February 1, 1999

Most patients with a herniated lumbar disc respond to conservative management. An initial examination to exclude serious pathology is essential, along with monitoring for the development of complications such as neurologic defects, cauda equina syndrome and refractory pain.

Preterm labor is a complex condition with multiple clinical presentations. New clinical and biochemical markers may help physicians predict which women will develop preterm labor, and new management strategies may improve maternal and neonatal outcomes.

By introducing the subject of advance care planning during a routine office visit, physicians can facilitate a structured discussion of the patient's wishes for end-of-life care.

In patients with exfoliative dermatitis, most of the skin undergoes an erythematous inflammation that results in massive scaling. A biopsy is usually necessary to make the diagnosis.

Warfarin, the most frequently prescribed oral anticoagulant, has a complicated dose-response relationship. Safe and effective administration requires a thorough understanding of the pharmacology of warfarin.

This form is a combined durable power of attorney for health care and a living will (in some jurisdictions). With this form, you can name someone to make medical decisions for you if in the future you're unable to make those decisions yourself. You can also say what medical…

(Australia—Australian Family Physician, September 1998, p. 780.) The most common form of transmission of hepatitis C virus (HCV) is direct percutaneous inoculation, and up to 80 percent of persons who begin injecting drugs become positive for hepatitis C antibody within one…

AFP recently earned more kudos: the prestigious Gold Circle Award presented by the American Society of Association Executives (ASAE). For the past 21 years, ASAE's Communications Section has sponsored an awards program that recognizes outstanding accomplishments of American…

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

Years later, the memory of war may still affect people's emotional health, but not their physical health. A study of over 4,700 pairs of identical and fraternal twin brothers who were exposed to combat in Vietnam found that the psychologic trauma of combat had only a minor role…

Advance directives have been on the American health care scene for over 20 years. Yet, despite their long life and legitimate legal and moral bases, signing rates are still far from universal. If one ascribes to the catch phrase in a popular movie—“if you build it, they will…

Remarkable advances in the ability to treat persons living with human immunodeficiency virus (HIV) infection have occurred in the past two years. The availability of viral load monitoring and a larger palette of antiretroviral medications have made a substantive impact on…

WLL argued valiantly, but the parents-to-be refused to have vitamin K administered intramuscularly to their yet-to-be newborn. These parents were concerned about reports that pain experienced during the neonatal period may have long-term effects (i.e., the March 1, 1997, issue…

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

I believe that the problem here could have been avoided by acknowledging the mother's concerns and answering them specifically and directly. A recent study performed in Atlanta indicated that 84 percent of parents would accept a physician's decision not to prescribe antibiotics…

The American College of Sports Medicine (ACSM) and the American Heart Association (AHA) have developed recommendations for cardiovascular screening of participants in physical activities at health/fitness facilities. The recommendations also discuss the qualifications for staff…

To provide physicians and their patients with information on the management of cough manifested both as a defense mechanism and as a symptom of diseases, such as asthma, gastroesophageal reflux disease (GERD) or bronchogenic carcinoma, the American College of Chest Physicians…

The American Psychiatric Association (APA) has issued a new treatment guideline for persons with panic disorder. According to the APA guideline, published in the May 1998 issue of the American Journal of Psychiatry, medication and cognitive behavioral therapy, a form of…

Book Reviews | Also Received

Letter

When the soft part between bones in the spine presses on the nerves around the backbone, it's called a herniated disc. The word “herniate” (say: her-nee-ate) means to bulge or to stick out. Sometimes this is called a ruptured disc.

Talking with your doctor about your wishes for medical care at the end of your life is called advance care planning. It's a way for you and your doctor to discuss the kinds of care you want and the kinds of care you don't want at that time. You can tell your doctor about the…