Abstract:
:Irritable bowel syndrome is the most common functional disorder of the gastrointestinal tract and is frequently treated by family physicians. Despite patients' worries about the symptoms of irritable bowel syndrome, it is a benign condition. The diagnosis should be made using standard criteria after red flags that may signify organic disease have been ruled out. An effective physician-patient relationship is vital to successful management. Episodes of diarrhea are best managed with loperamide, while constipation often will respond to fiber supplements. Antispasmodics or anticholinergic agents may help relieve the abdominal pain of irritable bowel syndrome. Refractory cases are often treated with tricyclic antidepressants. Newer agents such as tegaserod and ondansetron target neurotransmitter receptors in the gastrointestinal tract Some forms of psychologic treatment may be helpful, and gastroenterology consultation is occasionally needed to reassure the patient. Comorbid conditions such as depression or anxiety should be investigated and treated.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Viera AJ,Hoag S,Shaughnessy Jsubject
Has Abstractpub_date
2002-11-15 00:00:00pages
1867-74issue
10eissn
0002-838Xissn
1532-0650journal_volume
66pub_type
杂志文章,评审abstract::Otitis externa, green nail syndrome, toe web infections, hot tub folliculitis, superinfections in chronic antibiotic-treated acne and infectious eczematoid dermatitis are examples of mild cutaneous infections due to Pseudomonas aeruginosa. These may occur in otherwise healthy persons. In persons with lowered resistanc...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-01-01 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::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::Outpatient intravenous antibiotic therapy is a cost-effective modality to shorten hospital stays and provide continued care to patients with infections. The recent availability of tamper-proof pumps that can deliver multiple antibiotics on independently timed regimens will further expand the use of home intravenous an...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract::Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocatio...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-03-01 00:00:00
abstract::Patients with symptomatic lumbar disk disease may present with back pain, referred leg pain, radicular leg pain, sensory changes and leg weakness. Because neurologic deficits are commonly localized to the L5 or S1 nerve roots, evaluation of patients with such symptoms should focus on these dermatomes and muscle groups...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-04-01 00:00:00
abstract::Hemolytic anemias usually present with persistent reticulocytosis, a characteristic that differentiates them from other types of anemia. Once the presence of a hemolytic process has been documented, simple observation of red blood cell morphology will yield important etiologic information. Hemolysis may result from in...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::Atypical moles can be distinguished visually by clinical features of size greater than 6 mm in diameter, color variegation, indistinct borders, and textured surface. All patients who have atypical moles should be counselled about sun avoidance, screening of family members, and regular skin checks at least once per yea...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2008-09-15 00:00:00
abstract::Myocardial infarction and congestive heart failure are associated with high morbidity and mortality rates. The results of recent clinical trials support a beneficial role for angiotensin-converting enzyme (ACE) inhibitors in attenuating mortality from myocardial infarction and left ventricular dysfunction. Large-scale...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract::Determining the cause of metabolic acidosis with a high anion gap may present a diagnostic challenge. Possible causes include ketoacidosis, certain toxic ingestions, renal failure and lactic acidosis. Many of these entities present with nausea, vomiting and changes in mental status; however, there are specific hallmar...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1989-04-01 00:00:00
abstract::Patients with variceal or other gastrointestinal hemorrhage require aggressive resuscitative measures and early diagnosis for optimal therapy. A number of nonsurgical endoscopic modalities, such as laser therapy, sclerotherapy, heater probe and electrocoagulation (monopolar or bipolar), are available to arrest and som...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract::More women, men and children receive medical care each month in the offices of primary care physicians than any other professional setting. There is an urgent need for health policies that encourage further innovation and implementation ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2001-09-15 00:00:00
abstract::Atrial fibrillation is associated with potentially life-threatening strokes. Anticoagulation with warfarin or aspirin reduces the risk of embolic events in patients with chronic atrial fibrillation and mitral valve stenosis or other underlying heart disease. In patients with acute onset of atrial fibrillation, anticoa...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::The records of 1,381 patients with gonorrhea were examined by the Massachusetts Department of Public Health to determine the efficacy of their treatment schedules. Urethritis, cervicitis and pharyngitis were treated with 4.8 million u. of aqueous procaine penicillin G intramuscularly, without probenecid. Cure rates we...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract::Thyroiditis is a spectrum of diseases that includes acute, subacute and chronic thyroiditis, all of which demonstrate the histologic findings of inflammation, fibrosis or lymphocytic infiltration. Acute thyroiditis is an infectious disease characterized by the abrupt onset of anterior neck pain and swelling. Subacute ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-15 00:00:00
