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 discharge and post-hospital care. Part II of this two-part article discusses coronary revascularization, hospital discharge, and post-hospital care. Decisions must be made about the use of coronary angiography and coronary revascularization in patients hospitalized with UA/NSTEMI. With an early conservative strategy, medical management is employed. Coronary angiography and revascularization are reserved for use in patients with evidence of ischemia at rest (or with minimal activity) and patients with a strongly positive stress test. With an early invasive strategy, coronary angiography and revascularization are recommended within 48 hours in patients without contraindications. Hospital discharge planning involves coordination of medical care, preparation of the patient for resumption of normal activities, and evaluation of the need for long-term risk factor reduction. Discharge medications should be continued to control ongoing symptoms (anti-ischemic agents) and prevent recurrent events (aspirin, clopidogrel, beta blocker, and an angiotensin-converting enzyme inhibitor or statins in selected patients).
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Wiviott SD,Braunwald Esubject
Has Abstractpub_date
2004-08-01 00:00:00pages
535-8issue
3eissn
0002-838Xissn
1532-0650journal_volume
70pub_type
杂志文章,评审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：:Antidepressant drugs are now an important component of the analgesic pharmacopeia. Their ability to relieve pain is independent of the presence of clinical depression, and their efficacy has been documented in the treatment of migraine and tension headaches, neuropathic pain and chronic pain syndromes, including those...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1985-02-01 00:00:00
abstract：:Prompt diagnosis of problems in the first trimester of pregnancy is facilitated by ultrasound scanning and quantitative serum human chorionic gonadotropin and progesterone testing. When used appropriately, these tests can determine whether a patient has a normal early pregnancy, a miscarriage, a missed abortion, an ec...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-11-01 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
abstract：:Eczematous dermatitis is a common condition that can interfere with social function, sleep and employment. Its persistence and accompanying pruritus may be stressful and frustrating for patients. The most common and best characterized type of eczema, atopic dermatitis, appears to be increasing in incidence. Other comm...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-09-15 00:00:00
abstract：:Appendicitis is one of the most common causes of acute abdominal pain in adults and children, with a lifetime risk of 8.6% in males and 6.7% in females. It is the most common nonobstetric surgical emergency during pregnancy. Findings from the history, physical examination, and laboratory studies aid in the diagnosis o...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2018-07-01 00:00:00
abstract：:Microscopic hematuria, a common finding on routine urinalysis of adults, is clinically significant when three to five red blood cells per high-power field are visible. Etiologies of microscopic hematuria range from incidental causes to life-threatening urinary tract neoplasm. The lack of evidence-based imaging guideli...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2006-05-15 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：:Chronic bladder catheterization is the treatment of last resort for incontinence. Urinary infection is a normal state in these patients. It should be treated only when there are signs of systemic illness. Accumulations of encrusted debris cause urinary leakage. This problem can be lessened by using silicone catheters ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-09-01 00:00:00
abstract：:Post-traumatic stress disorder evolved from the concepts of shell shock and traumatic war neurosis. In Vietnam veterans, the disorder is associated with unemployment, marital discord, alcoholism and increased autonomic system response to perceived symbols of war trauma. A combination of psychotherapy and pharmacothera...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1988-02-01 00:00:00
abstract：:Although a rare entity, laryngeal tuberculosis must be a diagnostic consideration--along with laryngeal carcinoma--whenever patients present with prolonged hoarseness or painful dysphagia. This form of tuberculosis was once thought to be especially virulent and more infectious than other forms; however, severity was p...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 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：:The clinical course is highly variable. The chance of recurrence is about 60 percent. Patients are infectious when lesions are present and, to a lesser extent, when asymptomatic virus shedding occurs. The chain of transmission can be difficult to ascertain. Transmission to the neonate is the most feared complication. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-09-01 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：:The hallmark of agoraphobia is the spontaneous panic attack, a reaction of extreme fearfulness and impending doom with cardiorespiratory symptoms. The end result can be a patient who is housebound. The basic therapeutic principle is confrontation with the avoided object or activity. Controlled clinical experiments dem...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-01-01 00:00:00
abstract：:Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications and poor outcomes following these injuries. Radiography (commonly anteroposterior, true lateral, and oblique views) is required in the evaluation of ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-04-15 00:00:00
abstract：:Medical problems associated with prematurity are frequently complex, and a multidisciplinary approach is often required. Some common problems include the following: (1) anemia, which can be reduced by iron supplementation, (2) cerebral palsy or mental retardation as a result of intraventricular hemorrhage or periventr...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-05-15 00:00:00
abstract：:Gallstone disease is a major health problem in the United States and in most Western countries. During the past century, cholecystectomy has been the treatment of choice. Recently, new modalities of treatment have been developed, including oral dissolution therapy, extracorporeal shock-wave lithotripsy, percutaneous t...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-10-01 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：:Pressure sore are caused by multiple mechanisms. Preventive management requires relief of pressure, skin care, control of spasms, release of contractures and treatment of infection. Conservative treatment succeeds only when pressure on the ulcer site is relieved. Surgical treatment involves primary, secondary and tert...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1982-02-01 00:00:00
abstract：:Infectious endocarditis results from bacterial or fungal infection of the endocardial surface of the heart and is associated with significant morbidity and mortality. Risk factors include the presence of a prosthetic heart valve, structural or congenital heart disease, intravenous drug use, and a recent history of inv...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-05-15 00:00:00
abstract：:Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective component of this practice. Oxytocin...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2017-04-01 00:00:00
abstract：:Adopted children are emotionally vulnerable. Adoptive parents must cope with more complex problems than biologic parents. The family physician can provide valuable counseling. Preadoption counseling focuses on motivation and ambivalence. After adoption, however, serious, sometimes predictable, issues arise, such as: h...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1976-09-01 00:00:00
abstract：:During the past decade, continuous ambulatory peritoneal dialysis has emerged as a successful alternative to hemodialysis in the treatment of chronic renal failure. Performed continuously, peritoneal dialysis achieves total transfer comparable to hemodialysis and removes peptides faster. Studies have shown that surviv...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-11-01 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：:The safety of vaginal birth after cesarean (VBAC) delivery has been documented. Fetal and neonatal morbidity is not increased, and the mortality rate is less than one in 2,000 deliveries. Maternal morbidity and mortality rates for VBAC delivery are significantly lower than those for repeat cesarean section. Family phy...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1988-06-01 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：: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：:The Food and Drug Administration has recommended that blood donated for transfusion in the United States be screened for antibodies to human T lymphotropic virus type I. Since seropositive donors will be referred to health care providers for advice, physicians should become familiar with HTLV-I, its modes of transmiss...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-08-01 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
