Abstract：
:Ectopic pregnancy occurs at a rate of 19.7 cases per 1,000 pregnancies in North America and is a leading cause of maternal mortality in the first trimester. Greater awareness of risk factors and improved technology (biochemical markers and ultrasonography) allow ectopic pregnancy to be identified before the development of life-threatening events. The evaluation may include a combination of determination of urine and serum human chorionic gonadotropin (hCG) levels, serum progesterone levels, ultrasonography, culdocentesis and laparoscopy. Key to the diagnosis is determination of the presence or absence of an intrauterine gestational sac correlated with quantitative serum beta-subunit hCG (beta-hCG) levels. An ectopic pregnancy should be suspected if transvaginal ultrasonography shows no intrauterine gestational sac when the beta-hCG level is higher than 1,500 mlU per mL (1,500 IU per L). If the beta-hCG level plateaus or fails to double in 48 hours and the ultrasound examination fails to identify an intrauterine gestational sac, uterine curettage may determine the presence or absence of chorionic villi. Although past treatment consisted of an open laparotomy and salpingectomy, current laparoscopic techniques for unruptured ectopic pregnancy emphasize tubal preservation. Other treatment options include the use of methotrexate therapy for small, unruptured ectopic pregnancies in hemodynamically stable patients. Expectant management may have a role when beta-hCG levels are low and declining.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Tenore JLsubject
Has Abstractpub_date
2000-02-15 00:00:00pages
1080-8issue
4eissn
0002-838Xissn
1532-0650journal_volume
61pub_type
杂志文章,评审abstract：:Burns are the second most common cause of death in childhood. More than half of pediatric burns are partial-thickness scald burns; the majority occur in the kitchen. Generally, minor burns may be treated on an outpatient basis, while moderate burns are treated in a community hospital. Children with major burns should ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-10-01 00:00:00
abstract：OBJECTIVES:People with acute bronchitis may show little evidence of bacterial infection. If effective, antibiotics could shorten the course of the disease. However, if they are not effective, the risk of antibiotic resistance may be increased. The objective of this review was to assess the effects of antibiotic treatme...
journal_title：American family physician
pub_type： 杂志文章,meta分析
doi：
更新日期：2001-07-01 00:00:00
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：: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：:Gout is a disease resulting from the deposition of urate crystals caused by the overproduction or underexcretion of uric acid. The disease is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute and chronic arthritis, tophi, interstitial renal disease and uric a...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-04-01 00:00:00
abstract：:The primary therapy for anaphylaxis is epinephrine, which should be stocked in the office in the appropriate dilution (1:1,000). Antihistamines and corticosteroids are useful adjunctive agents that may be given in the office. Patients with progressive or severe symptoms should be transferred immediately to a facility ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-09-01 00:00:00
abstract：:Endometriosis is a progressive disease affecting 5 to 10 percent of women. It can cause dyspareunia, dysmenorrhea, low back pain and infertility. A definitive diagnosis can be made only by means of laparoscopy. Medical treatment designed to interfere with ovulation generally provides effective pain relief, but the rec...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-10-15 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：:Strenuous exercise may cause menstrual abnormalities, including amenorrhea. The hypoestrogenemia that accompanies amenorrhea has been associated with a low bone mineral content and an increased incidence of stress fractures. With the resumption of menses, which usually occurs soon after female athletes decrease the in...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 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：:More than 100,000 children are born in the U.S. each year with major congenital defects or genetic disorders, with or without mental retardation. Advances in prenatal diagnosis have now made it possible to detect an increasing number of these disorders in utero. Carrier detection is advised prior to pregnancy, rather ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1977-01-01 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：:Carbon monoxide poisoning usually results from inhalation of exhaust fumes from motor vehicles, smoke from fires or fumes from faulty heating systems. Carbon monoxide has a high affinity for hemoglobin, with which it forms carboxyhemoglobin. The resulting decrease in both oxygen-carrying capacity and oxygen release ca...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-01 00:00:00
abstract：:Although a rare entity, laryngeal tuberculosis must be a diagnostic consideration--along with laryngeal carcinoma--whenever patients present with prolonged hoarseness or painful dysphagia. This form of tuberculosis was once thought to be especially virulent and more infectious than other forms; however, severity was p...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate entity. The pathogenesis of HELLP...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-09-01 00:00:00
