American family physician最新文献_第4页

The PEER Team: Simplifying Evidence, Empowering Primary Care. 同伴团队：简化证据，增强初级保健能力。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

Michael R Kolber, Adrienne J Lindblad, Christina Korownyk

引用次数: 0

Seborrheic Dermatitis: Diagnosis and Treatment. 脂溢性皮炎：诊断和治疗。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

Nicholas M LeFevre, Kara Braudis, Lawrence S Feigenbaum

{"title":"Seborrheic Dermatitis: Diagnosis and Treatment.","authors":"Nicholas M LeFevre, Kara Braudis, Lawrence S Feigenbaum","doi":"","DOIUrl":"","url":null,"abstract":"Seborrheic dermatitis is a common, chronic relapsing skin condition that predominantly affects areas of the body that are rich in sebaceous glands. Clinically, seborrheic dermatitis presents as symmetric, poorly defined erythematous patches with yellow, oily scales and fine, superficial desquamation (flaking). In people who have darker skin, erythema may be less apparent, and postinflammatory pigmentary changes might be a presenting sign with hypopigmented, slightly scaly areas. Seborrheic dermatitis of the scalp can be effectively treated with topical over-the-counter antifungal shampoos and prescription-strength antifungal or corticosteroid solutions, foams, or oils. Thick, scaly areas can be treated with keratolytic shampoos and lotions. Seborrheic dermatitis of the face and body can be treated with over-the-counter and prescription-strength antifungal creams, over-the-counter and prescription-strength corticosteroid creams and ointments, and calcineurin inhibitor cream or ointment. Neonatal seborrheic dermatitis is common and typically self-resolves by 6 months of age. Mild cases of the scalp (cradle cap) may be treated conservatively with mineral oil to loosen scale and gentle combing. More severe cases may overlap with atopic dermatitis and can be treated with topical antifungals or topical corticosteroids.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 2","pages":"166-173"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939579","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

Provision of Quality Contraceptive Services: Updates From National Guidelines. 提供优质避孕服务：来自国家指南的更新。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

David A Klein, Chloe E Forlini, Patsy Kremsreiter

{"title":"Provision of Quality Contraceptive Services: Updates From National Guidelines.","authors":"David A Klein, Chloe E Forlini, Patsy Kremsreiter","doi":"","DOIUrl":"","url":null,"abstract":"In 2024, the Centers for Disease Control and Prevention and the US Department of Health and Human Services Office of Population Affairs updated national guidelines on provision of quality contraceptive services and sexual and reproductive health care. New recommendations systematically promote care that is person-centered and accessible for all people. Contraceptive services may be addressed through a stepwise approach in which the clinician asks about an individual's contraceptive preferences based on their needs, desires, and prior experiences and then collaboratively works with the patient to align methods with their values and preferences. The clinician should discuss all methods that can be used safely based on medical eligibility criteria regardless of method availability and defer the decision to the patient. Physical assessment includes in-office or self-reported blood pressure measurement before starting an estrogen-containing contraceptive or pelvic examination when inserting an intrauterine device. If it is reasonably certain that the patient is not pregnant, any contraceptive may be started immediately; otherwise, a nonintrauterine bridge method may be initiated with follow-up pregnancy testing. To reduce barriers, a 1-year supply of short-acting or injectable contraceptives may be prescribed, and telehealth may be incorporated. The Centers for Disease Control and Prevention supports advance provision of emergency contraceptives. New recommendations include pain control during intrauterine device insertion, management of bleeding irregularities related to contraception, updated eligibility criteria (eg, venous thromboembolism, kidney disease), and new methods (eg, progestin-only formulations). Expanded sexual and reproductive health care services, such as screening for cervical cancer or sexually transmitted infections, should be offered, but patient acceptance of these services is not required during contraception management.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 2","pages":"176-186"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939516","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

Hyperthyroidism: Diagnosis and Treatment. 甲状腺机能亢进：诊断和治疗。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

