{"title":"Testosterone Replacement Therapy in Men With Sexual Dysfunction.","authors":"Kento Sonoda","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 5","pages":"464-465"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666900","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}
Simone Bigelow, Kimberly Crosby, Viviane Sachs, Alberto Benjamin Chong, Toni Hoberecht
{"title":"High Fruit and Vegetable Intake to Decrease Risk of Depression in Adults.","authors":"Simone Bigelow, Kimberly Crosby, Viviane Sachs, Alberto Benjamin Chong, Toni Hoberecht","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 5","pages":"533-534"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666889","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}
Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 and type 2 diabetes resulting from an absolute or relative insulin deficiency. It can occur in patients of all ages and can be the initial presentation of diabetes, especially in young children. Polyuria and polydipsia are the most common symptoms, followed by nausea, vomiting, abdominal pain, weight loss, severe fatigue, dyspnea, and preceding febrile illness. Traditionally, DKA has been diagnosed by the triad of hyperglycemia (blood glucose greater than 250 mg/dL), metabolic acidosis (pH less than 7.3, serum bicarbonate less than 18 mEq/L, anion gap greater than 10 mEq/L), and elevated serum (preferred) or urine ketones. However, hyperglycemia has been de-emphasized in recent guidelines because of the increasing incidence of euglycemic DKA. The use of sodium-glucose cotransporter-2 inhibitors modestly increases the risk of DKA and euglycemic DKA. Electrolytes, phosphate, blood urea nitrogen, creatinine, urinalysis, complete blood cell count with differential, A1C, and electrocardiography should be evaluated for all patients diagnosed with DKA to identify causes and complications of DKA. Amylase, lipase, hepatic transaminase levels, troponin, creatine kinase, blood and urine cultures, and chest radiography are additional tests to consider. Treatment involves fluid and electrolyte replacement, insulin, treatment of precipitating causes, and close monitoring to adjust therapy and identify complications. Prevention strategies include identifying diabetes before DKA develops, educating patients to manage high-risk situations, and ensuring uninterrupted access to therapies for diabetes.
{"title":"Diabetic Ketoacidosis: Evaluation and Treatment.","authors":"Brian Veauthier, Blaine Levy-Grau","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 and type 2 diabetes resulting from an absolute or relative insulin deficiency. It can occur in patients of all ages and can be the initial presentation of diabetes, especially in young children. Polyuria and polydipsia are the most common symptoms, followed by nausea, vomiting, abdominal pain, weight loss, severe fatigue, dyspnea, and preceding febrile illness. Traditionally, DKA has been diagnosed by the triad of hyperglycemia (blood glucose greater than 250 mg/dL), metabolic acidosis (pH less than 7.3, serum bicarbonate less than 18 mEq/L, anion gap greater than 10 mEq/L), and elevated serum (preferred) or urine ketones. However, hyperglycemia has been de-emphasized in recent guidelines because of the increasing incidence of euglycemic DKA. The use of sodium-glucose cotransporter-2 inhibitors modestly increases the risk of DKA and euglycemic DKA. Electrolytes, phosphate, blood urea nitrogen, creatinine, urinalysis, complete blood cell count with differential, A1C, and electrocardiography should be evaluated for all patients diagnosed with DKA to identify causes and complications of DKA. Amylase, lipase, hepatic transaminase levels, troponin, creatine kinase, blood and urine cultures, and chest radiography are additional tests to consider. Treatment involves fluid and electrolyte replacement, insulin, treatment of precipitating causes, and close monitoring to adjust therapy and identify complications. Prevention strategies include identifying diabetes before DKA develops, educating patients to manage high-risk situations, and ensuring uninterrupted access to therapies for diabetes.</p>","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 5","pages":"476-486"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666884","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}
{"title":"Using Artificial Intelligence in Screening Mammography.","authors":"Karl T Clebak, Michael T Partin, Nathan J Hemerly","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 5","pages":"535-536"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666901","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}
K Robin Yabroff, Ya-Chen Tina Shih, Cathy J Bradley
{"title":"Financial Hardship Following a Cancer Diagnosis: A Family Matter.","authors":"K Robin Yabroff, Ya-Chen Tina Shih, Cathy J Bradley","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 5","pages":"457-459"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666887","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}
{"title":"Navigating Polygenic Risk Scores in Primary Care: Challenges and Considerations for Diverse Populations.","authors":"Sean P David, Latha Palaniappan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 5","pages":"454-456"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666891","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}
Easy bruising and bleeding are commonly seen in primary care. Use of a bleeding assessment tool and a comprehensive history, physical examination, and patient-provided photographs can help identify causes of abnormal bleeding and bruising. Family history can aid diagnosis of a heritable cause. Nonaccidental trauma should be considered, especially in vulnerable populations. Initial laboratory testing includes a complete blood cell count, peripheral blood smear, prothrombin time (PT), international normalized ratio, activated partial thromboplastin time (aPTT), and fibrinogen. Normal PT and aPTT results may indicate a platelet disorder. A normal PT result with a prolonged aPTT result indicates a disorder of the intrinsic coagulation pathway, and a prolonged PT result with a normal aPTT result may indicate a disorder of the extrinsic coagulation pathway. Consultation with a hematologist is recommended when initial evaluation indicates a bleeding disorder or when suspicion remains high despite a normal laboratory workup result.
{"title":"Bleeding and Bruising: Primary Care Evaluation.","authors":"Pamela R Hughes, Meghan N Lewis, Shalease S Adams","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Easy bruising and bleeding are commonly seen in primary care. Use of a bleeding assessment tool and a comprehensive history, physical examination, and patient-provided photographs can help identify causes of abnormal bleeding and bruising. Family history can aid diagnosis of a heritable cause. Nonaccidental trauma should be considered, especially in vulnerable populations. Initial laboratory testing includes a complete blood cell count, peripheral blood smear, prothrombin time (PT), international normalized ratio, activated partial thromboplastin time (aPTT), and fibrinogen. Normal PT and aPTT results may indicate a platelet disorder. A normal PT result with a prolonged aPTT result indicates a disorder of the intrinsic coagulation pathway, and a prolonged PT result with a normal aPTT result may indicate a disorder of the extrinsic coagulation pathway. Consultation with a hematologist is recommended when initial evaluation indicates a bleeding disorder or when suspicion remains high despite a normal laboratory workup result.</p>","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 5","pages":"504-514"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666879","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}
{"title":"Brexpiprazole (Rexulti) for the Treatment of Agitation Associated With Alzheimer Disease.","authors":"Jennie B Jarrett, Alexander F Infante","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"110 5","pages":"537-538"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666880","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}
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