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 average age at diagnosis is 35 to 55 years. Morbidity and mortality are secondary to chronic pain and complications (e.g., diabetes, pancreatic cancer). Contrast-enhanced computed tomography is the radiographic test of choice for diagnosis, with ductal calcifications being pathognomonic. Newer modalities, such as endoscopic ultrasonography and magnetic resonance cholangiopancreatography, provide diagnostic results similar to those of endoscopic retrograde cholangiopancreatography. Management begins with lifestyle modifications (e.g., cessation of alcohol and tobacco use) and dietary changes followed by analgesics and pancreatic enzyme supplementation. Before proceeding with endoscopic or surgical interventions, physicians and patients should weigh the risks and benefits of each procedure. Therapeutic endoscopy is indicated for symptomatic or complicated pseudocyst, biliary obstruction, and decompression of pancreatic duct. Surgical procedures include decompression for large duct disease (pancreatic duct dilatation of 7 mm or more) and resection for small duct disease. Lateral pancreaticojejunostomy is the most commonly performed surgery in patients with large duct disease. Pancreatoduodenectomy is indicated for the treatment of chronic pancreatitis with pancreatic head enlargement. Patients with chronic pancreatitis are at increased risk of pancreatic neoplasm; regular surveillance is sometimes advocated, but formal guidelines and evidence of clinical benefit are lacking.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Nair RJ,Lawler L,Miller MRsubject
Has Abstractpub_date
2007-12-01 00:00:00pages
1679-88issue
11eissn
0002-838Xissn
1532-0650journal_volume
76pub_type
杂志文章,评审abstract：:Peripheral nerve injury of the upper extremity commonly occurs in patients who participate in recreational (e.g., sports) and occupational activities. Nerve injury should be considered when a patient experiences pain, weakness, or paresthesias in the absence of a known bone, soft tissue, or vascular injury. The onset ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2010-01-15 00:00:00
abstract：:Tension-type headache typically causes pain that radiates in a band-like fashion bilaterally from the forehead to the occiput. Pain often radiates to the neck muscles and is described as tightness, pressure, or dull ache. Migraine-type features (unilateral, throbbing pain, nausea, photophobia) are not present All pati...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-09-01 00:00:00
abstract：:Genital herpes affects over 30 million persons in the United States. Genital herpes has three distinct presenting syndromes, depending on the patient's immune status with regard to the herpes simplex virus. Current diagnostic strategy relies on clinical findings and the selective use of viral culture. Acyclovir is the...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-01-01 00:00:00
abstract：:Aspirin should not be used to treat acute febrile viral illness in children. (Strength of Recommendation [SOR]: C, based on case-control studies). Although no causal link has been proven, data from case-control and historic cohort studies demonstrate an association between aspirin use and Reye syndrome. The risk of Re...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-12-15 00:00:00
abstract：:Zidovudine, the first widely used antiretroviral agent, prevents replication of the human immunodeficiency virus (HIV) by inhibiting reverse transcriptase. Its use in patients with acquired immunodeficiency syndrome slows progression of the disease and prolongs survival. Zidovudine also significantly reduces the rate ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1990-08-01 00:00:00
abstract：:Patellofemoral pain syndrome (PFPS) is one of the most common causes of anterior knee pain encountered in the outpatient setting in adolescents and adults younger than 60 years. The incidence in the United States is between 3% and 6%. The cardinal feature of PFPS is pain in or around the anterior knee that intensifies...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2019-01-15 00:00:00
abstract：:Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10.8 cases per 100,000 children. It usually occurs in children eight to 15 years of age, and it is one of the most commonly missed diagnoses in children. Slipped capital femoral epiphysis is classified as stabl...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2010-08-01 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：:Acute diarrhea in adults is a common problem encountered by family physicians. The most common etiology is viral gastroenteritis, a self-limited disease. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. A history and physical examination evaluating for ri...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2014-02-01 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：:Acute ankle injury, a common musculoskeletal injury, can cause ankle sprains. Some evidence suggests that previous injuries or limited joint flexibility may contribute to ankle sprains. The initial assessment of an acute ankle injury should include questions about the timing and mechanism of the injury. The Ottawa Ank...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-11-15 00:00:00
abstract：:The incidence of skin cancer is increasing by epidemic proportions. Basal cell cancer remains the most common skin neoplasm, and simple excision is generally curative. Squamous cell cancers may be preceded by actinic keratoses-premalignant lesions that are treated with cryotherapy, excision, curettage or topical 5-flu...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-07-15 00:00:00
abstract：:Risk factors for stroke should be evaluated in patients who have had a transient ischemic attack. Blood pressure, lipid levels, and diabetes mellitus should be controlled. When applicable, smoking cessation and weight loss also are important. Angiotensin-converting enzyme inhibitor therapy may help prevent stroke. Asp...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-04-01 00:00:00
abstract：:Preterm birth is a major cause of infant morbidity and mortality. Although studies have been complicated by problems of definition and methodology, certain strategies have the potential to reduce both the incidence and the impact of preterm birth. These strategies include accurate assessment of gestational age, educat...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1992-08-01 00:00:00
abstract：:Hepatitis B causes significant morbidity and mortality worldwide. More than 400 million persons, including 1.25 million Americans, have chronic hepatitis B. In the United States, chronic hepatitis B virus infection is responsible for about 5,000 annual deaths from cirrhosis and hepatocellular carcinoma. Hepatitis B vi...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-01-01 00:00:00
abstract：:Rosacea is a common, but often overlooked, skin condition of uncertain etiology that can lead to significant facial disfigurement, ocular complications, and severe emotional distress. The progression of rosacea is variable; however, typical stages include: (1) facial flushing, (2) erythema and/or edema and ocular symp...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-08-01 00:00:00
abstract：:More than 100,000 children are born in the U.S. each year with major congenital defects or genetic disorders, with or without mental retardation. Advances in prenatal diagnosis have now made it possible to detect an increasing number of these disorders in utero. Carrier detection is advised prior to pregnancy, rather ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1977-01-01 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：:Rational use of psychoactive drugs in frail elderly patients requires an understanding of the physiologic changes produced by aging and chronic disease. Other drugs being used and the patient's nutritional status and lifestyle also must be considered. Affective disorders and thought disorders may be effectively treate...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:Nitrates are frequently found in vegetables and ground water. Nitrate levels in ground water have increased over the past two decades because of the heightened use of nitrogenous fertilizers. Following ingestion, nitrates are converted to nitrites by fecal organisms. Nitrites are absorbed and form methemoglobin, which...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1992-07-01 00:00:00
abstract：:The report states that chronic rhinosinusitis is an evolving area of study and new information is being assessed on an ongoing basis. Debate continues about potential etiologies and associated conditions, pathophysiology, common inflammatory mediators, and whether or not most cases of chronic rhinosinusitis are associ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2004-05-01 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：:Although testicular cancer accounts for only 1 percent of all tumors in males, it is the most common malignancy in males between 15 and 34 years of age. Cryptorchidism is the most significant risk factor for testicular cancer, increasing the risk up to 11-fold. A painless testicular mass is the classic presentation fo...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-05-01 00:00:00
abstract：:Urine drug screening can enhance workplace safety, monitor medication compliance, and detect drug abuse. Ordering and interpreting these tests requires an understanding of testing modalities, detection times for specific drugs, and common explanations for false-positive and false-negative results. Employment screening...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2010-03-01 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：:The family physician is in a unique position to care for the total needs of the patient. Suggestion therapy and clinical hypnosis are helpful in managing the psychologic aspects of disease in all age groups beyond five years, and are well within the purview of family physicians. Learning these techniques can enhance t...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-06-01 00:00:00
abstract：:Self-care is becoming increasingly popular among health care consumers. The availability of over-the-counter medications makes it possible for consumers to treat numerous ailments without the supervision of a health care professional. Many of the medications now available without a prescription were previously classif...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-05-01 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：: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：:Vacuum extractors have replaced forceps for many situations in which assistance is required to achieve vaginal delivery. Compared with metal-cup vacuum extractors, soft-cup devices are easier to use and cause fewer neonatal scalp injuries; however, they detach more frequently. Vacuum extractors can cause neonatal inju...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-09-15 00:00:00
