Abstract：
:Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, for diagnosis, and suspected atrial fibrillation should be confirmed with 12-lead electrocardiography. Because normal electrocardiographic findings do not rule out atrial fibrillation, home monitoring is recommended if there is clinical suspicion of arrhythmia despite normal test results. Treatment is based on decisions made regarding when to convert to normal sinus rhythm vs. when to treat with rate control, and, in either case, how to best reduce the risk of stroke. For most patients, rate control is preferred to rhythm control. Ablation therapy is used to destroy abnormal foci responsible for atrial fibrillation. Anticoagulation reduces the risk of stroke while increasing the risk of bleeding. The CHA2DS2-VASc scoring system assesses the risk of stroke, with a score of 2 or greater indicating a need for anticoagulation. The HAS-BLED score estimates the risk of bleeding. Scores of 3 or greater indicate high risk. Warfarin, dabigatran, factor Xa inhibitors (e.g., rivaroxaban, apixaban, edoxaban), and aspirin are options for stroke prevention. Selection of therapy should be individualized based on risks and potential benefits, cost, and patient preference. Left atrial appendage obliteration is an option for reducing stroke risk. Two implantable devices used to occlude the appendage, the Watchman and the Amplatzer Cardiac Plug, appear to be as effective as warfarin in preventing stroke, but they are invasive. Another percutaneous approach to occlusion, wherein the left atrium is closed off using the Lariat, is also available, but data on its long-term effectiveness and safety are still limited. Surgical treatments for atrial fibrillation are reserved for patients who are undergoing cardiac surgery for other reasons.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Gutierrez C,Blanchard DGsubject
Has Abstractpub_date
2016-09-15 00:00:00pages
442-52issue
6eissn
0002-838Xissn
1532-0650pii
d12735journal_volume
94pub_type
杂志文章abstract：:Group B streptococci and Escherichia coli are the most frequently isolated etiologic agents in neonatal septicemia. Neonatal infection that is caused by Pseudomonas aeruginosa is usually late in onset, nosocomial in origin and epidemic in pattern. However, P. aeruginosa must be considered in all neonatal infections, r...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
abstract：:Gait disorders in the elderly are common and in most cases cannot be treated medically or surgically. Therefore, treatment often relies on ambulatory devices such as canes, crutches, and walkers. Before selecting a device, the patient should be evaluated to define whether one or both upper extremities are required to ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-04-15 00:00:00
abstract：:Analgesic and sedative needs depend on the type of procedure, the child's age and the degree of cooperation from the child and parents. Local anesthesia, which may be administered subcutaneously or in topical gel form, generally is sufficient for common procedures such as lumbar puncture and laceration repair. Frequen...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-02-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,病人教育讲义
doi：
更新日期：2015-10-15 00:00:00
abstract：:Group B streptococcus (GBS) is a leading cause of morbidity and mortality among newborns. Universal screening for GBS among women at 35 to 37 weeks of gestation is more effective than administration of intrapartum antibiotics based on risk factors. Lower vaginal and rectal cultures for GBS are collected at 35 to 37 we...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-03-01 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
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-10-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1999-10-01 00:00:00
abstract：:Given that nearly one-half of pregnancies are unintended, preconception care should be considered an integral part of primary care for women of reproductive age. Common issues in preconception care include family planning, achieving a healthy body weight, screening and treatment for infectious diseases, updating appro...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2013-10-15 00:00:00
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journal_title：American family physician
pub_type： 指南,杂志文章,评审
doi：
更新日期：1990-12-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1983-02-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1992-02-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2018-01-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2018-06-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2020-07-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-07-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2016-05-15 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
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1978-10-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1991-12-01 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：
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1988-06-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-02-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2016-04-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-03-01 00:00:00
abstract：:Prompt defibrillation with lower energy levels (200 joules) initially is now recommended. Epinephrine is effective when instilled intratracheally and remains the treatment of choice for restoring cardiac rhythm. Enthusiasm for isoproterenol and calcium chloride has waned. Sodium bicarbonate and atropine are now used m...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-02-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2018-10-01 00:00:00
