abstract：:Effective management of life-threatening emergencies in infants and children demands a high level of technical skill. The Pediatric Advanced Life Support (PALS) provider course, developed jointly by the American Academy of Pediatrics and the American Heart Association, is highly recommended to help physicians prepare ...

journal_title：American family physician

authors： Rockney RM,Alario AJ,Lewander WJ

更新日期：1991-04-01 00:00:00

abstract：:Dorsal penile nerve block with lidocaine is safe and effective for reducing the pain associated with newborn circumcision. Administering the anesthesia adds little time or expense to the overall routine. Complications are minor, limited to local bleeding and hematoma formation. Family physicians performing circumcisio...

journal_title：American family physician

authors： Fontaine P,Toffler WL

更新日期：1991-04-01 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

authors： Dipalma J,Colon AR

更新日期：1991-03-01 00:00:00

abstract：:As effective antipsychotic pharmacotherapy has become available, patients with schizophrenia are increasingly managed in an outpatient setting by primary care physicians. Pharmacotherapy is generally effective in treating "positive," or psychotic, symptoms and lessening the risks of relapse, but ineffective in improvi...

journal_title：American family physician

authors： Martin RL

更新日期：1991-03-01 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

authors： Guthrie RA

更新日期：1991-02-01 00:00:00

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

authors： Kastner T,Burlingham K,Friedman DL

更新日期：1990-12-01 00:00:00

abstract：:Although many physicians consider constipation a trivial problem, it is one of the most frequent and chronic digestive disorders in the United States, affecting 4.53 million people and causing considerable morbidity. More than $200 million are spent for over-the-counter laxatives and untold millions of dollars are spe...

journal_title：American family physician

authors： Donatelle EP

更新日期：1990-11-01 00:00:00

abstract：:The protein-sparing modified fast is a safe and effective method for losing a large amount of weight relatively quickly. This diet should be used in combination with an exercise program, behavior modification and patient education. Caloric intake is in the range of 400 to 800 per day. Candidates for the diet should be...

journal_title：American family physician

authors： Seim HC,Rigden SR

更新日期：1990-11-01 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

authors： Husten CG,Manley MW

更新日期：1990-10-01 00:00:00

abstract：:Causes of congestive heart failure include hypertension, coronary artery disease, alcohol abuse and valvular heart disease. Two-dimensional echocardiography with Doppler examination is excellent for identifying valvular heart disease. While noninvasive screening for coronary artery disease may seem cost-effective, the...

journal_title：American family physician

authors： Vine DL

更新日期：1990-09-01 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

authors： Pepe R,Molavi A

更新日期：1990-08-01 00:00:00

abstract：:Zidovudine is now used extensively in an effort to control infection with the human immunodeficiency virus (HIV). The drug is associated with major hematologic toxicity, especially anemia and granulocytopenia. Conservative management of hematologic toxicity includes dosage reduction or cessation of therapy, diagnosis ...

journal_title：American family physician

authors： Brogan KL,Zell SC

更新日期：1990-05-01 00:00:00

abstract：:Growth hormone from human pituitary glands has been available for 30 years. Because of the scarce supply and the danger of transmitting Creutzfeldt-Jakob disease, use of the hormone was discontinued in 1984. Fortunately, synthetic growth hormone produced with recombinant DNA technology became available in 1985 and eli...

journal_title：American family physician

authors： Shulman L,Miller JL,Rose LI

更新日期：1990-05-01 00:00:00

abstract：:Synovial cell sarcoma frequently presents as a painful periarticular mass in the lower extremity of a young male patient. The mass may appear encapsulated and is calcified in approximately 50 percent of cases. Surgery is the mainstay of therapy, with radical resection often necessary to prevent local recurrence. The m...

journal_title：American family physician

authors： Scialabba FA,DeLuca SA

更新日期：1990-04-01 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

authors： Popma JJ,Dehmer GJ

更新日期：1990-01-01 00:00:00

abstract：:Magnetic resonance imaging uses powerful magnetic fields and a radiofrequency pulse to provide a diagnostic image. Physicians must identify patients with metallic internal implants, pacemakers and cochlear implants before MRI scanning to prevent serious injury. Some patients also experience severe anxiety from the con...

