June 1, 1999

Although about 10 percent of adult patients experience persistent insomnia, most do not report the problem during routine office visits. Asking sleep-related questions while taking the general history may help to identify these patients.

Case studies are presented to acquaint family physicians with five diseases that are common in immigrants: strongyloidiasis, hookworm infestation, cysticercosis, clonorchiasis and tropical pancreatitis.

Mastocytosis is a cutaneous disorder or a systemic disease with symptoms ranging from a pruritic rash to vascular collapse. The diagnosis can easily be overlooked.

Endometrial cancer is a common malignancy in women but, with risk screening and endometrial sampling, it can be identified at an earlier stage, when treatment is highly successful.

The detection and treatment of early-stage cancers and adenomatous polyps can reduce the mortality rate for colorectal cancer. Current screening recommendations are reviewed.

Kawasaki disease is a leading cause of acquired heart disease in children. Criteria for early diagnosis are described, and acute treatment modalities are reviewed.

Patients with physically unexplainable symptoms present a genuine clinical challenge. Few patients in primary care meet the strict criteria for somatoform disorder; the family physician is more likely to be faced with somatic preoccupation.

Timely detection and appropriate intervention may mitigate the adverse effects of speech delay and improve the outcome in children with this disability.

Angiotensin-II receptor antagonists are effective in the treatment of hypertension. These drugs have a favorable side effect profile and are well tolerated by most patients.

Over 400 scientific editors and other members of the Council of Biology Editors (CBE) recently met in Montreal, Quebec, for a forum on communicating science in the 21st century. Several AFP staff members and representatives of other journals from the United States, Canada and…

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

Just a spoonful of sugar helps the electronic data-recording pill go down? Astronaut John Glenn swallowed an electronic pill that took measurements of his vital signs on his recent space mission, and doctors will soon be using such devices in corrective fetal surgery. The pill…

Colorectal cancer is a significant disease in both men and women. The American Academy of Family Physicians (AAFP) in 1996 established policy recommending routine screening of persons age 50 years and over for colorectal cancer.1 More recently, the AAFP participated in…

In their article on somatically preoccupied patients in this issue of American Family Physician,1 Righter and Sansone point out that patients who have multiple, physically unexplainable symptoms are a heterogeneous group presenting great challenge and, sometimes, frustration to…

Everyone cheers when a ballplayer steps up to the plate and hits a home run the first time at bat, or when the underdog rallies in the final lap and wins the race. Would you cheer in this case? Today a 44-year-old man visited JRH for the first time. He was accompanied by his…

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

(48th Annual Scientific Session of the American College of Cardiology) Azimilide, an investigational anti-arrhythmic drug, shows promise in significantly prolonging the arrhythmia-free period in patients with atrial fibrillation, according to the results of three randomized…

(Great Britian—The Practitioner, January 1999, p. 39) Parkinson's disease usually progresses slowly over 15 to 20 years, and the classic symptoms of rigidity and hypokinesia (with or without tremor) may be caused by several neurologic processes, making diagnosis difficult. One…

It is always frustrating when patients withhold important medical information or are not trusting or honest with their physicians. In these situations, it is helpful to first look at the possible reasons for the lack of forthrightness.

The American Thoracic Society (ATS) has issued a consensus statement on the mechanisms, assessment and management of dyspnea. Published in the January 1999 issue of the American Journal of Respiratory and Critical Care Medicine, the 19-page statement, developed by an 18-member…

A group of more than 150 cardiologists has issued recommendations for the treatment of chronic heart failure. The recommendations were developed on behalf of a not-for-profit organization called the Advisory Council to Improve Outcomes Nationwide in Heart Failure (ACTION HF…

The American Academy of Pediatrics (AAP) Committee on Infectious Diseases has released the complete AAP recommendations for the use of inactivated poliovirus vaccine (IPV) and live oral poliovirus vaccine (OPV). The recommendations are published in the January 1999 issue of…

The findings in a report from the Centers for Disease Control and Prevention (CDC), published in the March 19, 1999, issue of Morbidity and Mortality Weekly Report, document the continuing hazard of lead exposure as an occupational health problem. The report presents prevalence…

Also Received

Letter

Mastocytosis (say “mas-toe-sigh-toe-sis”) is a rare disease of the skin (the most common form), or of other parts of the body (very rare), like the stomach, the intestines and the bone marrow. It's caused by having too many mast cells. Mast cells are a kind of blood cell.

Endometrial cancer is an out-of-control growth of the lining of the uterus. It happens most often in women 50 to 60 years old. It is the fourth most common cause of cancer in women, after breast, lung and colon cancer.

Kawasaki disease (say: kah-wuh-sock-ee) is an illness that young children can get (usually children under age 5). It can cause any of these symptoms:

If your child doesn't talk as much as most children of the same age, the problem may be speech delay. Your doctor may think your child has speech delay if he or she isn't able to do these things: