Abstract：
:Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used, but have risks associated with their use, including significant upper gastrointestinal tract bleeding. Older persons, persons taking anticoagulants, and persons with a history of upper gastrointestinal tract bleeding associated with NSAIDs are at especially high risk. Although aspirin is cardioprotective, other NSAIDs can worsen congestive heart failure, can increase blood pressure, and are related to adverse cardiovascular events, such as myocardial infarction and ischemia. Cyclooxygenase-2 inhibitors have been associated with increased risk of myocardial infarction; however, the only cyclooxygenase-2 inhibitor still available in the United States, celecoxib, seems to be safer in this regard. Hepatic damage from NSAIDs is rare, but these medications should not be used in persons with cirrhotic liver diseases because bleeding problems and renal failure are more likely. Care should be used when prescribing NSAIDs in persons taking anticoagulants and in those with platelet dysfunction, as well as immediately before surgery. Potential central nervous system effects include aseptic meningitis, psychosis, and tinnitus. Asthma may be induced or exacerbated by NSAIDs. Although most NSAIDs are likely safe in pregnancy, they should be avoided in the last six to eight weeks of pregnancy to prevent prolonged gestation from inhibition of prostaglandin synthesis, premature closure of the ductus arteriosus, and maternal and fetal complications from antiplatelet activity. Ibuprofen, indomethacin, and naproxen are safe in breastfeeding women. Care should be taken to prevent accidental NSAID overdose in children by educating parents about correct dosing and storage in childproof containers.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Risser A,Donovan D,Heintzman J,Page Tsubject
Has Abstractpub_date
2009-12-15 00:00:00pages
1371-8issue
12eissn
0002-838Xissn
1532-0650journal_volume
80pub_type
杂志文章,实务指引abstract：:Heart failure is associated with high rates of morbidity and mortality. Because heart failure is difficult to diagnose accurately on the basis of the history and physical examination alone, It is vital that clinical evaluation such as echocardiography be used to confirm the diagnosis. In addition, it is important to i...
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：:The major chlamydial infections are conjunctivitis and pneumonia in infants and urethritis, cervicitis, salpingitis and ocular infection in adults. Tetracyclines are usually the drugs of choice for the treatment of chlamydial infections. Erythromycin therapy is preferred for pregnant women and for neonates with conjun...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-07-01 00:00:00
abstract：:Eczematous dermatitis is a common condition that can interfere with social function, sleep and employment. Its persistence and accompanying pruritus may be stressful and frustrating for patients. The most common and best characterized type of eczema, atopic dermatitis, appears to be increasing in incidence. Other comm...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-09-15 00:00:00
abstract：:Atrial fibrillation is the most common arrhythmia in patients visiting a primary care practice. Although many patients with atrial fibrillation experience relief of symptoms with control of the heart rate, some patients require restoration of sinus rhythm. External direct current (DC) cardioversion is the most effecti...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-08-01 00:00:00
abstract：:Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is characterized by cessation of previously ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2019-07-01 00:00:00
abstract：:The diagnosis of sleep apnea should be considered when a patient complains of snoring and excessive daytime somnolence. Middle-aged obese men are at particular risk, although apnea can occur in women and the elderly, as well as in persons who are not obese. An overnight polysomnographic sleep study can reveal the degr...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-02-01 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 ability to properly apply casts and splints is a technical skill easily mastered with practice and an understanding of basic principles. The initial approach to casting and splinting requires a thorough assessment of the injured extremity for proper diagnosis. Once the need for immobilization is ascertained, casti...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-01-01 00:00:00
abstract：:The rapidity with which heparin anticoagulation is achieved is essential to a positive clinical outcome in patients with deep venous thrombosis or pulmonary embolus. However, adequate anticoagulation is frequently not achieved, either as a result of dosing regimens that do not take heparin kinetics into account or bec...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-12-01 00:00:00
abstract：:The incidence of work-related repetitive motion disorders has increased rapidly during the past 20 years. While it appears that psychosocial factors have contributed largely to the increasing incidence of these disorders, ergonomic factors and other medical conditions also play a role. The most common single diagnosti...
