Abstract：
:Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to associated conditions, such as blood loss, or related to decreased oxygen-carrying capacity, such as weakness, fatigue, and shortness of breath. Causes of anemia in older adults include nutritional deficiency, chronic kidney disease, chronic inflammation, and occult blood loss from gastrointestinal malignancy, although in many patients the etiology is unknown. The evaluation includes a detailed history and physical examination, assessment of risk factors for underlying conditions, and assessment of mean corpuscular volume. A serum ferritin level should be obtained for patients with normocytic or microcytic anemia. A low serum ferritin level in a patient with normocytic or microcytic anemia is associated with iron deficiency anemia. In older patients with suspected iron deficiency anemia, endoscopy is warranted to evaluate for gastrointestinal malignancy. Patients with an elevated serum ferritin level or macrocytic anemia should be evaluated for underlying conditions, including vitamin B12 or folate deficiency, myelodysplastic syndrome, and malignancy. Treatment is directed at the underlying cause. Symptomatic patients with serum hemoglobin levels of 8 g per dL or less may require blood transfusion. Patients with suspected iron deficiency anemia should be given a trial of oral iron replacement. Lower-dose formulations may be as effective and have a lower risk of adverse effects. Normalization of hemoglobin typically occurs by eight weeks after treatment in most patients. Parenteral iron infusion is reserved for patients who have not responded to or cannot tolerate oral iron therapy.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Lanier JB,Park JJ,Callahan RCsubject
Has Abstractpub_date
2018-10-01 00:00:00pages
437-442issue
7eissn
0002-838Xissn
1532-0650pii
d13747journal_volume
98pub_type
杂志文章,评审abstract：:More than 30% of U.S. adults report having experienced low back pain within the preceding three months. Although most low back pain is nonspecific and self-limiting, a subset of patients develop chronic low back pain, defined as persistent symptoms for longer than three months. Low back pain is categorized as nonspeci...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2015-05-15 00:00:00
abstract：:Sarcoidosis is a systemic granulomatous disease of unknown cause affecting young and middle-aged adults. Patients commonly present with bilateral hilar lymphadenopathy, pulmonary infiltrates, and ocular and skin lesions. The heart, liver,spleen, salivary glands, muscles,bones, kidneys, and central nervous system also ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-07-15 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：: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：:The incidence of skin cancer is increasing by epidemic proportions. Basal cell cancer remains the most common skin neoplasm, and simple excision is generally curative. Squamous cell cancers may be preceded by actinic keratoses-premalignant lesions that are treated with cryotherapy, excision, curettage or topical 5-flu...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-07-15 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：:Hepatitis A is a common viral illness worldwide, although the incidence in the United States has diminished in recent years as a result of extended immunization practices. Hepatitis A virus is transmitted through fecal-oral contamination, and there are occasional outbreaks through food sources. Young children are usua...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-12-01 00:00:00
abstract：:Despite the widespread use of propoxyphene products as analgesics, there is no profile of a typical abuser of propoxyphene. Propoxyphene is structurally related to methadone and has central nervous system effects similar to those of opioids. The patient with dependence needs professional help in withdrawing from propo...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-09-01 00:00:00
abstract：:This is a tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons contained within the osseofibrous tunnel of the distal radius. Multiple tendons for the abductor pollicis longus and a separate, severely narrowed sheath for the extensor pollicis brevis make nonsurgical treatment difficult at...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1979-07-01 00:00:00
abstract：:Alzheimer's disease accounts for about 60 percent of dementia cases. Misdiagnosis of the treatable dementias can have devastating results. Pseudodementia accompanying major depression and chronic cognitive dysfunction due to psychoactive drugs are among the most commonly missed diagnoses. Although cortical atrophy is ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-11-01 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：:Although often used in the medical management of anxiety, insomnia, seizures and muscle spasm, benzodiazepines lead to significant complications after continuous use. These complications include tolerance, addiction, dependence and abuse. Knowledge of the diagnostic criteria and treatment of side effects improves the ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-10-01 00:00:00
abstract：:Rheumatoid arthritis is a connective tissue disorder of unknown etiology that can involve any synovial-lined joint in the body. The most frequently involved joints are the small joints of the hands and feet, the wrists, knees and elbows, and the glenohumeral and acromioclavicular joints. The radiographic hallmarks of ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-10-01 00:00:00
abstract：:Virology has become an increasingly important field of medicine in the past decade. Many infectious diseases that were once of unknown etiology can now be linked to the specific viral pathogen. New methods for diagnosing and treating viral diseases are being developed. In addition, antiviral therapy or prophylaxis is ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-07-01 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：: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：:Status epilepticus is an increasingly recognized public health problem in the United States. Status epilepticus is associated with a high mortality rate that is largely contingent on the duration of the condition before initial treatment, the etiology of the condition, and the age of the patient. Treatment is evolving...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-08-01 00:00:00
abstract：:When first seen, the overtranquilized patient may already be in withdrawal, may have other medical problems or may be seeking psychiatric help. The patient may, however, be primarily interested in obtaining more medication. Abuse and withdrawal of sedatives, tranquilizers, narcotics or alcohol, or a combination of the...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1979-10-01 00:00:00
abstract：:Chronic pancreatitis is the progressive and permanent destruction of the pancreas resulting in exocrine and endocrine insufficiency and, often, chronic disabling pain. The etiology is multifactorial. Alcoholism plays a significant role in adults, whereas genetic and structural defects predominate in children. The aver...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2007-12-01 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
abstract：:Zidovudine is now used extensively in an effort to control infection with the human immunodeficiency virus (HIV). The drug is associated with major hematologic toxicity, especially anemia and granulocytopenia. Conservative management of hematologic toxicity includes dosage reduction or cessation of therapy, diagnosis ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1990-05-01 00:00:00
abstract：:Smell and taste disorders can be challenging to diagnose because of the large number of potential etiologies. Patients are often unable to provide a clear history of symptoms, because they frequently cannot distinguish between difficulties with smell and taste. Standardized questionnaires may be helpful in diagnosis. ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2013-12-15 00:00:00
abstract：:The herbal remedies referred to as "ginseng" are derived from the roots of several plants. One of the most commonly used and researched of the ginsengs is Panax ginseng, also called Asian or Korean ginseng. The main active components of Panax ginseng are ginsenosides, which have been shown to have a variety of benefic...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-10-15 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：:Hospitals present a variety of infectious, chemical and physical hazards to their workers. Important pathogens include AIDS, hepatitis B and rubella viruses and Mycobacterium tuberculosis. Ethylene oxide is probably the greatest chemical hazard, but anesthetic gases, antineoplastic drugs and skin irritants or sensitiz...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
abstract：:Respiratory difficulty is a common presenting complaint in the outpatient primary care setting. Because patients may first seek care by calling their physician's office, telephone triage plays a role in the early management of dyspnea. Once the patient is in the office, the initial goal of assessment is to determine t...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-11-01 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：: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：:This common fracture most frequently affects young males. In most cases, the fracture is found on initial examination. Occasionally, it is missed on the initial radiographic evaluation but becomes apparent on follow-up films. Although most scaphoid fractures respond to conservative therapy, some fail to heal. Nonunion...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-04-01 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
