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, federal regulations, unusual patient behavior, and risk patterns may prompt urine drug screening. Compliance testing may be necessary for patients taking controlled substances. Standard immunoassay testing is fast, inexpensive, and the preferred initial test for urine drug screening. This method reliably detects morphine, codeine, and heroin; however, it often does not detect other opioids such as hydrocodone, oxycodone, methadone, fentanyl, buprenorphine, and tramadol. Unexpected positive test results should be confirmed with gas chromatography/mass spectrometry or high-performance liquid chromatography. A positive test result reflects use of the drug within the previous one to three days, although marijuana can be detected in the system for a longer period of time. Careful attention to urine collection methods can identify some attempts by patients to produce false-negative test results.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Standridge JB,Adams SM,Zotos APsubject
Has Abstractpub_date
2010-03-01 00:00:00pages
635-40issue
5eissn
0002-838Xissn
1532-0650journal_volume
81pub_type
杂志文章abstract：:Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of the diagnosis of ischemic stroke. The most common presenting symptoms of ischemic stroke are speech disturbance and weaknes...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2015-04-15 00:00:00
abstract：:A large number of drugs are introduced every year, and new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely on memory alone to avoid potential drug interactions. Multiple drug regimens carry the risk of adverse interactions. Precipitant drugs mo...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-03-15 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：:Health promotion activities benefit the elderly as much as they benefit younger persons. Motor vehicle accident and pedestrian injuries can be reduced by encouraging seat belt use and identifying unsafe drivers. Both medical and environmental factors should be considered in the prevention of falls in the elderly. All ...
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：:Testicular torsion is characterized by the sudden onset of testicular pain associated with abdominal pain, nausea and vomiting. Fever is unusual and urinalysis is often normal. Fever, pyuria, dysuria and urethral discharge are characteristic of epididymitis. Radionuclide scanning and Doppler ultrasound are helpful in ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to associated conditions, such as b...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2018-10-01 00:00:00
abstract：:Smell and taste disorders can be challenging to diagnose because of the large number of potential etiologies. Patients are often unable to provide a clear history of symptoms, because they frequently cannot distinguish between difficulties with smell and taste. Standardized questionnaires may be helpful in diagnosis. ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2013-12-15 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：:Despite an 80 to 90 percent success rate in removing common bile duct stones, this technique has yet to receive universal acceptance in the United States. Originally developed for retained or newly formed common bile duct stones in patients with previous cholecystectomy, the procedure is now also used to remove common...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-03-01 00:00:00
abstract：:Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications and poor outcomes following these injuries. Radiography (commonly anteroposterior, true lateral, and oblique views) is required in the evaluation of ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-04-15 00:00:00
abstract：:Careful examination of the neonate at delivery can detect anomalies, birth injuries, and disorders that may compromise successful adaptation to extrauterine life. A newborn with one anatomic malformation should be evaluated for associated anomalies. If a newborn is found to have an abdominal wall defect, management in...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-01-15 00:00:00
abstract：:Dorsal penile nerve block with lidocaine is safe and effective for reducing the pain associated with newborn circumcision. Administering the anesthesia adds little time or expense to the overall routine. Complications are minor, limited to local bleeding and hematoma formation. Family physicians performing circumcisio...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-04-01 00:00:00
abstract：:Many patients in primary care present with ear pain (otalgia). When the ear is the source of the pain (primary otalgia), the ear examination is usually abnormal. When the ear is not the source of the pain (secondary otalgia), the ear examination is typically normal. The cause of primary otalgia is usually apparent on ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-03-01 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：: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：: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：:The specific type of epilepsy must be identified. The history and the EEG provide the evidence. Drug selection is then based on the classification of the patient's epilepsy. Major drugs used in the management of epilepsy are phenytoin, phenobarbital, primidone, carbamazepine, ethosuximide and valproic acid. The physic...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1978-10-01 00:00:00
abstract：:Most commonly, constipation in the infant is functional, with increased tone of colonic smooth muscle. Hirschsprung's disease is the best known of the infrequent organic causes. Treatment includes reassurance of parents, use of sugars, fluids and bulk and care of fissures. Voluntary stool withholding occurs in older c...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：:Cultures of the urine, throat and genitalia account for 90 percent of the cultures performed in an outpatient setting. The presence of a urinary tract infection, Group A beta-hemolytic streptococci or Neisseria gonorrhoeae can be ascertained easily, quickly, accurately and inexpensively in an office laboratory. Only a...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-01-01 00:00:00
abstract：:Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. A petechial rash initially af...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-06-15 00:00:00
abstract：:During the past decade, continuous ambulatory peritoneal dialysis has emerged as a successful alternative to hemodialysis in the treatment of chronic renal failure. Performed continuously, peritoneal dialysis achieves total transfer comparable to hemodialysis and removes peptides faster. Studies have shown that surviv...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-11-01 00:00:00
abstract：:All major health organizations recommend breastfeeding as the optimal source of infant nutrition, with exclusive breastfeeding recommended for the first six months of life. After six months, complementary foods may be introduced. Most organizations recommend breastfeeding for at least one year, and the World Health Or...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2018-09-15 00:00:00
abstract：:Healing by primary intention is a threefold process, consisting of an initial phase in which red and white blood cells bind the wound; epithelialization and fibroplasia, and a maturation phase involving collagen synthesis. The appearance of the wound reflects its maturation. Skillful wound management is based on biolo...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:Management of a wide variety of musculoskeletal conditions requires the use of a cast or splint. Splints are noncircumferential immobilizers that accommodate swelling. This quality makes splints ideal for the management of a variety of acute musculoskeletal conditions in which swelling is anticipated, such as acute fr...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-09-01 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：:The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk alcohol use receive treatment. T...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2016-03-15 00:00:00
abstract：:Primary immunodeficiencies include a variety of disorders that render patients more susceptible to infections. If left untreated, these infections may be fatal. The disorders constitute a spectrum of more than 80 innate defects in the body's immune system. Primary immunodeficiencies generally are considered to be rela...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-11-15 00:00:00
abstract：:Patients commonly present to family physicians with low back pain. Because the majority of patients fully or partially recover within six weeks, imaging studies are generally not recommended in the first month of acute low back pain. Exceptions include patients with suspected cauda equina syndrome, infection, tumor, f...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-06-01 00:00:00
abstract：:Use of performance-enhancing supplements occurs at all levels of sports, from professional athletes to junior high school students. Although some supplements do enhance athletic performance, many have no proven benefits and have serious adverse effects. Anabolic steroids and ephedrine have life-threatening adverse eff...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-11-01 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
