Abstract:
:Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. Prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic technique when inserting, and device removal when no longer necessary. Specific recommendations for preventing central line-associated bloodstream infections include use of chlorhexidine for skin preparation, as a component of dressings, and for daily bathing of patients in intensive care units. Catheter-associated urinary tract infections are the most common device-related health care-associated infection. Maintaining a closed drainage system below the patient reduces the risk of infection. To prevent ventilator-associated pneumonia, which is associated with high mortality, mechanically ventilated patients should be placed in the semirecumbent position and receive antiseptic oral care. Prevention of surgical site infections includes hair removal using clippers, glucose control, and preoperative antibiotic prophylaxis. Reducing transmission of Clostridium difficile and multidrug-resistant organisms in the hospital setting begins with hand hygiene and contact precautions. Institutional efforts to reduce unnecessary antibiotic prescribing are also strongly recommended. Reducing rates of methicillin-resistant Staphylococcus aureus infection can be achieved through active surveillance cultures and decolonization therapy with mupirocin.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Hsu Vsubject
Has Abstractpub_date
2014-09-15 00:00:00pages
377-82issue
6eissn
0002-838Xissn
1532-0650pii
d11242journal_volume
90pub_type
杂志文章abstract::Down syndrome is caused by triplicate material of chromosome 21. The syndrome has a variable physical expression, but congenital cardiac defects, transient myelodysplasia of the newborn and duodenal atresia are highly specific for this chromosomal disorder. Routine health maintenance is important because infants and c...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-15 00:00:00
abstract::Respiratory difficulty is a common presenting complaint in the outpatient primary care setting. Because patients may first seek care by calling their physician's office, telephone triage plays a role in the early management of dyspnea. Once the patient is in the office, the initial goal of assessment is to determine t...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2003-11-01 00:00:00
abstract::Exercise-induced bronchoconstriction describes the narrowing of the airway that occurs with exercise. More than 10 percent of the general population and up to 90 percent of persons previously diagnosed with asthma have exercise-induced bronchoconstriction. Common symptoms include coughing, wheezing, and chest tightnes...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2011-08-15 00:00:00
abstract::In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one oral agent plus a glucagon-like pep...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2018-01-01 00:00:00
abstract::Distribution of accumulated fluid is the important element in the differentiation of peripheral edema resulting from different etiologies. Isolated upper extremity edema is rare and is usually caused by obstruction of the superior vena cava by a malignancy. The cause of unilateral edema of a lower limb can usually be ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-04-01 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::Gas, bloating, and belching are associated with a variety of conditions but are most commonly caused by functional gastrointestinal disorders. These disorders are characterized by disordered motility and visceral hypersensitivity that are often worsened by psychological distress. An organized approach to the evaluatio...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2019-03-01 00:00:00
abstract::Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in postmenopausal women. Pregnancy is the onl...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2020-05-01 00:00:00
abstract::Parkinson's disease is a common neurodegenerative disorder that can cause significant disability and decreased quality of life. The cardinal physical signs of the disease are distal resting tremor, rigidity, bradykinesia, and asymmetric onset. Levodopa is the primary treatment for Parkinson's disease; however, its lon...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-12-15 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::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 aver...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2007-12-01 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::Family physicians can effectively help their patients stop smoking by using brief intervention and simple office organizational procedures. Intervention involves asking all patients about smoking, advising smokers to stop, assisting with self-help materials, establishing a date for quitting, possibly prescribing nicot...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1990-10-01 00:00:00
abstract::Endometrial cancer is the fourth most common cancer in women, accounting for approximately 6,000 deaths per year in the United States. It is more common in women who are older, white, affluent obese and of low parity. Hypertension and diabetes mellitus are also predisposing factors. Because any condition that increase...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::Allergies may cause gastrointestinal symptoms such as diarrhea, vomiting and pain, dermatologic manifestations, asthma and rhinitis. The most common offender among the foodstuffs is milk. Elimination diets are designed not only to remove the offending food but to identify it and to prevent new sensitizations. Canker s...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1975-02-01 00:00:00
abstract::The practicality of the office spirometer as an effective, inexpensive diagnostic device is well established. It can be used in a matter of seconds by minimally trained office personnel. Two basic parameters can be quickly and accurately measured: forced vital capacity (FVC), a test of volume indicative of restrictive...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
abstract::Injuries to the head and neck are common in sports. Sideline physicians must be attentive and prepared with an organized approach to detect and manage these injuries. Because head and neck injuries often occur simultaneously, the sideline physician can combine the head and neck evaluations. When assessing a conscious ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-10-15 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::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 principle of confidentiality is one of the clearest and firmest rules of professional ethics. However, situations can arise in which confidentiality ought to be abridged in favor of other, weightier values. In the case of a teenager who asks a family physician to prescribe birth control pills for her without infor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1982-01-01 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::Osteoporosis is the most common bone disorder in the United States. Bone mass is decreased, and porosity and fragility are increased. Dual-beam photon absorptiometry is currently considered the best detection technique. Prevention involves increased calcium intake and avoidance of diets high in protein and phosphates,...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1985-11-01 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::An educational dialog founded on open communication between clinician and patient is necessary for a successful partnership in asthma care. Educating patients in self-management of asthma has become a major challenge in primary care practice. The process should begin at the time of diagnosis and should be integrated i...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-07-01 00:00:00
abstract::Orofacial pain can have an inflammatory, neurologic or musculoskeletal cause. Inflammatory diseases include dental abscess, sinusitis, temporal arteritis, sialolithiasis and infections of the parotid gland. Common neurologic diseases that cause facial pain are trigeminal neuralgia, glossopharyngeal neuralgia, paratrig...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-02-01 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::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::Colorectal cancer is the third most common cancer in men and women. The incidence and mortality rate of the disease have been declining over the past two decades because of early detection and treatment. Screening in persons at average risk should begin at 50 years of age; the U.S. Preventive Services Task Force recom...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2015-01-15 00:00:00
abstract::Thyroiditis is a spectrum of diseases that includes acute, subacute and chronic thyroiditis, all of which demonstrate the histologic findings of inflammation, fibrosis or lymphocytic infiltration. Acute thyroiditis is an infectious disease characterized by the abrupt onset of anterior neck pain and swelling. Subacute ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-15 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