Abstract：
:Status epilepticus is an increasingly recognized public health problem in the United States. Status epilepticus is associated with a high mortality rate that is largely contingent on the duration of the condition before initial treatment, the etiology of the condition, and the age of the patient. Treatment is evolving as new medications become available. Three new preparations--fosphenytoin, rectal diazepam, and parenteral valproate--have implications for the management of status epilepticus. However, randomized controlled trials show that benzodiazepines (in particular, diazepam and lorazepam) should be the initial drug therapy in patients with status epilepticus. Despite the paucity of clinical trials comparing medication regimens for acute seizures, there is broad consensus that immediate diagnosis and treatment are necessary to reduce the morbidity and mortality of this condition. Moreover, investigators have reported that status epilepticus often is not considered in patients with altered consciousness in the intensive care setting. In patients with persistent alteration of consciousness for which there is no clear etiology, physicians should be more quickly prepared to obtain electroencephalography to identify status epilepticus. Physicians should rely on a standardized protocol for management of status epilepticus to improve care for this neurologic emergency.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Sirven JI,Waterhouse Esubject
Has Abstractpub_date
2003-08-01 00:00:00pages
469-76issue
3eissn
0002-838Xissn
1532-0650journal_volume
68pub_type
杂志文章,评审abstract：:Myasthenia gravis is characterized by variable ocular and skeletal muscle weakness. Peak incidence is in young women and older men. Thymomas are present in 30 percent of myasthenic patients over age 40. Binding of acetylcholine receptors by IgG antibodies may be the mechanism of the neuromuscular disorder. Repetitive ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-02-01 00:00:00
abstract：:AIDS dementia complex is a major source of disability for many AIDS patients. Less commonly, the spinal cord or peripheral nerves are affected by HIV infection. Physicians working with AIDS patients must differentiate these manifestations from those caused by the infectious, neoplastic and vascular complications. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-12-01 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：:Recent innovations in medical technology have changed newborn screening programs in the United States. The widespread use of tandem mass spectrometry is helping to identify more inborn errors of metabolism. Primary care physicians often are the first to be contacted by state and reference laboratories when neonatal sc...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-06-01 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：:Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is characterized by cessation of previously ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2019-07-01 00:00:00
abstract：:Management of a wide variety of musculoskeletal conditions requires the use of a cast or splint. Splints are noncircumferential immobilizers that accommodate swelling. This quality makes splints ideal for the management of a variety of acute musculoskeletal conditions in which swelling is anticipated, such as acute fr...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-09-01 00:00:00
abstract：:More than 100,000 children are born in the U.S. each year with major congenital defects or genetic disorders, with or without mental retardation. Advances in prenatal diagnosis have now made it possible to detect an increasing number of these disorders in utero. Carrier detection is advised prior to pregnancy, rather ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
abstract：:Gout is a disease resulting from the deposition of urate crystals caused by the overproduction or underexcretion of uric acid. The disease is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute and chronic arthritis, tophi, interstitial renal disease and uric a...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-04-01 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：:Worry is a normal response to uncertainty. Education, empathetic support, reassurance, and passage of time usually ameliorate ordinary worries. However, these common-sense strategies for dealing with transient worries often prove ineffective for patients with excessive worry, many of whom meet the criteria for disorde...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-03-15 00:00:00
abstract：:The report states that chronic rhinosinusitis is an evolving area of study and new information is being assessed on an ongoing basis. Debate continues about potential etiologies and associated conditions, pathophysiology, common inflammatory mediators, and whether or not most cases of chronic rhinosinusitis are associ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2004-05-01 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：:Although clinical evaluation remains the cornerstone in the diagnosis of multiple sclerosis, magnetic resonance imaging (MRI) has emerged as the ancillary study of choice. An important diagnostic tool, MRI can also be used to assess disease load, activity and progression, and distinguish between acute and chronic lesi...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-08-01 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：:Ischemic heart disease is one of the most common disorders managed by family physicians. Stratifying patients according to risk is important early in the course of the disease to identify patients who require invasive (percutaneous or surgical) treatment. Physical examination, clinical history, noninvasive tests and a...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-12-01 00:00:00
