abstract：:The term "shoulder instability" constitutes a spectrum of disorders that includes dislocation, subluxation and laxity. Anterior instability is the most common form of glenohumeral instability and may be associated with nerve injury. The diagnosis of anterior, posterior or multidirectional instability is based on a tho...

journal_title：American family physician

authors： Mahaffey BL,Smith PA

更新日期：1999-05-15 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

authors： Kinkade S

更新日期：1999-05-01 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

authors： Bagheri MM,Kerbeshian J,Burd L

更新日期：1999-04-15 00:00:00

abstract：:Gout is a disease resulting from the deposition of urate crystals caused by the overproduction or underexcretion of uric acid. The disease is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute and chronic arthritis, tophi, interstitial renal disease and uric a...

journal_title：American family physician

authors： Pittman JR,Bross MH

更新日期：1999-04-01 00:00:00

abstract：:Urinary tract infections in children are sometimes associated with vesicoureteral reflux, which can lead to renal scarring if it remains unrecognized. Since the risk of renal scarring is greatest in infants, any child who presents with a urinary tract infection prior to toilet training should be evaluated for the pres...

journal_title：American family physician

authors： Ross JH,Kay R

更新日期：1999-03-15 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

authors： Rydberg EJ,Westfall JM,Nicholas RA

更新日期：1999-03-15 00:00:00

abstract：:The prevalence of childhood obesity in the United States has risen dramatically in the past several decades. Although 25 to 30 percent of children are affected, this condition is underdiagnosed and undertreated. Hormonal and genetic factors are rarely the cause of childhood obesity; unnecessary diagnostic evaluations ...

journal_title：American family physician

authors： Moran R

更新日期：1999-02-15 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

authors： Saenz RB

更新日期：1999-01-15 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

authors： Bax T,Sheppard BC,Crass RA

更新日期：1999-01-01 00:00:00

abstract：:Senile dementia of the Binswanger's type is a term used to describe a dementia syndrome characterized by onset in the sixth or seventh decade of life, subcortical neurologic deficits, psychiatric disorders and evidence of hypertension or systemic vascular disease. The status of senile dementia of the Binswanger's type...

journal_title：American family physician

authors： Olsen CG,Clasen ME

更新日期：1998-12-01 00:00:00

abstract：:The prognosis remains poor for patients with congestive heart failure (CHF), despite reduced mortality rates resulting from the addition of angiotensin converting enzyme inhibitors to traditional treatment regimens. Because much of the myocardial damage that occurs in patients with CHF may be related to sympathetic ac...

journal_title：American family physician

authors： Vanderhoff BT,Ruppel HM,Amsterdam PB

更新日期：1998-11-01 00:00:00

abstract：:New recommendations for the classification and diagnosis of diabetes mellitus include the preferred use of the terms "type 1" and "type 2" instead of "IDDM" and "NIDDM" to designate the two major types of diabetes mellitus; simplification of the diagnostic criteria for diabetes mellitus to two abnormal fasting plasma ...

journal_title：American family physician

authors： Mayfield J

更新日期：1998-10-15 00:00:00

abstract：:Proteinuria is a common laboratory finding in children. It can be identified as either a transient or a persistent finding and can represent a benign condition or a serious disease. A rapid but qualitative assessment of proteinuria can be made using dipstick or sulfosalicylic acid methods. More precise quantitation is...

journal_title：American family physician

authors： Loghman-Adham M

更新日期：1998-10-01 00:00:00

abstract：:Multiple chemical sensitivity (MCS) is a syndrome in which multiple symptoms reportedly occur with low-level chemical exposure. Several theories have been advanced to explain the cause of MCS, including allergy, toxic effects and neurobiologic sensitization. There is insufficient scientific evidence to confirm a relat...

journal_title：American family physician

authors： Magill MK,Suruda A

更新日期：1998-09-01 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

authors： Dell'Orfano JT,Luck JC,Wolbrette DL,Patel H,Naccarelli GV

更新日期：1998-08-01 00:00:00

abstract：:Hoarseness is the term often used by patients to describe changes in their voice quality. The causes of hoarseness are determined after obtaining a detailed medical history of the circumstances preceding the onset of hoarseness and performing a thorough physical examination. The latter may include visualization of the...

journal_title：American family physician

authors： Rosen CA,Anderson D,Murry T

更新日期：1998-06-01 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

authors： Trachtenbarg DE,Golemon TB

更新日期：1998-05-15 00:00:00

abstract：:Self-care is becoming increasingly popular among health care consumers. The availability of over-the-counter medications makes it possible for consumers to treat numerous ailments without the supervision of a health care professional. Many of the medications now available without a prescription were previously classif...

journal_title：American family physician

authors： Jacobs LR

更新日期：1998-05-01 00:00:00

abstract：:Hyperparathyroidism is a common cause of hypercalcemia. The hypercalcemia usually is discovered during a routine serum chemistry profile. Often, there has been no previous suspicion of this disorder. In most patients initially believed to be asymptomatic, previously unrecognized symptoms resolve with surgical correcti...

