Abstract:
:Atrial fibrillation, a common cardiac arrhythmia, is now recognized as a powerful risk factor for stroke. Previously, atrial fibrillation was thought to predispose persons to stroke only in the presence of rheumatic heart disease with mitral stenosis. The significant impact of nonvalvular atrial fibrillation on stroke incidence, recurrence and mortality was not fully appreciated. A series of clinical trials have confirmed that a five-fold increase in stroke incidence occurs in patients with atrial fibrillation, and that warfarin anticoagulation is efficacious in stroke prevention. This anticoagulation benefit was achieved with an acceptably low risk of serious hemorrhage.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Wolf PA,Singer DEsubject
Has Abstractpub_date
1997-12-01 00:00:00pages
2242-50issue
9eissn
0002-838Xissn
1532-0650journal_volume
56pub_type
杂志文章,评审abstract::Persons with mental retardation sometimes exhibit behaviors that are difficult to control. Use of neuroleptic medications may be limited by side effects or ineffectiveness. Beta blockers such as propranolol and metoprolol have been shown to decrease aggressive and impulsive behaviors in some patients with mental retar...
journal_title:American family physician
pub_type: 指南,杂志文章,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::Cultures of the urine, throat and genitalia account for 90 percent of the cultures performed in an outpatient setting. The presence of a urinary tract infection, Group A beta-hemolytic streptococci or Neisseria gonorrhoeae can be ascertained easily, quickly, accurately and inexpensively in an office laboratory. Only a...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::Natural supplements are widely used in the United States and, while claims of their therapeutic effects abound, medical research does not always support their effectiveness. St. John's wort acts as a weak selective serotonin reuptake inhibitor with fewer side effects. S-Adenosylmethionine (SAMe) has enough of an antid...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-09-01 00:00:00
abstract::The family physician is in a unique position to care for the total needs of the patient. Suggestion therapy and clinical hypnosis are helpful in managing the psychologic aspects of disease in all age groups beyond five years, and are well within the purview of family physicians. Learning these techniques can enhance t...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1981-06-01 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::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::Medical problems associated with prematurity are frequently complex, and a multidisciplinary approach is often required. Some common problems include the following: (1) anemia, which can be reduced by iron supplementation, (2) cerebral palsy or mental retardation as a result of intraventricular hemorrhage or periventr...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-15 00:00:00
abstract::Low-molecular-weight heparin is a relatively recent addition to the list of therapies for prophylaxis and treatment of deep venous thrombosis (DVT). As a prophylactic, low-molecular-weight heparin is as effective as standard heparin or warfarin and does not require monitoring of the activated partial thromboplastin ti...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-03-15 00:00:00
abstract::An educational dialog founded on open communication between clinician and patient is necessary for a successful partnership in asthma care. Educating patients in self-management of asthma has become a major challenge in primary care practice. The process should begin at the time of diagnosis and should be integrated i...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1997-07-01 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::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::Down syndrome is caused by triplicate material of chromosome 21. The syndrome has a variable physical expression, but congenital cardiac defects, transient myelodysplasia of the newborn and duodenal atresia are highly specific for this chromosomal disorder. Routine health maintenance is important because infants and c...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-15 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::Streptomycin is still the treatment of choice for tularemia and plague, and is effective in a few other diseases. Neomycin is used primarily as a topical agent. The other aminoglycoside antibiotics are indicated in serious infections caused by the gram-negative enterobacteria and, except for kanamycin, are also effect...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract::House calls can still serve many functions in the overall care of the patient. By improving the relationship between physician and patient, providing the physician with important information that can only be gained from a home visit and allowing the physician to remain active in the care of the homebound patient, hous...
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::Pneumocystis carinii pneumonia is a life-threatening complication of diseases and therapies associated with immunosuppression. Approximately 80 percent of patients with acquired immunodeficiency syndrome will develop pneumocystis pneumonia. Diagnosis is important, because effective therapy is available. In most cases,...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1991-08-01 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::Spinal cord compression from metastatic cancer is a medical emergency. Prompt intervention affords the best chance for successful recovery, while delay may result in devastating neurologic impairment. In the appropriate clinical setting, emergency myelography should be done to confirm the diagnosis of metastatic disea...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::Prompt diagnosis and treatment of infectious arthritis can help prevent significant morbidity and mortality. The acute onset of monoarticular joint pain, erythema, heat, and immobility should raise suspicion of sepsis. Constitutional symptoms such as fever, chills, and rigors are poorly sensitive for septic arthritis....
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2011-09-15 00:00:00
abstract::Although local anesthesia usually is used in surgical procedures, field or nerve blocks can provide more effective anesthesia in some situations. In a field block, local anesthetic is infiltrated around the border of the surgical field, leaving the operative area undisturbed. In field blocks, epinephrine may be added ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2004-02-01 00:00:00
abstract::Common anorectal disorders can produce one or more of the following symptoms: pain, protrusion, pruritus, bleeding or discharge. The cause may be cryptitis, anal fissure, hemorrhoids, anorectal abscess, fistula in ano, neoplasm, condylomata acuminata, pilonidal cyst or inflammatory bowel disease. Each disorder is sugg...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1980-10-01 00:00:00
abstract::Delayed hypersensitivity skin tests, when properly planned and performed, are both practical and sensitive in determining the status of cell-mediated immunity. They can be diagnostic of specific exposure, such as tuberculosis, or they can rule out anergy. Pitfalls include poor selection of antigens, inappropriate appl...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::So many topical antifungal agents have been introduced that it has become very difficult to select the proper agent for a given infection. Nonspecific agents have been available for many years, and they are still effective in many situations. These agents include Whitfield's ointment, Castellani paint, gentian violet,...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract::Atypical moles can be distinguished visually by clinical features of size greater than 6 mm in diameter, color variegation, indistinct borders, and textured surface. All patients who have atypical moles should be counselled about sun avoidance, screening of family members, and regular skin checks at least once per yea...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2008-09-15 00:00:00
abstract::Skin laceration repair is an important skill in family medicine. Sutures, tissue adhesives, staples, and skin-closure tapes are options in the outpatient setting. Physicians should be familiar with various suturing techniques, including simple, running, and half-buried mattress (corner) sutures. Although suturing is t...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2008-10-15 00:00:00
abstract::Hypothyroidism can often be misdiagnosed as psychiatric illness. The hypothyroid patient may present with depression, an organic mental disorder, apathy and/or frank psychosis (usually with paranoid symptoms). Psychiatric manifestations of the endocrinopathy will abate with thyroid hormone replacement therapy, unless ...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract::Ischemic heart disease is one of the most common disorders managed by family physicians. Stratifying patients according to risk is important early in the course of the disease to identify patients who require invasive (percutaneous or surgical) treatment. Physical examination, clinical history, noninvasive tests and a...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-12-01 00:00:00
abstract::Benign pulmonary neoplasms are relatively uncommon. The symptoms vary, depending on the location of the tumor. Specific diagnosis can be a time-consuming process and requires an orderly plan. Polytomography or computed tomographic scan, bronchoscopy, percutaneous biopsy or thoracotomy may be required. Tissue diagnosis...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
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::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 diagn...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2020-01-01 00:00:00