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Acute Appendicitis: Efficient Diagnosis and Management - American Family Physician

Jul 1, 2018 - Appendicitis is one of the most common causes of acute abdominal pain in adults and children, with a lifetime risk of 8.6% in males and 6.7% in females. It is the most common nonobstetric surgical emergency during pregnancy. Findings from the history, physical examination, and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p25.html

Hemorrhoids: Diagnosis and Treatment Options - American Family Physician

Feb 1, 2018 - Many Americans between 45 and 65 years of age experience hemorrhoids. Hemorrhoidal size, thrombosis, and location (i.e., proximal or distal to the dentate line) determine the extent of pain or discomfort. The history and physical examination must assess for risk factors and clinical ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p172.html

Laceration Repair: A Practical Approach - American Family Physician

May 15, 2017 - The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. Many aspects of laceration repair have not changed over the years, but there is evidence to support some updates to standard management. Studies have been ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p628.html

Surgical and Nonsurgical Management of Gallstones - American Family Physician

May 15, 2014 - Cholelithiasis, or gallstones, is one of the most common and costly of all the gastrointestinal diseases. The incidence of gallstones increases with age. At-risk populations include persons with diabetes mellitus, persons who are obese, women, rapid weight cyclers, and patients on ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0515/p795.html

Ingrown Toenail Management - American Family Physician

Aug 1, 2019 - Ingrown toenails account for approximately 20% of foot problems in primary care. The great toe is most often affected. Ingrown toenails occur most commonly in young men, and nail care habits and footwear are most often contributory factors. No consensus has been reached for the best ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p158.html

Evaluation of Jaundice in Adults - American Family Physician

Feb 1, 2017 - Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p164.html

Varicose Veins: Diagnosis and Treatment - American Family Physician

Jun 1, 2019 - Varicose veins are twisted, dilated veins most commonly located on the lower extremities. The exact pathophysiology is debated, but it involves a genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure. Risk factors include family history ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p682.html

Intestinal Obstruction: Evaluation and Management - American Family Physician

Sep 15, 2018 - Acute intestinal obstruction occurs when the forward flow of intestinal contents is interrupted or impaired by a mechanical cause. It is most commonly induced by intra-abdominal adhesions, malignancy, and herniation. The clinical presentation generally includes nausea, emesis, colicky ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p362.html

Inguinal Hernias: Diagnosis and Management - American Family Physician

Jun 15, 2013 - Inguinal hernias are one of the most common reasons a primary care patient may need referral for surgical intervention. The history and physical examination are usually sufficient to make the diagnosis. Symptomatic patients often have groin pain, which can sometimes be severe. Inguinal ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0615/p844.html

Acute Abdominal Pain in Children - American Family Physician

May 15, 2016 - Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0515/p830.html

Preoperative Assessment in Older Adults: A Comprehensive Approach - American Family ...

Aug 15, 2018 - Surgical outcomes are significantly influenced by patients’ overall health, function, and life expectancy. A comprehensive geriatric preoperative assessment of older adults requires expanding beyond an organ-based or disease-based assessment. At a preoperative visit, it is important to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p214.html

Common Questions About Wound Care - American Family Physician

Jan 15, 2015 - Lacerations, abrasions, burns, and puncture wounds are common in the outpatient setting. Because wounds can quickly become infected, the most important aspect of treating a minor wound is irrigation and cleaning. There is no evidence that antiseptic irrigation is superior to sterile ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0115/p86.html

Evaluation and Mangement of Intestinal Obstruction - American Family Physician

Jan 15, 2011 - Acute intestinal obstruction occurs when there is an interruption in the forward flow of intes- tinal contents. This interruption can occur at any point along the length of the gastrointestinal tract, and clinical symptoms often vary based on the level of obstruction. Intestinal ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0115/p159.html

Preoperative Testing Before Noncardiac Surgery: Guidelines and Recommendations - ...

Mar 15, 2013 - Preoperative testing (e.g., chest radiography, electrocardiography, laboratory testing, urinalysis) is often performed before surgical procedures. These investigations can be helpful to stratify risk, direct anesthetic choices, and guide postoperative management, but often are obtained ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0315/p414.html

Perioperative Cardiovascular Medication Management in Noncardiac Surgery: Common ...

