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 artery disease, hypertension or valvular heart disease. It is important to determine whether the patient has had a previous cardiac event, in particular a myocardial infarction. The physical examination should include Valsalva's maneuver, a test that is highly specific and sensitive for the detection of left ventricular systolic and diastolic dysfunction in patients with heart failure. An electrocardiograph and a chest radiograph should also be obtained. Two-dimensional echocardiography of the heart helps differentiate systolic from diastolic dysfunction. Coronary angiography is indicated in patients with heart failure and anginal chest pain and should be strongly considered in patients with an electrocardiogram suggestive of ischemia or myocardial infarction.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Shamsham F,Mitchell Jsubject
Has Abstractpub_date
2000-03-01 00:00:00pages
1319-28issue
5eissn
0002-838Xissn
1532-0650journal_volume
61pub_type
杂志文章,评审abstract：:While abdominoperineal resection with permanent colostomy is still required for most distal [corrected] rectal cancers, sphincter-saving local treatment by means of local excision, electrocoagulation or endocavitary contact radiation can be used for some highly selected distal tumors. Local treatment avoids a permanen...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-10-15 00:00:00
abstract：:Although herpes simplex virus is a recognized cause of esophagitis in immunocompromised patients, it may also be the etiologic agent in otherwise healthy individuals. Odynophagia and dysphagia are the major symptoms. The esophagogram may reveal ulcers in the distal esophagus and there may be motor disturbances as well...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-07-01 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：:Zidovudine, the first widely used antiretroviral agent, prevents replication of the human immunodeficiency virus (HIV) by inhibiting reverse transcriptase. Its use in patients with acquired immunodeficiency syndrome slows progression of the disease and prolongs survival. Zidovudine also significantly reduces the rate ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1990-08-01 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：:Rheumatic complaints secondary to viral infections are usually brief, self-limited and nondestructive. They may accompany almost any type of viral illness, and the arthritic presentation is nonspecific. These manifestations are protean, ranging from arthralgia to vasculitis. Often the cause of the rheumatic complaint ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1996-11-01 00:00:00
abstract：:Legionella pneumophila is transmitted by aerosolization of water or dust from soil. There are six serotypes and four newly recognized related organisms. Sporadic cased of Legionnaires; disease are more common than epidemic case and are less likely to be suspected . Most reporters cases are characterized by severe pneu...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-07-01 00:00:00
abstract：:Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2014-07-01 00:00:00
abstract：:Nephrolithiasis is a rare but important condition in pregnant women. The most common presenting complaint is flank pain. Recurrent or persistent urinary tract infections may also be due to nephrolithiasis. Ultrasound is the first-line diagnostic study, but a limited intravenous pyelogram can be obtained when indicated...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
abstract：:Primary immunodeficiencies include a variety of disorders that render patients more susceptible to infections. If left untreated, these infections may be fatal. The disorders constitute a spectrum of more than 80 innate defects in the body's immune system. Primary immunodeficiencies generally are considered to be rela...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-11-15 00:00:00
abstract：:Major complications of cirrhosis include ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, variceal bleeding, and hepatorenal syndrome. Diagnostic studies on ascitic fluid should include a differential leukocyte count, total protein level, a serum-ascites albumin gradient, and fl...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-09-01 00:00:00
abstract：:Nocturnal enuresis is a common problem that can be troubling for children and their families. Recent studies indicate that nocturnal enuresis is best regarded as a group of conditions with different etiologies. A genetic component is likely in many affected children. Research also indicates the possibility of two subt...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-04-01 00:00:00
abstract：:Transient organic causes of impotence include alcohol consumption, drug use or inflammatory genital disease. Many diagnoses of organic impotence, with diabetes, for example, have been premature and have resulted in iatrogenic, psychogenic impotence. After a stroke, heart attack or major surgery, depression may cause i...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1978-02-01 00:00:00
abstract：:Persons whose experienced or expressed gender differs from their sex assigned at birth may identify as transgender. Transgender and gender-diverse persons may have gender dysphoria (i.e., distress related to this incongruence) and often face substantial health care disparities and barriers to care. Gender identity is ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2018-12-01 00:00:00
abstract：:Chronic liver disease is the 10th leading cause of death in the United States. Hepatitis C virus infection is the most frequent cause of chronic liver disease and the most common indication for liver transplantation. Preventive care can significantly reduce the progression of liver disease. Alcohol and hepatitis C vir...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-11-01 00:00:00
abstract：:Prompt diagnosis of problems in the first trimester of pregnancy is facilitated by ultrasound scanning and quantitative serum human chorionic gonadotropin and progesterone testing. When used appropriately, these tests can determine whether a patient has a normal early pregnancy, a miscarriage, a missed abortion, an ec...
