Abstract:
:A throat culture is necessary for accurate diagnosis of group A beta-hemolytic streptococcal tonsillopharyngitis. The use of penicillin therapy in every patient with sore throat results in overtreatment of 85 percent of children and 95 percent of adults presenting to family physicians with the complaint of sore throat. Indiscriminate use of penicillin also increases the risk of drug side effects and subjects some patients to unnecessary alterations of microbial ecology. The signs and symptoms of group A beta-hemolytic streptococcal tonsillopharyngitis are nonspecific, and reliable clinical diagnosis is difficult. Throat culture is cost-effective and, if properly obtained and processed, more than 95 percent accurate. Antigen detection tests (rapid strep tests) are a viable laboratory alternative to throat cultures if these tests are properly performed and if negative test results are confirmed with traditional throat culture.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Pichichero MEsubject
Has Abstractpub_date
1992-01-01 00:00:00pages
199-205issue
1eissn
0002-838Xissn
1532-0650journal_volume
45pub_type
杂志文章abstract::Streptomycin is still the treatment of choice for tularemia and plague, and is effective in a few other diseases. Neomycin is used primarily as a topical agent. The other aminoglycoside antibiotics are indicated in serious infections caused by the gram-negative enterobacteria and, except for kanamycin, are also effect...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract::Although the role of digoxin therapy has been the subject of debate, the drug is generally accepted as effective in the treatment of heart failure due to systolic dysfunction and as therapy for atrial fibrillation and supraventricular tachyarrhythmias. Serum digoxin concentrations are commonly used to gauge patient re...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-08-01 00:00:00
abstract::Chlamydial cervicitis has the potential for serious gynecologic complications, including pelvic inflammatory disease, infertility and ectopic pregnancy. In the pregnant patient, this infection is associated with premature rupture of membranes and increased fetal morbidity and mortality. In addition, infants infected b...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 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::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::Bowenoid papulosis usually appears as small papules on the penis or vulva. Histologically, these lesions display the atypia of Bowen's disease (squamous cell carcinoma in situ). Bowenoid papulosis is now considered to be a sexually transmitted disease, probably caused by human papillomavirus type 16. Malignant transfo...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1988-07-01 00:00:00
abstract::For centuries, chasteberry has been used to treat many hormone-related gynecologic conditions. The current literature supports the use of chasteberry for cyclical breast discomfort and premenstrual syndrome; data on its use for menstrual irregularities and fertility disorders are weak. Its traditional use as a galacta...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2005-09-01 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
abstract::The principle of confidentiality is one of the clearest and firmest rules of professional ethics. However, situations can arise in which confidentiality ought to be abridged in favor of other, weightier values. In the case of a teenager who asks a family physician to prescribe birth control pills for her without infor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1982-01-01 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::Alopecia can be divided into disorders in which the hair follicle is normal but the cycling of hair growth is abnormal and disorders in which the hair follicle is damaged. Androgenetic alopecia is the most common cause of hair loss in women. Other disorders include alopecia areata, telogen effluvium, cicatricial alope...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2003-03-01 00:00:00
abstract::Transdermal nicotine systems are a useful adjunct to smoking cessation. The larger-sized nicotine patches provide steady-state replacement of approximately 50 percent of the average serum nicotine level obtained by smoking one to one and one-half packs of cigarettes a day. This level is sufficient to prevent many symp...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 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
abstract::Amputated or devascularized digits should be appropriately cooled as quickly as possible. The injured extremity is dressed, splinted and elevated. Careful selection of patients for replantation has yielded satisfying results to both patients and surgeons. Replantation is indicated for a thumb or multiple-digit amputat...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
abstract::Primary carcinoma of the fallopian tube is a rare disease and has traditionally been managed in the same manner as epithelial ovarian cancer. However, unlike ovarian cancer, fallopian tube cancer is not routinely suspected and treatment may be delayed. The clinical presentations of seven cases of fallopian tube cancer...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract::Patients with variceal or other gastrointestinal hemorrhage require aggressive resuscitative measures and early diagnosis for optimal therapy. A number of nonsurgical endoscopic modalities, such as laser therapy, sclerotherapy, heater probe and electrocoagulation (monopolar or bipolar), are available to arrest and som...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract::Fulguration of polyps, rectal biopsy and the Barron method of removing hemorrhoids require no anesthesia. Anal fissures, warts, small fistulas and hemorrhoids can be removed with a minimal amount of anesthesia. Pilonidal cysts or abscesses can also be incised and drained in this manner. Extensive fistulas, unusually l...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract::Myasthenia gravis is a disorder that most commonly affects young adults but occasionally appears in the elderly. Muscle weakness and easy fatigability, particularly of the ocular muscles, are characteristic. Diagnosis is confirmed by electromyography and the edrophonium (Tensilon) test. The pathology results from inab...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1978-06-01 00:00:00
abstract::Menière's disease may be the underlying cause of dizziness, which is a common presenting complaint. This disease is differentiated from other causes of dizziness by its classic constellation of four symptoms; dizziness characterized as episodic spinning or whirling vertigo; fluctuating, low-frequency sensorineural hea...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-03-01 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::Hepatitis A is a common viral illness worldwide, although the incidence in the United States has diminished in recent years as a result of extended immunization practices. Hepatitis A virus is transmitted through fecal-oral contamination, and there are occasional outbreaks through food sources. Young children are usua...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2012-12-01 00:00:00
abstract::HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate entity. The pathogenesis of HELLP...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-09-01 00:00:00
abstract::Prompt defibrillation with lower energy levels (200 joules) initially is now recommended. Epinephrine is effective when instilled intratracheally and remains the treatment of choice for restoring cardiac rhythm. Enthusiasm for isoproterenol and calcium chloride has waned. Sodium bicarbonate and atropine are now used m...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract::A herpes zoster infection in patients with lymphoma has been associated with subsequent metastatic disease involving the spinal cord and vertebrae of the affected dermatome segment. This correlation can be used in planning radiation therapy to avert neurologic complications secondary to spinal cord involvement. ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract::So many topical antifungal agents have been introduced that it has become very difficult to select the proper agent for a given infection. Nonspecific agents have been available for many years, and they are still effective in many situations. These agents include Whitfield's ointment, Castellani paint, gentian violet,...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract::Systemic causes of leg edema include idiopathic cyclic edema, heart failure, cirrhosis, nephrosis and other hypoproteinemic states. Lymphedema may be primary, or secondary to neoplasm, lymphangitis, retroperitoneal fibrosis and, rarely (in the U.S.), filariasis. Thrombophlebitis and chronic venous insufficiency are no...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Diet is the single most significant risk factor for disability and premature death. Patients and physicians often have difficulty staying abreast of diet trends, many of which focus primarily on weight loss rather than nutrition and health. Recommending an eating style can help patients make positive change. Dietary p...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2018-06-01 00:00:00
abstract::Many normal children have heart murmurs, but most children do not have heart disease. An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonar...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::Nearly 40 percent of Americans complain about insomnia. Such complaints are even more common among the elderly, possibly because sleep efficiency decreases with age. As a result, the use of hypnotics in this age group is high--sometimes too high. Hypnotics can be addictive, and many have a low therapeutic index. The b...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-08-01 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