May 15, 2017 - Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p645.html

Refractive Eye Surgery: Helping Patients Make Informed Decisions About LASIK - American...

May 15, 2017 - A variety of refractive surgery techniques, which reshape the corneal stroma using laser energy, have been marketed as simple and safe alternatives to glasses or contact lenses. Laser-assisted in-situ keratomileusis (LASIK) is the most common of these procedures. Although there are few ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p637.html

Essentials of Skin Laceration Repair - American Family Physician

Oct 15, 2008 - Skin laceration repair is an important skill in family medicine. Sutures, tissue adhesives, staples, and skin-closure tapes are options in the outpatient setting. Physicians should be familiar with various suturing techniques, including simple, running, and half-buried mattress (corner)...

American Family Physician : Article

https://www.aafp.org/afp/2008/1015/p945.html

Treatment of Adult Obesity with Bariatric Surgery - American Family Physician

Jan 1, 2016 - In 2013, approximately 179,000 bariatric surgery procedures were performed in the United States, including the laparoscopic sleeve gastrectomy (42.1%), Roux-en-Y gastric bypass (34.2%), and laparoscopic adjustable gastric banding (14.0%). Choice of procedure depends on the medical ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0101/p31.html

Primary Care of the Solid Organ Transplant Recipient - American Family Physician

Feb 1, 2016 - The advancing science of transplantation has led to more transplants and longer survival. As a result, primary care physicians are more involved in the care of transplant recipients. Immunosuppressive therapy has significantly decreased rates of transplant rejection but accounts for ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0201/p203.html

Antiobiotic Prophylaxis to Prevent Surgical Site Infections - American Family Physician

Mar 1, 2011 - Surgical site infections are the most common nosocomial infections in surgical patients, accounting for approximately 500,000 infections annually. Surgical site infections also account for nearly 4 million excess hospital days annually, and nearly $2 billion in increased health care ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0301/p585.html

Complications of Adjustable Gastric Banding Surgery for Obesity - American Family ...

May 15, 2014 - Laparoscopic adjustable gastric banding procedures have a favorable risk-benefit profile and are increasingly important as part of the overall management of obesity. These procedures are effective at inducing weight loss and improving comorbid conditions, including diabetes mellitus, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0515/p813.html

Left Lower-Quadrant Pain: Guidelines from the American College of Radiology ...

Oct 1, 2010 - The differential diagnosis of left lower-quadrant pain includes gastrointestinal, gynecologic, and renal/ureteric pathology. Imaging is helpful in evaluating left lower-quadrant pain, and is generally guided by the clinical presentation. Acute sigmoid diverticulitis should be suspected ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1001/p766.html

Infiltrative Anesthesia in Office Practice - American Family Physician

Jun 15, 2014 - When choosing an infiltrative anesthetic agent, the type of procedure, the length of time required for anesthesia, and the pharmacodynamics of each medication are important considerations. Distraction techniques and buffering with sodium bicarbonate can be used to decrease the pain ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p956.html

Perioperative Antiplatelet Therapy - American Family Physician

Dec 15, 2010 - Aspirin is recommended as a lifelong therapy that should never be interrupted for patients with cardiovascular disease. Clopidogrel therapy is mandatory for six weeks after placement of bare-metal stents, three to six months after myocardial infarction, and at least 12 months after ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1215/p1484.html

Management of the Ingrown Toenail - American Family Physician

Feb 15, 2009 - Ingrown toenail, or onychocryptosis, most commonly affects the great toenail. Many anatomic and behavioral factors are thought to contribute to ingrown toenails, such as improper trimming, repetitive or inadvertent trauma, genetic predisposition, hyperhidrosis, and poor foot hygiene. ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0215/p303.html

Perioperative Cardiac Risk Reduction - American Family Physician

Feb 1, 2012 - Cardiovascular complications are the most common cause of perioperative morbidity and mortality. Noninvasive stress testing is rarely helpful in assessing risk, and for most patients there is no evidence that coronary revascularization provides more protection against perioperative ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0201/p239.html

