American family physician最新文献_第3页

Adding a LABA or LAMA to Current ICS Therapy for Uncontrolled Asthma. 在当前治疗不受控制的哮喘的 ICS疗法中添加 LABA 或 LAMA。

IF 3.8 3区医学

American family physician Pub Date : 2024-10-01

Kyle Jordan Fletke, Nel Trasybule

引用次数: 0

Management of Late-Term and Postterm Pregnancy. 晚期和过期妊娠管理。

IF 3.8 3区医学

American family physician Pub Date : 2024-10-01

Breanna Gawrys, Diana Trang, Whay Cheng

{"title":"Management of Late-Term and Postterm Pregnancy.","authors":"Breanna Gawrys, Diana Trang, Whay Cheng","doi":"","DOIUrl":"","url":null,"abstract":"Postterm pregnancy is defined as a pregnancy that has reached 42 weeks' gestation and late-term pregnancy includes 41 weeks' and 0 days' to 41 weeks' and 6 days' gestation. Accurate first-trimester dating is essential for determining or verifying gestational age. Ideal management of late-term and postterm pregnancy involves shared decision-making on timing of planned delivery based on risks and preferences. Starting at 42 weeks' gestation, the risks of fetal mortality, admission to the neonatal intensive care unit, and stillbirth increase exponentially. Induction of labor at 41 weeks' gestation reduces perinatal mortality and stillbirth compared with expectant management or induction starting at 42 weeks' gestation. Recent studies have shown a decrease in cesarean deliveries and hypertensive disorders of pregnancy with induction of labor in nulliparous, low-risk pregnancies beginning at 39 weeks' gestation. Induction of labor before 42 weeks' gestation decreases the risk of stillbirth, perinatal mortality, and cesarean delivery compared with expectant management. The American College of Obstetricians and Gynecologists suggests considering an elective induction of labor in low-risk, nulliparous patients starting at 39 weeks' and 0 days' gestation and recommends induction of labor in all patients by 42 weeks' gestation. The American College of Obstetricians and Gynecologists recommends antepartum monitoring of pregnancies beginning at 41 weeks' gestation to mitigate the risks of perinatal morbidity and mortality.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456076","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

Melanoma: Diagnosis and Treatment. 黑色素瘤：诊断与治疗。

IF 3.8 3区医学

American family physician Pub Date : 2024-10-01

Rebecca Lauters, Ashley Dianne Brown, Kari-Claudia Allen Harrington

{"title":"Melanoma: Diagnosis and Treatment.","authors":"Rebecca Lauters, Ashley Dianne Brown, Kari-Claudia Allen Harrington","doi":"","DOIUrl":"","url":null,"abstract":"Cutaneous malignant melanoma accounts for 5% of cancer diagnoses and is the fifth most common cancer diagnosed in the United States. Risk factors for cutaneous malignant melanoma include ultraviolet radiation from sun exposure, Fitzpatrick skin type I or II, a history of dysplastic nevi, indoor tanning, older age, and a personal or family history of melanoma. The U.S. Preventive Services Task Force recommends counseling with patient education on minimizing early ultraviolet radiation exposure, including the use of protective clothing and sunscreen, especially for patients 6 months to 24 years of age. Tools to aid in the diagnosis of cutaneous malignant melanoma and the decision to biopsy include the ABCDE mnemonic, ugly duckling sign, and dermoscopy. Any suspicious pigmented lesion should be biopsied. Biopsy with a deep scoop shave, saucerization, punch biopsy, or full-thickness excision is preferred to ensure the entire lesion is removed to obtain an accurate measurement of Breslow depth. Breslow depth is important in staging, treatment consideration, and prognosis. Wide local excision by a dermatologist or surgeon with appropriate margins is the primary treatment of choice. Thin lesions with a Breslow depth of less than 0.8 mm usually do not need further treatment after wide local excision and have an excellent prognosis. Lesions with a Breslow depth greater than 0.8 mm may need further diagnostic tests or procedures, including sentinel lymph node biopsy, complete lymph node dissection, gene mutation analysis, and possible treatment with systemic immunotherapy. Use of systemic immunotherapies has improved the prognosis for advanced melanoma (stages III and IV), with 5-year survival rates of 74.8% and 35%, respectively, compared with 62.6% and 16% from 1975 to 2011 before immunotherapy was available.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456077","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

