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 treatment in patients with a clinical diagnosis of acute bronchitis. SEARCH STRATEGY:The authors searched MEDLINE, Embase, reference lists of articles, personal collections up to 1996 and Sci-search from 1989 to 1996. SELECTION CRITERIA:Randomized trials comparing any antibiotic therapy with placebo in acute bronchitis. DATA COLLECTION AND ANALYSIS:At least two reviewers extracted data and assessed trial quality. PRIMARY RESULTS:The results of eight trials involving 750 patients from eight years of age to 65 and older and including smokers and nonsmokers were included. The quality of the trials was variable. A variety of outcome measures was assessed. In many cases, only outcomes that showed a statistically significant difference between groups were reported. Overall, patients taking antibiotics had slightly better outcomes than those taking placebo. They were less likely to report feeling unwell at a follow-up visit (odds ratio, 0.42; 95 percent confidence interval [CI] 0.22 to 0.82), to show no improvement on physician assessment (odds ratio, 0.43; CI, 0.23 to 0.79) or to have abnormal lung findings (odds ratio, 0.33; CI, 0.13 to 0.86), and had a more rapid return to work or usual activities (weighted mean difference, 0.7 days earlier; CI, 0.2 to 1.3). Antibiotic-treated patients reported significantly more adverse effects (odds ratio, 1.64; CI, 1.05 to 2.57), such as nausea, vomiting, headache, skin rash or vaginitis. REVIEWERS' CONCLUSIONS:Antibiotics appear to have a modest beneficial effect in the treatment of acute bronchitis, with a correspondingly small risk of adverse effects. The benefits of antibiotics may be overestimated in this analysis because of the tendency of published reports to include complete data only on outcomes found to be statistically significant.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Chandran Rsubject
Has Abstractpub_date
2001-07-01 00:00:00pages
135-8issue
1eissn
0002-838Xissn
1532-0650journal_volume
64pub_type
杂志文章,meta分析abstract：:Arnold-Chiari malformation is a disorder of embryologic development. In Type I, there is cerebellar displacement into the spinal canal, but hydrocephalus and syringomyelia are variable. Type II usually is manifested by severe hydrocephalus and myelomeningocele in infancy. Type I malformations may pose diagnostic chall...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1989-03-01 00:00:00
abstract：:Caring for the problem drinker in the perioperative period is a challenging task. If alcohol abuse is suspected, a careful assessment is indicated before surgery is performed. Both the CAGE and SMAST questionnaires are good screening tools for alcoholism. Preoperative evaluation of alcohol-dependent patients should in...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1995-12-01 00:00:00
abstract：:The family physician often provides the first and only medical intervention for fingertip injuries. Proper diagnosis and management of fingertip injuries are vital to maintaining proper function of the hand and preventing permanent disability. A subungual hematoma is a painful condition that involves bleeding beneath ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-05-15 00:00:00
abstract：:Chronic pancreatitis is the progressive and permanent destruction of the pancreas resulting in exocrine and endocrine insufficiency and, often, chronic disabling pain. The etiology is multifactorial. Alcoholism plays a significant role in adults, whereas genetic and structural defects predominate in children. The aver...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2007-12-01 00:00:00
abstract：:The physician needs to know the signs, symptoms and recommended treatments of drug overdoses. Overdose of hallucinogens usually does not require drug therapy. Overdose of amphetamines ("uppers") may be complicated by the presence of PCP, a dissociative substance. It is important for the physician to be familiar with t...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
abstract：:Grief and depression present similarly in patients who are dying. Conventional symptoms (e.g., frequent crying, weight loss, thoughts of death) used to assess for depression in these patients may be imprecise because these symptoms are also present in preparatory grief and as a part of the normal dying process. Prepar...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2002-03-01 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：: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：:The incidence of skin cancer is increasing by epidemic proportions. Basal cell cancer remains the most common skin neoplasm, and simple excision is generally curative. Squamous cell cancers may be preceded by actinic keratoses-premalignant lesions that are treated with cryotherapy, excision, curettage or topical 5-flu...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-07-15 00:00:00
abstract：:Healing by primary intention is a threefold process, consisting of an initial phase in which red and white blood cells bind the wound; epithelialization and fibroplasia, and a maturation phase involving collagen synthesis. The appearance of the wound reflects its maturation. Skillful wound management is based on biolo...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:Nitrous oxide analgesia is a safe alternative to parenteral narcotics for outpatient surgical procedures. This type of analgesia is effective, well tolerated by most age groups, easily administered, rapidly reversible and associated with a low incidence of serious side effects. Hypoxia can be prevented by using fail-s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:Prisoners in U.S. correctional facilities constitute a unique patient population in need of health services. Physicians who provide medical services to inmates also must interact with prison officials. Drug withdrawal, self-destructive behavior and infectious diseases, including acquired immunodeficiency syndrome, are...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1988-07-01 00:00:00