Treatment of Adult Obesity with Bariatric Surgery - American Family Physician

Oct 1, 2011 - Bariatric surgery procedures, including laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, and Roux-en-Y gastric bypass, result in an average weight loss of 50 percent of excess body weight. Remission of diabetes mellitus occurs in approximately 80 percent of ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1001/p805.html

Diagnosis of Acute Abdominal Pain in Older Patients - American Family Physician

Nov 1, 2006 - Acute abdominal pain is a common presenting complaint in older patients. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. The physical examination can be misleadingly ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1101/p1537.html

Acute Abdominal Pain in Children - American Family Physician

Jun 1, 2003 - Acute abdominal pain in children presents a diagnostic dilemma. Although many cases of acute abdominal pain are benign, some require rapid diagnosis and treatment to minimize morbidity. Numerous disorders can cause abdominal pain. The most common medical cause is gastroenteritis, and ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0601/p2321.html

Management of Varicose Veins - American Family Physician

Dec 1, 2008 - Varicose veins are twisted, dilated veins most commonly located on the lower extremities. Risk factors include chronic cough, constipation, family history of venous disease, female sex, obesity, older age, pregnancy, and prolonged standing. The exact pathophysiology is debated, but it ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1289.html

Imaging for Suspected Appendicitis - American Family Physician

Jan 1, 2005 - Acute appendicitis is the most common reason for emergency abdominal surgery and must be distinguished from other causes of abdominal pain. Family physicians play a valuable role in the early diagnosis and management of this condition. However, the overall diagnostic accuracy achieved ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0101/p71.html

Preoperative Cardiac Risk Assessment - American Family Physician

Nov 15, 2002 - Heart disease is the leading cause of mortality in the United States. An important subset of heart disease is perioperative myocardial infarction, which affects approximately 50,000 persons each year. The American College of Cardiology (ACC) and American Heart Association (AHA) have ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1115/p1889.html

Preoperative Evaluation - American Family Physician

Jul 15, 2000 - A history and physical examination, focusing on risk factors for cardiac, pulmonary and infectious complications, and a determination of a patient's functional capacity, are essential to any preoperative evaluation. In addition, the type of surgery influences the overall perioperative ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0715/p387.html

Pancreatic Cancer: Diagnosis and Management - American Family Physician

Feb 1, 2006 - Although only 32,000 new cases of adenocarcinoma of the pancreas occur in the United States each year, it is the fourth leading cause of cancer deaths in this country. The overall five-year survival rate is 4 percent, and localized, resectable disease has only a 17 percent survival ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0201/p485.html

Preparation of the Cardiac Patient for Noncardiac Surgery - American Family Physician

Mar 1, 2007 - Approximately 20 to 40 percent of patients at high risk of cardiac-related morbidity develop myocardial ischemia perioperatively. The preferred approach to diagnostic evaluation depends on the interactions of patient-specific risk factors, surgery-specific risk factors, and exercise ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0301/p656.html

Caring for Patients After Bariatric Surgery - American Family Physician

Apr 15, 2006 - Bariatric surgery leads to sustainable long-term weight loss and may be curative for such obesity-related comorbidities as diabetes and obstructive sleep apnea in severely obese patients. The Roux-en-Y gastric bypass has become the most common procedure for patients undergoing bariatric...

American Family Physician : Article

https://www.aafp.org/afp/2006/0415/p1403.html

Vasectomy: An Update - American Family Physician

Dec 15, 2006 - Vasectomy remains an important option for contraception. Research findings have clarified many questions regarding patient selection, optimal technique, postsurgical follow-up, and risk of long-term complications. Men who receive vasectomies tend to be non-Hispanic whites, well ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1215/p2069.html

Vascular Surgery: An Update - American Family Physician

Jan 1, 2007 - Caring for patients with vascular illnesses has become increasingly more complex and has changed dramatically over the past 10 years, with a widening array of diagnostic and treatment options. Carotid artery stenting has the potential to become a viable alternative to open surgery in ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0101/p85.html

The Mattress Sutures: Vertical, Horizontal, and Corner Stitch - American Family Physician

Dec 15, 2002 - The interrupted vertical and horizontal mattress suture techniques are two of the most commonly used skin closure methods. These mattress sutures promote wound edge eversion and less prominent scarring. Vertical and horizontal mattress sutures allow for skin edges to be closed under ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1215/p2231.html

Current Guidelines for Antibiotic Prophylaxis of Surgical Wounds - American Family ...

