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 should strongly advise patients to quit smoking, and use motivational interviewing techniques for patients who are not yet willing to stop smoking. Clinical contacts with unmotivated patients should emphasize the rewards and relevance of quitting, as well as the risks of smoking and anticipated barriers to abstinence. These messages should be repeated at every opportunity. Appropriate patients should be offered pharmacologic assistance in quitting, such as nicotine replacement therapies, bupropion, and varenicline. Use of pharmacologic support during smoking cessation can double the rate of successful abstinence. Using more than one type of nicotine replacement therapy ("patch plus" method) and combining these therapies with bupropion provide additional benefit. However, special populations pose unique challenges in pharmacotherapy for smoking cessation. Nicotine replacement therapies increase the risk of birth defects and should not be used during pregnancy. They are usually safe in patients with cardiovascular conditions, except for those with unstable angina or within two weeks of a coronary event. Varenicline may increase the risk of coronary events. Nicotine replacement therapies are safe for use in adolescents; however, they are less effective than in adults. Physicians also should arrange to have repeated contact with smokers around their quit date to reinforce cessation messages.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Larzelere MM,Williams DEsubject
Has Abstractpub_date
2012-03-15 00:00:00pages
591-8issue
6eissn
0002-838Xissn
1532-0650pii
d10294journal_volume
85pub_type
杂志文章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：: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：:Inflammatory breast cancer is a devastating disease with an extremely high rate of morbidity and mortality. Differentiating this disease from acute mastitis may be difficult on initial diagnosis. The expeditious diagnosis and treatment of inflammatory breast cancer has important ramifications for the patient's prognos...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-09-01 00:00:00
abstract：:Gallstone disease is a major health problem in the United States and in most Western countries. During the past century, cholecystectomy has been the treatment of choice. Recently, new modalities of treatment have been developed, including oral dissolution therapy, extracorporeal shock-wave lithotripsy, percutaneous t...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-10-01 00:00:00
abstract：:Tay-Sachs disease is a fatal genetic disease affecting Jewish infants of eastern European ancestry. While the disease may go unrecognized until nearly one year of age, death occurs by age three or four. Community screening programs have been organized to detect carriers of this autosomal recessive trait. Prenatal diag...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1976-04-01 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：:Home monitoring of blood glucose and blood pressure levels can provide patients and physicians with valuable information in the management of diabetes mellitus and hypertension. Home monitoring allows patients to play an active role in their care and may improve treatment adherence and clinical outcomes. Glucose meter...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2007-07-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-01 00:00:00
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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：:Ectopic pregnancy occurs at a rate of 19.7 cases per 1,000 pregnancies in North America and is a leading cause of maternal mortality in the first trimester. Greater awareness of risk factors and improved technology (biochemical markers and ultrasonography) allow ectopic pregnancy to be identified before the developmen...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-02-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-11-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-08-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-07-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1980-08-01 00:00:00
abstract：:Hyperparathyroidism is a common cause of hypercalcemia. The hypercalcemia usually is discovered during a routine serum chemistry profile. Often, there has been no previous suspicion of this disorder. In most patients initially believed to be asymptomatic, previously unrecognized symptoms resolve with surgical correcti...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-04-15 00:00:00
abstract：:External hemorrhoids represent distended vascular tissue in the anal canal distal to the dentate line. Persons with thrombosed external hemorrhoids usually present with pain on standing, sitting or defecating. Acutely tender, thrombosed external hemorrhoids can be surgically removed if encountered within the first 72 ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-04-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-04-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-04-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-08-01 00:00:00
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journal_title：American family physician
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doi：
更新日期：2011-08-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1995-12-01 00:00:00
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journal_title：American family physician
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更新日期：2002-02-15 00:00:00
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journal_title：American family physician
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doi：
更新日期：2018-01-01 00:00:00
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journal_title：American family physician
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更新日期：2006-03-15 00:00:00
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journal_title：American family physician
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更新日期：2008-05-01 00:00:00
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journal_title：American family physician
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doi：
更新日期：1994-03-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-08-01 00:00:00
abstract：:As effective antipsychotic pharmacotherapy has become available, patients with schizophrenia are increasingly managed in an outpatient setting by primary care physicians. Pharmacotherapy is generally effective in treating "positive," or psychotic, symptoms and lessening the risks of relapse, but ineffective in improvi...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1991-03-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-09-15 00:00:00
