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 disorder is a patient's concern with physical symptoms that he or she attributes to a nonpsychiatric disease. Primary care physicians often treat patients who manifest symptoms for which there are no biologic cause, and patients with somatic symptom disorder may be subjected to unnecessary testing and procedures. As a result, appropriate diagnosis is essential. Screening instruments are useful in determining the presence of somatic symptom disorder. It is important for the primary care physician to schedule regular appointments, establish a strong therapeutic alliance, acknowledge and legitimize the patient's symptoms, and limit diagnostic testing or referrals to subspecialists. Proven treatments include cognitive behavior therapy, mindfulness-based therapy, and pharmacotherapy. The use of selective serotonin reuptake inhibitors or tricyclic antidepressants has been effective in alleviating symptoms. Referral to a mental health professional may be necessary when treatment by the primary care physician is ineffective.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Kurlansik SL,Maffei MSsubject
Has Abstractpub_date
2016-01-01 00:00:00pages
49-54issue
1eissn
0002-838Xissn
1532-0650pii
d12225journal_volume
93pub_type
杂志文章abstract：:Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2014-07-01 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：: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：:Cardiac pacemakers are generally used in conditions where bradyarrhythmia is a major problem, such as advanced heart block, sick sinus syndrome and bundle branch block. Temporary or permanent pacing may be needed to control certain tachyarrhythmias refractory to medical therapy. Temporary pacing may be of value in the...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-05-01 00:00:00
abstract：:Celiac disease is a genetic, immunologically mediated small bowel enteropathy that causes malabsorption. The immune inflammatory response to gluten frequently causes damage to many other tissues of the body. The condition is frequently underdiagnosed because of its protean presentations. New prevalence data indicate t...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-03-01 00:00:00
abstract：:Patients with restless legs syndrome often have difficulty describing their symptoms. Three features characterize the classic syndrome: an unusual, almost indescribable sensation in the lower extremities; an irresistible urge to move the legs, and the exclusive occurrence of the symptoms at rest, with their relief by ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1986-01-01 00:00:00
abstract：:Scanning is based on the uptake of a nuclide by the crystal lattice of bone and is related to bone blood flow. Cancer cells do not take up the tracer. Normally, the scan visualizes the highly vascular bones. Scans are useful and are indicated in metastatic bone disease, primary bone tumors, hematologic malignancies an...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-03-01 00:00:00
abstract：:Thyroid function tests, radioiodine uptake and scintiscanning, and antithyroid antibody titers are the main laboratory tests useful in the management of goiter. Scintiscanning and ultrasonography aid in differentiating a functioning adenoma from a "cold" solid nodule--a crucial distinction since the incidence of cance...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：:The classic modes of heat loss affecting the newborn are conduction, convection, radiation and evaporation. The disproportionate ratio of surface area to body weight (SA/BW) of the premature infant is the basis of inefficient heat conservation, combined with a blunted metabolic response. Hypothermia leads to hypoxemia...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1977-11-01 00:00:00
abstract：:Acute bronchitis is one of the top 10 conditions for which patients seek medical care. Physicians show considerable variability in describing the signs and symptoms necessary to its diagnosis. Because acute bronchitis most often has a viral cause, symptomatic treatment with protussives, antitussives, or bronchodilator...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-05-15 00:00:00
abstract：:Peritonsillar abscess remains the most common deep infection of the head and neck. The condition occurs primarily in young adults, most often during November to December and April to May, coinciding with the highest incidence of streptococcal pharyngitis and exudative tonsillitis. A peritonsillar abscess is a polymicr...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-01-15 00:00:00
abstract：:Self-induced injury of one or more of the extremities may represent a distinct variety of Munchausen syndrome. The nature of the injury may be infectious, dermatologic or orthopedic. The mechanism may be secondary gain or another unconscious motivation that causes a craving for attention. In many cases, the underlying...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1988-06-01 00:00:00
abstract：:Coxsackievirus B infection is common in children and young adults, usually causing mild symptoms in the gastrointestinal or upper respiratory tract. However, some patients develop pleurodynia, carditis or aseptic meningitis. This viral infection can be serious in the fetus and fatal in the newborn. Coxsackievirus B in...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1988-11-01 00:00:00
