Abstract：
:Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be considered in the differential diagnosis. History and examination, including anoscopy, are usually sufficient for diagnosing these conditions, although additional testing is needed in some situations. The primary treatment for hemorrhoids is fiber supplementation. Patients who do not improve and those with large high-grade hemorrhoids should be referred for surgery. Acutely thrombosed external hemorrhoids should be excised. Perianal pruritus should be treated with hygienic measures, barrier emollients, and low-dose topical corticosteroids. Capsaicin cream and tacrolimus ointment are effective for recalcitrant cases. Treatment of acute anal fissures with pain and bleeding involves adequate fluid and fiber intake. Chronic anal fissures should be treated with topical nitrates or calcium channel blockers, with surgery for patients who do not respond to medical management. Patients with functional rectal pain should be treated with warm baths, fiber supplementation, and biofeedback. Patients with superficial perianal abscesses not involving the sphincter should undergo office-based drainage; patients with more extensive abscesses or possible fistulas should be referred for surgery. Condylomata can be managed with topical medicines, excision, or destruction. Patients with rectal prolapse should be referred for surgical evaluation. Biofeedback is a first-line treatment for fecal incontinence, but antidiarrheal agents are useful if diarrhea is involved, and fiber and laxatives may be used if impaction is present. Colostomy can help improve quality of life for patients with severe fecal incontinence.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Cohee MW,Hurff A,Gazewood JDsubject
Has Abstractpub_date
2020-01-01 00:00:00pages
24-33issue
1eissn
0002-838Xissn
1532-0650pii
d14560journal_volume
101pub_type
杂志文章,评审abstract：:Fulguration of polyps, rectal biopsy and the Barron method of removing hemorrhoids require no anesthesia. Anal fissures, warts, small fistulas and hemorrhoids can be removed with a minimal amount of anesthesia. Pilonidal cysts or abscesses can also be incised and drained in this manner. Extensive fistulas, unusually l...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-03-01 00:00:00
abstract：:Grief and depression present similarly in patients who are dying. Conventional symptoms (e.g., frequent crying, weight loss, thoughts of death) used to assess for depression in these patients may be imprecise because these symptoms are also present in preparatory grief and as a part of the normal dying process. Prepar...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2002-03-01 00:00:00
abstract：:Coronary angioplasty is an accepted method of revascularization in selected patients with coronary artery disease. Immediately after a successful angioplasty, initial management concentrates on the detection and treatment of coronary artery spasm and acute vessel closure, should these complications occur. Once the pat...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1990-01-01 00:00:00
abstract：:Serotonin syndrome is a potentially life-threatening complication of psychopharmacologic drug therapy. The syndrome is produced most often by the concurrent use of two or more drugs that increase brainstem serotonin activity and is often unrecognized because of the varied and nonspecific nature of its symptomatology. ...
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：:Middle ear fluid is a common problem in children. Eustachian tube dysfunction has been considered the key to the pathogenesis of this disorder, but new studies show that other factors may be operative. Inflammation appears to play a significant role in high-viscosity effusion, and these effusions may be related to acu...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1978-04-01 00:00:00
abstract：:Cystic masses of the neck may represent thyroid, parathyroid, thyroglossal duct or branchial cleft cysts. Analysis of the cyst fluid may establish the etiology. Elevated levels of parathyroid hormone can be found in parathyroid cysts without concomitant hyperparathyroidism. A high concentration of cholesterol without ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-07-01 00:00:00
abstract：:Heart failure is associated with high rates of morbidity and mortality. Because heart failure is difficult to diagnose accurately on the basis of the history and physical examination alone, It is vital that clinical evaluation such as echocardiography be used to confirm the diagnosis. In addition, it is important to i...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:Vacuum extractors have replaced forceps for many situations in which assistance is required to achieve vaginal delivery. Compared with metal-cup vacuum extractors, soft-cup devices are easier to use and cause fewer neonatal scalp injuries; however, they detach more frequently. Vacuum extractors can cause neonatal inju...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-09-15 00:00:00
abstract：:Peripartum depression affects up to one in seven women and is associated with significant maternal and neonatal morbidity if untreated. A history of depression is the strongest risk factor for developing peripartum depression. The U.S. Preventive Services Task Force recommends screening pregnant and postpartum women f...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2016-05-15 00:00:00