abstract：:Adult immunization rates have fallen short of national goals partly because of misconceptions about the safety and benefits of current vaccines. The danger of these misconceptions is magnified during pregnancy, when concerned physicians are hesitant to administer vaccines and patients are reluctant to accept them. Rou...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2003-07-15 00:00:00
abstract：:Defined as three hours of crying per day occurring more than three days in any one week, colic affects 10 to 20 percent of infants during the first three to four months of life. Food allergy, parental attitude, flatulence, maternal medication and parental smoking have been implicated. Dietary modification, pharmacothe...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-09-01 00:00:00
abstract：:Ginger (Zingiber officinale) is one of the more commonly used herbal supplements. Although often consumed for culinary purposes, it is taken by many patients to treat a variety of conditions. Ginger has been shown to be effective for pregnancy-induced and postoperative nausea and vomiting. There is less evidence to su...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2007-06-01 00:00:00
abstract：:Causes of congestive heart failure include hypertension, coronary artery disease, alcohol abuse and valvular heart disease. Two-dimensional echocardiography with Doppler examination is excellent for identifying valvular heart disease. While noninvasive screening for coronary artery disease may seem cost-effective, the...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1990-09-01 00:00:00
abstract：:Analgesic and sedative needs depend on the type of procedure, the child's age and the degree of cooperation from the child and parents. Local anesthesia, which may be administered subcutaneously or in topical gel form, generally is sufficient for common procedures such as lumbar puncture and laceration repair. Frequen...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-02-15 00:00:00
abstract：:Cirrhosis is a diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules. The modified Child-Pugh score, which ranks the severity of cirrhosis based on signs and liver function test results, has been shown to predict survival. Strategies have been esta...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-11-15 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：:Careful examination of a fresh, properly collected urine specimen can indicate the presence of urinary tract disease or uncover unsuspected local or systemic pathology. Urinalysis also can lead to a more complete understanding of a systemic disorder or can assure both the patient and the physician that urinary tract d...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:"White coat" or "office" hypertension is often defined as the transient rise or elevation of blood pressure that occurs in the medical setting. Patients with these elevated readings have normal ambulatory pressures as determined by individual home blood pressure measurements or continuous 24-hour blood pressure monito...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-07-01 00:00:00
abstract：:The principal means of evaluating perimenopausal bleeding is endometrial biopsy performed in the office. With the rising incidence of endometrial cancer, an accurate diagnosis is imperative. Outpatient endometrial biopsy is well accepted by patients, provides ample tissue for histologic examination and has good diagno...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-02-01 00:00:00
abstract：:A comprehensive medical history that includes questions about a personal and family history of cardiovascular disease is the most important initial component of the preparticipation athletic evaluation. Additional questions should focus on any history of neurologic or musculoskeletal problems. A limited physical exami...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2000-05-01 00:00:00
abstract：:Dissecting aneurysm is the most common acute disease of the aorta. Men are more likely than women to develop aortic dissection. One-third of the cases show neurologic manifestations, which may be a clue to early diagnosis. Cerebral, spinal cord and peripheral nerve ischemia can occur. In general, the treatment of choi...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-06-01 00:00:00
abstract：:Synovial cell sarcoma frequently presents as a painful periarticular mass in the lower extremity of a young male patient. The mass may appear encapsulated and is calcified in approximately 50 percent of cases. Surgery is the mainstay of therapy, with radical resection often necessary to prevent local recurrence. The m...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：:Henoch-Schönlein purpura is an acute, systemic, immune complex-mediated, leukocytoclastic vasculitis. It is characterized by a triad of palpable purpura (without thrombocytopenia), abdominal pain, and arthritis. Most patients have an antecedent upper respiratory illness. More than 90 percent of Henoch-Schönlein purpur...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-10-01 00:00:00