journal_title：American family physician

authors： Allerheiligen DA,Schoeber J,Houston RE,Mohl VK,Wildman KM

更新日期：1998-04-15 00:00:00

abstract：:Acute bronchitis is a lower respiratory tract infection that causes reversible bronchial inflammation. In up to 95 percent of cases, the cause, is viral. While antibiotics are often prescribed for patients with acute bronchitis, little evidence shows that these agents provide significant symptomatic relief or shorten ...

journal_title：American family physician

authors： Hueston WJ,Mainous AG 3rd

更新日期：1998-03-15 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

authors： Pruessner HT

更新日期：1998-03-01 00:00:00

abstract：:While screening patients for thyroid disease, physicians often find increased thyrotropin-stimulating hormone (TSH) levels in patients whose free thyroxine (T4) levels are not below normal. This state, termed "subclinical hypothyroidism," is most commonly an early stage of hypothyroidism. Although the condition may re...

journal_title：American family physician

authors： Adlin V

更新日期：1998-02-15 00:00:00

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...

journal_title：American family physician

authors： Wolf PA,Singer DE

更新日期：1997-12-01 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

authors： Salzman KL,Lillegard WA,Butcher JD

更新日期：1997-11-01 00:00:00

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 permanen...

journal_title：American family physician

authors： Pidala MJ,Oliver GC

更新日期：1997-10-15 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

authors： Engstrom JW,Aminoff MJ

更新日期：1997-10-01 00:00:00

abstract：:Abdominal aortic aneurysms occur in 5 to 7 percent of people over age 60 in the United States. An aneurysm is defined as a permanent localized dilatation of an artery, with an increase in diameter of greater than 1.5 times its normal diameter. Abdominal aortic aneurysms may be manifested by catastrophic rupture, signs...

journal_title：American family physician

authors： Santilli JD,Santilli SM

更新日期：1997-09-15 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

authors： Cauffield JS,Gums JG,Grauer K

更新日期：1997-08-01 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

authors： Stoloff SW,Janson S

更新日期：1997-07-01 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

authors： Damianos AJ,McGarrity TJ

更新日期：1997-06-01 00:00:00

abstract：:Functional constipation is the cause of fecal incontinence in 95 percent of affected children, and anatomic or neurologic causes account for up to 5 percent of cases. The history and the physical examination (with emphasis on abdominal, rectal and neurologic examinations) are most helpful in identifying organic diseas...

journal_title：American family physician

authors： Loening-Baucke V

更新日期：1997-05-01 00:00:00

abstract：:Distribution of accumulated fluid is the important element in the differentiation of peripheral edema resulting from different etiologies. Isolated upper extremity edema is rare and is usually caused by obstruction of the superior vena cava by a malignancy. The cause of unilateral edema of a lower limb can usually be ...

journal_title：American family physician

authors： Powell AA,Armstrong MA

更新日期：1997-04-01 00:00:00

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, endos...

journal_title：American family physician

authors： Trevillyan J,Carroll PJ

更新日期：1997-04-01 00:00:00

abstract：:Menière's disease may be the underlying cause of dizziness, which is a common presenting complaint. This disease is differentiated from other causes of dizziness by its classic constellation of four symptoms; dizziness characterized as episodic spinning or whirling vertigo; fluctuating, low-frequency sensorineural hea...

journal_title：American family physician

authors： Knox GW,McPherson A

更新日期：1997-03-01 00:00:00

abstract：:The incidence of work-related repetitive motion disorders has increased rapidly during the past 20 years. While it appears that psychosocial factors have contributed largely to the increasing incidence of these disorders, ergonomic factors and other medical conditions also play a role. The most common single diagnosti...

journal_title：American family physician

authors： Downs DG

更新日期：1997-03-01 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

authors： Sectish TC

更新日期：1997-02-15 00:00:00

abstract：:Early prophylaxis after exposure to human immunodeficiency virus (HIV) can reduce the risk of HIV infection 10-fold and should be recommended or offered after all parenteral exposures. The current recommendations from the Centers for Disease Control and Prevention call for the use of two nucleoside antiretroviral drug...

journal_title：American family physician

authors： Perlmutter BL,Harris BR

更新日期：1997-02-01 00:00:00

abstract：:Myocardial perfusion imaging with stress testing by exercise or pharmacologic methods and functional evaluation of the left ventricle are useful in many patients. Uses include determination of diagnosis and prognosis of patients with coronary artery disease, preoperative evaluation, management and risk stratification ...

journal_title：American family physician

authors： Butler RR Jr,Wilf LH

更新日期：1997-01-01 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

authors： Schaefer DC,Hufnagle J,Williams L

更新日期：1996-12-01 00:00:00

abstract：:In evaluating recurrent childhood infections, the physician must keep in mind the rarity of true immunodeficiency and the frequency of atopy, day care, exposure to cigarette smoke and anatomic variations as predisposing factors in recurrent childhood illnesses. Determining true immunodeficiency involves exclusion of r...

journal_title：American family physician

authors： Wheeler JG

更新日期：1996-11-15 00:00:00