Abstract：
:The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk alcohol use receive treatment. Three medications are approved by the U.S. Food and Drug Administration to treat alcohol use disorder: acamprosate, disulfiram, and naltrexone. Acamprosate and naltrexone reduce alcohol consumption and increase abstinence rates, although the effects appear to be modest. Disulfiram has been used for years, but evidence supporting its effectiveness is inconsistent. Other medications may be beneficial to reduce heavy alcohol use. The anticonvulsants topiramate and gabapentin may reduce alcohol ingestion, although long-term studies are lacking. Antidepressants do not decrease alcohol use in patients without mood disorders, but sertraline and fluoxetine may help depressed patients decrease alcohol ingestion. Ondansetron may reduce alcohol use, particularly in selected subpopulations. Further study is needed for genetically targeted or as-needed medications to reduce alcohol use.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Winslow BT,Onysko M,Hebert Msubject
Has Abstractpub_date
2016-03-15 00:00:00pages
457-65issue
6eissn
0002-838Xissn
1532-0650pii
d12454journal_volume
93pub_type
杂志文章,评审abstract：:Arnold-Chiari malformation is a disorder of embryologic development. In Type I, there is cerebellar displacement into the spinal canal, but hydrocephalus and syringomyelia are variable. Type II usually is manifested by severe hydrocephalus and myelomeningocele in infancy. Type I malformations may pose diagnostic chall...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1989-03-01 00:00:00
abstract：:Nephrolithiasis is a rare but important condition in pregnant women. The most common presenting complaint is flank pain. Recurrent or persistent urinary tract infections may also be due to nephrolithiasis. Ultrasound is the first-line diagnostic study, but a limited intravenous pyelogram can be obtained when indicated...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
abstract：:Many patients in primary care present with ear pain (otalgia). When the ear is the source of the pain (primary otalgia), the ear examination is usually abnormal. When the ear is not the source of the pain (secondary otalgia), the ear examination is typically normal. The cause of primary otalgia is usually apparent on ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-03-01 00:00:00
abstract：:Effective management of life-threatening emergencies in infants and children demands a high level of technical skill. The Pediatric Advanced Life Support (PALS) provider course, developed jointly by the American Academy of Pediatrics and the American Heart Association, is highly recommended to help physicians prepare ...
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：:Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonergic activity in the nervous system. It is characterized by mental status changes, autonomic instability, and neuromuscular hyperactivity. Most reported cases of serotonin syndrome are in patients using multiple serotonergic dru...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2010-05-01 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：:The Food and Drug Administration has recommended that blood donated for transfusion in the United States be screened for antibodies to human T lymphotropic virus type I. Since seropositive donors will be referred to health care providers for advice, physicians should become familiar with HTLV-I, its modes of transmiss...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-08-01 00:00:00
abstract：:The ability to properly apply casts and splints is a technical skill easily mastered with practice and an understanding of basic principles. The initial approach to casting and splinting requires a thorough assessment of the injured extremity for proper diagnosis. Once the need for immobilization is ascertained, casti...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-01-01 00:00:00
abstract：:Despite steady increases in U.S. health care spending, the population's self-perceived health status has been in a long-term decline. Increased support for public health, prevention, and primary care could reduce growth in spending and improve actual and perceived health. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-09-01 00:00:00
abstract：:Garlic has long been used medicinally, most recently for its cardiovascular, antineoplastic, and antimicrobial properties. Sulfur compounds, including allicin, appear to be the active components in the root bulb of the garlic plant. Studies show significant but modest lipid-lowering effects and antiplatelet activity. ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-07-01 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：:A comprehensive medical history that includes questions about a personal and family history of cardiovascular disease is the most important initial component of the preparticipation athletic evaluation. Additional questions should focus on any history of neurologic or musculoskeletal problems. A limited physical exami...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2000-05-01 00:00:00
abstract：:Premature rupture of the membranes is associated with considerable neonatal and maternal morbidity when it leads to premature birth. In most cases, this condition occurs at term, does not require medical intervention and has a benign course. Although few effective preventive measures are available, the family physicia...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-08-01 00:00:00