Anne Mounsey, Ryan Paulus, Wesley Roten

{"title":"Hyperthyroidism: Diagnosis and Treatment.","authors":"Anne Mounsey, Ryan Paulus, Wesley Roten","doi":"","DOIUrl":"","url":null,"abstract":"Hyperthyroidism is characterized by overproduction of thyroid hormone in the thyroid gland and affects 1.3% of adults in the United States. Thyrotoxicosis is a state of thyroid hormone excess and may be caused by hyperthyroidism, thyroiditis, or exogenous administration. The most common symptoms of hyperthyroidism are weakness, palpitations, weight loss, and heat intolerance, and the most common signs are a palpable goiter, tachycardia, muscle weakness, and tremor. A low thyroid-stimulating hormone (thyrotropin) level has a high sensitivity and specificity for diagnosing thyrotoxicosis. The most common cause of hyperthyroidism is the autoimmune condition Graves disease, typically diagnosed by the presence of thyroid eye disease, which is pathognomonic, or thyrotropin receptor antibodies. Other causes of hyperthyroidism are toxic multinodular goiter, toxic adenoma, and thyroiditis, which can be differentiated by the pattern of uptake on a radioactive iodine scan. Thionamides (most commonly methimazole) typically induce remission of Graves disease and can control hyperthyroidism caused by multinodular goiter and toxic adenoma. Radioactive iodine resolves hyperthyroidism in more than 90% of patients with Graves disease and toxic multinodular goiter, with hypothyroidism developing in most patients 1 year after treatment. Thyroidectomy is the treatment of choice for patients with compressive symptoms from an obstructive goiter.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 2","pages":"146-152"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939385","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

Heart Failure With Reduced Ejection Fraction: Medical Management. 心力衰竭伴射血分数降低：医疗管理。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

Robert L Gauer, Adam Rifaat, Ashley M Foulkrod

{"title":"Heart Failure With Reduced Ejection Fraction: Medical Management.","authors":"Robert L Gauer, Adam Rifaat, Ashley M Foulkrod","doi":"","DOIUrl":"","url":null,"abstract":"The management of heart failure with reduced ejection fraction (HFrEF) has advanced in recent decades, and patients are surviving longer. The goals of HFrEF treatment are to reduce mortality, hospitalizations, and the severity of symptoms while improving functional status and quality of life. Treatments shown to reduce morbidity and mortality in patients with HFrEF, known as guideline-directed medical therapy, include renin-angiotensin system/neprilysin inhibitors, beta blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors. Guidelines recommend initiation with target dose titration within 6 to 12 weeks of diagnosis. Secondary therapies such as digoxin, hydralazine and isosorbide dinitrate, ivabradine, and vericiguat are indicated in certain patients with persistent or worsening symptoms. Guideline-directed medical therapy may require dosage adjustment due to adverse effects such as hypotension, hyperkalemia, and worsening kidney function. Intravenous iron replacement is recommended in patients with iron deficiency to improve functional status and quality of life. Device and interventional therapies may be indicated in those with prolonged QRS duration to decrease the risk of sudden cardiac death. Point-of-care ultrasonography can help diagnose heart failure and assess effectiveness of diuretic therapy.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 2","pages":"131-145"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939387","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

Resuscitation of Patients With Burns: Guidelines From the American Burn Association. 烧伤患者的复苏：美国烧伤协会指南。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

Michelle Nelson

引用次数: 0

Outpatient Care of the Premature Infant. 早产儿的门诊护理。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

Michael Bybel, Catherine A Delaney, Katie Coble

{"title":"Outpatient Care of the Premature Infant.","authors":"Michael Bybel, Catherine A Delaney, Katie Coble","doi":"","DOIUrl":"","url":null,"abstract":"Family physicians oversee the complex care of premature infants after discharge from the neonatal intensive care unit, taking into consideration the degree of prematurity and unique complications that can occur. Early family engagement is critical for these infants. Before hospital discharge, at least two caregivers should demonstrate the ability to appropriately feed and provide necessary care for the infant. Premature infants are at risk of hypoxic-ischemic encephalopathy, periventricular leukomalacia, retinopathy of prematurity, bronchopulmonary dysplasia, necrotizing enterocolitis, and intraventricular hemorrhage. Routine vaccination is recommended. This includes newer prevention options for respiratory syncytial virus (eg, nirsevimab [Beyfortus]) and the prenatal vaccine Abrysvo. Growth of premature infants is monitored using corrected age and may improve with use of breast milk fortifiers or enriched formulas. Premature infants are also at risk for neurodevelopmental disabilities, including cerebral palsy, intellectual disability, and vision and hearing impairment. Developmental screening using corrected age is recommended at ages 9, 18, and 30 months, with screening for autism spectrum disorder at 18 and 24 months.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 2","pages":"153-161"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939423","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

Oral and Topical Treatment of Male Partners of Women With Bacterial Vaginosis Reduces Recurrence. 口服和局部治疗女性细菌性阴道病的男性伴侣减少复发。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

Mark H Ebell

引用次数: 0

Screening and Supplementation for Iron Deficiency and Iron Deficiency Anemia During Pregnancy. 妊娠期缺铁和缺铁性贫血的筛查和补充。

IF 3.5 3区医学

American family physician Pub Date : 2025-08-01

Sheena Harris, Joseph Merfeld, Stephen Kane

引用次数: 0

Reconsidering the Harms of Delayed Prostate Cancer Screening. 重新考虑延迟前列腺癌筛查的危害。