American family physician
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American family physician · May 1993
ReviewPractical approach to bacterial meningitis in childhood.
The classic triad of headache, fever and nuchal rigidity that occurs in adults with bacterial meningitis is often absent in children. Evaluation of the cerebrospinal fluid remains the gold standard for the diagnosis of bacterial meningitis. ⋯ Dexamethasone has become an important adjunct to antimicrobial therapy for meningitis due to Haemophilus influenzae type b. Prevention, especially administration of H. influenzae type b vaccine at an early age, is probably the most effective way to reduce the significant mortality and morbidity associated with bacterial meningitis in children.
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Acute gastroenteritis is a leading cause of visits to physicians among children in the United States. Oral rehydration therapy has prevented or reversed dehydration among millions of children in developing countries. Although most U. ⋯ Viral pathogens in diarrheal illness can destroy absorptive cells at the intestinal villous tip while leaving secretory cells intact. Oral rehydration therapy takes advantage of the remaining intact absorptive cells, is less invasive than intravenous rehydration and allows parents to be involved in their children's care. This article outlines how to select patients for oral rehydration therapy, what fluids to use and how to implement therapy.
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American family physician · Mar 1993
ReviewDisorders of sexual desire: diagnosis and treatment of decreased libido.
Decreased libido is the most common concern expressed by patients when they discuss sexual issues with their physicians. The causes of decreased libido are complex and multifactorial, requiring attention and a careful history to isolate the primary origin. Although dissatisfaction with the relationship or marriage is the most common factor in patients with depressed desire, organic causes must also be considered. Physicians must remember that depressed libido is relative and depends on the patient's definition, not on an absolute standard of how frequently people do or should have sexual relations.
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Henoch-Schönlein purpura is a small vessel vasculitic disease thought to be caused by an immunoglobulin-mediated inflammatory process resulting from immune complex reaction to antigenic stimuli. It is a relatively common disease that will be encountered in the clinical practice of most family physicians. ⋯ It is classically manifested by palpable purpura on the lower extremities, abdominal pain, arthritis and renal involvement. Family physicians should be familiar with the disease's clinical manifestations and be aware of potentially serious complications that may affect long-term prognosis and management.