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, providing continuous labor support, using intermittent auscultation in low-risk deliveries, and following the Centers for Disease Control and Prevention guidelines for group B streptococcus prophylaxis. Most women with a low transverse uterine incision are candidates for a trial of labor after cesarean delivery and should be counseled accordingly. Pain management during labor includes complementary modalities and systemic opioids, epidural anesthesia, and pudendal block. Outcomes in the second stage of labor can be improved by using warm perineal compresses, allowing women more time to push before intervening, and offering labor support. Delayed pushing increases the length of the second stage of labor and does not affect the rate of spontaneous vaginal delivery. A tight nuchal cord can be clamped twice and cut before delivery of the shoulders, or the baby may be delivered using a somersault maneuver in which the cord is left nuchal and the distance from the cord to placenta minimized by pushing the head toward the maternal thigh. After delivery, skin-to-skin contact with the mother is recommended. Beyond 35 weeks' gestation, there is no benefit to bulb suctioning the nose and mouth. Postpartum maternal and neonatal outcomes can be improved through delayed cord clamping, active management to prevent postpartum hemorrhage, careful examination for external anal sphincter injuries, and use of absorbable synthetic suture for second-degree perineal laceration repair. Practices that will not improve outcomes and may result in negative outcomes include discontinuation of epidurals late in labor and routine episiotomy.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Dresang LT,Yonke Nsubject
Has Abstractpub_date
2015-08-01 00:00:00pages
202-8issue
3eissn
0002-838Xissn
1532-0650pii
d12023journal_volume
92pub_type
杂志文章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：:New beta lactams and the quinolone class of antibiotics represent major improvements in the therapy of moderate to severe infections. These newer antibiotics have an extended spectrum of antimicrobial activity, excellent pharmacokinetic properties and low toxicity. The beta lactams include carbapenems, represented by ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1988-10-01 00:00:00
abstract：:Myasthenia gravis is characterized by variable ocular and skeletal muscle weakness. Peak incidence is in young women and older men. Thymomas are present in 30 percent of myasthenic patients over age 40. Binding of acetylcholine receptors by IgG antibodies may be the mechanism of the neuromuscular disorder. Repetitive ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-02-01 00:00:00
abstract：:Joint and soft tissue injection of the ankle and foot region is a useful diagnostic and therapeutic tool for the family physician. This article reviews the injection procedure for the plantar fascia, ankle joint, tarsal tunnel, interdigital space, and first metatarsophalangeal joint. Indications for plantar fascia inj...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-10-01 00:00:00
abstract：:Running is a common form of exercise but predisposes athletes to several running-related injuries. Most running injuries are due to overuse and respond to conservative treatment. Tendinopathies in the patellar, Achilles, and hamstring tendons are common, and are primarily treated with eccentric exercise. Iliotibial ba...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2018-04-15 00:00:00
abstract：:AIDS dementia complex is a major source of disability for many AIDS patients. Less commonly, the spinal cord or peripheral nerves are affected by HIV infection. Physicians working with AIDS patients must differentiate these manifestations from those caused by the infectious, neoplastic and vascular complications. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-12-01 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：: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：:Lyme disease, caused by the bacterium Borrelia burgdorferi, is the most common tick-borne illness in the United States. Transmission occurs primarily through the bite of an infected deer tick (Ixodes scapularis). Identification of an erythema migrans rash following a tick bite is the only clinical manifestation suffic...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-06-01 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：:Esophagogastroduodenoscopy is most commonly performed for evaluation of epigastric pain, severe heartburn, chronic nausea and other dyspepsia syndromes that are not relieved by medical therapy. It should not be performed as an in-office procedure in patients with unstable angina, respiratory failure, active upper gast...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-01-01 00:00:00
abstract：:Atrial fibrillation is the arrhythmia most commonly encountered in family practice. Serious complications can include congestive heart failure, myocardial infarction, and thromboembolism. Initial treatment is directed at controlling the ventricular rate, most often with a calcium channel blocker, a beta blocker, or di...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2002-07-15 00:00:00
abstract：:Acute pancreatitis is a clinical syndrome characterized by midepigastric pain, nausea and vomiting. Numerous etiologies have been linked with this entity, principally alcoholism and biliary disease. Once the clinical suspicion of pancreatitis is confirmed, supportive therapy with intravenous hydration and close observ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-08-01 00:00:00
