Abstract：
:While abdominoperineal resection with permanent colostomy is still required for most distal [corrected] rectal cancers, sphincter-saving local treatment by means of local excision, electrocoagulation or endocavitary contact radiation can be used for some highly selected distal tumors. Local treatment avoids a permanent colostomy and is associated with much lower morbidity and mortality rates than abdominoperineal resection. Strict criteria for patient selection are essential to successful local treatment. Optimal candidates include patients exhibiting the following features of rectal cancer: a distal rectal cancer less than 8 cm from the anal verge; a tumor with a diameter of 3 cm or less; a tumor that is well to moderately well differentiated histologically, and a tumor that is limited to the bowel wall. Preoperative studies such as transrectal ultrasonography enhance the accuracy of preoperative staging. In properly selected patients, the results of local treatment are equivalent to those of abdominoperineal resection of comparable tumors. Close follow-up is essential, and tumor recurrence can be treated for cure by abdominoperineal resection.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Pidala MJ,Oliver GCsubject
Has Abstractpub_date
1997-10-15 00:00:00pages
1622-8issue
6eissn
0002-838Xissn
1532-0650journal_volume
56pub_type
杂志文章,评审abstract：:Improved hand function after injury or disease is achieved by increasing joint mobility, muscle strength and coordination, while reducing edema and pain. Static and dynamic orthoses assist in correcting deformities, provide strengthening activities and maintain a functional hand position. Many orthotic appliances are ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-08-01 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：: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：:Immediate attention must be given to the respiratory system of the heroin abuser; then he should be given naloxone HCl. Search for evidence of use of additional drugs, which may compound problems. Pulmonary edema, aspiration pneumonia and pulmonary embolization are the most common complications. Infections, particular...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-02-01 00:00:00
abstract：:Knowledge about diabetes mellitus and its management has steadily increased since the discovery of insulin in 1921. Specific therapies for both type I and type II diabetes have resulted in greater normalization of plasma glucose levels. Information obtained from self-monitoring of blood glucose levels has given physic...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-02-01 00:00:00
abstract：:Primary immunodeficiencies include a variety of disorders that render patients more susceptible to infections. If left untreated, these infections may be fatal. The disorders constitute a spectrum of more than 80 innate defects in the body's immune system. Primary immunodeficiencies generally are considered to be rela...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2003-11-15 00:00:00
abstract：:Atrial fibrillation is the most common arrhythmia in patients visiting a primary care practice. Although many patients with atrial fibrillation experience relief of symptoms with control of the heart rate, some patients require restoration of sinus rhythm. External direct current (DC) cardioversion is the most effecti...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1998-08-01 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：:In the guideline developed by the American College of Cardiology and the American Heart Association, the management of suspected unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI) has four components: initial evaluation and management; hospital care; coronary revascularization; and hospital...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-08-01 00:00:00
abstract：:Chronic bladder catheterization is the treatment of last resort for incontinence. Urinary infection is a normal state in these patients. It should be treated only when there are signs of systemic illness. Accumulations of encrusted debris cause urinary leakage. This problem can be lessened by using silicone catheters ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-09-01 00:00:00
abstract：:Hypertension is the most common chronic condition treated by family physicians. Elevated blood pressure is associated with an increased risk of heart failure, myocardial infarction, cerebrovascular disease, and death. Treatment of hypertension reduces the risk of these events. Several lifestyle modifications are assoc...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2015-02-01 00:00:00
abstract：:Idiopathic facial (Bell's) palsy is an affliction commonly seen and managed by the family physician. Although the prognosis is generally good, steroids and cromolyn sodium have each been advocated to enhance full recovery. Surgical exploration of the nerve is indicated when the diagnosis is unclear. Various measures m...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1989-08-01 00:00:00