journal_title：American family physician

authors： DeLuca SA,Castronovo FP Jr

更新日期：1990-01-01 00:00:00

abstract：:During the past decade, continuous ambulatory peritoneal dialysis has emerged as a successful alternative to hemodialysis in the treatment of chronic renal failure. Performed continuously, peritoneal dialysis achieves total transfer comparable to hemodialysis and removes peptides faster. Studies have shown that surviv...

journal_title：American family physician

authors： Maher JF,Maher AT

更新日期：1989-11-01 00:00:00

abstract：:Although often used in the medical management of anxiety, insomnia, seizures and muscle spasm, benzodiazepines lead to significant complications after continuous use. These complications include tolerance, addiction, dependence and abuse. Knowledge of the diagnostic criteria and treatment of side effects improves the ...

journal_title：American family physician

authors： Miller NS,Gold MS

更新日期：1989-10-01 00:00:00

abstract：:Outpatient intravenous antibiotic therapy is a cost-effective modality to shorten hospital stays and provide continued care to patients with infections. The recent availability of tamper-proof pumps that can deliver multiple antibiotics on independently timed regimens will further expand the use of home intravenous an...

journal_title：American family physician

authors： Brown RB,Sands M

更新日期：1989-10-01 00:00:00

abstract：:Nephrolithiasis is a rare but important condition in pregnant women. The most common presenting complaint is flank pain. Recurrent or persistent urinary tract infections may also be due to nephrolithiasis. Ultrasound is the first-line diagnostic study, but a limited intravenous pyelogram can be obtained when indicated...

journal_title：American family physician

authors： Marlow RA

更新日期：1989-09-01 00:00:00

abstract：:The Food and Drug Administration has recommended that blood donated for transfusion in the United States be screened for antibodies to human T lymphotropic virus type I. Since seropositive donors will be referred to health care providers for advice, physicians should become familiar with HTLV-I, its modes of transmiss...

journal_title：American family physician

authors： Kaplan JE,Khabbaz RF

更新日期：1989-08-01 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

authors： Ohye RG,Altenberger EA

更新日期：1989-08-01 00:00:00

abstract：:Jellyfish stings are usually mild except those caused by species in the South Pacific. The box jellyfish can produce a severe cardiorespiratory insult. The sting of the Portuguese man-of-war is more potent than that of the common jellyfish. The Indo-Pacific area is the source of the most venomous bony fish. Many injur...

journal_title：American family physician

authors： Soppe GG

更新日期：1989-08-01 00:00:00

abstract：:Cystic masses of the neck may represent thyroid, parathyroid, thyroglossal duct or branchial cleft cysts. Analysis of the cyst fluid may establish the etiology. Elevated levels of parathyroid hormone can be found in parathyroid cysts without concomitant hyperparathyroidism. A high concentration of cholesterol without ...

journal_title：American family physician

authors： Favus LH,Kaplan EL,Schneider AB,Favus MJ

更新日期：1989-07-01 00:00:00

abstract：:Use of a diaphragm plus spermicide provides effective protection against pregnancy in motivated women and decreases the risk for some sexually transmitted diseases. Potential risks of this contraceptive method include the development of urinary tract infections and the possible teratogenic effects of nonoxynol-9, the ...

journal_title：American family physician

authors： Heaton CJ,Smith MA

更新日期：1989-05-01 00:00:00

abstract：:Determining the cause of metabolic acidosis with a high anion gap may present a diagnostic challenge. Possible causes include ketoacidosis, certain toxic ingestions, renal failure and lactic acidosis. Many of these entities present with nausea, vomiting and changes in mental status; however, there are specific hallmar...

journal_title：American family physician

authors： Hertford JA,McKenna JP,Chamovitz BN

更新日期：1989-04-01 00:00:00

abstract：:The incidence of pleural mesothelioma will probably increase into the next century. A complete occupational history should include an inquiry about asbestos exposure, especially in patients with chest pain or dyspnea. The latency period between exposure and mesothelioma is as long as 50 years. In some patients, early ...

journal_title：American family physician

authors： Davenport J

更新日期：1989-03-01 00:00:00

abstract：:Arnold-Chiari malformation is a disorder of embryologic development. In Type I, there is cerebellar displacement into the spinal canal, but hydrocephalus and syringomyelia are variable. Type II usually is manifested by severe hydrocephalus and myelomeningocele in infancy. Type I malformations may pose diagnostic chall...