abstract：:The physician needs to know the signs, symptoms and recommended treatments of drug overdoses. Overdose of hallucinogens usually does not require drug therapy. Overdose of amphetamines ("uppers") may be complicated by the presence of PCP, a dissociative substance. It is important for the physician to be familiar with t...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-03-01 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：:Prisoners in U.S. correctional facilities constitute a unique patient population in need of health services. Physicians who provide medical services to inmates also must interact with prison officials. Drug withdrawal, self-destructive behavior and infectious diseases, including acquired immunodeficiency syndrome, are...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1988-07-01 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：:Asymptomatic bacteriuria, defined as the presence of bacteria in the urine in the absence of urinary symptoms, is a common clinical finding that often warrants a decision about whether to initiate antimicrobial therapy. There are few indications to treat asymptomatic bacteriuria, and inappropriate treatment contribute...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2020-07-15 00:00:00
abstract：:Transient organic causes of impotence include alcohol consumption, drug use or inflammatory genital disease. Many diagnoses of organic impotence, with diabetes, for example, have been premature and have resulted in iatrogenic, psychogenic impotence. After a stroke, heart attack or major surgery, depression may cause i...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1978-02-01 00:00:00
abstract：:Atrial fibrillation is the most common arrhythmia in patients visiting a primary care practice. Although many patients with atrial fibrillation experience relief of symptoms with control of the heart rate, some patients require restoration of sinus rhythm. External direct current (DC) cardioversion is the most effecti...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-08-01 00:00:00
abstract：:Superficial bursitis most often occurs in the olecranon and prepatellar bursae. Less common locations are the superficial infrapatellar and subcutaneous (superficial) calcaneal bursae. Chronic microtrauma (e.g., kneeling on the prepatellar bursa) is the most common cause of superficial bursitis. Other causes include a...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2017-02-15 00:00:00
abstract：:Disposable soft contact lenses are an alternative to conventional extended-wear lenses and provide an acceptable margin of safety and convenience for the wearer. The lenses are worn for one to two weeks and then discarded. Buildup of tear film deposits is minimized, and the need for cleaning and disinfecting solutions...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：:Because of the increasing popularity of recreational scuba diving, primary care physicians should be familiar with common diving injuries. One form of barotrauma, middle ear squeeze, is the most common diving injury. Other important diving injuries include inner ear barotrauma and pulmonary barotrauma. Arterial gas em...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-04-01 00:00:00
abstract：:Myocardial perfusion imaging with stress testing by exercise or pharmacologic methods and functional evaluation of the left ventricle are useful in many patients. Uses include determination of diagnosis and prognosis of patients with coronary artery disease, preoperative evaluation, management and risk stratification ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-01-01 00:00:00
abstract：:Patients who have been or may have been bitten by a snake should receive prompt and careful clinical and laboratory evaluation. Fang marks, pain and swelling are characteristic of pit viper envenomation. Although no therapy is universally accepted, a number of treatment plans appear to be effective. If envenomation ha...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-07-01 00:00:00
abstract：:Orthostatic hypotension is defined as a decrease of at least 20 mm Hg in systolic blood pressure when an individual moves from a supine position to a standing position. Nonneurogenic causes of orthostatic hypotension are related to cardiac pump failure, reduced intravascular volume, venous pooling or a medication side...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-10-01 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
abstract：:For centuries, chasteberry has been used to treat many hormone-related gynecologic conditions. The current literature supports the use of chasteberry for cyclical breast discomfort and premenstrual syndrome; data on its use for menstrual irregularities and fertility disorders are weak. Its traditional use as a galacta...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-09-01 00:00:00
abstract：:Zidovudine, the first widely used antiretroviral agent, prevents replication of the human immunodeficiency virus (HIV) by inhibiting reverse transcriptase. Its use in patients with acquired immunodeficiency syndrome slows progression of the disease and prolongs survival. Zidovudine also significantly reduces the rate ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1990-08-01 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