abstract::Hospitals present a variety of infectious, chemical and physical hazards to their workers. Important pathogens include AIDS, hepatitis B and rubella viruses and Mycobacterium tuberculosis. Ethylene oxide is probably the greatest chemical hazard, but anesthetic gases, antineoplastic drugs and skin irritants or sensitiz...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1987-02-01 00:00:00
abstract::Risk factors for stroke should be evaluated in patients who have had a transient ischemic attack. Blood pressure, lipid levels, and diabetes mellitus should be controlled. When applicable, smoking cessation and weight loss also are important. Angiotensin-converting enzyme inhibitor therapy may help prevent stroke. Asp...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2004-04-01 00:00:00
abstract::Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for hip fracture. Patients may present with acute respiratory symptoms, including tachypnea, tachycardia and rales. Chest radiographs and clinical and laboratory findings alone cannot provide a firm diagnosis. A completely nor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::Heel pain is a common presenting symptom in ambulatory clinics. There are many causes, but a mechanical etiology is most common. Location of pain can be a guide to the proper diagnosis. The most common diagnosis is plantar fasciitis, a condition that leads to medial plantar heel pain, especially with the first weight-...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2011-10-15 00:00:00
abstract::The specific type of epilepsy must be identified. The history and the EEG provide the evidence. Drug selection is then based on the classification of the patient's epilepsy. Major drugs used in the management of epilepsy are phenytoin, phenobarbital, primidone, carbamazepine, ethosuximide and valproic acid. The physic...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
abstract::Bowenoid papulosis usually appears as small papules on the penis or vulva. Histologically, these lesions display the atypia of Bowen's disease (squamous cell carcinoma in situ). Bowenoid papulosis is now considered to be a sexually transmitted disease, probably caused by human papillomavirus type 16. Malignant transfo...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1988-07-01 00:00:00
abstract::Delayed hypersensitivity skin tests, when properly planned and performed, are both practical and sensitive in determining the status of cell-mediated immunity. They can be diagnostic of specific exposure, such as tuberculosis, or they can rule out anergy. Pitfalls include poor selection of antigens, inappropriate appl...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::Many normal children have heart murmurs, but most children do not have heart disease. An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonar...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 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::The peak expiratory flow rate (PEFR) may be measured in the office or at home with an inexpensive, hand-held meter. Measurement of the PEFR provides a rapid, objective means of diagnosing and monitoring asthma. Use of the peak flow meter permits early detection of deteriorating function, allowing timely institution of...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract::Traumatic spinal injuries are a major health problem. Any accident victim suspected of having a spinal injury must be immobilized immediately to prevent further damage to the spine. Management is directed toward achieving the most favorable environment for spinal cord recovery. This includes maintaining adequate oxyge...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract::All major health organizations recommend breastfeeding as the optimal source of infant nutrition, with exclusive breastfeeding recommended for the first six months of life. After six months, complementary foods may be introduced. Most organizations recommend breastfeeding for at least one year, and the World Health Or...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2018-09-15 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::Atrial fibrillation is the most common arrhythmia in patients visiting a primary care practice. Although many patients with atrial fibrillation experience relief of symptoms with control of the heart rate, some patients require restoration of sinus rhythm. External direct current (DC) cardioversion is the most effecti...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-08-01 00:00:00
abstract::Anemia in children is commonly encountered by the family physician. Multiple causes exist, but with a thorough history, a physical examination and limited laboratory evaluation a specific diagnosis can usually be established. The use of the mean corpuscular volume to classify the anemia as microcytic, normocytic or ma...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2001-10-15 00:00:00