 相似文献
105.
Physician perspectives on care of individuals with severe mobility impairments in primary care in Southwestern Ontario,Canada 下载免费PDF全文
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Chizimuzo T. C. Okoli PhD MPH RN Milan Khara MBChB CCFP Dip. ABAM 《Journal of dual diagnosis》2014,10(1):9-18
Objective: Individuals with substance use and psychiatric disorders have a high prevalence of tobacco use disorders and are disproportionately affected by tobacco-related morbidity and mortality. However, it is unclear how having co-occurring disorders affects tobacco cessation. Our aim was to examine smoking cessation outcomes and relevant predictors of smoking cessation among smokers with substance use and/or psychiatric disorders. Methods: Data from medical records of 674 participants in a tobacco treatment program within mental health and addictions services in Vancouver, Canada, were analyzed. The 26-week treatment program included an 8-week structured behavioral counseling group, an 18-week support group, and 26 weeks of no-cost pharmacotherapy. Information on demographics, tobacco use and history, type of pharmacotherapy received, nicotine dependence, importance of and confidence in quitting smoking, expired carbon monoxide level, substance use and psychiatric disorder history, and total program visits were gathered. Results: Approximately 67% (n = 449) of participants had co-occurring substance use and psychiatric disorders, while 20% (n = 136) had substance use disorder only, 10% (n = 67) had psychiatric disorder only, and 3% (n = 22) had tobacco dependence only. Rates of tobacco cessation (i.e., 7-day point prevalence of abstinence verified by expired carbon monoxide of ≤8 ppm) by group in the 522 people who completed treatment were as follows: 38.2% for those with co-occurring disorders, 47.1% for those with tobacco dependence only, 47.1% for those with substance use disorder only, and 41.8% for those with psychiatric disorder only. Length of treatment was a significant predictor of smoking cessation for those with co-occurring disorders and substance use disorder only. In the final stratified multivariate analysis, for individuals with co-occurring disorders, having an opiate use disorder (as compared to an alcohol use disorder) and higher nicotine dependence scores at baseline were predictive of poor cessation outcomes, while greater length of treatment was predictive of successful smoking cessation. Conclusions: Tobacco cessation treatment for individuals with co-occurring substance use and psychiatric disorders is likely to be as effective as for smokers with either disorder alone. Treatment duration predicts success among these smokers so strategies to enhance engagement and retention are needed. 相似文献
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Healthcare providers’ perspectives on perceived barriers and facilitators of compassion: Results from a grounded theory study 下载免费PDF全文
110.
Emergency Physician Recognition of Adverse Drug-related Events in Elder Patients Presenting to an Emergency Department 总被引:3,自引:1,他引:3
Corinne Michèle Hohl MD CCFP FRCPC Caroline Robitaille BPharm MSc Vicky Lord BPharm MSc Jerrald Dankoff MD CSPQ Antoinette Colacone BSc CCRA Luc Pham BSc Anick Bérard PhD Jocelyne Pépin BPharm MSc Marc Afilalo MD FRCPC 《Academic emergency medicine》2005,12(3):197-205
Objectives: The authors examined the ability of emergency physicians (EPs) to recognize adverse drug‐related events (ADREs) in elder patients presenting to the emergency department (ED). Methods: This was a prospective observational study of patients at least 65 years of age who presented to the ED. ADREs were identified using a validated, standardized scoring system. EP recognition of ADREs was assessed through physician interview and subsequent chart review. Results: A total of 161 patients were enrolled in the study. Thirty‐seven ADREs were identified, which occurred in 26 patients (16.2%; 95% confidence interval [CI] = 10.5% to 22.0%). The treating EPs recognized 51.2% (95% CI = 35.2% to 67.4%) of all ADREs. There was better recognition of those ADREs related to the patient's chief complaint (91%; 95% CI = 74.1% to 100%) as compared with recognition of ADREs that were not associated with the chief complaint (32.1%; 95% CI = 14.8% to 49%). EPs recognized six of seven severe ADREs (85.7%), 13 of 23 moderate ADREs (56.5%; 95% CI = 36.8% to 77%), and none of the mild ADREs. Recognition of ADREs varied with medication class. Conclusions: EP performance was superior at identifying severe ADREs relating to the patients' chief complaints. However, EP performance was suboptimal with respect to identifying ADREs of lower severity, having missed a significant number of ADREs of moderate severity as well as ones unrelated to the patients' chief complaints. ADRE detection methods need to be developed for the ED to aid EPs in detecting those ADREs that are most likely to be missed. 相似文献