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：:Vacuum extractors have replaced forceps for many situations in which assistance is required to achieve vaginal delivery. Compared with metal-cup vacuum extractors, soft-cup devices are easier to use and cause fewer neonatal scalp injuries; however, they detach more frequently. Vacuum extractors can cause neonatal inju...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-09-15 00:00:00
abstract：:The prognosis remains poor for patients with congestive heart failure (CHF), despite reduced mortality rates resulting from the addition of angiotensin converting enzyme inhibitors to traditional treatment regimens. Because much of the myocardial damage that occurs in patients with CHF may be related to sympathetic ac...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-11-01 00:00:00
abstract：:The blood sample for phenylketonuria (PKU) screening should be obtained at least 12 hours after the infant's birth. Newborn screening for PKU has largely eliminated mental retardation caused by this disease. If the first phenylalanine test demonstrates positive results, a repeat test should be performed. Treatment to ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1999-10-01 00:00:00
abstract：:Infectious endocarditis results from bacterial or fungal infection of the endocardial surface of the heart and is associated with significant morbidity and mortality. Risk factors include the presence of a prosthetic heart valve, structural or congenital heart disease, intravenous drug use, and a recent history of inv...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-05-15 00:00:00
abstract：:Improved hand function after injury or disease is achieved by increasing joint mobility, muscle strength and coordination, while reducing edema and pain. Static and dynamic orthoses assist in correcting deformities, provide strengthening activities and maintain a functional hand position. Many orthotic appliances are ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-08-01 00:00:00
abstract：:Carpal tunnel syndrome is the most common focal entrapment syndrome. Forceful repetitive activity and vibration may be important workplace risk factors for carpal tunnel syndrome. Although systematic study has suggested that carpal tunnel syndrome is work-related, no clear "dose-response" curve has been found between ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-05-01 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：: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 increase...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-06-01 00:00:00
abstract：:Suspect this common syndrome in young women who are pregnant or on oral contraceptives, in menopausal women, in patients performing unaccustomed repetitive manual activity, in those on hemodialysis and in those with endocrine abnormalities. Diagnosis requires precise neurologic examination and electrodiagnostic studie...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
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 tho...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-05-15 00:00:00
abstract：:Pregnant women commonly use over-the-counter medications. Although most over-the-counter drugs have an excellent safety profile, some have unproven safety or are known to adversely affect the fetus. The safety profile of some medications may change according to the gestational age of the fetus. Because an estimated 10...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-06-15 00:00:00
abstract：:A 56-year-old man, who had previously been treated for arthritis of the hands, was admitted to the hospital because of abdominal pain and fever. Physical examination, laboratory tests and liver biopsy led to the diagnosis of hemochromatosis. The patient's brother, who had also been treated for arthritis, was then foun...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-06-01 00:00:00
abstract：:Low-molecular-weight heparin is a relatively recent addition to the list of therapies for prophylaxis and treatment of deep venous thrombosis (DVT). As a prophylactic, low-molecular-weight heparin is as effective as standard heparin or warfarin and does not require monitoring of the activated partial thromboplastin ti...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-03-15 00:00:00
abstract：:While screening patients for thyroid disease, physicians often find increased thyrotropin-stimulating hormone (TSH) levels in patients whose free thyroxine (T4) levels are not below normal. This state, termed "subclinical hypothyroidism," is most commonly an early stage of hypothyroidism. Although the condition may re...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-02-15 00:00:00
