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    11995 results match your criteria American family physician[Journal]

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    Testosterone Therapy: Review of Clinical Applications.
    Am Fam Physician 2017 Oct;96(7):441-449
    Oregon Health and Science University, Portland, OR, USA.
    Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure testosterone levels unless a patient has signs and symptoms of hypogonadism, such as loss of body hair, sexual dysfunction, hot flashes, or gynecomastia. Read More

    Secondary Hypertension: Discovering the Underlying Cause.
    Am Fam Physician 2017 Oct;96(7):453-461
    University of Alberta, Edmonton, Alberta, Canada.
    Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. Read More

    Recurrent Ischemic Stroke: Strategies for Prevention.
    Am Fam Physician 2017 Oct;96(7):436-440
    The Ohio State University Wexner Medical Center, Columbus, OH, USA.
    Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Read More

    Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders.
    Am Fam Physician 2017 Oct;96(8):515-522
    University of Arizona College of Medicine, Phoenix, AZ, USA.
    Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) result from intrauterine exposure to alcohol and are the most common nonheritable causes of intellectual disability. The percentage of women who drink or binge drink during pregnancy has increased since 2012. FAS is commonly missed or misdiagnosed, preventing affected children from receiving needed services in a timely fashion. Read More

    Bladder Cancer: Diagnosis and Treatment.
    Am Fam Physician 2017 Oct;96(8):507-514
    University of Virginia School of Medicine, Charlottesville, VA, USA.
    Bladder cancer is the sixth most prevalent malignancy in the United States and causes more than 16,000 deaths annually. The most common clinical presentation is asymptomatic hematuria, which should prompt evaluation with cystoscopy, renal function testing, and upper urinary tract imaging in adults 35 years and older and in those with irritative voiding symptoms, risk factors for bladder cancer, or gross hematuria at any age. Transurethral resection of the bladder tumor allows for definitive diagnosis, staging, and primary treatment. Read More

    Disorders of Puberty: An Approach to Diagnosis and Management.
    Am Fam Physician 2017 Nov;96(9):590-599
    Walter Reed National Military Medical Center, Bethesda, MD, USA.
    Disorders of puberty can profoundly impact physical and psychosocial well-being. Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. Patients with early isolated pubertal changes, prepubertal linear growth, and no worrisome neurologic symptoms typically have a benign pattern of development and should be monitored in the appropriate clinical context. Read More

    Heart Failure with Preserved Ejection Fraction: Diagnosis and Management.
    Am Fam Physician 2017 Nov;96(9):582-588
    Richmond, VA, USA.
    Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular relaxation and passive ventricular compliance, leading to a decline in stroke volume and cardiac output. Heart failure with preserved ejection fraction should be suspected in patients with typical symptoms (e. Read More

    Chronic Cough: Evaluation and Management.
    Am Fam Physician 2017 Nov;96(9):575-580
    University of Florida College of Medicine, Gainesville, FL, USA.
    Although chronic cough in adults (cough lasting longer than eight weeks) can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic bronchitis. Patients should be evaluated clinically (with spirometry, if indicated), and empiric treatment should be initiated. Other potential causes include angiotensin-converting enzyme inhibitor use, environmental triggers, tobacco use, chronic obstructive pulmonary disease, and obstructive sleep apnea. Read More

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