Abstract:
:Portal hypertension is a frequent consequence of liver disease, especially alcoholic cirrhosis. Unabated elevations in portal pressure may presage an esophageal variceal hemorrhage. Propranolol or isosorbide therapy is effective in the prophylaxis of variceal bleeding. In patients with acute variceal hemorrhage, endoscopic sclerotherapy or ligation is the best initial intervention. Stapled esophageal transection is often effective when endoscopic management fails. Surgical shunts have a lower associated mortality rate when they are performed electively and involve partial shunting of hepatic blood flow. Transjugular intrahepatic portosystemic shunts are indicated as a salvage procedure or as a bridge to liver transplantation. Ultimately, liver transplantation offers the best survival rate.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Trevillyan J,Carroll PJsubject
Has Abstractpub_date
1997-04-01 00:00:00pages
1851-8, 1861-2issue
5eissn
0002-838Xissn
1532-0650journal_volume
55pub_type
杂志文章,评审abstract::Patients who have been or may have been bitten by a snake should receive prompt and careful clinical and laboratory evaluation. Fang marks, pain and swelling are characteristic of pit viper envenomation. Although no therapy is universally accepted, a number of treatment plans appear to be effective. If envenomation ha...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-07-01 00:00:00
abstract::Nitrates are frequently found in vegetables and ground water. Nitrate levels in ground water have increased over the past two decades because of the heightened use of nitrogenous fertilizers. Following ingestion, nitrates are converted to nitrites by fecal organisms. Nitrites are absorbed and form methemoglobin, which...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-07-01 00:00:00
abstract::Recognition of the allergic individual is facilitated by an awareness of certain characteristic actions and various facial lesions which may be clues to other allergic problems. A gaping expression, clearing of the throat and rubbing or mashing of the eyes and nose may indicate significant rhinitis. Dark circles and b...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract::The Centers for Disease Control and Prevention has redefined the threshold of concern for low-level lead toxicity, reducing it from a blood lead level of 25 micrograms per dL (1.21 mumol per L) to a blood lead level of 10 micrograms per dL (0.48 mumol per L), and has recommended universal screening of young children. ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-12-01 00:00:00
abstract::Tic disorders and Tourette's syndrome are conditions that primary care physicians are likely to encounter. Up to 20 percent of children have at least a transient tic disorder at some point. Once believed to be rare, Tourette's syndrome is now known to be a more common disorder that represents the most complex and seve...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-04-15 00:00:00
abstract::Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. Gastroesophageal reflux disease (GERD) ...
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::Peptic ulcer disease is strongly associated with infection by Helicobacter pylori, a spiral-shaped, flagellated organism found predominantly in the gastric antrum. More than 90 percent of duodenal ulcers and adenocarcinomas of the distal stomach are associated with H. pylori infection. Eradication of the organism effe...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-06-01 00:00:00
abstract::Primary carcinoma of the fallopian tube is a rare disease and has traditionally been managed in the same manner as epithelial ovarian cancer. However, unlike ovarian cancer, fallopian tube cancer is not routinely suspected and treatment may be delayed. The clinical presentations of seven cases of fallopian tube cancer...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1988-11-01 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
abstract::Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease pain and improve function. Acet...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2011-06-01 00:00:00
abstract::Parkinson's disease is a common neurodegenerative disorder that can cause significant disability and decreased quality of life. The cardinal physical signs of the disease are distal resting tremor, rigidity, bradykinesia, and asymmetric onset. Levodopa is the primary treatment for Parkinson's disease; however, its lon...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-12-15 00:00:00
abstract::Because the prevalence of urinary incontinence increases with age, a working knowledge of the diagnosis and treatment of the various types of urinary incontinence is fundamental to the care of women. As the population of the United States ages, primary care physicians can expect to see an increasing number of patients...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract::Labor is induced if pregnancy must be completed before the onset of spontaneous labor, usually for reasons of maternal illness, fetal distress or, most commonly, prolonged pregnancy. Although various mechanical methods are available for labor induction, pharmacologic methods are more commonly used. Oxytocin is the sta...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 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::The family physician often provides the first and only medical intervention for fingertip injuries. Proper diagnosis and management of fingertip injuries are vital to maintaining proper function of the hand and preventing permanent disability. A subungual hematoma is a painful condition that involves bleeding beneath ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2001-05-15 00:00:00
abstract::Chronic tendon injuries present unique management challenges. The assumption that these injuries result from ongoing inflammation has caused physicians to rely on treatments demonstrated to be ineffective in the long term. Nonsteroidal anti-inflammatory drugs should be limited in the treatment of these injuries. Corti...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2013-04-01 00:00:00
abstract::Two large kindreds manifesting the "cancer family syndrome" have been studied. Genetic and biologic studies reveal markers which have important implications for cancer detection, control and prevention. Valuable markers may be found in the major histocompatibility system, HL-A. The presence of carcinoembryonic antigen...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract::The Papanicolaou smear is a well-established component of preventive health protocols for women. The purpose of this screening tool is to detect precursor lesions of invasive cervical carcinoma; however, the natural progression of these lesions is unclear, and it currently is not possible to determine which of the man...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract::Hematuria, symptomatic and incidental, that involves more than three red blood cells per high-power field on two of three properly collected urinalysis specimens warrants some type of imaging to evaluate the upper tracts. Traditionally, excretory urography or the intravenous pyelogram has been the mainstay of the hema...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2008-08-01 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::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::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::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 atria...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2016-09-15 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::Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for hip fracture. Patients may present with acute respiratory symptoms, including tachypnea, tachycardia and rales. Chest radiographs and clinical and laboratory findings alone cannot provide a firm diagnosis. A completely nor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::Transient organic causes of impotence include alcohol consumption, drug use or inflammatory genital disease. Many diagnoses of organic impotence, with diabetes, for example, have been premature and have resulted in iatrogenic, psychogenic impotence. After a stroke, heart attack or major surgery, depression may cause i...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1978-02-01 00:00:00
abstract::Upper extremity bursae are injured through a number of processes, including overuse, hemorrhage, crystal deposition, autoimmune diseases and infection. These injuries may be disabling and can pose significant diagnostic and therapeutic challenges for the clinician. Treatment of the most common forms is directed at pai...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-11-01 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
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
abstract::Clinically significant gastroesophageal reflux occurs in one in 500 infants. Symptoms resolve in 60 to 80 percent of infants by 18 months of age. Thickened formula and position changes are often recommended. Medication and surgical intervention may be needed in refractory cases. ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00