abstract：:Women experience depression twice as often as men. The diagnostic criteria for depression are the same for both sexes, but women with depression more frequently experience guilt, anxiety, increased appetite and sleep, weight gain and comorbid eating disorders. Women may achieve higher plasma concentrations of antidepr...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-07-01 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：:Although testicular cancer accounts for only 1 percent of all tumors in males, it is the most common malignancy in males between 15 and 34 years of age. Cryptorchidism is the most significant risk factor for testicular cancer, increasing the risk up to 11-fold. A painless testicular mass is the classic presentation fo...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1999-05-01 00:00:00
abstract：:Patients with variceal or other gastrointestinal hemorrhage require aggressive resuscitative measures and early diagnosis for optimal therapy. A number of nonsurgical endoscopic modalities, such as laser therapy, sclerotherapy, heater probe and electrocoagulation (monopolar or bipolar), are available to arrest and som...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-10-01 00:00:00
abstract：:Genital herpes affects over 30 million persons in the United States. Genital herpes has three distinct presenting syndromes, depending on the patient's immune status with regard to the herpes simplex virus. Current diagnostic strategy relies on clinical findings and the selective use of viral culture. Acyclovir is the...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1995-01-01 00:00:00
abstract：:The diagnosis of sleep apnea should be considered when a patient complains of snoring and excessive daytime somnolence. Middle-aged obese men are at particular risk, although apnea can occur in women and the elderly, as well as in persons who are not obese. An overnight polysomnographic sleep study can reveal the degr...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1994-02-01 00:00:00
abstract：:The acute and chronic effects of alcohol on bone, muscle and peripheral nerves are not well appreciated. Bone complications include traumatic fractures, osteoporosis and osteonecrosis. In muscle, a sustained bout of heavy drinking may cause rhabdomyolysis, while chronic alcohol abuse may produce proximal myopathy. In ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocatio...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-03-01 00:00:00
abstract：:The ability to properly apply casts and splints is a technical skill easily mastered with practice and an understanding of basic principles. The initial approach to casting and splinting requires a thorough assessment of the injured extremity for proper diagnosis. Once the need for immobilization is ascertained, casti...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-01-01 00:00:00
abstract：:Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, an...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2014-09-15 00:00:00
abstract：:Persons whose experienced or expressed gender differs from their sex assigned at birth may identify as transgender. Transgender and gender-diverse persons may have gender dysphoria (i.e., distress related to this incongruence) and often face substantial health care disparities and barriers to care. Gender identity is ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2018-12-01 00:00:00
abstract：:Carpal tunnel syndrome is the most common focal entrapment syndrome. Forceful repetitive activity and vibration may be important workplace risk factors for carpal tunnel syndrome. Although systematic study has suggested that carpal tunnel syndrome is work-related, no clear "dose-response" curve has been found between ...
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：:Sudden cardiac death is a major public health problem, affecting 500,000 patients in the United States annually. An implantable cardioverter-defibrillator (ICD) can terminate malignant ventricular arrhythmias and has been shown to improve survival in high-risk populations. Although sudden cardiac death is a heterogene...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2010-12-01 00:00:00
abstract：:Group B streptococci and Escherichia coli are the most frequently isolated etiologic agents in neonatal septicemia. Neonatal infection that is caused by Pseudomonas aeruginosa is usually late in onset, nosocomial in origin and epidemic in pattern. However, P. aeruginosa must be considered in all neonatal infections, r...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1986-03-01 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：: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：:The hallmark of agoraphobia is the spontaneous panic attack, a reaction of extreme fearfulness and impending doom with cardiorespiratory symptoms. The end result can be a patient who is housebound. The basic therapeutic principle is confrontation with the avoided object or activity. Controlled clinical experiments dem...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-01-01 00:00:00
abstract：:The status of the fibula is an index of the severity of injury. Open tibial fracture with associated fractured fibula is more likely to develop complications. Antibiotics should be started promptly. Judicious debridement is essential but bone fragments should be left whenever possible. When there is any question about...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1975-01-01 00:00:00
