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::Carpal tunnel syndrome is the most common focal entrapment syndrome. Forceful repetitive activity and vibration may be important workplace risk factors for carpal tunnel syndrome. Although systematic study has suggested that carpal tunnel syndrome is work-related, no clear "dose-response" curve has been found between ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::The term "shoulder instability" constitutes a spectrum of disorders that includes dislocation, subluxation and laxity. Anterior instability is the most common form of glenohumeral instability and may be associated with nerve injury. The diagnosis of anterior, posterior or multidirectional instability is based on a tho...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-15 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::Benign pulmonary neoplasms are relatively uncommon. The symptoms vary, depending on the location of the tumor. Specific diagnosis can be a time-consuming process and requires an orderly plan. Polytomography or computed tomographic scan, bronchoscopy, percutaneous biopsy or thoracotomy may be required. Tissue diagnosis...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Each year physicians must decide which of the thousands of newly published articles they will take time to read. To determine which articles are the most clinically useful, physicians should assess their relevance, validity, and clinical importance. Using these criteria can drastically decrease the number of articles ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2009-04-15 00:00:00
abstract::Alzheimer disease is the most common form of dementia, affecting nearly one-half [corrected] of Americans older than 85 years. It is characterized by progressive memory loss and cognitive decline. Amyloid plaque accumulation, neurofibrillary tau tangles, and depletion of acetylcholine are among the pathologic manifest...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2011-06-15 00:00:00
abstract::While abdominoperineal resection with permanent colostomy is still required for most distal [corrected] rectal cancers, sphincter-saving local treatment by means of local excision, electrocoagulation or endocavitary contact radiation can be used for some highly selected distal tumors. Local treatment avoids a permanen...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-10-15 00:00:00
abstract::Osteoporosis is characterized by low bone mineral density and a deterioration in the microarchitecture of bone that increases its susceptibility to fracture. The World Health Organization defines osteoporosis as a bone mineral density that is 2.5 standard deviations or more below the reference mean for healthy, young ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2004-10-01 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 case of bilateral compression femoral neuropathy due to iliopsoas muscle hematomas during anticoagulant therapy is described. Diagnosis was confirmed with computed tomographic scan. The right hematoma was larger than the left and caused a more severe femoral neuropathy. The hematoma on the right side was surgically ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1991-12-01 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::Multiple chemical sensitivity (MCS) is a syndrome in which multiple symptoms reportedly occur with low-level chemical exposure. Several theories have been advanced to explain the cause of MCS, including allergy, toxic effects and neurobiologic sensitization. There is insufficient scientific evidence to confirm a relat...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 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::Progestational agents have many important functions, including regulation of the menstrual cycle, treatment of dysfunctional uterine bleeding, prevention of endometrial cancer and hyperplastic precursor lesions, and contraception. Because of the reported side effects of synthetic analogs called "progestins," there has...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-10-15 00:00:00
abstract::Headaches are common during childhood and become more common and increase in frequency during adolescence. The rational, cost-effective evaluation of children with headache begins with a careful history. The first step is to identify the temporal pattern of the headache--acute, acute-recurrent, chronic-progressive, ch...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2002-02-15 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::Given that nearly one-half of pregnancies are unintended, preconception care should be considered an integral part of primary care for women of reproductive age. Common issues in preconception care include family planning, achieving a healthy body weight, screening and treatment for infectious diseases, updating appro...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2013-10-15 00:00:00
abstract::Inguinal and femoral hernias are the most common conditions for which primary care physicians refer patients for surgical management. Hernias usually present as swelling accompanied by pain or a dragging sensation in the groin. Most hernias can be diagnosed based on the history and clinical examination, but ultrasonog...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::Early prophylaxis after exposure to human immunodeficiency virus (HIV) can reduce the risk of HIV infection 10-fold and should be recommended or offered after all parenteral exposures. The current recommendations from the Centers for Disease Control and Prevention call for the use of two nucleoside antiretroviral drug...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-02-01 00:00:00
abstract::Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. A petechial rash initially af...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2005-06-15 00:00:00
abstract::Because the prevalence of urinary incontinence increases with age, a working knowledge of the diagnosis and treatment of the various types of urinary incontinence is fundamental to the care of women. As the population of the United States ages, primary care physicians can expect to see an increasing number of patients...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract::Patients with myopia, hyperopia and astigmatism can now reduce or eliminate their dependence on contact lenses and eyeglasses through refractive surgery that includes radial keratotomy (RK), photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK), laser thermal keratoplasty (LTK) and intrastro...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2001-10-01 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::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::Coronary angioplasty is an accepted method of revascularization in selected patients with coronary artery disease. Immediately after a successful angioplasty, initial management concentrates on the detection and treatment of coronary artery spasm and acute vessel closure, should these complications occur. Once the pat...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::Health promotion activities benefit the elderly as much as they benefit younger persons. Motor vehicle accident and pedestrian injuries can be reduced by encouraging seat belt use and identifying unsafe drivers. Both medical and environmental factors should be considered in the prevention of falls in the elderly. All ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-05-01 00:00:00
abstract::Idiopathic facial (Bell's) palsy is an affliction commonly seen and managed by the family physician. Although the prognosis is generally good, steroids and cromolyn sodium have each been advocated to enhance full recovery. Surgical exploration of the nerve is indicated when the diagnosis is unclear. Various measures m...
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::Some skin conditions, such as blistering diseases, guttate and pustular psoriasis, exfoliative erythroderma, reactive erythemas and acute contact dermatitis have an acute onset and require prompt intervention. Acute vesicular or weeping dermatoses are best treated with cool, wet compresses and topical lotions, whereas...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-11-01 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::Orofacial pain can have an inflammatory, neurologic or musculoskeletal cause. Inflammatory diseases include dental abscess, sinusitis, temporal arteritis, sialolithiasis and infections of the parotid gland. Common neurologic diseases that cause facial pain are trigeminal neuralgia, glossopharyngeal neuralgia, paratrig...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-02-01 00:00:00