February 15, 1998

Rotator cuff impingement and tears are shoulder problems frequently encountered by family physicians. Learning to conduct a thorough, concise examination of the shoulder will help family physicians diagnose and treat these problems.

A knowledge of normal male genital anatomy and the pathophysiology of major emergency and benign processes causing testicular masses allows family physicians to appropriately manage patients and refer them to a urologist when indicated.

Acute pericarditis has a variety of etiologies and produces characteristic findings on ECG, including diffuse ST-segment elevation that, at times, may be difficult to distinguish from changes of acute myocardial infarction or other conditions.

Dyspnea, like other undifferentiated general symptoms, can best be diagnosed with the help of a careful history and physical examination. Selective diagnostic testing can be helpful in difficult cases.

Despite our increased awareness of the adverse health effects of lead, occupational lead poisoning continues to be a major problem, requiring a high index of suspicion for accurate diagnosis. Prompt removal of the worker from the source of exposure remains the mainstay of…

While the etiology of conjunctivitis can usually be determined on the basis of the history and ocular examination, cultures are sometimes necessary to establish the diagnosis and guide therapy.

Isoniazid toxicity can result in recurrent seizures, profound metabolic acidosis, coma and death.

Electromyography and nerve conduction studies can help distinguish axonal from demyelinating neuropathies.

Hemangiomas typically have proliferative, stationary and involutional phases. Many resolve without treatment, but others, often because of their location, require prompt intervention.

An isolated thyrotropin-stimulating hormone elevation usually indicates an early stage of thyroid failure. Because subtle symptoms and changes in lipid levels and cardiac function are common in this condition, treatment with levothyroxine may be advisable.

(Great Britain—The Practitioner, August 1997, p. 470.) Approximately 10 percent of women report some form of incontinence of urine, and it is estimated that 70 percent of cases can be cured. Stress incontinence is characterized by daytime leakage of urine on movement or…

Perhaps a little-appreciated aspect of publishing a journal is the work involved in piecing together the jigsaw puzzle of articles and advertisements that make up each issue. What does it take to produce 20 issues a year of a journal like AFP? To start with, it takes the…

Selected policy and health issues news briefs from AAFP News Now.

Do computer nerds have low bone density? In a study of 44 nonobese boys ages 15 to 17, one group was enrolled in two hours of group endurance training five days a week for five weeks, while the other group was enrolled in a computer class for the same amount of time. The…

Obesity is a common condition in adults and has significant cardiovascular consequences. Several pharmacologic agents have been approved by the U.S. Food and Drug Administration (FDA) for the short-term single-drug treatment of obesity, including phentermine (Adipex, Fastin…

We are doing more and more procedures in our office that once were done exclusively in the emergency department, hospital or outpatient surgery center. Today, JRH saw a longtime patient of his who had suddenly experienced shortness of breath two months after coronary artery…

(25th Annual Meeting of the North American Primary Care Research Group) For cesarean sections performed by family physicians, the clinical outcomes in both women and their infants are excellent compared with standard measures of surgical care, according to results of an…

Most calculi that are lodged in the ureter but are not causing excruciating pain for the patient can best be managed initially by observation without resorting to surgery, according to new treatment guidelines issued by the American Urological Association (AUA). Because…

The American College of Obstetricians and Gynecologists, under the auspices of the ACOG Committee on Educational Bulletins, has issued a report (ACOG Educational Bulletin No. 238) on the diagnosis and management of operative injuries of the urethra, bladder and ureters…

The U.S. Department of Health and Human Services (HHS) has issued preliminary recommendations for the medical management of persons who took the diet drugs fenfluramine or dexfenfluramine. The recommendations, published in the November 14, 1997, issue of Morbidity and Mortality…

Remember that the exercises described on the next two pages, which help strengthen the muscles of your shoulder (especially the rotator cuff), should not cause you pain. If the exercise hurts, use a smaller weight and stop exercising when the pain begins.

Lead can get into your body in two ways: inhalation (breathing it in) and ingestion (eating it). You might breathe in lead dust or lead fumes without even knowing it. You can swallow lead dust if it gets in your food or drinks. You might even swallow lead dust if you eat…