Abstract：
:The term "shoulder instability" constitutes a spectrum of disorders that includes dislocation, subluxation and laxity. Anterior instability is the most common form of glenohumeral instability and may be associated with nerve injury. The diagnosis of anterior, posterior or multidirectional instability is based on a thorough history and physical examination that includes specific provocative maneuvers. The load-and-shift test, the relocation test, the drawer test, the sulcus test and the anterior apprehension test are useful for assessment of the shoulder. Radiographic studies should include special views to delineate specific lesions, such as a Bankart lesion and a Hill-Sachs defect. Early surgical intervention may be a consideration, especially in younger patients. Recent studies suggest that surgical intervention after the first dislocation may reduce the rate of recurrence. Rehabilitation is accomplished in four phases, beginning with rest and pain control and proceeding to isometric and isotonic exercises. The goal is for the patient to reach 90 percent strength in the injured shoulder compared with the uninjured shoulder.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Mahaffey BL,Smith PAsubject
Has Abstractpub_date
1999-05-15 00:00:00pages
2773-82, 2787issue
10eissn
0002-838Xissn
1532-0650journal_volume
59pub_type
杂志文章,评审abstract：:Lyme disease, caused by the bacterium Borrelia burgdorferi, is the most common tick-borne illness in the United States. Transmission occurs primarily through the bite of an infected deer tick (Ixodes scapularis). Identification of an erythema migrans rash following a tick bite is the only clinical manifestation suffic...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-06-01 00:00:00
abstract：:Running is a common form of exercise but predisposes athletes to several running-related injuries. Most running injuries are due to overuse and respond to conservative treatment. Tendinopathies in the patellar, Achilles, and hamstring tendons are common, and are primarily treated with eccentric exercise. Iliotibial ba...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2018-04-15 00:00:00
abstract：:If current trends continue, U.S. health insurance costs will consume the average household's annual income by 2025. As health care becomes unaffordable for most people in the United States, it will be necessary to implement innovative models to move the system in a more equitable and sustainable direction. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2005-11-15 00:00:00
abstract：:Asthmatics may develop a considerable increase in airways obstruction during the night or early hours of the morning. In most patients, this causes only mild symptoms. In others, the effects may be severe, resulting in sudden death. Greater awareness of the potential severity of nocturnal asthma, together with actual ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1976-12-01 00:00:00
abstract：:Family physicians should be familiar with the various drugs available for treating and preventing viral infections. Part II of this two-part article focuses on agents used to manage influenza and respiratory syncytial virus. Rimantadine and amantadine traditionally have been used to prevent and treat influenza type A ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-02-15 00:00:00
abstract：:Healing by primary intention is a threefold process, consisting of an initial phase in which red and white blood cells bind the wound; epithelialization and fibroplasia, and a maturation phase involving collagen synthesis. The appearance of the wound reflects its maturation. Skillful wound management is based on biolo...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:Historically, osteopathic physicians have made an important contribution to the primary care workforce. More than one half of osteopathic physicians are primary care physicians, and most of these are family physicians. However, the proportion of osteopathic students choosing family medicine, like that of their allopat...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2005-08-15 00:00:00
abstract：:Pretibial myxedema is a localized dermopathy seen in patients with past or present hyperthyroidism. Massive intradermal deposition of mucin (acid mucopolysaccharide) produces the classic indurated nodules or plaques on the anterior lower legs. Most patients have elevated levels of LATS in their serum; however, this ap...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-05-01 00:00:00
abstract：:Despite steady increases in U.S. health care spending, the population's self-perceived health status has been in a long-term decline. Increased support for public health, prevention, and primary care could reduce growth in spending and improve actual and perceived health. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-09-01 00:00:00
abstract：:Although heart failure is a common clinical syndrome, especially in the elderly, its diagnosis is often missed. A detailed clinical history is crucial and should address not only current signs and symptoms of heart failure but also signs and symptoms that point to a specific cause of the syndrome, such as coronary art...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-03-01 00:00:00
abstract：:Transdermal nicotine systems are a useful adjunct to smoking cessation. The larger-sized nicotine patches provide steady-state replacement of approximately 50 percent of the average serum nicotine level obtained by smoking one to one and one-half packs of cigarettes a day. This level is sufficient to prevent many symp...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:Cat-scratch disease is a common infection that usually presents as tender lymphadenopathy. It should be included in the differential diagnosis of fever of unknown origin and any lymphadenopathy syndrome. Asymptomatic, bacteremic cats with Bartonella henselae in their saliva serve as vectors by biting and clawing the s...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2011-01-15 00:00:00
abstract：:Although many physicians consider constipation a trivial problem, it is one of the most frequent and chronic digestive disorders in the United States, affecting 4.53 million people and causing considerable morbidity. More than $200 million are spent for over-the-counter laxatives and untold millions of dollars are spe...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1990-11-01 00:00:00
