Abstract:
:Endometrial cancer is the fourth most common cancer in women, accounting for approximately 6,000 deaths per year in the United States. It is more common in women who are older, white, affluent obese and of low parity. Hypertension and diabetes mellitus are also predisposing factors. Because any condition that increases exposure to unopposed estrogen increases the risk of endometrial cancer, tamoxifen therapy, estrogen replacement therapy without progestin and the presence of estrogen-secreting tumors are all risk factors. Smoking and the use of oral contraceptives appear to decrease the risk. Women with an increased risk and those with postmenopausal bleeding should be screened for endometrial cancer. Endometrial sampling is currently the most accurate and widely used screening technique, but ultrasonographic measurement of endometrial thickness and hysteroscopy have also been studied. Patients with endometrial specimens that show atypia have about a 25 percent likelihood of progressing to carcinoma, compared with less than 2 percent in patients without atypia. Endometrial cancer is usually treated surgically, but in patients with appropriate pathologic findings who decline surgical treatment, progestin therapy may be satisfactory.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Canavan TP,Doshi NRsubject
Has Abstractpub_date
1999-06-01 00:00:00pages
3069-77issue
11eissn
0002-838Xissn
1532-0650journal_volume
59pub_type
杂志文章,评审abstract::Postpartum hemorrhage, the loss of more than 500 mL of blood after delivery, occurs in up to 18 percent of births and is the most common maternal morbidity in developed countries. Although risk factors and preventive strategies are dearly documented, not all cases are expected or avoidable. Uterine atony is responsibl...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2007-03-15 00:00:00
abstract::Hoarseness is the term often used by patients to describe changes in their voice quality. The causes of hoarseness are determined after obtaining a detailed medical history of the circumstances preceding the onset of hoarseness and performing a thorough physical examination. The latter may include visualization of the...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-06-01 00:00:00
abstract::Hypertension is the most common chronic condition treated by family physicians. Elevated blood pressure is associated with an increased risk of heart failure, myocardial infarction, cerebrovascular disease, and death. Treatment of hypertension reduces the risk of these events. Several lifestyle modifications are assoc...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2015-02-01 00:00:00
abstract::Sarcoidosis is a systemic granulomatous disease of unknown cause affecting young and middle-aged adults. Patients commonly present with bilateral hilar lymphadenopathy, pulmonary infiltrates, and ocular and skin lesions. The heart, liver,spleen, salivary glands, muscles,bones, kidneys, and central nervous system also ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2004-07-15 00:00:00
abstract::Parkinson's disease is a common neurodegenerative disorder that can cause significant disability and decreased quality of life. The cardinal physical signs of the disease are distal resting tremor, rigidity, bradykinesia, and asymmetric onset. Levodopa is the primary treatment for Parkinson's disease; however, its lon...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-12-15 00:00:00
abstract::The rapidity with which heparin anticoagulation is achieved is essential to a positive clinical outcome in patients with deep venous thrombosis or pulmonary embolus. However, adequate anticoagulation is frequently not achieved, either as a result of dosing regimens that do not take heparin kinetics into account or bec...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-12-01 00:00:00
abstract::Because the prevalence of urinary incontinence increases with age, a working knowledge of the diagnosis and treatment of the various types of urinary incontinence is fundamental to the care of women. As the population of the United States ages, primary care physicians can expect to see an increasing number of patients...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract::Streptomycin is still the treatment of choice for tularemia and plague, and is effective in a few other diseases. Neomycin is used primarily as a topical agent. The other aminoglycoside antibiotics are indicated in serious infections caused by the gram-negative enterobacteria and, except for kanamycin, are also effect...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract::Cardiac pacemakers are generally used in conditions where bradyarrhythmia is a major problem, such as advanced heart block, sick sinus syndrome and bundle branch block. Temporary or permanent pacing may be needed to control certain tachyarrhythmias refractory to medical therapy. Temporary pacing may be of value in the...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract::Peritonsillar abscess remains the most common deep infection of the head and neck. The condition occurs primarily in young adults, most often during November to December and April to May, coinciding with the highest incidence of streptococcal pharyngitis and exudative tonsillitis. A peritonsillar abscess is a polymicr...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2008-01-15 00:00:00
abstract::The principle of confidentiality is one of the clearest and firmest rules of professional ethics. However, situations can arise in which confidentiality ought to be abridged in favor of other, weightier values. In the case of a teenager who asks a family physician to prescribe birth control pills for her without infor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::Effective management of life-threatening emergencies in infants and children demands a high level of technical skill. The Pediatric Advanced Life Support (PALS) provider course, developed jointly by the American Academy of Pediatrics and the American Heart Association, is highly recommended to help physicians prepare ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
abstract::Vitamin D deficiency among hospitalized patients may be more widespread than realized. Vague musculoskeletal complaints in these chronically ill patients may be attributed to multiple underlying disease processes rather than a deficiency in vitamin D. However, the failure to diagnose an underlying deficiency places th...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2005-01-15 00:00:00
