May 15, 1999

In any newborn or young infant with fever and lethargy or irritability, the diagnosis of meningitis must be considered and lumbar puncture performed, unless clinically contraindicated. Antimicrobial therapy that targets all likely organisms should be administered until the…

Shoulder instability is a common injury in young athletes. Tests to determine whether anterior, posterior or multidirectional instability is present are important aspects of the physical examination. Early surgical repair of the shoulder may reduce the risk of recurrent…

Management of the minimally abnormal Papanicolaou smear may include testing for human papillomavirus (HPV). The hybrid capture test detects both oncogenic and nononcogenic types of the virus.

Mistreatment includes physical abuse and neglect, psychologic abuse, financial exploitation and violation of rights. Diagnosis of elder mistreatment depends on a detailed history from both patient and caregiver, and a comprehensive physical examination. When mistreatment is…

Making a diagnosis early in the course of cutaneous T-cell lymphoma is difficult, since the signs of this disease mimic several benign skin disorders.

Medical causes of learning difficulties can be identified or excluded with the help of a thorough history and physical examination. Assessment and management of the child with these complex problems requires the help of a multidisciplinary team of professionals.

Stroke should be considered a true medical emergency requiring rapid assessment and early intervention. The use of tissue plasminogen activator within three hours of stroke onset improves neurologic outcome, and more agents should be available soon.

In the past three years, the development of new oral agents for the treatment of type 2 diabetes has expanded the range of therapy for patients with this disorder.

Near the end of last year, we took a look at some of the improvements AFP had in store for this year. While we're not yet halfway into the year, many of the changes on our list are already old news: graphic refinements in tables and figures, redesigned patient information…

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

Transplants using organs from “marginal” donors (those who are clinically unstable or over 45 years of age) may be more successful than transplants using organs from “normal” donors, according to results of a study in Transplantation that included 137 patients who received…

False-positive screening tests are common and can be emotionally devastating to patients. Unfortunately, many patients are not aware that the vast majority of positive screening tests occur in completely healthy persons. In the case of fecal occult blood testing, for instance…

Today a father came in after “go-carting” with his son and daughter over the weekend. It had occurred to him that by following the go-cart on his dirt bike, he could gauge the cart's speed by following at the same speed himself. The theory worked just fine, and the peak…

(36th Annual Meeting of the Infectious Diseases Society of America) Research indicates that men who are positive for human immunodeficiency virus (HIV) infection and who are undergoing treatment with highly active antiretroviral chemotherapy (HAART) may still be able to…

(Australia—Australian Family Physician, December 1998, p. 1095.) Recurrent lower urinary tract infections (UTIs) can be difficult to treat in older (toilet-trained) children. Infrequent episodes, up to three per year, can usually be managed by a five-day course of an antibiotic…

The American Heart Association (AHA) has issued a report on the impact of laboratory molecular diagnosis of three genetically transmitted cardiovascular diseases: hypertrophic cardiomyopathy, long-QT syndrome and Marfan syndrome. The report notes that the present role for the…

Although circumcision has potential benefits, the data “are not sufficient” to recommend neonatal male circumcision as a part of routine medical care, according to a new policy statement from the American Academy of Pediatrics (AAP) published in the March 1999 issue of…

Most Americans do not receive screening for colorectal cancer even though evidence exists that reduction in colorectal cancer morbidity and mortality can be achieved through detection and treatment of early-stage colorectal cancers and the identification and removal of…

Letter

“Shoulder instability” is what doctors say you have when your shoulder goes a little out of place or feels like it might. “Instability” means that the shoulder bones aren't stable—they aren't held together as tight as they should be.

Human papillomavirus (also called HPV) causes a common infection that one person can give to another person during sex. There are many types of HPV. Some types of HPV cause genital warts. Other types of HPV are connected with cancer of the cervix.

Diabetes is a disease that you can get when your body doesn't make enough of a hormone called insulin, or when your body can't use insulin the right way. Insulin helps balance the glucose (sugar) in your blood. The blood sugar level is too high in people with diabetes. Children…