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. Frequently used local anesthetics in children include buffered lidocaine, the eutectic mixture of lidocaine and prilocaine and the combination of tetracaine, adrenaline and cocaine. To reduce the potential for systemic absorption and toxicity, anesthetics should not be applied on or near mucosal areas. To minimize drug interactions, only a single sedating drug should be used, with dosage limits defined and never exceeded. If sedation is necessary, continuous pulse oximetry, a resuscitation cart and personnel trained in sedative drug use and advanced airway management must be available. Because of its therapeutic index and low toxicity, chloral hydrate has long been a popular sedative-hypnotic drug. Midazolam may be considered when amnesia is desired.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Sectish TCsubject
Has Abstractpub_date
1997-02-15 00:00:00pages
909-16issue
3eissn
0002-838Xissn
1532-0650journal_volume
55pub_type
杂志文章,评审abstract::AIDS dementia complex is a major source of disability for many AIDS patients. Less commonly, the spinal cord or peripheral nerves are affected by HIV infection. Physicians working with AIDS patients must differentiate these manifestations from those caused by the infectious, neoplastic and vascular complications. ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract::Genetic testing may be applied in a variety of clinical situations, including preconception counseling, prenatal diagnosis and postnatal determination of genetic predisposition to disease. The family physician needs to become familiar with the full range of genetic testing possibilities in all phases of the human life...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00
abstract::The rapidity with which heparin anticoagulation is achieved is essential to a positive clinical outcome in patients with deep venous thrombosis or pulmonary embolus. However, adequate anticoagulation is frequently not achieved, either as a result of dosing regimens that do not take heparin kinetics into account or bec...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1996-12-01 00:00:00
abstract::Rational use of psychoactive drugs in frail elderly patients requires an understanding of the physiologic changes produced by aging and chronic disease. Other drugs being used and the patient's nutritional status and lifestyle also must be considered. Affective disorders and thought disorders may be effectively treate...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract::Hydrofluoric acid is widely used in both industrial and household settings. The acid may cause insidious burns that can be very destructive. If the burns are not treated appropriately, the continued action of the free fluoride ion leads to liquefaction necrosis of the affected soft tissues, bony erosion and, ultimatel...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::Traveler's diarrhea is the most common health problem in persons who visit developing countries. Dietary precautions are the mainstay of prevention. Since bacteria are responsible for 50 to 80 percent of cases of traveler's diarrhea, antibiotics are the drugs of choice for empiric therapy. Because bacteria are becomin...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract::Oral administration of xanthine compounds represents the first line of therapy in most patients with asthma. Establishment and maintenance of a therapeutic blood level of the medication requires regular dosgae. Oral sympathomimetic agents with predominantly beta-2 adrenergic activity, if tolerated, are often useful ad...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::Although the role of digoxin therapy has been the subject of debate, the drug is generally accepted as effective in the treatment of heart failure due to systolic dysfunction and as therapy for atrial fibrillation and supraventricular tachyarrhythmias. Serum digoxin concentrations are commonly used to gauge patient re...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-08-01 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::Poisoning is a common cause of morbidity and mortality in the United States, with several million episodes reported annually. Acute medication poisonings account for nearly one half of all poisonings reported in the United States and should be considered in persons with an acute change in mental status. The initial ap...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2010-02-01 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::Proper suturing technique is essential for obtaining good cosmetic results and avoiding infection, scarring and poor wound healing. Techniques that must be mastered include good eversion of skin edges, avoiding suture marks, maintaining uniform tensile strength along the skin edges and precise approximation of skin ed...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-11-01 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::Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times per month in less than a year shou...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2016-04-15 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::Allergies may cause gastrointestinal symptoms such as diarrhea, vomiting and pain, dermatologic manifestations, asthma and rhinitis. The most common offender among the foodstuffs is milk. Elimination diets are designed not only to remove the offending food but to identify it and to prevent new sensitizations. Canker s...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1975-02-01 00:00:00
abstract::Successful long-term weight loss maintenance can be achieved by various means. A combination of dietary and physical activity interventions, along with one or more behavioral approaches, has proven successful in some persons, as documented by the National Weight Control Registry, but is limited by adherence to a consi...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2010-09-15 00:00:00
abstract::Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic cr...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2015-01-01 00:00:00
abstract::Use of complementary and alternative medicine has increased over the past decade. A variety of studies have suggested that this use is greater in persons with symptoms or diagnoses of anxiety and depression. Data support the effectiveness of some popular herbal remedies and dietary supplements; in some of these produc...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2007-08-15 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::Atrial fibrillation is associated with potentially life-threatening strokes. Anticoagulation with warfarin or aspirin reduces the risk of embolic events in patients with chronic atrial fibrillation and mitral valve stenosis or other underlying heart disease. In patients with acute onset of atrial fibrillation, anticoa...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Several effective and inexpensive over-the-counter treatments are available for minor but troubling foot problems. In most cases, one week of therapy with topical terbinafine is effective for interdigital tinea pedis. Treatment of plantar warts with 17 percent salicylic acid with lactic acid in a collodion base is as ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2001-09-01 00:00:00
abstract::Celiac disease is a genetic, immunologically mediated small bowel enteropathy that causes malabsorption. The immune inflammatory response to gluten frequently causes damage to many other tissues of the body. The condition is frequently underdiagnosed because of its protean presentations. New prevalence data indicate t...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-03-01 00:00:00
abstract::Frostbite can cause loss of life and limbs. Proper treatment and follow-up care are essential in reducing morbidity and mortality. Management of the frostbite patient consists of three stages. Initial care includes protection of the extremity from trauma or partial thawing. The second stage consists of rapid rewarming...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract::Some skin conditions, such as blistering diseases, guttate and pustular psoriasis, exfoliative erythroderma, reactive erythemas and acute contact dermatitis have an acute onset and require prompt intervention. Acute vesicular or weeping dermatoses are best treated with cool, wet compresses and topical lotions, whereas...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Zidovudine, the first widely used antiretroviral agent, prevents replication of the human immunodeficiency virus (HIV) by inhibiting reverse transcriptase. Its use in patients with acquired immunodeficiency syndrome slows progression of the disease and prolongs survival. Zidovudine also significantly reduces the rate ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1990-08-01 00:00:00
abstract::Use of performance-enhancing supplements occurs at all levels of sports, from professional athletes to junior high school students. Although some supplements do enhance athletic performance, many have no proven benefits and have serious adverse effects. Anabolic steroids and ephedrine have life-threatening adverse eff...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2008-11-01 00:00:00
abstract::More than 100,000 children are born in the U.S. each year with major congenital defects or genetic disorders, with or without mental retardation. Advances in prenatal diagnosis have now made it possible to detect an increasing number of these disorders in utero. Carrier detection is advised prior to pregnancy, rather ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::The clinical course is highly variable. The chance of recurrence is about 60 percent. Patients are infectious when lesions are present and, to a lesser extent, when asymptomatic virus shedding occurs. The chain of transmission can be difficult to ascertain. Transmission to the neonate is the most feared complication. ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::Primary closure of intraoral wounds can be done up to 24 hours after the injury. A mucosal seal decreases the possibility of infection and allows the wound to heal more rapidly and less painfully than a wound left open to heal by secondary intention. Defects of the lips must be closed with exact alignment of the vermi...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00