Abstract:
:Acute renal failure occurs in 5 percent of hospitalized patients. Etiologically, this common condition can be categorized as prerenal, intrinsic or postrenal. Most patients have prerenal acute renal failure or acute tubular necrosis (a type of intrinsic acute renal failure that is usually caused by ischemia or toxins). Using a systematic approach, physicians can determine the cause of acute renal failure in most patients. This approach includes a thorough history and physical examination, blood tests, urine studies and a renal ultrasound examination. In certain situations, such as when a patient has glomerular disease, microvascular disease or obstructive disease, rapid diagnosis and treatment are necessary to prevent permanent renal damage. By maintaining euvolemia, recognizing patients who are at increased risk and minimizing exposure to nephrotoxins, physicians can decrease the incidence of acute renal failure. Once acute renal failure develops, supportive therapy is critical to maintain fluid and electrolyte balances, minimize nitrogenous waste production and sustain nutrition. Death is most often caused by infection or cardiorespiratory complications.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Agrawal M,Swartz Rsubject
Has Abstractpub_date
2000-04-01 00:00:00pages
2077-88issue
7eissn
0002-838Xissn
1532-0650journal_volume
61pub_type
杂志文章,评审abstract::Kernicterus and neurologic sequelae caused by severe neonatal hyperbilirubinemia are preventable conditions. A structured and practical approach to the identification and care of infants with jaundice can facilitate prevention, thus decreasing rates of morbidity and mortality. Primary prevention includes ensuring adeq...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2008-05-01 00:00:00
abstract::Urinary tract infections in children are sometimes associated with vesicoureteral reflux, which can lead to renal scarring if it remains unrecognized. Since the risk of renal scarring is greatest in infants, any child who presents with a urinary tract infection prior to toilet training should be evaluated for the pres...
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::Use of complementary and alternative medicine has increased over the past decade. A variety of studies have suggested that this use is greater in persons with symptoms or diagnoses of anxiety and depression. Data support the effectiveness of some popular herbal remedies and dietary supplements; in some of these produc...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2007-08-15 00:00:00
abstract::The incidence of malignant melanoma has increased in recent years more than that of any other cancer in the United States. About one in 70 people will develop melanoma during their lifetime. Family physicians should be aware that a patient with a changing mole, an atypical mole or multiple nevi is at considerable risk...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2001-04-01 00:00:00
abstract::Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used, but have risks associated with their use, including significant upper gastrointestinal tract bleeding. Older persons, persons taking anticoagulants, and persons with a history of upper gastrointestinal tract bleeding associated with NSAIDs are at especia...
journal_title:American family physician
pub_type: 杂志文章,实务指引
doi:
更新日期:2009-12-15 00:00:00
abstract::Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be considered in the differential diagn...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2020-01-01 00:00:00
abstract::The best condoms are made of latex, are lubricated and coated with a spermicide, and have a reservoir tip. Condoms can protect against conception and sexually transmitted diseases, including acquired immunodeficiency syndrome. When condoms are used properly and in combination with vaginal spermicidal foam, the contrac...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::Jellyfish stings are usually mild except those caused by species in the South Pacific. The box jellyfish can produce a severe cardiorespiratory insult. The sting of the Portuguese man-of-war is more potent than that of the common jellyfish. The Indo-Pacific area is the source of the most venomous bony fish. Many injur...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1989-08-01 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::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::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::With the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., the diagnostic category previously known as somatoform disorders is now called somatic symptom and related disorders. The revisions were intended to increase their relevance in the primary care setting. The main feature of this dis...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2016-01-01 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::Clinically significant gastroesophageal reflux occurs in one in 500 infants. Symptoms resolve in 60 to 80 percent of infants by 18 months of age. Thickened formula and position changes are often recommended. Medication and surgical intervention may be needed in refractory cases. ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1991-03-01 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::Herpes zoster ("shingles") is usually a benign, self-limited disease. However, it can be debilitating or even fatal. The potentially serious complications of ocular involvement or postherpetic neuralgia and the confusing therapeutic regimens that are often advocated make this a complicated subject. Dissemination is mo...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-12-01 00:00:00
abstract::This is a tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons contained within the osseofibrous tunnel of the distal radius. Multiple tendons for the abductor pollicis longus and a separate, severely narrowed sheath for the extensor pollicis brevis make nonsurgical treatment difficult at...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, for diagnosis, and suspected atria...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2016-09-15 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::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::In many cases, the family physician will set the tone for rehabilitation of the stroke patient. It is imperative that the physician understand the recovery process, as well as the nature, benefits and limitations of rehabilitation. Since there are no precise predictors of individual outcome, no patient should be exclu...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::Appropriate preconception health care improves pregnancy outcomes. When started at least one month before conception, folic acid supplements can prevent neural tube defects. Targeted genetic screening and counseling should be offered on the basis of age, ethnic background, or family history. Before conception, women s...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2002-06-15 00:00:00
abstract::Skin laceration repair is an important skill in family medicine. Sutures, tissue adhesives, staples, and skin-closure tapes are options in the outpatient setting. Physicians should be familiar with various suturing techniques, including simple, running, and half-buried mattress (corner) sutures. Although suturing is t...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2008-10-15 00:00:00
abstract::Zidovudine is now used extensively in an effort to control infection with the human immunodeficiency virus (HIV). The drug is associated with major hematologic toxicity, especially anemia and granulocytopenia. Conservative management of hematologic toxicity includes dosage reduction or cessation of therapy, diagnosis ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1990-05-01 00:00:00
abstract::Nearly 40 percent of Americans complain about insomnia. Such complaints are even more common among the elderly, possibly because sleep efficiency decreases with age. As a result, the use of hypnotics in this age group is high--sometimes too high. Hypnotics can be addictive, and many have a low therapeutic index. The b...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::Poisoning is a common cause of morbidity and mortality in the United States, with several million episodes reported annually. Acute medication poisonings account for nearly one half of all poisonings reported in the United States and should be considered in persons with an acute change in mental status. The initial ap...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2010-02-01 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::Colonic angiodysplasia is now recognized as a frequent cause of gastrointestinal bleeding in patients over age 55. These microvascular arteriovenous malformations may be as common a cause of colonic bleeding as diverticular disease. The lesions are not evident on barium studies. Even colonoscopy and selective colonic ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1985-09-01 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::Vertigo is the illusion of motion, usually rotational motion. As patients age, vertigo becomes an increasingly common presenting complaint. The most common causes of this condition are benign paroxysmal positional vertigo, acute vestibular neuronitis or labyrinthitis, Ménière's disease, migraine, and anxiety disorders...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2005-03-15 00:00:00