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Journal of Family Practice最新文献

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Reducing Cardiopulmonary Risk and Exacerbations in COPD. 降低COPD患者的心肺风险和急性加重。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0623
Barbara Yawn

Key takeaways: New updates in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report include major changes to initial disease assessment and pharmacologic therapy, highlighting the clinical relevance of exacerbations. The updated GOLD 2023 algorithms offer a shorter path to consideration of triple therapy, including both initial and follow-up treatment. Most mild- or moderate-severity chronic obstructive pulmonary disease (COPD) exacerbations can be successfully managed in outpatient settings; primary care clinicians have many opportunities to identify, diagnose, and treat patients with COPD earlier to reduce lung damage and disease progression. COPD and cardiovascular disease share common mechanisms and risk factors that influence COPD management.

慢性阻塞性肺疾病全球倡议(GOLD) 2023报告的最新更新包括初始疾病评估和药物治疗的重大变化，突出了恶化的临床相关性。更新后的GOLD 2023算法为考虑三联疗法提供了更短的途径，包括初始和随访治疗。大多数轻度或中度慢性阻塞性肺疾病(COPD)恶化可以在门诊环境中成功管理;初级保健临床医生有很多机会及早识别、诊断和治疗COPD患者，以减少肺损伤和疾病进展。慢性阻塞性肺病和心血管疾病具有影响慢性阻塞性肺病管理的共同机制和危险因素。
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引用次数: 0
Acute Pain in Perspective. 透视急性疼痛。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0617
Bill McCarberg

Key takeaways: Acute pain is a common and nearly universal experience that usually has a sudden onset and is limited in duration. It is a normal physiologic response to a noxious stimulus that can become pathologic if untreated or not treated effectively. Acute pain has a limited duration (<1 month) and often is caused by injury, trauma, or medical treatments such as surgery. Primary care practitioners (PCPs) who encounter patients with acute pain can help preserve function and quality of life and prevent progression to chronic pain by implementing appropriate management strategies. PCPs in rural settings may bear greater responsibility for acute pain management because of the lack of accessible specialists. All current guidelines support using a multimodal approach to pain management and reserving use of opioids for patients with severe pain that cannot be managed with other agents. There are several new agents and formulations recently approved or in development for the treatment of acute pain. The recently approved co-crystal formulation of celecoxib and tramadol hydrochloride provides an additional option for acute pain management and utilizes a single-medication multimodal approach.

关键要点:急性疼痛是一种常见的，几乎是普遍的经历，通常突然发作，持续时间有限。这是一种对有害刺激的正常生理反应，如果不治疗或不有效治疗，可能会变成病理性的。急性疼痛持续时间有限(
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引用次数: 0
Generalized maculopapular rash and fever. 全身性黄斑丘疹及发热。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0640
Alexandra Verdieck, Eric Ardman, Nicholas Defelice

Was this a case of the "great masquerader"? Or was it something else?

这是一个“伟大的假面舞者”的例子吗?还是别的什么?
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引用次数: 0
30-year-old woman • progressive dyspnea and peripheral edema • 35th week of gestation with a history of mild preeclampsia • Dx? 30岁女性•进行性呼吸困难和周围水肿•妊娠第35周，有轻度先兆子痫史•Dx?
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0633
Neal Robert Abarbanell, Anqi Abarbanell

► progressive dyspnea and peripheral edema ► 35th week of gestation with a history of mild preeclampsia.

►进行性呼吸困难和周围水肿►妊娠第35周，有轻度先兆子痫史。
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引用次数: 0
Knee pain and injury: When is a surgical consult needed? 膝关节疼痛和损伤:何时需要外科会诊?
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0629
David M Siebert, Christopher Kweon

This review identifies clinical scenarios-such as unstable or displaced fractures, major tendon ruptures, and significant mechanical issues-that likely warrant surgical consultation.

本综述确定了可能需要外科会诊的临床情况，如不稳定或移位骨折、主要肌腱断裂和重大机械问题。
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引用次数: 0
New Paradigms for CKD Management in Patients With T2D. T2D患者CKD管理的新范式。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0621
Joshua J Neumiller, Stephen A Brunton

Learning objectives: At the end of the activity, participants will be able to: Identify the risks of kidney disease and their consequences in patients with type 2 diabetes (T2D). Appropriately screen for the presence of chronic kidney disease (CKD) in patients with T2D. Initiate evidence-based therapy to slow the progression of kidney disease in patients with T2D and CKD. Become familiar with the novel nonsteroidal mineralocorticoid receptor antagonist finerenone and its role in the treatment of patients with T2D and CKD.

学习目标:活动结束时，参与者将能够:识别2型糖尿病(T2D)患者肾脏疾病的风险及其后果。适当筛查T2D患者是否存在慢性肾病(CKD)。启动循证治疗以减缓T2D和CKD患者肾脏疾病的进展。熟悉新型非甾体类矿物皮质激素受体拮抗剂芬烯酮及其在治疗T2D和CKD患者中的作用。
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引用次数: 0
An STI upsurge requires a nimble approach to care. 性传播感染激增需要采取灵活的护理方法。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0641
Kelsie Kelly, Michelle Sommer, Belinda Vail

Being fluent in new guidelines helps you meet the challenges of changing disease prevalence, rising antibiotic resistance, and evolving social patterns.

熟练掌握新指南有助于你应对疾病流行变化、抗生素耐药性上升和社会模式演变等挑战。
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引用次数: 0
Prescribing DOACs with specific patient populations in mind. 为特定的患者群体开处方。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0631
Kevin Schleich, Brigit E Ray

What prescribing considerations should be top of mind when obesity, renal disease, cancer, or thrombophilia are at play?

当肥胖、肾脏疾病、癌症或血栓形成时，应该首先考虑哪些处方因素?
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引用次数: 0
Early Life Nutrition and the Developing Brain. 生命早期营养和大脑发育。
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0619
Danielle Christifano, Lara Bennett
KEY TAKEAWAYSThe developmental origins of health and disease (DOHaD) hypothesis suggests prenatal nutrition sets the stage for the developing brain, with effects that last into adulthood. Macronutrient and micronutrient requirements increase in pregnancy and deficiencies can influence fetal neurodevelopment and cognition. Foods such as eggs, meat, and seafood contain many of the nutrients needed for healthy neurodevelopment and intake should be encouraged among women of reproductive age. Family practice clinicians play an important role in providing nutrition recommendations surrounding food and prenatal supplements to consume before, during, and after pregnancy.
关键要点:健康和疾病的发育起源(DOHaD)假说认为，产前营养为大脑发育奠定了基础，其影响将持续到成年。大量营养素和微量营养素的需求在怀孕期间增加，缺乏会影响胎儿的神经发育和认知。鸡蛋、肉类和海鲜等食物含有健康神经发育所需的许多营养素，应鼓励育龄妇女摄入这些食物。家庭医生在提供有关食物和产前补充剂的营养建议方面发挥重要作用，以便在怀孕前，怀孕期间和怀孕后食用。
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引用次数: 1
Is injectable PrEP superior to oral therapy for HIV protection? 预防艾滋病毒注射是否优于口服治疗?
4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Journal of Family Practice
Pub Date : 2023-07-01 DOI: 10.12788/jfp.0630
David Kriegel, Anthony Daniels, Dean A Seehusen

An RCT of HIV preexposure prophylaxis compared long-acting injectable cabotegravir with traditional daily oral tenofovir-emtricitabine-with clear results.

一项HIV暴露前预防的随机对照试验比较了长效注射卡博特韦和传统每日口服替诺福韦-恩曲他滨的效果。
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引用次数: 0
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