Abstract：
:Group B streptococcus (GBS) is a leading cause of morbidity and mortality among newborns. Universal screening for GBS among women at 35 to 37 weeks of gestation is more effective than administration of intrapartum antibiotics based on risk factors. Lower vaginal and rectal cultures for GBS are collected at 35 to 37 weeks of gestation, and routine dindamycin and erythromycin susceptibility testing is performed in women allergic to penicillin. Women with GBS bacteriuria in the current pregnancy and those who previously delivered a GBS-septic newborn are not screened but automatically receive intrapartum antibiotics. Intrapartum chemoprophylaxis is selected based on maternal allergy history and susceptibility of GBS isolates. Intravenous penicillin G is the preferred antibiotic, with ampicillin as an alternative. Penicillin G should be administered at least four hours before delivery for maximum effectiveness. Cefazolin is recommended in women allergic to penicillin who are at low risk of anaphylaxis. Clindamycin and erythromycin are options for women at high risk for anaphylaxis, and vancomycin should be used in women allergic to penicillin and whose cultures indicate resistance to clindamycin and erytbromycin or when susceptibility is unknown. Asymptomatic neonates born to GBS-colonized mothers should be observed for at least 24 hours for signs of sepsis. Newborns who appear septic should have diagnostic work-up including blood culture followed by initiation of ampicillin and gentamicin. Studies indicate that intrapartum prophylaxis of GBS carriers and selective administration of antibiotics to newborns reduce neonatal GBS sepsis by as much as 80 to 95 percent.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Apgar BS,Greenberg G,Yen Gsubject
Has Abstractpub_date
2005-03-01 00:00:00pages
903-10issue
5eissn
0002-838Xissn
1532-0650journal_volume
71pub_type
杂志文章,评审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：:Joint and soft tissue injection of the ankle and foot region is a useful diagnostic and therapeutic tool for the family physician. This article reviews the injection procedure for the plantar fascia, ankle joint, tarsal tunnel, interdigital space, and first metatarsophalangeal joint. Indications for plantar fascia inj...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-10-01 00:00:00
abstract：:Clinically significant gastroesophageal reflux occurs in one in 500 infants. Symptoms resolve in 60 to 80 percent of infants by 18 months of age. Thickened formula and position changes are often recommended. Medication and surgical intervention may be needed in refractory cases. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1991-03-01 00:00:00
abstract：:Atypical moles can be distinguished visually by clinical features of size greater than 6 mm in diameter, color variegation, indistinct borders, and textured surface. All patients who have atypical moles should be counselled about sun avoidance, screening of family members, and regular skin checks at least once per yea...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-09-15 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：:Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited cause of kidney disease. Enlarging cysts within the kidneys are the clinical hallmark of the disease. Renal manifestations include varying degrees of kidney injury, urinary tract infections, kidney stones, and hematuria. Extrarenal manif...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2014-09-01 00:00:00
abstract：:Although rare, invasive amebiasis should be considered in the differential diagnosis of rectal disease suggesting carcinoma. In the case reported, rectal ameboma was responsible for the patient's rectal pain, hematochezia and weight loss. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-02-01 00:00:00
abstract：:Particularly in rural settings, Trichophyton verrucosum commonly causes an inflammatory tinea infection, sometimes called 'barn itch." There is usually a history of contact with animals. The demonstration of clusters of large spores in a potassium hydroxide preparation of scrappings obtained from clinically involved s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1983-01-01 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：: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：:Endometriosis is a progressive disease affecting 5 to 10 percent of women. It can cause dyspareunia, dysmenorrhea, low back pain and infertility. A definitive diagnosis can be made only by means of laparoscopy. Medical treatment designed to interfere with ovulation generally provides effective pain relief, but the rec...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-10-15 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：: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：: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：: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...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-08-01 00:00:00
abstract：:Treatment of eating disorders is difficult regardless of the methods employed. Pharmacologic management in anorexia nervosa and in bulimia nervosa is especially helpful when it is part of a multimodal treatment approach that includes individual, family and behavioral therapy. Care must be taken to guard against side e...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1988-05-01 00:00:00
abstract：:With the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., the diagnostic category previously known as somatoform disorders is now called somatic symptom and related disorders. The revisions were intended to increase their relevance in the primary care setting. The main feature of this dis...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2016-01-01 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：:Down syndrome is caused by triplicate material of chromosome 21. The syndrome has a variable physical expression, but congenital cardiac defects, transient myelodysplasia of the newborn and duodenal atresia are highly specific for this chromosomal disorder. Routine health maintenance is important because infants and c...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-01-15 00:00:00
abstract：:The Papanicolaou smear is a well-established component of preventive health protocols for women. The purpose of this screening tool is to detect precursor lesions of invasive cervical carcinoma; however, the natural progression of these lesions is unclear, and it currently is not possible to determine which of the man...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-02-01 00:00:00
abstract：:Labor is induced if pregnancy must be completed before the onset of spontaneous labor, usually for reasons of maternal illness, fetal distress or, most commonly, prolonged pregnancy. Although various mechanical methods are available for labor induction, pharmacologic methods are more commonly used. Oxytocin is the sta...
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：:Ectopic pregnancy occurs at a rate of 19.7 cases per 1,000 pregnancies in North America and is a leading cause of maternal mortality in the first trimester. Greater awareness of risk factors and improved technology (biochemical markers and ultrasonography) allow ectopic pregnancy to be identified before the developmen...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-02-15 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：:Schirmer's test is a simple, semiquantitative test of tear production. It is based on the physical tendency of a fluid to travel along a strip of porous material by capillary action due to surface tension. Sterile strips, standardized and prepackaged, are available from local scientific supply houses. The low cost and...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
abstract：:Vomiting, amnesia, a history of falls and other injuries, and depression and anxiety may all be clues to a drinking problem. Decreased work performance, absenteeism and difficulty in getting along with others may be present. Coming to grips with the problem is essential. Once the patient accepts the need for abstinenc...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:Hypothyroidism can often be misdiagnosed as psychiatric illness. The hypothyroid patient may present with depression, an organic mental disorder, apathy and/or frank psychosis (usually with paranoid symptoms). Psychiatric manifestations of the endocrinopathy will abate with thyroid hormone replacement therapy, unless ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-05-01 00:00:00
abstract：:Several effective and inexpensive over-the-counter treatments are available for minor but troubling foot problems. In most cases, one week of therapy with topical terbinafine is effective for interdigital tinea pedis. Treatment of plantar warts with 17 percent salicylic acid with lactic acid in a collodion base is as ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-09-01 00:00:00
abstract：:Frostbite can cause loss of life and limbs. Proper treatment and follow-up care are essential in reducing morbidity and mortality. Management of the frostbite patient consists of three stages. Initial care includes protection of the extremity from trauma or partial thawing. The second stage consists of rapid rewarming...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-12-01 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：:Family physicians can effectively help their patients stop smoking by using brief intervention and simple office organizational procedures. Intervention involves asking all patients about smoking, advising smokers to stop, assisting with self-help materials, establishing a date for quitting, possibly prescribing nicot...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1990-10-01 00:00:00