Practice Alert: CDC Guidelines on Doxycycline for STI Postexposure Prophylaxis. 实践快讯：美国疾病预防控制中心关于暴露后预防性传播疾病的强力霉素指南。

IF 3.8 3区医学

American family physician Pub Date : 2024-10-01

Doug Campos-Outcalt

引用次数: 0

Atopic Dermatitis: Updated Guidelines From the AAAAI/ACAAI Joint Task Force on Practice Parameters. 特应性皮炎：AAAAI/ACAAI 实践参数联合工作组的最新指南。

IF 3.8 3区医学

American family physician Pub Date : 2024-10-01

Winfred Frazier, Lynda Schneider, Derek K Chu

引用次数: 0

Injections of the Hand and Wrist: Part II. Carpal Tunnel Syndrome, Ganglion Cyst, Intersection Syndrome, Triangular Fibrocartilage Complex Injury, and de Quervain Tenosynovitis. 手部和腕部注射：第二部分。腕管综合征、神经节囊肿、交叉综合征、三角纤维软骨复合体损伤和杜氏腱鞘炎。

IF 3.8 3区医学

American family physician Pub Date : 2024-10-01

George G A Pujalte, Rock Vomer, Neil Shah

{"title":"Injections of the Hand and Wrist: Part II. Carpal Tunnel Syndrome, Ganglion Cyst, Intersection Syndrome, Triangular Fibrocartilage Complex Injury, and de Quervain Tenosynovitis.","authors":"George G A Pujalte, Rock Vomer, Neil Shah","doi":"","DOIUrl":"","url":null,"abstract":"Family physicians are well-positioned to provide injections for patients who have wrist pain, especially when initial treatments such as nonsteroidal anti-inflammatory drugs and rest fail. Although corticosteroid injections can offer pain relief, possible risks (e.g., infection, cartilage damage, skin depigmentation) should be discussed. Techniques and procedures for injections vary. Studies have shown significant improvement in carpal tunnel syndrome severity over 12 weeks using ultrasound-guided injections compared with landmark-guided injections. Ganglion cyst aspiration can be helpful for patients with significant symptoms, although more than 50% of ganglion cysts may recur within a year. Corticosteroid injections of ganglion cysts do not appear to produce additional benefits to aspiration. Intersection syndrome is an overuse injury; management involves rest, adjustment of activities, use of braces, nonsteroidal anti-inflammatory drugs, and physical or occupational therapy. For symptoms not improved by these methods, an ultrasound-guided glucocorticoid injection may be administered. Treatment options for a triangular fibrocartilage complex injury include immobilization, kinesio taping, relative rest, and analgesics; corticosteroid injection may relieve acute inflammatory pain. De Quervain tenosynovitis is treated conservatively with palpation- or ultrasound-guided corticosteroid injection, splinting, occupational therapy, and activity modification.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456074","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

Psychological Therapy for Older Adults in Long-Term Care Who Have Depression. 为长期护理机构中患有抑郁症的老年人提供心理治疗。

IF 3.8 3区医学

American family physician Pub Date : 2024-10-01

Russell S Blackwelder, Victoria A Sullivan

引用次数: 0

RSV, Testosterone Therapy, Prenatal Medication Risk, Obstructive Sialadenitis, Conjunctivitis, Gout. RSV、睾酮疗法、产前用药风险、阻塞性咽峡炎、结膜炎、痛风。

IF 3.8 3区医学

American family physician Pub Date : 2024-10-01

引用次数: 0

Treatment Options for Morton Neuroma. 莫顿神经瘤的治疗方案

IF 3.8 3区医学