Abstract:
:Although many physicians consider constipation a trivial problem, it is one of the most frequent and chronic digestive disorders in the United States, affecting 4.53 million people and causing considerable morbidity. More than $200 million are spent for over-the-counter laxatives and untold millions of dollars are spent for prescription drugs and other medical services to manage this disorder. Successful management requires an appreciation of the magnitude of the problem, an understanding of colorectal function and a clear assessment of the causes. Careful examination of the patient's anorectal anatomy and improvement in the patient's dietary habits are the first steps in management. Therapeutic options include behavioral modification strategies, diet and lifestyle changes, pharmacologic therapy and, rarely, surgical intervention.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Donatelle EPsubject
Has Abstractpub_date
1990-11-01 00:00:00pages
1335-42issue
5eissn
0002-838Xissn
1532-0650journal_volume
42pub_type
杂志文章,评审abstract::Children six months to four years of age are at greatest risk for aspiration of foreign bodies. A history of coughing after contact with small objects is the most important clue. The clinical presentation varies from paroxysms of choking and coughing to chronic cough or wheezing. Chest radiographs are normal in up to ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::Patients with myopia, hyperopia and astigmatism can now reduce or eliminate their dependence on contact lenses and eyeglasses through refractive surgery that includes radial keratotomy (RK), photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK), laser thermal keratoplasty (LTK) and intrastro...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2001-10-01 00:00:00
abstract::Middle ear fluid is a common problem in children. Eustachian tube dysfunction has been considered the key to the pathogenesis of this disorder, but new studies show that other factors may be operative. Inflammation appears to play a significant role in high-viscosity effusion, and these effusions may be related to acu...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1978-04-01 00:00:00
abstract::The physician is increasingly asked to play a role in relocating elderly patients to special housing. The goal is to find the housing that is best suited to the patient's needs. Important factors to be considered are building design, sponsorship, financing and nonshelter services. Proper housing, with appropriate supp...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract::Acute renal failure occurs in 5 percent of hospitalized patients. Etiologically, this common condition can be categorized as prerenal, intrinsic or postrenal. Most patients have prerenal acute renal failure or acute tubular necrosis (a type of intrinsic acute renal failure that is usually caused by ischemia or toxins)...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-04-01 00:00:00
abstract::Delayed hypersensitivity skin tests, when properly planned and performed, are both practical and sensitive in determining the status of cell-mediated immunity. They can be diagnostic of specific exposure, such as tuberculosis, or they can rule out anergy. Pitfalls include poor selection of antigens, inappropriate appl...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::Adult immunization rates have fallen short of national goals partly because of misconceptions about the safety and benefits of current vaccines. The danger of these misconceptions is magnified during pregnancy, when concerned physicians are hesitant to administer vaccines and patients are reluctant to accept them. Rou...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2003-07-15 00:00:00
abstract::Osteopetrosis is a hereditary disorder in which pathologic alteration of osteoclast resorption of bone results in thickening of cortical and lamellar bone. Before bone marrow transplantation, the infantile recessive form was uniformly fatal within the first two decades of life as a result of invasion of the marrow spa...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-01-01 00:00:00
abstract::Parathyroid hyperplasia is second only to adenoma as the most common cause of hyperparathyroidism. Symptoms are most likely to result from elevated serum calcium levels. Symptoms include nephrocalcinosis and nephrolithiasis. Studies that may help confirm a suspected diagnosis include ultrasonography, computed tomograp...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::Serotonin syndrome is a potentially life-threatening complication of psychopharmacologic drug therapy. The syndrome is produced most often by the concurrent use of two or more drugs that increase brainstem serotonin activity and is often unrecognized because of the varied and nonspecific nature of its symptomatology. ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::Poisoning is a common cause of morbidity and mortality in the United States, with several million episodes reported annually. Acute medication poisonings account for nearly one half of all poisonings reported in the United States and should be considered in persons with an acute change in mental status. The initial ap...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2010-02-01 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::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::The peak expiratory flow rate (PEFR) may be measured in the office or at home with an inexpensive, hand-held meter. Measurement of the PEFR provides a rapid, objective means of diagnosing and monitoring asthma. Use of the peak flow meter permits early detection of deteriorating function, allowing timely institution of...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-12-01 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::Abdominal aortic aneurysms occur in 5 to 7 percent of people over age 60 in the United States. An aneurysm is defined as a permanent localized dilatation of an artery, with an increase in diameter of greater than 1.5 times its normal diameter. Abdominal aortic aneurysms may be manifested by catastrophic rupture, signs...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-09-15 00:00:00
