American family physician最新文献_第2页

Blood Pressure Targets for Hypertension in People With Chronic Kidney Disease. 慢性肾病患者高血压的血压目标

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Tara Devaraj, Karl T Clebak, Zakary S Newberry

引用次数: 0

Inappropriate Use of Oral Antiplatelet Drugs. 口服抗血小板药物使用不当。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Alan Roth, Andy Lazris, Helen Haskell, John James

引用次数: 0

Evaluation of Short and Tall Stature in Children. 儿童矮小与高大身材的评价。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Rebecca Caro, Paul Savel, Paul Isaiah Moss

{"title":"Evaluation of Short and Tall Stature in Children.","authors":"Rebecca Caro, Paul Savel, Paul Isaiah Moss","doi":"","DOIUrl":"","url":null,"abstract":"Short stature is defined as height that is more than 2 standard deviations below the mean height for age; tall stature is defined as height that is more than 2 standard deviations above the mean height for age. The initial evaluation of short and tall stature should include obtaining a comprehensive history, performing a physical examination, plotting serial height measurements on the Centers for Disease Control and Prevention or World Health Organization growth charts, calculating estimated adult height and comparing it with midparental height, determining bone age, and laboratory testing in select patients. The most common causes of short stature are constitutional delay of growth and puberty, familial short stature, and idiopathic short stature. Pathologic etiologies are less common and include nutritional deficiencies, systemic disease, growth hormone deficiencies, and genetic abnormalities. Common causes of tall stature include constitutional advancement of growth, familial tall stature, and obesity. Uncommon etiologies of tall stature include precocious puberty, Marfan syndrome, and Klinefelter syndrome. Referral to pediatric endocrinology is indicated in patients with idiopathic short stature for management of select genetic and metabolic conditions and for interventions to correct growth.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"111 6","pages":"532-542"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nocturia: Evaluation and Management. 夜尿症：评估与管理。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Feven W Getaneh, Rachael D Sussman, Cheryl B Iglesia

{"title":"Nocturia: Evaluation and Management.","authors":"Feven W Getaneh, Rachael D Sussman, Cheryl B Iglesia","doi":"","DOIUrl":"","url":null,"abstract":"Nocturia (ie, awakening to void one or more times per night) is common in adults, with increasing prevalence in older age. Nocturia is associated with increased risk of falls and fractures, cognitive impairment, and depressed mood. In general, mechanisms for nocturia fall into one of four categories: increased nighttime urine production, decreased storage ability, incomplete bladder emptying, or primary sleep disorder. Although screening for nocturia currently is not recommended, patients reporting bothersome symptoms should be evaluated and treated. Initial workup includes assessing urinary symptoms, fluid intake, and comorbidities. Using validated nocturia questionnaires and frequency-volume charts (bladder diaries) can aid in diagnosis. A urinalysis should be performed for all patients. Lifestyle modifications and treatment of underlying comorbidities are first-line therapies for nocturia. Limitation of fluid intake, especially in the evening; addressing timing of diuretic intake; and sleep hygiene are recommended. Pharmacotherapy should be reserved for those unresponsive to lifestyle modifications and adequate treatment of comorbidities. Pharmacotherapy should target the etiology of nocturia, such as nocturnal polyuria, overactive bladder, benign prostatic hyperplasia, and genitourinary syndrome of menopause. Patients with refractory symptoms should be referred for further treatment (eg, onabotulinumtoxinA injection, sacral neuromodulation, surgical management of benign prostatic hyperplasia).","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"111 6","pages":"515-523B"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute Monoarthritis: Diagnosis in Adults. 急性单关节炎：成人诊断。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Jeremy Swisher, Zachary Sitton, Kimberly Burbank, Chris Nelson

{"title":"Acute Monoarthritis: Diagnosis in Adults.","authors":"Jeremy Swisher, Zachary Sitton, Kimberly Burbank, Chris Nelson","doi":"","DOIUrl":"","url":null,"abstract":"Acute monoarthritis, characterized by pain or swelling in a single joint, is a diagnostic challenge in the primary care setting. Intra-articular conditions typically manifest with reduced active and passive range of motion, whereas patients with periarticular conditions such as tendinitis or bursitis often maintain passive range of motion. When evaluating a patient with acute monoarthritis, it is essential to remember that many polyarthritic processes can initially present in a single joint. A broad differential diagnosis for monoarthritis should include septic arthritis, osteoarthritis, gout, trauma, and Lyme arthritis. Of these, septic arthritis is the most urgent and requires prompt intervention. Bacterial culture of the synovial fluid is the most accurate diagnostic test for a septic joint. However, diagnostic accuracy can be increased in the short term by evaluating additional markers such as synovial white blood cell count, synovial lactate, and serum biomarkers. These supplementary tests aid in early decision-making while awaiting bacterial culture results. Osteoarthritis is often clinically diagnosed and may be confirmed with radiography. Gout, the most prevalent crystalline arthropathy, can be diagnosed using specialized calculators, ultrasonography, and dual energy computed tomography. Gout is typically most painful at night or in the early morning. Ultrasonography is useful for identifying effusions in less-visible joints and facilitating precise joint aspiration.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"111 6","pages":"497-506"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endometrial Cancer: Rapid Evidence Review. 子宫内膜癌：快速证据回顾。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Carl Bryce, Renee Gazda, Hadass Fuerst

