Abstract：
:Cutaneous leishmaniasis is a parasitic disease occurring throughout the Americas from Texas to Argentina, and in the Old World, particularly the Middle East and North Africa. It is spread by the female sandfly. The condition is diagnosed every year in travelers, immigrants, and military personnel. Physicians in the United States must be alert to the diagnosis of leishmaniasis in travelers returning from endemic areas. Physicians working for short periods in endemic areas often must make the diagnosis and should be aware of local disease patterns. When faced with a possible leishmanial skin lesion, a skin scraping with microscopic analysis is the best test. Punch biopsies with tissue-impression smears also can be diagnostic. Needle aspiration of tissue fluid from the margin of a lesion can yield fluid for culture to isolate the organism and identify the species. Immunologic tests are being developed, including a highly sensitive polymerase chain reaction test. The treatment mainstay is pentavalent antimony (e.g., sodium stibogluconate). Not all patients require treatment; many lesions heal spontaneously. Antimonials have a high incidence of reversible adverse effects. Other medications used for treatment include amphotericin B, pentamidine isethionate, paromomycin, and antifungals. This disease must be considered in at-risk patients, and family physicians should know the basics of diagnosis and where to go for more help.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Markle WH,Makhoul Ksubject
Has Abstractpub_date
2004-03-15 00:00:00pages
1455-60issue
6eissn
0002-838Xissn
1532-0650journal_volume
69pub_type
杂志文章,评审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：: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 screen...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-08-15 00:00:00
abstract：:Portal hypertension is a frequent consequence of liver disease, especially alcoholic cirrhosis. Unabated elevations in portal pressure may presage an esophageal variceal hemorrhage. Propranolol or isosorbide therapy is effective in the prophylaxis of variceal bleeding. In patients with acute variceal hemorrhage, endos...
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：:New evaluation and management codes were created by the Current Procedural Terminology (CPT) Editorial Panel to ensure more accurate and consistent reporting of physician services. The new hospital inpatient codes describe three levels of service for both initial and subsequent care. Critical care services are reporte...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:Asymptomatic bacteriuria, defined as the presence of bacteria in the urine in the absence of urinary symptoms, is a common clinical finding that often warrants a decision about whether to initiate antimicrobial therapy. There are few indications to treat asymptomatic bacteriuria, and inappropriate treatment contribute...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2020-07-15 00:00:00
abstract：:Kawasaki disease is an acute vasculitis of childhood that predominantly affects the coronary arteries. The etiology of Kawasaki disease remains unknown, although an infectious agent is strongly suspected based on clinical and epidemiologic features. A genetic predisposition is also likely, based on varying incidences ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-10-01 00:00:00
abstract：:Hearing conservation programs have not kept pace with changes in the workplace and in the work force. Heavy industry and noisy factories have yielded to quiet computers and high technology. Chemicals, self-administered or prescribed, may replace noise as a chief source of hearing loss. The aging working population and...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1988-09-01 00:00:00
abstract：:Pregnant women commonly use over-the-counter medications. Although most over-the-counter drugs have an excellent safety profile, some have unproven safety or are known to adversely affect the fetus. The safety profile of some medications may change according to the gestational age of the fetus. Because an estimated 10...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-06-15 00:00:00
abstract：:Wide complex tachycardias are cardiac rhythm disorders with three or more consecutive beats, rates exceeding 100 beats per minute and a QRS duration of 120 msec (0.12 second) or greater. The width of the QRS complex should be verified in a number of leads, since the QRS complex often appears mistakenly narrower (i.e.,...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1996-10-01 00:00:00
abstract：:Laparoscopic cholecystectomy is a commonly performed procedure for the removal of symptomatic gallstones. Compared with open cholecystectomy, laparoscopic cholecystectomy is associated with less postoperative pain, earlier discharge from the hospital and a more rapid recovery. However, there are specific contraindicat...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-12-01 00:00:00
abstract：:Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Assessment for and prevention of delirium should occur at admission and continue throughout a ...
