American family physician最新文献_第6页

Gastroesophageal Reflux in Infants and Children: Diagnosis and Treatment. 婴儿和儿童胃食管反流：诊断和治疗。

IF 3.8 3区医学

American family physician Pub Date : 2025-01-01

Brian Antono, Andrea Dotson

{"title":"Gastroesophageal Reflux in Infants and Children: Diagnosis and Treatment.","authors":"Brian Antono, Andrea Dotson","doi":"","DOIUrl":"","url":null,"abstract":"Gastroesophageal reflux is a common physiologic event in infants in which gastric contents pass from the stomach into the esophagus. Gastroesophageal reflux may be asymptomatic or cause regurgitation or \"spit up.\" This occurs daily in approximately 40% of infants. Symptoms often begin before 8 weeks of life, peak at approximately 4 months of age, and usually resolve by 1 year. The prevalence of gastroesophageal reflux is 2% to 8% in children and adolescents. Family physicians should reassure parents that gastroesophageal reflux is self-limited, not pathologic, and does not warrant routine testing or pharmacologic treatment. Gastroesophageal reflux may progress to gastroesophageal reflux disease when the reflux leads to troublesome symptoms (eg, recurrent postprandial expressions of distress or pain, coughing, choking) or causes complications, such as esophageal stricture or reflux esophagitis. Diagnostic tests, such as endoscopy, barium study, multichannel intraluminal impedance, and pH monitoring, may be used when there is diagnostic uncertainty or alarm symptoms are present (eg, bilious or projectile vomiting, hematemesis). Conservative treatments for gastroesophageal reflux disease in infants include the use of thickening agents or extensively hydrolyzed or amino acid-based formulas in formula-fed infants or maternal elimination of dairy for infants who are fed breast milk. Infants and children who do not improve with conservative measures may require pharmacologic treatment, including an empiric trial of acid-suppression therapy for 4 to 8 weeks.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"111 1","pages":"62-72"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998710","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

Psychosocial Interventions to Reduce Alcohol Use During Pregnancy. 减少怀孕期间饮酒的社会心理干预。

IF 3.8 3区医学

American family physician Pub Date : 2025-01-01

Alyssa Bruehlman, Elizabeth Salisbury-Afshar

引用次数: 0

Antibiotic Treatment for Uncomplicated Acute Appendicitis in Children. 儿童无并发症急性阑尾炎的抗生素治疗。

IF 3.8 3区医学

American family physician Pub Date : 2025-01-01

Timothy Mott, Carrie Gray

引用次数: 0

Dysuria: Evaluation and Differential Diagnosis in Adults. 成人排尿困难的评估与鉴别诊断。

IF 3.8 3区医学

American family physician Pub Date : 2025-01-01

Ariel Hoffman, Katelyn A Dolezal, Rob Powell

{"title":"Dysuria: Evaluation and Differential Diagnosis in Adults.","authors":"Ariel Hoffman, Katelyn A Dolezal, Rob Powell","doi":"","DOIUrl":"","url":null,"abstract":"Dysuria, a feeling of pain or discomfort during urination, is often caused by urinary tract infection but can also be due to sexually transmitted infection, bladder irritants, skin lesions, and some chronic pain conditions. History is most often useful for finding signs of sexually transmitted infection, complicated infections, lower urinary symptoms in males, and noninfectious causes. Most patients presenting with dysuria should have a urinalysis performed. Urine culture should be performed for infection to guide appropriate antibiotic use, especially for recurrent or suspected complicated urinary tract infection. Vaginal discharge decreases the likelihood of urinary tract infection, and other causes of dysuria, including cervicitis, should be investigated. If a patient has persistent urethritis or cervicitis with negative initial testing, Mycoplasma genitalium testing is recommended. Clinical decision rules may increase the accuracy of diagnosis with and without laboratory analysis. Evaluation and treatment of dysuria through a virtual encounter without laboratory testing may increase recurrent symptoms and antibiotic courses. Persistent symptoms after initial evaluation and treatment require further workup for infectious and noninfectious causes.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"111 1","pages":"37-46"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998706","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

Gepirone (Exxua) for the Treatment of Major Depressive Disorder. Gepirone （Exxua）治疗重度抑郁症。

IF 3.8 3区医学

American family physician Pub Date : 2025-01-01

Stephen R Foster, Kodi M Liddell

引用次数: 0

Painful Finger Lesion. 手指病变疼痛。

IF 3.8 3区医学

American family physician Pub Date : 2024-12-01

Allison Vogl, Carlie Hoffman, Emeil Shenouda

引用次数: 0

Painless Black Toe. 无痛黑脚趾。