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Should antenatal testing be performed in patients with a pre-pregnancy BMI ≥ 35? 孕前BMI≥35的患者应该进行产前检查吗?
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-01 DOI: 10.12788/jfp.0560
Lee Dresang, Lia Vellardita

Possibly. Elevated BMI is associated with an increased risk for stillbirth (strength of recommendation [SOR], B; cohort studies and meta-analysis of cohort studies). Three studies found an association between elevated BMI and stillbirth and one did not. However, no studies demonstrate that antenatal testing in pregnant people with higher BMIs decreases stillbirth rates, or that no harm is caused by unnecessary testing or resultant interventions.

可能。BMI升高与死产风险增加相关(推荐强度[SOR], B;队列研究和队列研究的荟萃分析)。三项研究发现BMI升高和死胎之间存在关联,另一项则没有。然而,没有研究表明,对bmi较高的孕妇进行产前检测可以降低死产率,也没有研究表明,不必要的检测或由此产生的干预不会造成伤害。
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引用次数: 0
Meaningful improvement for patients like Tante Ilse. 对像Tante Ilse这样的病人有意义的改善。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-01 DOI: 10.12788/jfp.0562
Henry C Barry
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引用次数: 0
44-year-old man • elevated total cholesterol • chest pains • ketogenic diet • Dx? 44岁男性•总胆固醇升高•胸痛•生酮饮食•Dx?
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-01 DOI: 10.12788/jfp.0556
Samuel Dickmann, Del Carter

► elevated total cholesterol ► chest pains ►ketogenic diet.

►总胆固醇升高→胸痛→生酮饮食。
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引用次数: 0
Basal Insulin/GLP-1 RA Fixed-Ratio Combinations as an Option for Advancement of Basal Insulin Therapy in Older Adults With Type 2 Diabetes. 基础胰岛素/GLP-1 RA固定比例组合作为老年2型糖尿病基础胰岛素治疗进展的选择
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.12788/jfp.0515
Mark Corriere, Brian Burtch, Naushira Pandya

The prevalence of type 2 diabetes (T2D) is increasing, and owing to the aging population, the number of older adults with T2D is growing rapidly. By virtue of their age, older adults are likely to have been living with the disease longer than their younger counterparts. This, coupled with differences in T2D pathophysiology between younger and older patients, means that older adults often require advancement of treatment from basal insulin. However, older adults with T2D represent a heterogeneous population, for whom the goals of treatment are complex, and overtreatment can increase the risk of complications. These factors highlight the need for individualized glycemic targets and therapeutic strategies. In this roundtable, the authors discuss the management of older adults with T2D--a large patient population who often require treatment simplification.

2型糖尿病(T2D)的患病率正在上升,由于人口老龄化,老年T2D患者的数量正在迅速增长。由于他们的年龄,老年人可能比年轻人患有这种疾病的时间更长。这一点,再加上年轻和老年患者之间T2D病理生理的差异,意味着老年人通常需要从基础胰岛素开始治疗。然而,老年T2D患者是异质人群,治疗目标复杂,过度治疗可增加并发症的风险。这些因素突出了个体化血糖目标和治疗策略的必要性。在这次圆桌会议上,作者讨论了老年T2D患者的管理,这是一个经常需要简化治疗的大患者群体。
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引用次数: 0
Shared decision-making (when you're wearing the paper gown). 共同决策(当你穿着纸袍的时候)。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.12788/jfp.0546
Kate Rowland
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引用次数: 0
Does regular walking improve lipid levels in adults? 经常散步能改善成年人的血脂水平吗?
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.12788/jfp.0547
Kayla Hatchell, Emily Chin, Brian Vukelic, Katherine Fortenberry, Dominick Ose, Eliza Taylor, Rachel Goossen

Minimally. Regular moderate-intensity walking for a period of 4 or more weeks minimally decreased total cholesterol (TC) and low-density lipoprotein (LDL) levels by about 7 mg/dL in women with overweight or obesity (strength of recommendation [SOR]: C, systematic review and meta-analysis on disease-oriented evidence). For adults ages 40 to 65 years, regular walking for 3 or more months inconsistently affected cholesterol and triglyceride levels (SOR: C, based on 3 randomized controlled trials [RCTs] with disease-oriented evidence).

最低限度。有规律的中等强度步行4周或更长时间,可使超重或肥胖女性的总胆固醇(TC)和低密度脂蛋白(LDL)水平降低约7 mg/dL(推荐强度[SOR]: C,疾病导向证据的系统评价和荟萃分析)。对于40至65岁的成年人,定期步行3个月或更长时间不一致地影响胆固醇和甘油三酯水平(SOR: C,基于3个随机对照试验[rct]与疾病为导向的证据)。
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引用次数: 0
Infant with red eyelid lesion. 婴儿眼睑红肿。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.12788/jfp.0549
Jimena G Cervantes, Richard P Usatine

The rapid growth of this lesion provided an important clue in the diagnosis.

该病变的快速生长为诊断提供了重要线索。
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引用次数: 0
Consider this tool to reduce antibiotic-associated adverse events in patients with sepsis. 考虑使用这个工具来减少脓毒症患者抗生素相关的不良事件。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.12788/jfp.0538
Timothy Mott, Zachary Orme

Predictive biomarker procalcitonin can aid clinical decision-making on continued antibiotic treatment in this patient population.

预测性生物标志物降钙素原可以帮助临床决策继续抗生素治疗的患者群体。
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引用次数: 0
14-year-old boy • Aching midsternal pain following a basketball injury • Worsening pain with direct pressure and when the patient sneezed • Dx? 14岁男孩•篮球受伤后胸骨中段疼痛•直接按压和患者打喷嚏时疼痛加重•Dx?
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.12788/jfp.0537
Catherine Romaine, Alyssa Heinrich, Megan Ferderber

Aching midsternal pain following a basketball injury ►Worsening pain with direct pressure and when the patient sneezed.

篮球受伤后胸骨中部疼痛►直接按压和打喷嚏时疼痛加重。
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引用次数: 0
How to integrate shared decision-making into your practice. 如何将共同决策整合到您的实践中。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.12788/jfp.0536
Matthew Brian Mackwood, Inger Imset, Cathleen Morrow

Despite the many benefits of shared decision-making, uptake of its practices is low. These tools and frameworks can help you to engage patients in their care decisions.

尽管共同决策有许多好处,但对其实践的接受程度很低。这些工具和框架可以帮助你让病人参与他们的护理决策。
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引用次数: 0
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Journal of Family Practice
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