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：:Hydrofluoric acid is widely used in both industrial and household settings. The acid may cause insidious burns that can be very destructive. If the burns are not treated appropriately, the continued action of the free fluoride ion leads to liquefaction necrosis of the affected soft tissues, bony erosion and, ultimatel...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：:Many patients expect to undergo screening tests for cancer. In evaluating screening procedures, physicians must take into account the known effects of lead time, length and screening biases, all of which can result in an overestimation of the benefits of screening. The gold standard by which a screening test is evalua...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-02-01 00:00:00
abstract：:After the safety and the tolerable dosage range of a new drug have been determined, it must be evaluated for efficacy and safety in patients having the condition for which the new drug is intended. The nature of certain drugs or diseases of of the patient population desired may suggest a family physician as the best d...
journal_title：American family physician
pub_type： 临床试验,杂志文章
doi：
更新日期：1976-01-01 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：:Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2014-07-01 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：:Because of the increasing popularity of recreational scuba diving, primary care physicians should be familiar with common diving injuries. One form of barotrauma, middle ear squeeze, is the most common diving injury. Other important diving injuries include inner ear barotrauma and pulmonary barotrauma. Arterial gas em...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-04-01 00:00:00
abstract：:The incidence of syphilis is increasing, predominantly among urban heterosexuals. Early recognition is important in preventing progression of the disease and transmission of Treponema pallidum to the fetus. Untreated primary syphilis is characterized by intervals of active disease punctuated by periods of latency. Not...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-10-01 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：: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：:Suicide attempts by drug overdose are a growing health care problem, now reaching epidemic proportions. The patient who attempts suicide is typically a young, single adult female with interpersonal conflicts who takes an overdose of a prescribed drug, frequently a benzodiazepine. Patients who have recently been separa...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-04-01 00:00:00
abstract：:Growth plate or physeal injuries are classified according to the zones of the physis that are affected and the disruption of bony structure. All physeal injuries should be reduced anatomically, particularly when an articular surface is involved. Inability to restore normal configuration can result in malunion, incongr...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-06-01 00:00:00
abstract：:The prognosis remains poor for patients with congestive heart failure (CHF), despite reduced mortality rates resulting from the addition of angiotensin converting enzyme inhibitors to traditional treatment regimens. Because much of the myocardial damage that occurs in patients with CHF may be related to sympathetic ac...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-11-01 00:00:00
abstract：:Caring for the problem drinker in the perioperative period is a challenging task. If alcohol abuse is suspected, a careful assessment is indicated before surgery is performed. Both the CAGE and SMAST questionnaires are good screening tools for alcoholism. Preoperative evaluation of alcohol-dependent patients should in...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1995-12-01 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：:Photosensitivity reactions associated with the use of prescription or over-the-counter drugs may be classified as phototoxic (caused by potentiation of solar energy by a drug) or photoallergic (in which the combination of a photosensitizing agent and light evokes a true cell-mediated hypersensitivity response). A case...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-08-01 00:00:00
abstract：:If current trends continue, U.S. health insurance costs will consume the average household's annual income by 2025. As health care becomes unaffordable for most people in the United States, it will be necessary to implement innovative models to move the system in a more equitable and sustainable direction. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2005-11-15 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：:Ganglioneuroblastoma, although a rare neoplasm, is one of the most common causes of posterior mediastinal masses in children. This tumor occurs in children from one to 10 years of age. With intrathoracic involvement, the tumor may remain asymptomatic until it is large. The case reported illustrates a typical presentat...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:Virology has become an increasingly important field of medicine in the past decade. Many infectious diseases that were once of unknown etiology can now be linked to the specific viral pathogen. New methods for diagnosing and treating viral diseases are being developed. In addition, antiviral therapy or prophylaxis is ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-07-01 00:00:00
