Abstract:
:Down syndrome (trisomy 21) is the most commonly recognized genetic cause of mental retardation. The risk of trisomy 21 is directly related to maternal age. All forms of prenatal testing for Down syndrome must be voluntary. A nondirective approach should be used when presenting patients with options for prenatal screening and diagnostic testing. Patients who will be 35 years or older on their due date should be offered chorionic villus sampling or second-trimester amniocentesis. Women younger than 35 years should be offered maternal serum screening at 16 to 18 weeks of gestation. The maternal serum markers used to screen for trisomy 21 are alpha-fetoprotein, unconjugated estriol and human chorionic gonadotropin. The use of ultrasound to estimate gestational age improves the sensitivity and specificity of maternal serum screening.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Newberger DSsubject
Has Abstractpub_date
2000-08-15 00:00:00pages
825-32, 837-8issue
4eissn
0002-838Xissn
1532-0650journal_volume
62pub_type
杂志文章,评审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::Prompt defibrillation with lower energy levels (200 joules) initially is now recommended. Epinephrine is effective when instilled intratracheally and remains the treatment of choice for restoring cardiac rhythm. Enthusiasm for isoproterenol and calcium chloride has waned. Sodium bicarbonate and atropine are now used m...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract::Patients with restless legs syndrome often have difficulty describing their symptoms. Three features characterize the classic syndrome: an unusual, almost indescribable sensation in the lower extremities; an irresistible urge to move the legs, and the exclusive occurrence of the symptoms at rest, with their relief by ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1986-01-01 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::Group B streptococcus (GBS) is a leading cause of morbidity and mortality among newborns. Universal screening for GBS among women at 35 to 37 weeks of gestation is more effective than administration of intrapartum antibiotics based on risk factors. Lower vaginal and rectal cultures for GBS are collected at 35 to 37 we...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2005-03-01 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::Endometrial biopsy is an office procedure that serves as a helpful tool in diagnosing various uterine abnormalities. The technique is fairly easy to learn and may be performed without assistance. The biopsy is obtained through the use of an endometrial suction catheter that is inserted through the cervix into the uter...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2001-03-15 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::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 diagnosis of sleep apnea should be considered when a patient complains of snoring and excessive daytime somnolence. Middle-aged obese men are at particular risk, although apnea can occur in women and the elderly, as well as in persons who are not obese. An overnight polysomnographic sleep study can reveal the degr...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 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::Allergies may cause gastrointestinal symptoms such as diarrhea, vomiting and pain, dermatologic manifestations, asthma and rhinitis. The most common offender among the foodstuffs is milk. Elimination diets are designed not only to remove the offending food but to identify it and to prevent new sensitizations. Canker s...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1975-02-01 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::Distribution of accumulated fluid is the important element in the differentiation of peripheral edema resulting from different etiologies. Isolated upper extremity edema is rare and is usually caused by obstruction of the superior vena cava by a malignancy. The cause of unilateral edema of a lower limb can usually be ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-04-01 00:00:00
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::Magnetic resonance imaging uses powerful magnetic fields and a radiofrequency pulse to provide a diagnostic image. Physicians must identify patients with metallic internal implants, pacemakers and cochlear implants before MRI scanning to prevent serious injury. Some patients also experience severe anxiety from the con...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Hawthorn medicinal extract has long been a favored herbal remedy in Europe. The active components of this slow-acting cardiotonic agent are thought to be flavonoids and oligomeric procyanidins. The most studied hawthorn extracts are WS 1442 and LI 132. Reviews of placebo- controlled trials have reported both subjectiv...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2010-02-15 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::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::Coronary angioplasty is an accepted method of revascularization in selected patients with coronary artery disease. Immediately after a successful angioplasty, initial management concentrates on the detection and treatment of coronary artery spasm and acute vessel closure, should these complications occur. Once the pat...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic cr...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2015-01-01 00:00:00
abstract::After the safety and the tolerable dosage range of a new drug have been determined, it must be evaluated for efficacy and safety in patients having the condition for which the new drug is intended. The nature of certain drugs or diseases of of the patient population desired may suggest a family physician as the best d...
journal_title:American family physician
pub_type: 临床试验,杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract::Multiple sclerosis, an idiopathic inflammatory disease of the central nervous system, is characterized pathologically by demyelination and subsequent axonal degeneration. The disease commonly presents in young adults and affects twice as many women as men. Common presenting symptoms include numbness, weakness, visual ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2004-11-15 00:00:00
abstract::The incidence of Lyme disease is increasing, and the disease is spreading geographically. Prompt diagnosis requires recognition of characteristic signs and symptoms of infection with the spirochete Borrelia burgdorferi. In more than half of cases, erythema migrans is the earliest sign of Lyme disease. Although less fr...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-05-01 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::Common anorectal disorders can produce one or more of the following symptoms: pain, protrusion, pruritus, bleeding or discharge. The cause may be cryptitis, anal fissure, hemorrhoids, anorectal abscess, fistula in ano, neoplasm, condylomata acuminata, pilonidal cyst or inflammatory bowel disease. Each disorder is sugg...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-10-01 00:00:00
abstract::Hepatitis A is a common viral illness worldwide, although the incidence in the United States has diminished in recent years as a result of extended immunization practices. Hepatitis A virus is transmitted through fecal-oral contamination, and there are occasional outbreaks through food sources. Young children are usua...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2012-12-01 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::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 practicality of the office spirometer as an effective, inexpensive diagnostic device is well established. It can be used in a matter of seconds by minimally trained office personnel. Two basic parameters can be quickly and accurately measured: forced vital capacity (FVC), a test of volume indicative of restrictive...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00