Abstract:
:Hypertension is the most common chronic condition treated by family physicians. Elevated blood pressure is associated with an increased risk of heart failure, myocardial infarction, cerebrovascular disease, and death. Treatment of hypertension reduces the risk of these events. Several lifestyle modifications are associated with improvements in blood pressure, including the Dietary Approaches to Stop Hypertension diet, sodium restriction, regular exercise, and moderate weight loss. There is strong evidence that reducing diastolic blood pressure to less than 90 mm Hg is beneficial in adults older than 30 years. Although there is good evidence to support reducing systolic blood pressure to less than 150 mm Hg in adults older than 60 years, the evidence in younger adults is insufficient to recommend a specific goal. Black patients with chronic kidney disease who are treated with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to a blood pressure of less than 140/90 mm Hg experience slower declines in glomerular filtration rates than patients treated with other medications. A blood pressure goal of less than 140/90 mm Hg is recommended in patients with chronic kidney disease and in those with diabetes mellitus. Thiazide diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers are the preferred medications in nonblack patients; thiazide diuretics and calcium channel blockers are preferred in black patients.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Langan R,Jones Ksubject
Has Abstractpub_date
2015-02-01 00:00:00pages
172-7issue
3eissn
0002-838Xissn
1532-0650pii
d11797journal_volume
91pub_type
杂志文章,评审abstract::Seizure patterns usually reflect known functions of the involved areas of the brain. The causes of epilepsy vary with the age at onset. For the purposes of determining drug therapy, seizures are divided into three groups. Focal and tonic-clonic seizures respond to one group of drugs, and absence seizures respond to an...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::Grief and depression present similarly in patients who are dying. Conventional symptoms (e.g., frequent crying, weight loss, thoughts of death) used to assess for depression in these patients may be imprecise because these symptoms are also present in preparatory grief and as a part of the normal dying process. Prepar...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract::With the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., the diagnostic category previously known as somatoform disorders is now called somatic symptom and related disorders. The revisions were intended to increase their relevance in the primary care setting. The main feature of this dis...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2016-01-01 00:00:00
abstract::The chief side effect of phenobarbital is drowsiness, which is usually associated with overdosage. Phenytoin, on the other hand, causes gingival hyperplasia in many patients, irreversible hypertrichosis in some patients and lethal reactions, such as Stevens-Johnson syndrome, in a few patients. Antiepileptic therapy sh...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract::Natural supplements are widely used in the United States and, while claims of their therapeutic effects abound, medical research does not always support their effectiveness. St. John's wort acts as a weak selective serotonin reuptake inhibitor with fewer side effects. S-Adenosylmethionine (SAMe) has enough of an antid...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-09-01 00:00:00
abstract::Recent innovations in medical technology have changed newborn screening programs in the United States. The widespread use of tandem mass spectrometry is helping to identify more inborn errors of metabolism. Primary care physicians often are the first to be contacted by state and reference laboratories when neonatal sc...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-06-01 00:00:00
abstract::Federally funded health centers and the National Health Service Corps (NHSC) depend on family physicians (FPs) and general practitioners (GPs) to meet the needs of millions of medically underserved people. Policy makers and workforce planners should consider how changes in the production of FPs would affect these prog...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2005-07-15 00:00:00
abstract::Hidradenitis suppurativa is a chronic folliculitis affecting intertriginous areas. Onset generally occurs in young adulthood to middle adulthood (18 to 39 years of age). Females and blacks are more than twice as likely to be affected. Additional risk factors include family history, smoking, and obesity. Hidradenitis s...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2019-11-01 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::Pneumocystis carinii pneumonia is a life-threatening complication of diseases and therapies associated with immunosuppression. Approximately 80 percent of patients with acquired immunodeficiency syndrome will develop pneumocystis pneumonia. Diagnosis is important, because effective therapy is available. In most cases,...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-08-01 00:00:00
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 especia...