abstract::Optimal management of corneal foreign-body injuries includes an accurate history, thorough examination of both eyes, atraumatic removal of the foreign body, elimination of the rust ring, appropriate antibiotic prophylaxis and protective patching. Pitfalls to be avoided include using topical steroids, which may promote...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1985-02-01 00:00:00
abstract::Cigarette smoking causes significant morbidity and mortality in the United States. Physicians can use the five A's framework (ask, advise, assess, assist, arrange) to promote smoking cessation. All patients should be asked about tobacco use and assessed for motivation to quit at every clinical encounter. Physicians sh...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2012-03-15 00:00:00
abstract::Left ventricular hypertrophy is more common in hypertensive individuals than in normotensive persons. Its presence in hypertensive patients is associated with an increased incidence of ventricular arrhythmias, myocardial infarction, congestive heart failure, stroke and cardiovascular mortality. Echocardiography is mor...
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::The protein-sparing modified fast is a safe and effective method for losing a large amount of weight relatively quickly. This diet should be used in combination with an exercise program, behavior modification and patient education. Caloric intake is in the range of 400 to 800 per day. Candidates for the diet should be...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1990-11-01 00:00:00
abstract::Careful examination of a fresh, properly collected urine specimen can indicate the presence of urinary tract disease or uncover unsuspected local or systemic pathology. Urinalysis also can lead to a more complete understanding of a systemic disorder or can assure both the patient and the physician that urinary tract d...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Asthmatics may develop a considerable increase in airways obstruction during the night or early hours of the morning. In most patients, this causes only mild symptoms. In others, the effects may be severe, resulting in sudden death. Greater awareness of the potential severity of nocturnal asthma, together with actual ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1976-12-01 00:00:00
abstract::Atrial fibrillation is associated with potentially life-threatening strokes. Anticoagulation with warfarin or aspirin reduces the risk of embolic events in patients with chronic atrial fibrillation and mitral valve stenosis or other underlying heart disease. In patients with acute onset of atrial fibrillation, anticoa...
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::Because the prevalence of urinary incontinence increases with age, a working knowledge of the diagnosis and treatment of the various types of urinary incontinence is fundamental to the care of women. As the population of the United States ages, primary care physicians can expect to see an increasing number of patients...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract::Osteoporosis is characterized by low bone mineral density and a deterioration in the microarchitecture of bone that increases its susceptibility to fracture. The World Health Organization defines osteoporosis as a bone mineral density that is 2.5 standard deviations or more below the reference mean for healthy, young ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2004-10-01 00:00:00
abstract::Proteinuria is a common laboratory finding in children. It can be identified as either a transient or a persistent finding and can represent a benign condition or a serious disease. A rapid but qualitative assessment of proteinuria can be made using dipstick or sulfosalicylic acid methods. More precise quantitation is...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-10-01 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::Spinal cord compression from metastatic cancer is a medical emergency. Prompt intervention affords the best chance for successful recovery, while delay may result in devastating neurologic impairment. In the appropriate clinical setting, emergency myelography should be done to confirm the diagnosis of metastatic disea...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::Kernicterus and neurologic sequelae caused by severe neonatal hyperbilirubinemia are preventable conditions. A structured and practical approach to the identification and care of infants with jaundice can facilitate prevention, thus decreasing rates of morbidity and mortality. Primary prevention includes ensuring adeq...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2008-05-01 00:00:00
abstract::Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for hip fracture. Patients may present with acute respiratory symptoms, including tachypnea, tachycardia and rales. Chest radiographs and clinical and laboratory findings alone cannot provide a firm diagnosis. A completely nor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00