American family physician最新文献_第8页

Gallstone Disease: Common Questions and Answers. 胆石症：常见问题与解答。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Hiten Patel, Jacqueline Jepsen

{"title":"Gallstone Disease: Common Questions and Answers.","authors":"Hiten Patel, Jacqueline Jepsen","doi":"","DOIUrl":"","url":null,"abstract":"In the United States, 10% to 15% of adults are affected by gallstones, and cholesterol gallstones are the most prevalent subtype. Risk factors for developing gallstone disease include female sex; older age; certain medications; and having type 2 diabetes mellitus, nonalcoholic fatty liver disease, obesity, rapid weight loss, or hemolytic anemia. Nearly 80% of gallstones are found incidentally and remain asymptomatic. When symptomatic, gallstone disease usually presents as sudden onset right upper quadrant or epigastric abdominal pain. Common complications of gallstones include cholecystitis, choledocholithiasis, gallstone pancreatitis, and ascending cholangitis. The Murphy sign is a specific physical examination finding for acute cholecystitis. Ultrasonography is the initial imaging choice for detecting gallstones and acute cholecystitis. A hepatobiliary iminodiacetic acid (HIDA) scan can be used to evaluate for cholecystitis in patients with negative or equivocal ultrasound findings. Magnetic resonance cholangiopancreatography (MRCP) is an accurate, noninvasive diagnostic test to identify choledocholithiasis, certain malignancies, and biliary obstruction. Nonsteroidal anti-inflammatory drugs are safe and effective in treating pain from acute cholecystitis and biliary colic. Laparoscopic cholecystectomy is the treatment of choice for most patients with biliary colic or acute cholecystitis. Ursodeoxycholic acid and chenodeoxycholic acid should not routinely be used to treat gallstone disease, but they can be used as a nonsurgical alternative for certain patients. Postcholecystectomy syndrome is a potential postoperative complication that presents with abdominal pain, bloating, and diarrhea. (Am Fam Physician. 2024;109(6):518-524.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436598","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

Lipid Management: Guidelines From the Canadian PEER Group for Primary Care. 血脂管理：加拿大 PEER 小组初级保健指南。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Laura Blinkhorn, Andrew Buelt

引用次数: 0

Oseltamivir Does Not Reduce the Likelihood of Hospitalization in Adults. 奥司他韦不会降低成人住院的可能性。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Mark H Ebell

引用次数: 0

Correction. 更正。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

引用次数: 0

Addressing Mood Disorders in Infertility Care. 在不孕不育护理中解决情绪障碍。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Megan Killeen

引用次数: 0

Combined Oral Contraceptives for Primary Dysmenorrhea. 治疗原发性痛经的复合口服避孕药。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Dustin K Smith, Bristal Thompson, Samantha Keefer, Helen Haskell

引用次数: 0

Lifelong Care of Patients After Gender-Affirming Surgery. 性别确认手术后患者的终生护理。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Quinn Jackson, Nicole T Yedlinsky, Meredith Gray

{"title":"Lifelong Care of Patients After Gender-Affirming Surgery.","authors":"Quinn Jackson, Nicole T Yedlinsky, Meredith Gray","doi":"","DOIUrl":"","url":null,"abstract":"Gender-affirming surgery includes a range of procedures that help align a transgender or gender diverse person's body with their gender identity. As rates of gender-affirming surgery increase, family physicians will need to have the knowledge and skills to provide lifelong health care to this population. Physicians should conduct an anatomic survey or organ inventory with patients to determine what health screenings are applicable. Health care maintenance should follow accepted guidelines for the body parts that are present. Patients do not require routine breast cancer screening after mastectomy; however, because there is residual breast tissue, symptoms of breast cancer warrant workup. After masculinizing genital surgery, patients should have lifelong follow-up with a urologist familiar with gender-affirming surgery. If a prostate examination is indicated after vaginoplasty, it should be performed vaginally. If a pelvic examination is indicated after vaginoplasty, it should be performed with a Pederson speculum or anoscope. After gonadectomy, patients require hormone therapy to prevent long-term morbidity associated with hypogonadism, including osteoporosis. The risk of sexually transmitted infections may change after genital surgery depending on the tissue used for the procedure. Patients should be offered the same testing and treatment for sexually transmitted infections as cisgender populations, with site-specific testing based on sexual history. If bowel tissue is used in vaginoplasty, vaginal bleeding may be caused by adenocarcinoma or inflammatory bowel disease. (Am Fam Physician. 2024;109(6):560-565.","PeriodicalId":7713,"journal":{"name":"American family physician","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436601","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

Management of Bipolar Disorder: Guidelines From the VA/DoD. 双相情感障碍管理：退伍军人事务部/国防部指南。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Michael J Arnold

引用次数: 0

RSVpreF (Abrysvo) and Nirsevimab-alip (Beyfortus) for the Prevention of Respiratory Syncytial Virus Infection. RSVpreF (Abrysvo) 和 Nirsevimab-alip (Beyfortus) 用于预防呼吸道合胞病毒感染。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Matthew Nodelman, A Miles Scott

引用次数: 0

Avoiding Racist and Judgmental Clinical Documentation: Helping to Achieve Health Equity. 避免种族主义和评判性临床文件：帮助实现健康平等。

IF 3.8 3区医学

American family physician Pub Date : 2024-06-01

Alan R Roth, Andy Lazris, Helen Haskell, John James

引用次数: 0