abstract::So many topical antifungal agents have been introduced that it has become very difficult to select the proper agent for a given infection. Nonspecific agents have been available for many years, and they are still effective in many situations. These agents include Whitfield's ointment, Castellani paint, gentian violet,...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract::Tension-type headache typically causes pain that radiates in a band-like fashion bilaterally from the forehead to the occiput. Pain often radiates to the neck muscles and is described as tightness, pressure, or dull ache. Migraine-type features (unilateral, throbbing pain, nausea, photophobia) are not present All pati...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2002-09-01 00:00:00
abstract::Self-induced injury of one or more of the extremities may represent a distinct variety of Munchausen syndrome. The nature of the injury may be infectious, dermatologic or orthopedic. The mechanism may be secondary gain or another unconscious motivation that causes a craving for attention. In many cases, the underlying...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract::Ischemic heart disease is one of the most common disorders managed by family physicians. Stratifying patients according to risk is important early in the course of the disease to identify patients who require invasive (percutaneous or surgical) treatment. Physical examination, clinical history, noninvasive tests and a...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-12-01 00:00:00
abstract::Rational use of psychoactive drugs in frail elderly patients requires an understanding of the physiologic changes produced by aging and chronic disease. Other drugs being used and the patient's nutritional status and lifestyle also must be considered. Affective disorders and thought disorders may be effectively treate...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract::The female athlete triad is defined as the combination of disordered eating, amenorrhea and osteoporosis. This disorder often goes unrecognized. The consequences of lost bone mineral density can be devastating for the female athlete. Premature osteoporotic fractures can occur, and lost bone mineral density may never b...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract::The ability to properly apply casts and splints is a technical skill easily mastered with practice and an understanding of basic principles. The initial approach to casting and splinting requires a thorough assessment of the injured extremity for proper diagnosis. Once the need for immobilization is ascertained, casti...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract::Synovial cell sarcoma frequently presents as a painful periarticular mass in the lower extremity of a young male patient. The mass may appear encapsulated and is calcified in approximately 50 percent of cases. Surgery is the mainstay of therapy, with radical resection often necessary to prevent local recurrence. The m...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::The chief side effect of phenobarbital is drowsiness, which is usually associated with overdosage. Phenytoin, on the other hand, causes gingival hyperplasia in many patients, irreversible hypertrichosis in some patients and lethal reactions, such as Stevens-Johnson syndrome, in a few patients. Antiepileptic therapy sh...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract::Neck pain is a common presenting symptom in the primary care setting and causes significant disability. The broad differential diagnosis requires an efficient but global assessment; therefore, emphasis is typically placed on red flags that can assist in the early recognition and treatment of more concerning diagnoses,...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2020-08-01 00:00:00
abstract::Many normal children have heart murmurs, but most children do not have heart disease. An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonar...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::Orofacial pain can have an inflammatory, neurologic or musculoskeletal cause. Inflammatory diseases include dental abscess, sinusitis, temporal arteritis, sialolithiasis and infections of the parotid gland. Common neurologic diseases that cause facial pain are trigeminal neuralgia, glossopharyngeal neuralgia, paratrig...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-02-01 00:00:00
abstract::Inflammatory breast cancer is a devastating disease with an extremely high rate of morbidity and mortality. Differentiating this disease from acute mastitis may be difficult on initial diagnosis. The expeditious diagnosis and treatment of inflammatory breast cancer has important ramifications for the patient's prognos...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::Melanoma is an increasingly common malignancy, and it affects a younger population than most cancers. Risk factors for melanoma include white race, sun sensitivity, family history of melanoma, and melanocytic nevi. Sunburn and intermittent sun exposure appear to increase the risk of developing melanoma. The role of po...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2005-07-15 00:00:00
abstract::Thyroiditis is a spectrum of diseases that includes acute, subacute and chronic thyroiditis, all of which demonstrate the histologic findings of inflammation, fibrosis or lymphocytic infiltration. Acute thyroiditis is an infectious disease characterized by the abrupt onset of anterior neck pain and swelling. Subacute ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-15 00:00:00
abstract::Spinal cord compression from metastatic cancer is a medical emergency. Prompt intervention affords the best chance for successful recovery, while delay may result in devastating neurologic impairment. In the appropriate clinical setting, emergency myelography should be done to confirm the diagnosis of metastatic disea...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::As effective antipsychotic pharmacotherapy has become available, patients with schizophrenia are increasingly managed in an outpatient setting by primary care physicians. Pharmacotherapy is generally effective in treating "positive," or psychotic, symptoms and lessening the risks of relapse, but ineffective in improvi...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00