April 1, 1998

Universal prostate cancer screening is a matter of controversy because of the lack of scientific evidence showing that early detection decreases morbidity and mortality. Treatment options include radical prostatectomy, radiotherapy and watchful waiting.

Recent reports of the potentially harmful effects of calcium channel antagonists in hypertensive patients must be critically evaluated to allow clinicians to make sound clinical decisions about the use of these agents in the treatment of hypertension.

The incidence of sudden infant death syndrome is on the decline, largely as a result of public education campaigns in recent years. Risk-reduction measures that appear to be beneficial are placing healthy infants to sleep in the supine position, avoiding passive smoke exposure…

Controversy continues regarding the appropriate management of urinary tract infections in children. Aggressive diagnostic and treatment strategies should be reserved for use in patients who are at higher risk for renal scarring and complications.

Successful management of patients with seizures includes accurate diagnosis and appropriate use of medications. New medications and surgical treatments may help patients who do not respond to conventional therapy.

Bartholin gland cysts and abscesses can often be effectively managed in the office or emergency department. A number of proven treatment options are available.

Although once considered resistant to treatment, obsessive-compulsive disorder can be effectively managed with behavioral and/or pharmacologic therapy.

(Great Britain—The Practitioner, December 1997, p. 763.) Modern management of osteoarthritis emphasizes individualized exercise programs, judicious use of medications and, eventually, consideration of surgery. When the knee is affected, taping and injections may relieve…

The article beginning on page 1623, titled “Recognition and Treatment of Obsessive-Compulsive Disorder,” launches a series of articles from the Department of Family Medicine at Wright State University School of Medicine, Dayton, Ohio. The guest editors of this “Practical…

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

Wait—don't toss that umbilical cord just yet! It may still have some life-saving left to do. At Duke University Medical Center, a patient with acute lymphocytic leukemia needed a bone marrow transplant badly, but no match was available. Doctors decided to try placental blood…

After their introduction in the mid-1980s, the calcium channel antagonists became an increasingly popular first choice for the treatment of hypertension. Patients liked them for various reasons: they are effective and easy to take (a once-daily regimen); they do not cause side…

In the care of a woman in her third trimester of pregnancy, we usually devote one visit to discussing the labor and delivery orders that will fit best into the patient's desires concerning the upcoming delivery and our concerns for a safe delivery. Today, JRH encountered a new…

Photo Quiz presents readers with a clinical challenge based on a photograph or other image.

The American Heart Association (AHA) has released practice guidelines on the use of diagnostic imaging in patients with transient ischemic attacks (TIAs) and acute stroke. The guidelines, published in the July 1997 issue of Stroke, were developed by the Stroke Council of the AHA.

The American College of Obstetricians and Gynecologists (ACOG) has issued a report (Practice Pattern No. 6, 1997) on the management of women with post-term pregnancy. The report includes discussions on the etiologic factors, assessment of gestational age, antenatal monitoring…

The overall rate of cesarean delivery is generally thought to be too high. Because breech presentations are associated with cesarean delivery, the American College of Obstetricians and Gynecologists (ACOG) has evaluated results of studies on external cephalic version and made…

Visiting the doctor can provoke anxiety. No one likes waiting in that sterile, rubbing-alcohol–scented room for the doctor to magically appear. But for a few, the experience is made atypical. To these patients, the doctor announces, “I have a medical student here today and I…

Also Received

The prostate gland is like a doughnut under your bladder. The urethra (the tube that carries urine out of your body) goes through the middle of the prostate gland. The prostate is about the size of a walnut (see the picture below). The prostate gland makes a fluid that carries…

A physical exam of the rectum (the area where the prostate gland can best be felt) and a test of the level of prostate-specific antigen (also called PSA) in the blood are the usual ways to find prostate cancer. A PSA level higher than 4 ng per mL is considered suspicious. If…

A UTI is an infection of the urinary tract. The urinary tract includes the kidneys, the bladder and the urethra. The bladder is a balloon-shaped organ that stores the urine. The urethra is the tube that carries urine from the bladder outside the body. The kidneys are two bean…

Epilepsy is a name for a condition that causes brief disturbances in the normal electric function of the brain. These disturbances are called seizures. Another name for epilepsy is “seizure disorder.” In someone who has epilepsy, the normal activity in the brain is interrupted…

The Bartholin gland is a tiny organ on each of the labia (vaginal lips), near the opening of the vagina. If the vagina were the face of a clock, these glands would be found at about 4 and 8 o'clock. Normally they are invisible. They put out a small amount of fluid to lubricate…

Obsessive-compulsive disorder is surprisingly common and affects about two or three people out of every 100. It has two main symptoms: obsessions and compulsions. Obsessions are upsetting thoughts, pictures or urges that keep coming into your mind even though you don't want…