Articles - June 1998 - American Family Physician


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2675 Problem-Oriented Diagnosis
Diagnostic Evaluation of Urinary Incontinence in Geriatric Patients
BARRY D. WEISS, M.D.
Diagnosis and management plans can usually be established based on the history, the physical examination, urinalysis and measurement of postvoid residual urine volume.

Patient information: "Finding Out About Incontinence," p. 2688

2695 Eyelid Disorders: Diagnosis and Management
SUSAN R. CARTER, M.D.
Eyelid problems range from benign to malignant; inflammation, infection, benign and malignant tumors and structural problems such as ectropion, entropion and blepharoptosis may occur. Warm compresses and antibiotics suffice for many conditions, while excision, cryotherapy or laser treatment are required for some.

2705 The Charcot Foot in Diabetes: Six Key Points
GREGORY M. CAPUTO, M.D., JAN ULBRECHT, M.D., PETER R. CAVANAGH, PH.D., and PAUL JULIANO, M.D.
The Charcot foot is a complication of sensory neuropathy in patients with diabetes mellitus. The acute Charcot foot is usually painless and may mimic cellulitis or deep venous thrombosis. If undiagnosed or improperly managed, it can result in disastrous complications for the patient, including amputation.

2713 Prevention of Neonatal Group B Streptococcal Infection
CHRIS KEENAN, M.D., M.P.H.
Neonatal group B streptococcal infection may be prevented through intrapartum treatment of women at high risk for delivering an infected infant.

Patient information: "Group B Streptococcal Infection in Pregnancy--What It Means," p. 2725

2731 Current Guidelines for Antibiotic Prophylaxis of Surgical Wounds
RONALD K. WOODS, M.D., PH.D., and E. PATCHEN DELLINGER, M.D.
Preoperative antibiotics reduce rates of wound infection, although antibiotics administered postoperatively do not. An appropriately chosen cephalosporin is generally recommended for single-regimen antibiotic prophylaxis.

2743 Assessment and Treatment of Bulimia Nervosa
BETH M. MCGILLEY, PH.D., and TAMARA L. PRYOR, PH.D.
Successful management of bulimia nervosa requires early detection, comprehensive assessment for comorbid conditions and complications, and individualized therapy.

2753 Treatment of Systemic Lupus Erythematosus: An Update
MICHELLE PETRI, M.D., M.P.H.
Systemic lupus erythematosus is a complex autoimmune disorder with a prolonged course that can involve more than one organ system. Treatment approaches emphasize using a combination of drugs to minimize chronic exposure to corticosteroids.

2763 Sudden Death in Young Athletes: Screening for the Needle in a Haystack
FRANCIS G. O'CONNOR, LTC, MC, USA, JOHN P. KUGLER, COL, MC, USA, and RALPH G. ORISCELLO, M.D.
Nontraumatic sudden death in young athletes is, despite public perception to the contrary, quite rare, occurring most often in male athletes. Congenital cardiovascular disease, especially hypertrophic cardiomyopathy, is the leading cause. Screening athletes is a challenge.

2775 Evaluating Hoarseness: Keeping Your Patient's Voice Healthy
CLARK A. ROSEN, M.D., DEBORAH ANDERSON, M.D., and THOMAS MURRY, PH.D.
Vocal abuse is one of the most common causes of hoarseness and can lead to vocal pathologies such as vocal nodules. In a patient with a history of tobacco use, cancer of the head and neck must be ruled out before any other diagnosis can be accepted.

2789 Clinical Pharmacology
Combination Antiretroviral Therapy for HIV Infection
JANINE MAENZA, M.D., and CHARLES FLEXNER, M.D.
Combination antiretroviral therapy is now standard treatment for HIV infection. The therapeutic goal is to decrease the viral load to undetectable levels within four to six months of initiating a new treatment regimen.

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	Articles

2675	Problem-Oriented Diagnosis Diagnostic Evaluation of Urinary Incontinence in Geriatric Patients BARRY D. WEISS, M.D. Diagnosis and management plans can usually be established based on the history, the physical examination, urinalysis and measurement of postvoid residual urine volume.
	Patient information: "Finding Out About Incontinence," p. 2688
2695	Eyelid Disorders: Diagnosis and Management SUSAN R. CARTER, M.D. Eyelid problems range from benign to malignant; inflammation, infection, benign and malignant tumors and structural problems such as ectropion, entropion and blepharoptosis may occur. Warm compresses and antibiotics suffice for many conditions, while excision, cryotherapy or laser treatment are required for some.
2705	The Charcot Foot in Diabetes: Six Key Points GREGORY M. CAPUTO, M.D., JAN ULBRECHT, M.D., PETER R. CAVANAGH, PH.D., and PAUL JULIANO, M.D. The Charcot foot is a complication of sensory neuropathy in patients with diabetes mellitus. The acute Charcot foot is usually painless and may mimic cellulitis or deep venous thrombosis. If undiagnosed or improperly managed, it can result in disastrous complications for the patient, including amputation.
2713	Prevention of Neonatal Group B Streptococcal Infection CHRIS KEENAN, M.D., M.P.H. Neonatal group B streptococcal infection may be prevented through intrapartum treatment of women at high risk for delivering an infected infant.
	Patient information: "Group B Streptococcal Infection in Pregnancy--What It Means," p. 2725
2731	Current Guidelines for Antibiotic Prophylaxis of Surgical Wounds RONALD K. WOODS, M.D., PH.D., and E. PATCHEN DELLINGER, M.D. Preoperative antibiotics reduce rates of wound infection, although antibiotics administered postoperatively do not. An appropriately chosen cephalosporin is generally recommended for single-regimen antibiotic prophylaxis.
2743	Assessment and Treatment of Bulimia Nervosa BETH M. MCGILLEY, PH.D., and TAMARA L. PRYOR, PH.D. Successful management of bulimia nervosa requires early detection, comprehensive assessment for comorbid conditions and complications, and individualized therapy.
2753	Treatment of Systemic Lupus Erythematosus: An Update MICHELLE PETRI, M.D., M.P.H. Systemic lupus erythematosus is a complex autoimmune disorder with a prolonged course that can involve more than one organ system. Treatment approaches emphasize using a combination of drugs to minimize chronic exposure to corticosteroids.
2763	Sudden Death in Young Athletes: Screening for the Needle in a Haystack FRANCIS G. O'CONNOR, LTC, MC, USA, JOHN P. KUGLER, COL, MC, USA, and RALPH G. ORISCELLO, M.D. Nontraumatic sudden death in young athletes is, despite public perception to the contrary, quite rare, occurring most often in male athletes. Congenital cardiovascular disease, especially hypertrophic cardiomyopathy, is the leading cause. Screening athletes is a challenge.
2775	Evaluating Hoarseness: Keeping Your Patient's Voice Healthy CLARK A. ROSEN, M.D., DEBORAH ANDERSON, M.D., and THOMAS MURRY, PH.D. Vocal abuse is one of the most common causes of hoarseness and can lead to vocal pathologies such as vocal nodules. In a patient with a history of tobacco use, cancer of the head and neck must be ruled out before any other diagnosis can be accepted.
2789	Clinical Pharmacology Combination Antiretroviral Therapy for HIV Infection JANINE MAENZA, M.D., and CHARLES FLEXNER, M.D. Combination antiretroviral therapy is now standard treatment for HIV infection. The therapeutic goal is to decrease the viral load to undetectable levels within four to six months of initiating a new treatment regimen.