abstract：:Constipation is a common childhood condition, estimated to occur in 5 to 10 percent of children. In most cases, the cause is functional. However, constipation may occasionally indicate a significant organic disorder, which can usually be determined by a thorough history and physical examination. Constipation that is p...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1996-08-01 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：:Breast milk is universally recommended as the preferred source of infant nutrition, in part because of its superior nutrient and immunologic properties. Successful breast feeding requires nursing on demand, prevention of sore nipples and convenient access to medical advice. For mothers relying on bottle feeding, cow's...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:Inguinal and femoral hernias are the most common conditions for which primary care physicians refer patients for surgical management. Hernias usually present as swelling accompanied by pain or a dragging sensation in the groin. Most hernias can be diagnosed based on the history and clinical examination, but ultrasonog...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-01-01 00:00:00
abstract：:Acute pancreatitis is a clinical syndrome characterized by midepigastric pain, nausea and vomiting. Numerous etiologies have been linked with this entity, principally alcoholism and biliary disease. Once the clinical suspicion of pancreatitis is confirmed, supportive therapy with intravenous hydration and close observ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-08-01 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：:Diet is the single most significant risk factor for disability and premature death. Patients and physicians often have difficulty staying abreast of diet trends, many of which focus primarily on weight loss rather than nutrition and health. Recommending an eating style can help patients make positive change. Dietary p...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2018-06-01 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：:Pharmacologic agents that attenuate the influence of the renin-angiotensin-aldosterone system are known to reduce systemic arterial blood pressure through vasodilatory action and enhanced renal clearance of sodium and water. Angiotensin-converting enzyme inhibitors are known to antagonize the renin-angiotensin-aldoste...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-02-01 00:00:00
abstract：:The records of 1,381 patients with gonorrhea were examined by the Massachusetts Department of Public Health to determine the efficacy of their treatment schedules. Urethritis, cervicitis and pharyngitis were treated with 4.8 million u. of aqueous procaine penicillin G intramuscularly, without probenecid. Cure rates we...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-05-01 00:00:00
abstract：:Ganglioneuroblastoma, although a rare neoplasm, is one of the most common causes of posterior mediastinal masses in children. This tumor occurs in children from one to 10 years of age. With intrathoracic involvement, the tumor may remain asymptomatic until it is large. The case reported illustrates a typical presentat...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:Pretibial myxedema is a localized dermopathy seen in patients with past or present hyperthyroidism. Massive intradermal deposition of mucin (acid mucopolysaccharide) produces the classic indurated nodules or plaques on the anterior lower legs. Most patients have elevated levels of LATS in their serum; however, this ap...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-05-01 00:00:00
abstract：:Infertility is generally defined as the inability to conceive after one year of unprotected, adequately timed intercourse. Causes of infertility include ovulatory dysfunction, tubal factors, peritoneal factors and uterine factors, as well as male factors that are the sole or contributing causes of infertility in up to...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-09-01 00:00:00
abstract：:Caring for the problem drinker in the perioperative period is a challenging task. If alcohol abuse is suspected, a careful assessment is indicated before surgery is performed. Both the CAGE and SMAST questionnaires are good screening tools for alcoholism. Preoperative evaluation of alcohol-dependent patients should in...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1995-12-01 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：:A herpes zoster infection in patients with lymphoma has been associated with subsequent metastatic disease involving the spinal cord and vertebrae of the affected dermatome segment. This correlation can be used in planning radiation therapy to avert neurologic complications secondary to spinal cord involvement. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1980-08-01 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：: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：:Determining the cause of metabolic acidosis with a high anion gap may present a diagnostic challenge. Possible causes include ketoacidosis, certain toxic ingestions, renal failure and lactic acidosis. Many of these entities present with nausea, vomiting and changes in mental status; however, there are specific hallmar...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-04-01 00:00:00
abstract：:Multiple sclerosis, an idiopathic inflammatory disease of the central nervous system, is characterized pathologically by demyelination and subsequent axonal degeneration. The disease commonly presents in young adults and affects twice as many women as men. Common presenting symptoms include numbness, weakness, visual ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-11-15 00:00:00
abstract：:Industrial carbon tetrachloride is used in the synthesis of chlorofluorocarbons and chlorinated solvents. Although both production and use of carbon tetrachloride are declining, industrial and hazardous waste sites remain as sources of exposure. Workers using carbon tetrachloride or products that contain it are at hig...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1992-10-01 00:00:00