abstract：:More women, men and children receive medical care each month in the offices of primary care physicians than any other professional setting. There is an urgent need for health policies that encourage further innovation and implementation ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2001-09-15 00:00:00
abstract：:Henoch-Schönlein purpura is an acute, systemic, immune complex-mediated, leukocytoclastic vasculitis. It is characterized by a triad of palpable purpura (without thrombocytopenia), abdominal pain, and arthritis. Most patients have an antecedent upper respiratory illness. More than 90 percent of Henoch-Schönlein purpur...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-10-01 00:00:00
abstract：:Proper suturing technique is essential for obtaining good cosmetic results and avoiding infection, scarring and poor wound healing. Techniques that must be mastered include good eversion of skin edges, avoiding suture marks, maintaining uniform tensile strength along the skin edges and precise approximation of skin ed...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-11-01 00:00:00
abstract：:Patients with seasonal affective disorder have episodes of major depression that tend to recur during specific times of the year, usually in winter. Like major depression, seasonal affective disorder probably is underdiagnosed in primary care settings. Although several screening instruments are available, such screeni...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-11-01 00:00:00
abstract：:Vomiting, amnesia, a history of falls and other injuries, and depression and anxiety may all be clues to a drinking problem. Decreased work performance, absenteeism and difficulty in getting along with others may be present. Coming to grips with the problem is essential. Once the patient accepts the need for abstinenc...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:Every year in the United States, at least 250,000 deaths are attributed to lack of physical activity. Because of the health benefits of physical activity, national guidelines recommend participation in 30 minutes of accumulated moderate-intensity physical activity such as walking fast on five or more days of the week....
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2008-04-15 00:00:00
abstract：:Acute pancreatitis is a clinical syndrome characterized by midepigastric pain, nausea and vomiting. Numerous etiologies have been linked with this entity, principally alcoholism and biliary disease. Once the clinical suspicion of pancreatitis is confirmed, supportive therapy with intravenous hydration and close observ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-08-01 00:00:00
abstract：:The interrupted vertical and horizontal mattress suture techniques are two of the most commonly used skin closure methods. These mattress sutures promote wound edge eversion and less prominent scarring. Vertical and horizontal mattress sutures allow for skin edges to be closed under tension when wound edges have to be...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-12-15 00:00:00
abstract：:Atypical moles can be distinguished visually by clinical features of size greater than 6 mm in diameter, color variegation, indistinct borders, and textured surface. All patients who have atypical moles should be counselled about sun avoidance, screening of family members, and regular skin checks at least once per yea...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-09-15 00:00:00
abstract：:Breast milk is universally recommended as the preferred source of infant nutrition, in part because of its superior nutrient and immunologic properties. Successful breast feeding requires nursing on demand, prevention of sore nipples and convenient access to medical advice. For mothers relying on bottle feeding, cow's...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:The birth of twins can be an exciting and challenging experience for a family. However, circumstances unique to the relationship between the twin and the family and the relationship between the twins themselves may exacerbate existing problems or create new ones. Parents are often overwhelmed by the amount of time and...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-03-01 00:00:00
abstract：:Careful examination of the neonate at delivery can detect anomalies, birth injuries, and disorders that may compromise successful adaptation to extrauterine life. A newborn with one anatomic malformation should be evaluated for associated anomalies. If a newborn is found to have an abdominal wall defect, management in...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-01-15 00:00:00
abstract：:Particularly in rural settings, Trichophyton verrucosum commonly causes an inflammatory tinea infection, sometimes called 'barn itch." There is usually a history of contact with animals. The demonstration of clusters of large spores in a potassium hydroxide preparation of scrappings obtained from clinically involved s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1983-01-01 00:00:00
abstract：:Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in postmenopausal women. Pregnancy is the onl...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2020-05-01 00:00:00
abstract：:Acute abdominal pain in children presents a diagnostic dilemma. Although many cases of acute abdominal pain are benign, some require rapid diagnosis and treatment to minimize morbidity. Numerous disorders can cause abdominal pain. The most common medical cause is gastroenteritis, and the most common surgical cause is ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2003-06-01 00:00:00
abstract：:The birth of a child with any developmental disability is an occasion of marked trauma to parents. Early, honest and frank counseling is imperative, and the family physician can play a unique role in this counseling process. When the physician is not knowledgeable in a paretcular case, he or she should seek expert hel...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1977-05-01 00:00:00
abstract：:For many years, there were no guidelines for evaluating patients with chronic neck pain. However, in the past 15 years, considerable research has led to recommendations regarding whiplash-associated disorders. This article summarizes the American College of Radiology Appropriateness Criteria for chronic neck pain. Ima...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2010-10-15 00:00:00
