October 1, 1998

The first part of this two-part article reviews the principles of antibiotic use in the treatment of otitis media and acute sinusitis in children, and ways in which antibiotic use could be curtailed without compromising patient care.

A three-minute systolic blood pressure ratio of greater than 0.90 has a diagnostic accuracy of about 75 percent for the detection of coronary artery disease. Higher values for this ratio are associated with more extensive coronary artery disease and an adverse prognosis after…

Family physicians can benefit from knowing about some of the popular herbal preparations their patients are taking and from becoming familiar with what is currently known about their effectiveness, dosages, side effects, toxicities and drug interactions.

Proteinuria is a common laboratory finding in children. It can be identified as either a transient or persistent finding and can represent benign conditions or serious disease.

Screening mammography is recommended in women up to 85 years of age who have a life expectancy of three years. Several options for the management of localized and metastatic breast cancer are available to older women.

Two cholinesterase-inhibiting medications are now available to delay the progression of Alzheimer's disease, and many other agents are presently being studied in the search for ways to minimize the ravages of this all-too-common disorder.

(Hong Kong—Hong Kong Practitioner, May 1998, p. 291.) Refusal of food is common in children and may be the result of physical, emotional or social factors. Food refusal may occur rarely after episodes of choking or as a manifestation of abuse or prepubertal anorexia nervosa…

In your day-to-day encounters with patients, how do you navigate through the complicated medical, ethical, legal and economic issues that arise, not to mention the family matters and cross-cultural concerns that come up? How do you handle delicate family issues when one of your…

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

Cigars may be hip, but they aren't harmless. A study by Kaiser Permanente comparing 225 cigar-smoking men with 14,200 nonsmokers showed that cigar smokers had a 25 percent higher mortality rate. Men who smoked two cigars per day had an 87 percent higher risk of dying of cancer…

Why should we as family physicians take on the difficult and perplexing task of learning about herbal medicines? There are several reasons. First, with approximately 60 million adult Americans regularly using herbal supplements,1 the principles of patient-centered and…

Mallory's now legendary explanation of why he was climbing Mt. Everest, “Because it's there,” may also be the only good reason that we have for using antibiotics or other drugs in the treatment of most upper respiratory tract infections (URIs). As is meticulously documented by…

When it rains in Florida, there is grass to be cut, hedges to be trimmed and plenty of other yard work. Today, a young woman came to the office sporting a unique attraction that she had acquired while working in her garden: a grid-like pattern from an insect bite on her forearm…

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

While this parent may have been difficult under any circumstances, it is likely that this particular situation played a substantial role in the parent's anger and hostility. Health care professionals, especially if they have never been a patient or a parent themselves, may not…

The American Geriatrics Society (AGS) has published the first clinical practice guidelines to focus specifically on the management of chronic pain in older persons. The guidelines were published in the May 1998 issue of the Journal of the American Geriatrics Society.

A policy statement on hepatitis C virus from the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) calls for the screening of all persons who have risk factors for hepatitis C virus infection to identify those who may have the disease. Hepatitis C…

The American College of Sports Medicine (ACSM) has issued a statement emphasizing that children can participate in strength training programs if they have the emotional maturity to accept and follow directions. The ACSM defines strength training as a systematic program of…

Also Received

Otitis media with effusion is an ear infection with fluid in the middle (inner) ear. (Effusion is another word for fluid.) This fluid usually doesn't bother children. It almost always goes away on its own. So, this kind of ear infection doesn't have to be treated with…

Proteins are essential in our bodies. Normally, proteins move around in our blood, carrying food, hormones and medicine to all parts of the body. They also help keep water inside tiny blood vessels.