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American Family Physician
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1125

Articles


1075
COVER ARTICLE
Serum Tumor Markers
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GREG L. PERKINS, M.D., EVAN D. SLATER, M.D., GEORGANNE K. SANDERS, M.D., and JOHN G. PRICHARD, M.D.
Tumor markers are most useful for monitoring response to therapy and detecting early cancer recurrence. With the exception of prostate-specific antigen, tumor markers do not have sufficient sensitivity or specificity for use in screening.
   

1089
CLINICAL PHARMACOLOGY
Ivermectin Use in Scabies
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ROBERT S. FAWCETT, M.D., M.S.
Although standard topical agents are effective in treating many patients with scabies infection, oral ivermectin is an effective alternative.
   
1103 Cerebrospinal Fluid Analysis
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DEAN A. SEEHUSEN, M.D., MARK M. REEVES, M.D., and DEMITRI A. FOMIN, M.D.
Lumbar puncture is performed frequently in primary care. Properly interpreted tests can make cerebrospinal fluid a key tool in the diagnosis of a variety of diseases. Proper evaluation of cerebrospinal fluid depends on knowing which tests to order, the normal value ranges for the patient's age, and the limitations of the tests.
   

1109
PRACTICAL THERAPEUTICS
The Nature and Management of Labor Pain: Part I. Nonpharmacologic Pain Relief
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LAWRENCE LEEMAN, M.D., M.P.H., PATRICIA FONTAINE, M.D., M.S., VALERIE KING, M.D., M.P.H., MICHAEL C. KLEIN, M.D., and STEPHEN RATCLIFFE, M.D., M.S.P.H.
Increased availability of nonpharmacologic methods of pain relief such as warm water baths, continuous caregiver support, and sterile-water injections could provide effective alternatives for women in labor.
Editorial: "Management of Labor Pain: Promoting Patient Choice," p. 1023
   

1115
PRACTICAL THERAPEUTICS
The Nature and Management of Labor Pain: Part II. Pharmacologic Pain Relief
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LAWRENCE LEEMAN, M.D., M.P.H., PATRICIA FONTAINE, M.D., M.S., VALERIE KING, M.D, M.P.H., MICHAEL C. KLEIN, M.D., and STEPHEN RATCLIFFE, M.D., M.S.P.H.
Parenteral opioids and epidural analgesia are the most commonly used methods of labor pain relief in the United States, despite some questions about safety and efficacy. Nitrous oxide and paracervical block could provide a wider range of pain-relief options for women in labor.
Patient information: "Labor Pain: What to Expect and Ways to Relieve Pain," p. 1121
   
1125 Differential Diagnosis and Treatment of Hearing Loss
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JON E. ISAACSON, M.D., and NEIL M. VORA, M.D.
More than 28 million Americans have some degree of hearing loss. The diagnosis of hearing loss includes determination of the type of loss--conductive, sensorineural, or both.
   
1135 Pruritus
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SCOTT MOSES, M.D.
Pruritus is common in skin disorders such as xerotic eczema, atopic dermatitis, and allergic contact dermatitis. In some patients, however, it may be a sign of an underlying systemic disease.
Patient information: "What Can I Do for Dry, Itchy Skin?" p. 1145
   

1151
PROBLEM-ORIENTED DIAGNOSIS
Diagnostic Approach to Polyarticular Joint Pain
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ANNA MIES RICHIE, M.D., and MARK L. FRANCIS, M.D.
A thorough history and a complete physical examination are essential in narrowing the many possible causes of polyarticular joint pain. Clinical factors that can be helpful in achieving a specific diagnosis include disease chronology, inflammation, distribution, extra-articular manifestations, disease course, and patient demographics.
   

Departments

996 Change-of-Address Form
999 Inside AFP

1003

Newsletter
1007 Quantum Sufficit
1009 Clinical Quiz
1016 Letters to the Editor

ONLINE LETTERS

1019 Corrections
1023 Editorials
  • Management of Labor Pain: Promoting Patient Choice
1039 Definitions for Evidence Labels in AFP
1040 CME Calendar
1071 Diary from a Week in Practice
2283 Patient Information Collection
PREGNANCY
1175 POEMs and Tips from Other Journals
  • MRA vs. Ultrasonography for Carotid Stenosis (POEM)
  • Which Diet Best Slows Diabetic Nephropathy? (POEM)
  • COX-2 Inhibitors Likely Safe for Aspirin-Allergic Asthma (POEM)
  • Insufficient Data on Preventing Partner Violence
  • Exercise in Patients with Deep Venous Thrombosis
  • Warfarin Management with Mild Elevation of INR
  • Hypoalbuminemia in Acute Illness: Should We Intervene?
  • Does Interferon Prevent Relapse in Multiple Sclerosis?
  • Management of the Clinically Inapparent Adrenal Mass
  • Six-Minute Walk Test and Functioning of Older Patients
  • Beta Blocker Initiation Safe and Effective in Heart Failure
  • Distal Hyperplastic Polyps and Proximal Hyperplasia
  • Naturopathic Ear Drops Work for Ear Pain in Children (POEM)
  • Effect of Artificial Nipple Use on Breastfeeding
  • Approach to Young Children with Febrile Seizures
  • Managing Respiratory Syncytial Virus Bronchiolitis
  • Factors Affecting Accuracy of Mammography Screening
  • Multidose vs. Single-Dose Therapy in Ectopic Pregnancy
  • Weekly Therapy Is Effective in Prevention of Osteoporosis
1182 Definition of POEMs
1215 Practice Guidelines
  • Evaluation of Epigastric Discomfort and Management of Dyspepsia and GERD
1224 Clinical Briefs
1228 Classified Information


Cover photographs provided by Todd Buck, Lombard, Ill.
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