Abstract：
:Gas, bloating, and belching are associated with a variety of conditions but are most commonly caused by functional gastrointestinal disorders. These disorders are characterized by disordered motility and visceral hypersensitivity that are often worsened by psychological distress. An organized approach to the evaluation of symptoms fosters trusting therapeutic relationships. Patients can be reliably diagnosed without exhaustive testing and can be classified as having gastric bloating, small bowel bloating, bloating with constipation, or belching disorders. Functional dyspepsia, irritable bowel syndrome, and chronic idiopathic constipation are the most common causes of these disorders. For presumed functional dyspepsia, noninvasive testing for Helicobacter pylori and eradication of confirmed infection (i.e., test and treat) are more cost-effective than endoscopy. Patients with symptoms of irritable bowel syndrome should be tested for celiac disease. Patients with chronic constipation should have a rectal examination to evaluate for dyssynergic defecation. Empiric therapy is a reasonable initial approach to functional gastrointestinal disorders, including acid suppression with proton pump inhibitors for functional dyspepsia, antispasmodics for irritable bowel syndrome, and osmotic laxatives and increased fiber for chronic idiopathic constipation. Nonceliac sensitivities to gluten and other food components are increasingly recognized, but highly restrictive exclusion diets have insufficient evidence to support their routine use except in confirmed celiac disease.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Wilkinson JM,Cozine EW,Loftus CGsubject
Has Abstractpub_date
2019-03-01 00:00:00pages
301-309issue
5eissn
0002-838Xissn
1532-0650pii
d13921journal_volume
99pub_type
杂志文章abstract：:Wide complex tachycardias are cardiac rhythm disorders with three or more consecutive beats, rates exceeding 100 beats per minute and a QRS duration of 120 msec (0.12 second) or greater. The width of the QRS complex should be verified in a number of leads, since the QRS complex often appears mistakenly narrower (i.e.,...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1996-10-01 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
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更新日期：2020-07-15 00:00:00
abstract：:Many normal children have heart murmurs, but most children do not have heart disease. An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonar...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-08-01 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：:The best condoms are made of latex, are lubricated and coated with a spermicide, and have a reservoir tip. Condoms can protect against conception and sexually transmitted diseases, including acquired immunodeficiency syndrome. When condoms are used properly and in combination with vaginal spermicidal foam, the contrac...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-06-01 00:00:00
abstract：:Herpes zoster ("shingles") is usually a benign, self-limited disease. However, it can be debilitating or even fatal. The potentially serious complications of ocular involvement or postherpetic neuralgia and the confusing therapeutic regimens that are often advocated make this a complicated subject. Dissemination is mo...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1983-12-01 00:00:00
abstract：:Despite an 80 to 90 percent success rate in removing common bile duct stones, this technique has yet to receive universal acceptance in the United States. Originally developed for retained or newly formed common bile duct stones in patients with previous cholecystectomy, the procedure is now also used to remove common...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-03-01 00:00:00
abstract：:Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications and poor outcomes following these injuries. Radiography (commonly anteroposterior, true lateral, and oblique views) is required in the evaluation of ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-04-15 00:00:00
abstract：:Hidradenitis suppurativa is a chronic folliculitis affecting intertriginous areas. Onset generally occurs in young adulthood to middle adulthood (18 to 39 years of age). Females and blacks are more than twice as likely to be affected. Additional risk factors include family history, smoking, and obesity. Hidradenitis s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2019-11-01 00:00:00
abstract：:Adverse effects of hormonal contraceptives usually diminish with continued use of the same method. Often, physi- cians only need to reassure patients that these symptoms will likely resolve within three to five months. Long-acting injectable depot medroxyprogesterone acetate is the only hormonal contraceptive that is ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2010-12-15 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
abstract：:Adverse publicity about nursing homes increases the anguish of many people as they face the decision of placing a loved one in a nursing home. It is true that there are shortcomings in some nursing homes: poorly trained staff, unesthetic environment, little privacy, few activities and loss of identity. Nevertheless, i...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-04-01 00:00:00
abstract：:Careful examination of a fresh, properly collected urine specimen can indicate the presence of urinary tract disease or uncover unsuspected local or systemic pathology. Urinalysis also can lead to a more complete understanding of a systemic disorder or can assure both the patient and the physician that urinary tract d...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-01-01 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：:Contrast sensitivity vision testing is the new technology in visual screening. Easy to administer and quick to perform, contrast sensitivity vision testing appears to be cost-effective for use by family physicians. It is a more sensitive indicator of ocular disease than traditional Snellen acuity testing and may detec...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1992-02-01 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：:Growth plate or physeal injuries are classified according to the zones of the physis that are affected and the disruption of bony structure. All physeal injuries should be reduced anatomically, particularly when an articular surface is involved. Inability to restore normal configuration can result in malunion, incongr...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-06-01 00:00:00
abstract：:Acute diarrhea in adults is a common problem encountered by family physicians. The most common etiology is viral gastroenteritis, a self-limited disease. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. A history and physical examination evaluating for ri...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2014-02-01 00:00:00
abstract：:If current trends continue, U.S. health insurance costs will consume the average household's annual income by 2025. As health care becomes unaffordable for most people in the United States, it will be necessary to implement innovative models to move the system in a more equitable and sustainable direction. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2005-11-15 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：:Burns are the second most common cause of death in childhood. More than half of pediatric burns are partial-thickness scald burns; the majority occur in the kitchen. Generally, minor burns may be treated on an outpatient basis, while moderate burns are treated in a community hospital. Children with major burns should ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-10-01 00:00:00
abstract：:Endometriosis is a progressive disease affecting 5 to 10 percent of women. It can cause dyspareunia, dysmenorrhea, low back pain and infertility. A definitive diagnosis can be made only by means of laparoscopy. Medical treatment designed to interfere with ovulation generally provides effective pain relief, but the rec...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-10-15 00:00:00
abstract：:Many patients expect to undergo screening tests for cancer. In evaluating screening procedures, physicians must take into account the known effects of lead time, length and screening biases, all of which can result in an overestimation of the benefits of screening. The gold standard by which a screening test is evalua...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-02-01 00:00:00
abstract：:More women, men and children receive medical care each month in the offices of primary care physicians than any other professional setting. There is an urgent need for health policies that encourage further innovation and implementation ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2001-09-15 00:00:00
abstract：:For many years, there were no guidelines for evaluating patients with chronic neck pain. However, in the past 15 years, considerable research has led to recommendations regarding whiplash-associated disorders. This article summarizes the American College of Radiology Appropriateness Criteria for chronic neck pain. Ima...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2010-10-15 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-10-01 00:00:00
abstract：:Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is characterized by cessation of previously ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2019-07-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-06-01 00:00:00
abstract：:Schirmer's test is a simple, semiquantitative test of tear production. It is based on the physical tendency of a fluid to travel along a strip of porous material by capillary action due to surface tension. Sterile strips, standardized and prepackaged, are available from local scientific supply houses. The low cost and...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
abstract：:Defined as three hours of crying per day occurring more than three days in any one week, colic affects 10 to 20 percent of infants during the first three to four months of life. Food allergy, parental attitude, flatulence, maternal medication and parental smoking have been implicated. Dietary modification, pharmacothe...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-09-01 00:00:00
