Primary care
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Some clinician physicians who provide perinatal care find that they have the motivation and practice volume to learn diagnostic ultrasonographic skills. These skills may be limited to labor and delivery applications or may extend to performance of the standard antepartum obstetric ultrasound examination. Limited skills include the diagnosis of fetal life number, presentation, amniotic fluid assessment, and placental localization. The standard antepartum obstetric ultrasound examination adds fetal biometry and a detailed assessment of fetal anatomy.
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Available evidence suggests that prenatal care has played an important role in reducing maternal and infant mortality. Medical surveillance throughout pregnancy is the foundation of prenatal care and should be enhanced by psychosocial support. Only tests and procedures shown to be useful should be performed. Patient education includes promotion of healthy behaviors, nutritional advice, and preparation for childbirth.
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The common cold is characterized by symptoms of rhinorrhea, nasal obstruction, sneezing, throat clearing, postnasal drip, and cough. Some of the many viruses that cause colds may cause mild additional symptoms such as sore throat, weakness, dizziness, and tearing. This article presents data concerning the cause, pathogenesis, and treatment of the common cold as well as discussion of the available diagnostic tests and their use in formulating differential diagnoses.
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Concerns over infraglottic and bronchial infections have been a source of anxiety and lost sleep for many children, parents, and physicians. The annual incidence of lower respiratory tract infections in children younger than 6 years old exceeds 5 million in the United States. Despite the frequency of these infections, the often common and nonspecific clinical symptomatology, variable severity, and changing epidemiology over time all have contributed to our understanding and misunderstanding of these disorders.
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Afebrile or atypical pneumonia is a relatively common illness in infants. These children often present afebrile with diffuse or bilateral infiltrates on chest radiograph. ⋯ The role of agents such as Chlamydia, Ureaplasma, Pneumocystis, and viruses is elucidated. Techniques for diagnosis and recommended treatment regimens are presented.