{"title":"Endometrial Cancer: Rapid Evidence Review.","authors":"Carl Bryce, Renee Gazda, Hadass Fuerst","doi":"","DOIUrl":"","url":null,"abstract":"Incidence and mortality rates associated with endometrial cancer are increasing in the United States. Risk factors include obesity, unopposed estrogen states, estrogen-producing tumors, younger age at menarche, nulliparity, late menopause, and tamoxifen use. There are no recommendations for endometrial cancer screening in individuals at average risk. Abnormal uterine bleeding, especially postmenopausal bleeding, is the most common symptom. Patients who present with postmenopausal bleeding should be evaluated with pelvic ultrasonography or endometrial biopsy. The diagnosis of endometrial cancer is made with endometrial biopsy, most often with Pipelle endometrial sampling. Dilation and curettage is recommended if an adequate sample cannot be obtained, the diagnosis is unclear, or a focal lesion such as an endometrial polyp or mass is present. Treatment of early-stage disease is primarily surgical. Radiation therapy decreases recurrence rates but not survival rates in early-stage cancers. Chemotherapy, hormone therapy, and biologic therapy are used to treat advanced endometrial cancer, and clinical trials are ongoing. Complementary medicine therapies can improve quality of life and survival rates in patients undergoing treatment. Patients should be referred to a gynecologic oncologist; early-stage treatment is associated with longer survival rates. Endometrial cancer survivors should undergo periodic surveillance that includes a history and physical examination.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"111 6","pages":"526-531"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Educational Interventions Improve Adverse Drug Reaction Reporting. 教育干预提高药物不良反应报告。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Elizabeth Chiang, Rashmi Rode, Arindam Sarkar

引用次数: 0

Invasive Strategy Is No Better Than Conservative Strategy for Older Patients With NSTEMI. 对于老年非stemi患者，侵入性治疗并不比保守治疗好。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Mark H Ebell

引用次数: 0

Zoledronate Given Twice 5 Years Apart to Women With Normal Bone Density or Osteopenia Reduces Fracture Risk. 对于骨密度正常或骨质减少的女性，间隔5年给予两次唑来膦酸钠可降低骨折风险。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Mark H Ebell

引用次数: 0

Long-Term Opioid Therapy for Nonterminal Pain. 长期阿片类药物治疗非终末期疼痛。

IF 3.8 3区医学

American family physician Pub Date : 2025-06-01

Kento Sonoda, Mako Wakabayashi

{"title":"Long-Term Opioid Therapy for Nonterminal Pain.","authors":"Kento Sonoda, Mako Wakabayashi","doi":"","DOIUrl":"","url":null,"abstract":"Chronic pain, defined as persistent pain lasting longer than 12 weeks, affects approximately 20% of US adults and often results in mental and social burdens. In general, nonopioid therapies are preferred for chronic nonterminal pain, and opioid therapy should not be considered a first-line treatment modality. Health disparities in pain management affect vulnerable populations, including racially and ethnically marginalized groups and those with cognitive impairment. Clinicians first must acknowledge the existing health inequities and the stigma surrounding chronic pain and then need to provide culturally tailored pain management. Opioid use should be limited to circumstances wherein benefits outweigh risks, such as in cases of nonterminal pain refractory to multiple other interventions. Harms of opioid therapy include constipation, depression, hormonal dysregulation, opioid-induced hyperalgesia, and overdose. Given the high prevalence of behavioral health disorders in individuals with chronic pain, it is crucial to address mental health in conjunction with pain management. Before prescribing opioids, it is essential to review risk factors for opioid use disorder and respiratory depression and to set realistic goals for improving function. Ongoing monitoring should include assessments of functional progress, urine drug testing, and review of data from the state prescription drug monitoring program. Buprenorphine is an effective medication for chronic pain management and may be safer than full opioid agonists, especially in individuals at risk for opioid use disorder, opioid misuse, or overdose.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"111 6","pages":"508-514"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0