abstract：:A previous venous thromboembolism is the most important risk factor for predicting recurrence of the condition. Several studies have shown that routine testing for inherited thrombophilias is not helpful in predicting the risk of recurrence or altering treatment decisions, and therefore is not cost-effective. Updated ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2011-02-01 00:00:00
abstract：:Family physicians should be aware of the potential effects and complications of vasectomy so they can appropriately counsel patients seeking sterilization. Vasectomy produces anatomic, hormonal and immunologic changes and, although not substantiated by clinical studies, has been reputed to be associated with atheroscl...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-15 00:00:00
abstract：:Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition is failure to reach menarche, i...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2013-06-01 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：:External hemorrhoids represent distended vascular tissue in the anal canal distal to the dentate line. Persons with thrombosed external hemorrhoids usually present with pain on standing, sitting or defecating. Acutely tender, thrombosed external hemorrhoids can be surgically removed if encountered within the first 72 ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-04-15 00:00:00
abstract：:Garlic has long been used medicinally, most recently for its cardiovascular, antineoplastic, and antimicrobial properties. Sulfur compounds, including allicin, appear to be the active components in the root bulb of the garlic plant. Studies show significant but modest lipid-lowering effects and antiplatelet activity. ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-07-01 00:00:00
abstract：:At least three models have been used to project the future physician workforce, and each produces different results. No physician workforce predictions can be relied on until there is more consideration of and agreement on desired health outcomes and what physicians must do to achieve them. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2005-11-01 00:00:00
abstract：:Necrotizing sialometaplasia is a benign inflammatory disease of salivary gland origin. Because of its clinical and histologic resemblance to squamous cell carcinoma, this disease must be recognized. The cause is unknown, but it may be related to oral trauma, tobacco use or inadequate blood supply. The lesion heals spo...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1983-02-01 00:00:00
abstract：:The herbal remedies referred to as "ginseng" are derived from the roots of several plants. One of the most commonly used and researched of the ginsengs is Panax ginseng, also called Asian or Korean ginseng. The main active components of Panax ginseng are ginsenosides, which have been shown to have a variety of benefic...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-10-15 00:00:00
abstract：:Colorectal cancer is the third most common cancer in men and women. The incidence and mortality rate of the disease have been declining over the past two decades because of early detection and treatment. Screening in persons at average risk should begin at 50 years of age; the U.S. Preventive Services Task Force recom...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2015-01-15 00:00:00
abstract：:Preterm birth is a major cause of infant morbidity and mortality. Although studies have been complicated by problems of definition and methodology, certain strategies have the potential to reduce both the incidence and the impact of preterm birth. These strategies include accurate assessment of gestational age, educat...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1992-08-01 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：:In the guideline developed by the American College of Cardiology and the American Heart Association, the management of suspected unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI) has four components: initial evaluation and management; hospital care; coronary revascularization; and hospital...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-08-01 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：: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：: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：:Health literacy includes a set of skills needed to make appropriate health decisions and successfully navigate the health care system. These skills include reading, writing, numeracy, communication, and, increasingly, the use of electronic technology. National data indicate that more than one-third of U.S. adults have...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2015-07-15 00:00:00
abstract：:The exposed and unprotected position of the auricle makes it susceptible to injuries. Because many of these injuries are initially managed in a primary care setting, family physicians should have an understanding of the management of auricular hematomas, lacerations, abrasions and thermal injuries. Auricular hematoma ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-05-15 00:00:00