journal_title：American family physician
pub_type： 杂志文章,已发布勘误,评审
doi：
更新日期：2014-08-01 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：:Patients who have been or may have been bitten by a snake should receive prompt and careful clinical and laboratory evaluation. Fang marks, pain and swelling are characteristic of pit viper envenomation. Although no therapy is universally accepted, a number of treatment plans appear to be effective. If envenomation ha...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-07-01 00:00:00
abstract：:Many patients require sedation during diagnostic or therapeutic procedures. Ideally, procedural sedation minimizes the patient's awareness and discomfort while maintaining the patient's safety. Appropriate monitoring by trained personnel is the key to successful procedural sedation. These techniques should be used onl...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-01-01 00:00:00
abstract：:Congenital hearing loss is estimated to affect one in every 1,000 newborns. Causes of hearing loss can be conductive, sensorineural, mixed, or central. Known risk factors for congenital hearing loss include cytomegalovirus infection and premature birth necessitating a stay in the neonatal intensive care unit. However,...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2007-05-01 00:00:00
abstract：:Functional constipation is the cause of fecal incontinence in 95 percent of affected children, and anatomic or neurologic causes account for up to 5 percent of cases. The history and the physical examination (with emphasis on abdominal, rectal and neurologic examinations) are most helpful in identifying organic diseas...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-05-01 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：:Premature rupture of the membranes is associated with considerable neonatal and maternal morbidity when it leads to premature birth. In most cases, this condition occurs at term, does not require medical intervention and has a benign course. Although few effective preventive measures are available, the family physicia...
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：:Scanning is based on the uptake of a nuclide by the crystal lattice of bone and is related to bone blood flow. Cancer cells do not take up the tracer. Normally, the scan visualizes the highly vascular bones. Scans are useful and are indicated in metastatic bone disease, primary bone tumors, hematologic malignancies an...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-03-01 00:00:00
abstract：:Two large kindreds manifesting the "cancer family syndrome" have been studied. Genetic and biologic studies reveal markers which have important implications for cancer detection, control and prevention. Valuable markers may be found in the major histocompatibility system, HL-A. The presence of carcinoembryonic antigen...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-03-01 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：: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：: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：:Federally funded health centers and the National Health Service Corps (NHSC) depend on family physicians (FPs) and general practitioners (GPs) to meet the needs of millions of medically underserved people. Policy makers and workforce planners should consider how changes in the production of FPs would affect these prog...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2005-07-15 00:00:00
abstract：:Urine drug screening can enhance workplace safety, monitor medication compliance, and detect drug abuse. Ordering and interpreting these tests requires an understanding of testing modalities, detection times for specific drugs, and common explanations for false-positive and false-negative results. Employment screening...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2010-03-01 00:00:00
abstract：:Adverse effects of hormonal contraceptives usually diminish with continued use of the same method. Often, physi- cians only need to reassure patients that these symptoms will likely resolve within three to five months. Long-acting injectable depot medroxyprogesterone acetate is the only hormonal contraceptive that is ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2010-12-15 00:00:00
abstract：:Many patients expect to undergo screening tests for cancer. In evaluating screening procedures, physicians must take into account the known effects of lead time, length and screening biases, all of which can result in an overestimation of the benefits of screening. The gold standard by which a screening test is evalua...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-02-01 00:00:00
abstract：:Appropriate dosage of levothyroxine for the treatment of hypothyroidism is assessed by determining the serum thyroxine (T4) concentration in secondary and tertiary types. In primary hypothyroidism, the optimal thyroid replacement is that which induces a normal thyroid-stimulating hormone level and a normal TSH respons...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：:Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of the diagnosis of ischemic stroke. The most common presenting symptoms of ischemic stroke are speech disturbance and weaknes...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2015-04-15 00:00:00
abstract：:Primary dysmenorrhea is menstrual pain that is not associated with pelvis pathology. It usually begins with the onset of ovulatory cycles, characteristically appearing in the year after menarche and increasing with time. The pain is associated with increased myometrial activity. Oral contraceptives and prostaglandin s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