abstract：:Herpes zoster ophthalmicus occurs when the varicella-zoster virus is reactivated in the ophthalmic division of the trigeminal nerve. Herpes zoster ophthalmicus represents up to one fourth of all cases of herpes zoster. Most patients with herpes zoster ophthalmicus present with a periorbital vesicular rash distributed ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-11-01 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：:The birth of a child with any developmental disability is an occasion of marked trauma to parents. Early, honest and frank counseling is imperative, and the family physician can play a unique role in this counseling process. When the physician is not knowledgeable in a paretcular case, he or she should seek expert hel...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1977-05-01 00:00:00
abstract：:The Papanicolaou smear is a well-established component of preventive health protocols for women. The purpose of this screening tool is to detect precursor lesions of invasive cervical carcinoma; however, the natural progression of these lesions is unclear, and it currently is not possible to determine which of the man...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-02-01 00:00:00
abstract：:Chronic bladder catheterization is the treatment of last resort for incontinence. Urinary infection is a normal state in these patients. It should be treated only when there are signs of systemic illness. Accumulations of encrusted debris cause urinary leakage. This problem can be lessened by using silicone catheters ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-09-01 00:00:00
abstract：:Ischemic heart disease is one of the most common disorders managed by family physicians. Stratifying patients according to risk is important early in the course of the disease to identify patients who require invasive (percutaneous or surgical) treatment. Physical examination, clinical history, noninvasive tests and a...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-12-01 00:00:00
abstract：:Risk factors for stroke should be evaluated in patients who have had a transient ischemic attack. Blood pressure, lipid levels, and diabetes mellitus should be controlled. When applicable, smoking cessation and weight loss also are important. Angiotensin-converting enzyme inhibitor therapy may help prevent stroke. Asp...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-04-01 00:00:00
abstract：:Rosacea is a common, but often overlooked, skin condition of uncertain etiology that can lead to significant facial disfigurement, ocular complications, and severe emotional distress. The progression of rosacea is variable; however, typical stages include: (1) facial flushing, (2) erythema and/or edema and ocular symp...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2002-08-01 00:00:00
abstract：:In the guideline developed by the American College of Cardiology and the American Heart Association, the management of suspected unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI) has four components: initial evaluation and management; hospital care; coronary revascularization; and hospital...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-08-01 00:00:00
abstract：:Anemia in children is commonly encountered by the family physician. Multiple causes exist, but with a thorough history, a physical examination and limited laboratory evaluation a specific diagnosis can usually be established. The use of the mean corpuscular volume to classify the anemia as microcytic, normocytic or ma...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-10-15 00:00:00
abstract：:Microscopic hematuria, a common finding on routine urinalysis of adults, is clinically significant when three to five red blood cells per high-power field are visible. Etiologies of microscopic hematuria range from incidental causes to life-threatening urinary tract neoplasm. The lack of evidence-based imaging guideli...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2006-05-15 00:00:00
abstract：:Menière's disease may be the underlying cause of dizziness, which is a common presenting complaint. This disease is differentiated from other causes of dizziness by its classic constellation of four symptoms; dizziness characterized as episodic spinning or whirling vertigo; fluctuating, low-frequency sensorineural hea...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-03-01 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：: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：:Family physicians should be familiar with the various drugs available for treating and preventing viral infections. Part II of this two-part article focuses on agents used to manage influenza and respiratory syncytial virus. Rimantadine and amantadine traditionally have been used to prevent and treat influenza type A ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-02-15 00:00:00
abstract：:Magnetic resonance imaging uses powerful magnetic fields and a radiofrequency pulse to provide a diagnostic image. Physicians must identify patients with metallic internal implants, pacemakers and cochlear implants before MRI scanning to prevent serious injury. Some patients also experience severe anxiety from the con...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：:Otitis externa, green nail syndrome, toe web infections, hot tub folliculitis, superinfections in chronic antibiotic-treated acne and infectious eczematoid dermatitis are examples of mild cutaneous infections due to Pseudomonas aeruginosa. These may occur in otherwise healthy persons. In persons with lowered resistanc...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