journal_title：American family physician

authors： Susman J,Jones C,Wheatley D

更新日期：1989-03-01 00:00:00

abstract：:Strenuous exercise may cause menstrual abnormalities, including amenorrhea. The hypoestrogenemia that accompanies amenorrhea has been associated with a low bone mineral content and an increased incidence of stress fractures. With the resumption of menses, which usually occurs soon after female athletes decrease the in...

journal_title：American family physician

authors： Olson BR

更新日期：1989-02-01 00:00:00

abstract：:Subungual hemorrhage, onychauxis, onychogryphosis, mycotic infections, onychia and paronychia are common toenail disorders in the elderly. The many contributing factors include impaired vision, changes in gait, past foot conditions and neurovascular disease. Hyperkeratotic disorders are secondary to external or intern...

journal_title：American family physician

authors： Helfand AE

更新日期：1989-02-01 00:00:00

abstract：:Coxsackievirus B infection is common in children and young adults, usually causing mild symptoms in the gastrointestinal or upper respiratory tract. However, some patients develop pleurodynia, carditis or aseptic meningitis. This viral infection can be serious in the fetus and fatal in the newborn. Coxsackievirus B in...

journal_title：American family physician

authors： Murray BJ

更新日期：1988-11-01 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

authors： Kimmel KD,Chamberlain DH,Bostrom SG,Christman JE

更新日期：1988-11-01 00:00:00

abstract：:New beta lactams and the quinolone class of antibiotics represent major improvements in the therapy of moderate to severe infections. These newer antibiotics have an extended spectrum of antimicrobial activity, excellent pharmacokinetic properties and low toxicity. The beta lactams include carbapenems, represented by ...

journal_title：American family physician

authors： Amin NM

更新日期：1988-10-01 00:00:00

abstract：:Hearing conservation programs have not kept pace with changes in the workplace and in the work force. Heavy industry and noisy factories have yielded to quiet computers and high technology. Chemicals, self-administered or prescribed, may replace noise as a chief source of hearing loss. The aging working population and...

journal_title：American family physician

authors： Keeve JP

更新日期：1988-09-01 00:00:00

abstract：:The classic chest radiograph, showing bilateral hilar and right paratracheal adenopathy, is found in half of sarcoidosis patients. Pulmonary infiltrates are a major cause of morbidity and mortality. Extrapulmonary disease may be found in the skin, eyes, liver and heart, and in the nervous, musculoskeletal and other sy...

journal_title：American family physician

authors： Zelitch SR,Israel HL

更新日期：1988-08-01 00:00:00

abstract：:Bowenoid papulosis usually appears as small papules on the penis or vulva. Histologically, these lesions display the atypia of Bowen's disease (squamous cell carcinoma in situ). Bowenoid papulosis is now considered to be a sexually transmitted disease, probably caused by human papillomavirus type 16. Malignant transfo...

journal_title：American family physician

authors： Rogozinski TT,Janniger CK

更新日期：1988-07-01 00:00:00

abstract：:Prisoners in U.S. correctional facilities constitute a unique patient population in need of health services. Physicians who provide medical services to inmates also must interact with prison officials. Drug withdrawal, self-destructive behavior and infectious diseases, including acquired immunodeficiency syndrome, are...

journal_title：American family physician

authors： Greenberg MJ

更新日期：1988-07-01 00:00:00

abstract：:The safety of vaginal birth after cesarean (VBAC) delivery has been documented. Fetal and neonatal morbidity is not increased, and the mortality rate is less than one in 2,000 deliveries. Maternal morbidity and mortality rates for VBAC delivery are significantly lower than those for repeat cesarean section. Family phy...

journal_title：American family physician

authors： Haq CL

更新日期：1988-06-01 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

authors： Yinnon AM,Zandman-Goddard G,Moreb J,Fisch RZ,Abraham AS

更新日期：1988-06-01 00:00:00

abstract：:Treatment of eating disorders is difficult regardless of the methods employed. Pharmacologic management in anorexia nervosa and in bulimia nervosa is especially helpful when it is part of a multimodal treatment approach that includes individual, family and behavioral therapy. Care must be taken to guard against side e...

journal_title：American family physician

authors： Price WA

更新日期：1988-05-01 00:00:00