Abstract：
:Multiple sclerosis, an idiopathic inflammatory disease of the central nervous system, is characterized pathologically by demyelination and subsequent axonal degeneration. The disease commonly presents in young adults and affects twice as many women as men. Common presenting symptoms include numbness, weakness, visual impairment, loss of balance, dizziness, urinary bladder urgency, fatigue, and depression. The diagnosis of multiple sclerosis should be made by a physician with experience in identifying the disease. Diagnosis should be based on objective evidence of two or more neurologic signs that are localized to the brain or spinal cord and are disseminated in time and space (i.e., occur in different parts of the central nervous system at least three months apart). Magnetic resonance imaging with gadolinium contrast, especially during or following a first attack, can be helpful in providing evidence of lesions in other parts of the brain and spinal cord. A second magnetic resonance scan may be useful at least three months after the initial attack to identify new lesions and provide evidence of dissemination over time. It is critical to exclude other diseases that can mimic multiple sclerosis, including vascular disease, spinal cord compression, vitamin B12 deficiency, central nervous system infection (e.g., Lyme disease, syphilis), and other inflammatory conditions (e.g., sarcoidosis, systemic lupus erythematosus, Sjögren's syndrome). Symptom-specific drugs can relieve spasticity, bladder dysfunction, depression, and fatigue. Five disease-modifying treatments for multiple sclerosis have been approved by the U.S. Food and Drug Administration. These treatments are partially effective in reducing exacerbations and may slow progression of disability.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Calabresi PAsubject
Has Abstractpub_date
2004-11-15 00:00:00pages
1935-44issue
10eissn
0002-838Xissn
1532-0650journal_volume
70pub_type
杂志文章,评审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：:Bordetella pertussis is a highly contagious bacterium known to cause pertussis (whooping cough) and is transmitted via airborne droplets. Although childhood vaccination has dramatically reduced reported pertussis cases, the incidence of the disease has increased over the past 20 years, most notably in previously immun...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-08-01 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：: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：:The exposed and unprotected position of the auricle makes it susceptible to injuries. Because many of these injuries are initially managed in a primary care setting, family physicians should have an understanding of the management of auricular hematomas, lacerations, abrasions and thermal injuries. Auricular hematoma ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-05-15 00:00:00
abstract：:Adverse publicity about nursing homes increases the anguish of many people as they face the decision of placing a loved one in a nursing home. It is true that there are shortcomings in some nursing homes: poorly trained staff, unesthetic environment, little privacy, few activities and loss of identity. Nevertheless, i...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-04-01 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：:Myocardial perfusion imaging with thallium-201 has been used extensively for many years in the evaluation of ischemic heart disease. It is a valuable adjunct to exercise treadmill testing and is especially helpful in evaluating cardiac perfusion in patients who have abnormal resting electrocardiograms, who are unable ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-01 00:00:00
abstract：:Cardiac pacemakers are generally used in conditions where bradyarrhythmia is a major problem, such as advanced heart block, sick sinus syndrome and bundle branch block. Temporary or permanent pacing may be needed to control certain tachyarrhythmias refractory to medical therapy. Temporary pacing may be of value in the...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-05-01 00:00:00
abstract：:Synovial osteochondromatosis is a benign disorder in which cartilaginous loose bodies develop about the large joints, usually the knee. It is caused by synovial metaplasia of unknown etiology. Symptoms are due either to mechanical problems caused by the loose bodies or to the degenerative arthritis that usually follow...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
abstract：:Breast milk is universally recommended as the preferred source of infant nutrition, in part because of its superior nutrient and immunologic properties. Successful breast feeding requires nursing on demand, prevention of sore nipples and convenient access to medical advice. For mothers relying on bottle feeding, cow's...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:Nonalcoholic fatty liver disease (NAFLD) is the most common form of liver disease in the United States, affecting up to 30% of adults. There are two forms of NAFLD: nonalcoholic fatty liver (NAFL), defined as 5% or greater hepatic steatosis without hepatocellular injury or fibrosis, and nonalcoholic steatohepatitis (N...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2020-11-15 00:00:00
abstract：:Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. Gastroesophageal reflux disease (GERD) ...
journal_title：American family physician
pub_type： 杂志文章,病人教育讲义
doi：
更新日期：2015-10-15 00:00:00
abstract：:Urinary tract infections in children are sometimes associated with vesicoureteral reflux, which can lead to renal scarring if it remains unrecognized. Since the risk of renal scarring is greatest in infants, any child who presents with a urinary tract infection prior to toilet training should be evaluated for the pres...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-03-15 00:00:00
abstract：:The physical examination requires careful palpation of pulses and measurement of blood pressure, evaluation of heart sounds (including detection of the third heart sound) and appreciation of clicks and murmurs. Combined with the chest x-ray and electrocardiographic findings, these steps usually lead to the most common...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-04-01 00:00:00
abstract：:Upper extremity bursae are injured through a number of processes, including overuse, hemorrhage, crystal deposition, autoimmune diseases and infection. These injuries may be disabling and can pose significant diagnostic and therapeutic challenges for the clinician. Treatment of the most common forms is directed at pai...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-11-01 00:00:00
abstract：:New recommendations for the classification and diagnosis of diabetes mellitus include the preferred use of the terms "type 1" and "type 2" instead of "IDDM" and "NIDDM" to designate the two major types of diabetes mellitus; simplification of the diagnostic criteria for diabetes mellitus to two abnormal fasting plasma ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-10-15 00:00:00
abstract：:Strenuous exercise may cause menstrual abnormalities, including amenorrhea. The hypoestrogenemia that accompanies amenorrhea has been associated with a low bone mineral content and an increased incidence of stress fractures. With the resumption of menses, which usually occurs soon after female athletes decrease the in...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 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
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：: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：:The interrupted vertical and horizontal mattress suture techniques are two of the most commonly used skin closure methods. These mattress sutures promote wound edge eversion and less prominent scarring. Vertical and horizontal mattress sutures allow for skin edges to be closed under tension when wound edges have to be...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-12-15 00:00:00
abstract：:The incidence of malignant melanoma has increased in recent years more than that of any other cancer in the United States. About one in 70 people will develop melanoma during their lifetime. Family physicians should be aware that a patient with a changing mole, an atypical mole or multiple nevi is at considerable risk...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-04-01 00:00:00
abstract：:House calls can still serve many functions in the overall care of the patient. By improving the relationship between physician and patient, providing the physician with important information that can only be gained from a home visit and allowing the physician to remain active in the care of the homebound patient, hous...
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：:Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic cr...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2015-01-01 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：:The status of the fibula is an index of the severity of injury. Open tibial fracture with associated fractured fibula is more likely to develop complications. Antibiotics should be started promptly. Judicious debridement is essential but bone fragments should be left whenever possible. When there is any question about...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-01-01 00:00:00
abstract：:Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages,...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2013-03-01 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：:Substantial advances have been made in the management of inflammatory bowel disease. Mesalamine and olsalazine are new anti-inflammatory agents that may serve as alternatives to corticosteroids and sulfasalazine, which have been the mainstays of medical therapy. These new agents are available in oral, enema and suppos...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-03-01 00:00:00
