February 15, 1999

Testicular torsion must be treated in a timely manner if the testis is to be saved. Other causes of scrotal pain or swelling include torsion of a testicular appendage, epididymitis, trauma, hernia, hydrocele, varicocele and Schönlein-Henoch purpura.

Rare liver diseases result in increased maternal and fetal mortality. Treatment may involve prompt delivery, whereupon the liver disease usually reverses.

The family physician is often instrumental in the process of returning a patient to work after injury or illness. Helpful sources of information include discussions with the patient's supervisor, job demand analysis evaluations and the Dictionary of Occupational Titles.

The most common types of unusual anemia are the anemia of renal disease, thalassemia, anemia of chronic disease and myelodysplastic syndrome.

Although the prevalence of childhood obesity has risen in the past several decades, this condition remains underdiagnosed and undertreated. All obese children should be screened for cardiac risk factors and other possible sequelae.

Brain metastases, the most common neurologic complication in cancer patients, typically present as headaches or altered mental status.

Most groin hernias require surgical repair. The many herniorrhaphy techniques can be grouped into four categories: open anterior repair, open posterior repair, tension-free repair with mesh and laparoscopic procedures.

Esophageal atresia, with or without tracheoesophageal fistula, is a congenital disorder that must be recognized immediately to prevent complications of aspiration and to prepare for timely surgical correction.

Clinical gout comprises a heterogeneous group of disorders characterized by deposition of monosodium urate crystals in and about the joints and tendons. Gout progresses through four clinical phases: asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout…

Problem sleepiness occurs when the amount of sleep is inadequate because of primary sleep disorders, other medical conditions or lifestyle factors.

Low-molecular-weight heparins are as safe and effective as unfractionated heparin in the treatment of deep venous thrombosis, and hospitalization may not be required with the use of these newer agents.

Recent advances in topical therapy for psoriasis offer considerable hope and convenience to patients with this dermatosis. Vitamin D analogs, topical retinoids and new anthralin preparations have expanded physicians' therapeutic armamentarium.

(Great Britain—The Practitioner, September 1998, p. 627.) Although only a small proportion of men with testicular lumps have testicular neoplasm, accurate diagnosis based on history, physical examination and selected investigations can significantly reduce patient anxiety. Key…

Many of our readers have seen AFP grow from 12 issues a year to 16 issues a year and now 20 issues per year. With continued growth comes continued change, and with this issue comes yet another change: the frequency of our longstanding “Practical Therapeutics” series has been…

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

For people who have trouble swallowing pills, time-release capsules haven't been an option. Instead, these people relied on taking small, frequent doses or using chewable pills, sometimes as often as six times a day. However, researchers at Oregon State University may have come…

As Moran1 describes in this issue of American Family Physician, an epidemic of childhood obesity is occurring in the United States; the prevalence of the most severe cases—defined as a body mass index (BMI) for age over the 95th percentile—has virtually doubled over the past 20…

Just as “problem drinking” is a useful term that defines excessive drinking by its repercussions rather than by a specific amount, so is the term “problem sleepiness” meant to refer to sleepiness that causes adverse effects for the person involved. The specific quantity or…

In a previous “Diary,” we mentioned that aphthous ulcers of the mouth might be prevented in the majority of patients by avoiding toothpaste containing the detergent sodium lauryl sulfate (SLS). Now, WLL has come across another study in the European literature (Acta Odontol…

(26th Annual Meeting of the North American Primary Care Research Group) Results of a survey showed that the use of shared obstetric call groups in family practices allows for a high level of patient satisfaction while offering a viable alternative to physicians who would…

The National Osteoporosis Foundation (NOF) has issued recommendations for the prevention, risk factor assessment, diagnosis and treatment of osteoporosis, including specific guidelines on the use of bone mineral density tests. “The Physician's Guide to Prevention and Treatment…

The National Institutes of Health (NIH) has issued a consensus development conference statement on the rehabilitation of persons with traumatic brain injury. The conference that culminated in the consensus statement was convened by the NIH to evaluate the scientific data…

The American Heart Association (AHA) and the American College of Cardiology (ACC) have issued an expert consensus document with recommendations for the safe and appropriate use of sildenafil (Viagra) when treating sexual dysfunction in patients at clinical risk of…

Your doctor will use a chart to find out if your child might be overweight. Your child is overweight if he or she is heavier than 85 percent of other children who are the same age and height. If your child has bigger bones, he or she may weigh more because of that, not because…

Not all heavy children have weight problems as adults. However, as children get older, their risk for staying overweight goes up. The risk is even higher if one or both parents also are overweight. It's important to catch weight problems early.

In babies with esophageal atresia, the esophagus doesn't go into the stomach. It just ends in a pouch, so nothing the baby swallows gets into the stomach. (This is how you say these words: ee-sof-ah-gee-all at-tree-see-ah; tray-key-oh-ee-sof-ah-gee-all fist-you-lah.)

Psoriasis (say “sore-eye-a-sis”) is a skin problem. It causes red, silvery scales and flaky skin patches. It can get better or worse, but there's no cure. No one knows what causes psoriasis. It's not caused by something you ate or something you're allergic to. You can't catch…