abstract：:Appropriate preconception health care improves pregnancy outcomes. When started at least one month before conception, folic acid supplements can prevent neural tube defects. Targeted genetic screening and counseling should be offered on the basis of age, ethnic background, or family history. Before conception, women s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2002-06-15 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：:The safety of vaginal birth after cesarean (VBAC) delivery has been documented. Fetal and neonatal morbidity is not increased, and the mortality rate is less than one in 2,000 deliveries. Maternal morbidity and mortality rates for VBAC delivery are significantly lower than those for repeat cesarean section. Family phy...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1988-06-01 00:00:00
abstract：:Particularly in rural settings, Trichophyton verrucosum commonly causes an inflammatory tinea infection, sometimes called 'barn itch." There is usually a history of contact with animals. The demonstration of clusters of large spores in a potassium hydroxide preparation of scrappings obtained from clinically involved s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1983-01-01 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：:Colonic angiodysplasia is now recognized as a frequent cause of gastrointestinal bleeding in patients over age 55. These microvascular arteriovenous malformations may be as common a cause of colonic bleeding as diverticular disease. The lesions are not evident on barium studies. Even colonoscopy and selective colonic ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-09-01 00:00:00
abstract：:Although heart failure is a common clinical syndrome, especially in the elderly, its diagnosis is often missed. A detailed clinical history is crucial and should address not only current signs and symptoms of heart failure but also signs and symptoms that point to a specific cause of the syndrome, such as coronary art...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-03-01 00:00:00
abstract：:Children six months to four years of age are at greatest risk for aspiration of foreign bodies. A history of coughing after contact with small objects is the most important clue. The clinical presentation varies from paroxysms of choking and coughing to chronic cough or wheezing. Chest radiographs are normal in up to ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1979-09-01 00:00:00
abstract：:Nitrous oxide analgesia is a safe alternative to parenteral narcotics for outpatient surgical procedures. This type of analgesia is effective, well tolerated by most age groups, easily administered, rapidly reversible and associated with a low incidence of serious side effects. Hypoxia can be prevented by using fail-s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:Medical problems associated with prematurity are frequently complex, and a multidisciplinary approach is often required. Some common problems include the following: (1) anemia, which can be reduced by iron supplementation, (2) cerebral palsy or mental retardation as a result of intraventricular hemorrhage or periventr...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-05-15 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：:Down syndrome (trisomy 21) is the most commonly recognized genetic cause of mental retardation. The risk of trisomy 21 is directly related to maternal age. All forms of prenatal testing for Down syndrome must be voluntary. A nondirective approach should be used when presenting patients with options for prenatal screen...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-08-15 00:00:00
abstract：:The birth of twins can be an exciting and challenging experience for a family. However, circumstances unique to the relationship between the twin and the family and the relationship between the twins themselves may exacerbate existing problems or create new ones. Parents are often overwhelmed by the amount of time and...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-03-01 00:00:00
abstract：:Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of the diagnosis of ischemic stroke. The most common presenting symptoms of ischemic stroke are speech disturbance and weaknes...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2015-04-15 00:00:00
abstract：:Many patients require sedation during diagnostic or therapeutic procedures. Ideally, procedural sedation minimizes the patient's awareness and discomfort while maintaining the patient's safety. Appropriate monitoring by trained personnel is the key to successful procedural sedation. These techniques should be used onl...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-01-01 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：:Anaphylaxis is a life-threatening systemic reaction, normally occurring within one to two hours of exposure to an allergen. The incidence of anaphylaxis in the United States is 2.1 per 1,000 person-years. Most anaphylactic reactions occur outside the hospital setting. Urticaria, difficulty breathing, and mucosal swell...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2020-09-15 00:00:00