journal_title:American family physician
pub_type: 杂志文章,实务指引
doi:
更新日期:2009-12-15 00:00:00
abstract::Tension-type headache typically causes pain that radiates in a band-like fashion bilaterally from the forehead to the occiput. Pain often radiates to the neck muscles and is described as tightness, pressure, or dull ache. Migraine-type features (unilateral, throbbing pain, nausea, photophobia) are not present All pati...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2002-09-01 00:00:00
abstract::Schirmer's test is a simple, semiquantitative test of tear production. It is based on the physical tendency of a fluid to travel along a strip of porous material by capillary action due to surface tension. Sterile strips, standardized and prepackaged, are available from local scientific supply houses. The low cost and...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1981-11-01 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::Patients with seasonal affective disorder have episodes of major depression that tend to recur during specific times of the year, usually in winter. Like major depression, seasonal affective disorder probably is underdiagnosed in primary care settings. Although several screening instruments are available, such screeni...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-11-01 00:00:00
abstract::Gout is a disease resulting from the deposition of urate crystals caused by the overproduction or underexcretion of uric acid. The disease is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute and chronic arthritis, tophi, interstitial renal disease and uric a...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-04-01 00:00:00
abstract::Pharmacologic agents that attenuate the influence of the renin-angiotensin-aldosterone system are known to reduce systemic arterial blood pressure through vasodilatory action and enhanced renal clearance of sodium and water. Angiotensin-converting enzyme inhibitors are known to antagonize the renin-angiotensin-aldoste...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-02-01 00:00:00
abstract::Vertigo is the illusion of motion, usually rotational motion. As patients age, vertigo becomes an increasingly common presenting complaint. The most common causes of this condition are benign paroxysmal positional vertigo, acute vestibular neuronitis or labyrinthitis, Ménière's disease, migraine, and anxiety disorders...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2005-03-15 00:00:00
abstract::Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease pain and improve function. Acet...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2011-06-01 00:00:00
abstract::The hemagglutinin and neuraminidase surface antigens of the influenza virus periodically undergo major or minor structural changes. These influence epidemiologic patterns and the composition of vaccine. Annual vaccination is recommended for individuals at increased risk of complications from lower respiratory tract in...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Most of the nearly 4 million births in the United States annually are normal spontaneous vaginal deliveries. In the first stage of labor, normal birth outcomes can be improved by encouraging the patient to walk and stay in upright positions, waiting until at least 6 cm dilation to diagnose active stage arrest, providi...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2015-08-01 00:00:00
abstract::Historically, osteopathic physicians have made an important contribution to the primary care workforce. More than one half of osteopathic physicians are primary care physicians, and most of these are family physicians. However, the proportion of osteopathic students choosing family medicine, like that of their allopat...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2005-08-15 00:00:00
abstract::Family physicians often encounter situations in which postexposure prophylaxis (PEP) with antiretroviral medications against human immunodeficiency virus (HIV) may be indicated. When the exposure source's HIV status is unknown and testing of the source is possible, use of a rapid HIV test kit may facilitate decision m...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2010-07-15 00:00:00
abstract::In evaluating recurrent childhood infections, the physician must keep in mind the rarity of true immunodeficiency and the frequency of atopy, day care, exposure to cigarette smoke and anatomic variations as predisposing factors in recurrent childhood illnesses. Determining true immunodeficiency involves exclusion of r...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-11-15 00:00:00
abstract::The preparticipation physical evaluation is a commonly requested medical visit for amateur and professional athletes of all ages. The overarching goal is to maximize the health of athletes and their safe participation in sports. Although studies have not found that the preparticipation physical evaluation prevents mor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2015-09-01 00:00:00
abstract::Women experience depression twice as often as men. The diagnostic criteria for depression are the same for both sexes, but women with depression more frequently experience guilt, anxiety, increased appetite and sleep, weight gain and comorbid eating disorders. Women may achieve higher plasma concentrations of antidepr...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-07-01 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::Childhood bullying has potentially serious implications for bullies and their targets. Bullying involves a pattern of repeated aggression, a deliberate intent to harm or disturb a victim despite the victim's apparent distress, and a real or perceived imbalance of power. Bullying can lead to serious academic, social, e...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2004-11-01 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::Manic episodes are characterized by the triad of unstable mood, pressured speech and increased motor activity. This type of episode is often due to bipolar disorder. Benzodiazepines and antipsychotic agents are generally used in the acute emergency management of mania. Lithium, carbamazepine or a valproate preparation...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-04-01 00:00:00