Jun 1, 1998 - Appropriately administered antibiotic prophylaxis reduces the incidence of surgical wound infection. Prophylaxis is uniformly recommended for all clean-contaminated, contaminated and dirty procedures. It is considered optional for most clean procedures, although it may be indicated for ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0601/p2731.html

Bilious Vomiting in the Newborn: Rapid Diagnosis of Intestinal Obstruction - American ...

May 1, 2000 - Bilious vomiting in newborns is an urgent condition that requires the immediate involvement of a team of pediatric surgeons and neonatologists for perioperative management. However, initial detection, evaluation and treatment are often performed by nurses, family physicians and general ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0501/p2791.html

Adult Circumcision - American Family Physician

Mar 15, 1999 - Adult circumcision can be performed under local or regional anesthesia. Medical indications for this procedure include phimosis, paraphimosis, recurrent balanitis and posthitis (inflammation of the prepuce). Nonmedical reasons may be social, cultural, personal or religious. The ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0315/p1514.html

Mohs Micrographic Surgery - American Family Physician

Sep 1, 2005 - Mohs micrographic surgery is an approach to skin cancer removal that aims to achieve the highest possible rates of cure and to minimize the size of the wound and consequent distortions at critical sites such as the eyes, ears, nose, and lips. Mohs micrographic surgery is a two-step, ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0901/p845.html

Acute Appendicitis: Review and Update - American Family Physician

Nov 1, 1999 - Appendicitis is common, with a lifetime occurrence of 7 percent. Abdominal pain and anorexia are the predominant symptoms. The most important physical examination finding is right lower quadrant tenderness to palpation. A complete blood count and urinalysis are sometimes helpful in ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1101/p2027.html

Regional Anesthesia For Office Procedures: Part I. Head and Neck Surgeries - American ...

Feb 1, 2004 - Although local anesthesia usually is used in surgical procedures, field or nerve blocks can provide more effective anesthesia in some situations. In a field block, local anesthetic is infiltrated around the border of the surgical field, leaving the operative area undisturbed. In field ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0201/p585.html

Preoperative Care of Patients with Kidney Disease - American Family Physician

Oct 15, 2002 - Patients with chronic kidney disease often require surgical interventions for vascular access and for medical problems related to comorbid conditions. Perioperative morbidity and mortality rates are increased in these patients. Preoperative attention to common medical problems that ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1015/p1471.html

Perioperative Management of Diabetes - American Family Physician

Jan 1, 2003 - Maintaining glycemic and metabolic control is difficult in diabetic patients who are undergoing surgery. The preoperative evaluation of all patients with diabetes should include careful screening for asymptomatic cardiac or renal disease. Frequent self-monitoring of glucose levels is ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0101/p93.html

Regional Anesthesia For Office Procedures: Part II. Extremity and Inguinal Area ...

Feb 15, 2004 - The hand can be anesthetized effectively with blocks of the median, ulnar, or radial nerve. Each digit is supplied by four digital nerves, which can be blocked with injections on each side of the digit. Anterior or posterior ankle blocks can be used for regional anesthesia for the foot....

American Family Physician : Article

https://www.aafp.org/afp/2004/0215/p896.html

When to Operate in Carotid Artery Disease - American Family Physician

Jan 15, 2000 - Carotid endarterectomy has proved to be beneficial in the prevention of stroke in selected patients. The procedure is indicated in symptomatic patients with carotid-territory transient ischemic attacks or minor strokes who have carotid artery stenosis of 70 to 99 percent. With a low ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0115/p400.html

Breast-Conserving Surgery for Breast Cancer - American Family Physician

Dec 15, 2002 - Surgical treatment of breast cancer has changed significantly in recent years. Fine-needle aspirations or core-needle biopsies can be used in the diagnostic process, thus avoiding scarring incisions. The preferred method of treatment for many women with early breast cancer is ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1215/p2271.html

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