abstract：:Alzheimer disease is the most common form of dementia, affecting nearly one-half [corrected] of Americans older than 85 years. It is characterized by progressive memory loss and cognitive decline. Amyloid plaque accumulation, neurofibrillary tau tangles, and depletion of acetylcholine are among the pathologic manifest...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2011-06-15 00:00:00
abstract：:Cigarette smoking causes significant morbidity and mortality in the United States. Physicians can use the five A's framework (ask, advise, assess, assist, arrange) to promote smoking cessation. All patients should be asked about tobacco use and assessed for motivation to quit at every clinical encounter. Physicians sh...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2012-03-15 00:00:00
abstract：:Cytochrome P450 enzymes are essential for the metabolism of many medications. Although this class has more than 50 enzymes, six of them metabolize 90 percent of drugs, with the two most significant enzymes being CYP3A4 and CYP2D6. Genetic variability (polymorphism) in these enzymes may influence a patient's response t...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2007-08-01 00:00:00
abstract：:Children six months to four years of age are at greatest risk for aspiration of foreign bodies. A history of coughing after contact with small objects is the most important clue. The clinical presentation varies from paroxysms of choking and coughing to chronic cough or wheezing. Chest radiographs are normal in up to ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1979-09-01 00:00:00
abstract：:Osteoporosis is the most common bone disorder in the United States. Bone mass is decreased, and porosity and fragility are increased. Dual-beam photon absorptiometry is currently considered the best detection technique. Prevention involves increased calcium intake and avoidance of diets high in protein and phosphates,...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-11-01 00:00:00
abstract：:An estimated 15% of children in the United States have at least one developmental delay, yet less than one-fifth of those children receive early intervention services before three years of age. Many barriers exist to implementing initial screening and referral, but screening tools can be easily incorporated into the w...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2017-07-01 00:00:00
abstract：:For centuries, chasteberry has been used to treat many hormone-related gynecologic conditions. The current literature supports the use of chasteberry for cyclical breast discomfort and premenstrual syndrome; data on its use for menstrual irregularities and fertility disorders are weak. Its traditional use as a galacta...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-09-01 00:00:00
abstract：:In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one oral agent plus a glucagon-like pep...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2018-01-01 00:00:00
abstract：:Senile dementia of the Binswanger's type is a term used to describe a dementia syndrome characterized by onset in the sixth or seventh decade of life, subcortical neurologic deficits, psychiatric disorders and evidence of hypertension or systemic vascular disease. The status of senile dementia of the Binswanger's type...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-12-01 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：:Minor neurologic signs or transient ischemic attacks (TIAs) precede stroke in 50 percent of patients. In men, antiplatelet therapy decreases the risk of recurrent TIA and stroke. Carotid endarterectomy for TIA is now one of the most commonly performed vascular operations. Preoperatively, the arterial anatomy of the pa...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-05-01 00:00:00
abstract：:The process of identifying and evaluating the common causes of vaginal bleeding during pregnancy changes as the pregnancy progresses to term. The most common identifiable causes of vaginal bleeding during early pregnancy include spontaneous abortion and ectopic pregnancy. Pelvic ultrasound and quantitative beta-human ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-02-15 00:00:00
abstract：:Knee pain is a common presenting complaint with many possible causes. An awareness of certain patterns can help the family physician identify the underlying cause more efficiently. Teenage girls and young women are more likely to have patellar tracking problems such as patellar subluxation and patellofemoral pain synd...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-09-01 00:00:00
abstract：:Myasthenia gravis is characterized by variable ocular and skeletal muscle weakness. Peak incidence is in young women and older men. Thymomas are present in 30 percent of myasthenic patients over age 40. Binding of acetylcholine receptors by IgG antibodies may be the mechanism of the neuromuscular disorder. Repetitive ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-02-01 00:00:00
abstract：:Dorsal penile nerve block with lidocaine is safe and effective for reducing the pain associated with newborn circumcision. Administering the anesthesia adds little time or expense to the overall routine. Complications are minor, limited to local bleeding and hematoma formation. Family physicians performing circumcisio...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-04-01 00:00:00
