July 1, 1999

The principal causes of loss of vision in elderly patients (age-related macular degeneration, glaucoma, cataract and diabetic retinopathy) may be detected and monitored with careful annual eye examinations that include dilation.

Ludwig's angina is a potentially life-threatening diffuse inflammation of the submandibular and sublingual spaces. Following treatment with high doses of penicillin, most patients recover without complications.

Judicious eating and drinking to avoid contaminated foodstuffs is essential in preventing traveler's diarrhea. The condition can usually be treated initially with loperamide; a fluoroquinolone can be added if loperamide fails to stop the diarrhea. Because drug resistance is…

Isolation of the vas is key to a successful vasectomy. Techniques for managing the vasal ends include surgical clipping, cautery, fascial interposition and the open-ended technique.

Hypertension in black patients is usually characterized by a low-renin, volume-expanded and salt-sensitive state. Isolated systolic hypertension and combined systolic and diastolic hypertension are common in older patients. Diuretics and calcium channel antagonists are the…

Updated information is presented on a variety of subjects about family practice, including income, scope of the specialty, continuing medical education, board certification and residency training.

Ultrasound imaging may have a role in the surveillance of mild hip abnormalities in infants and possibly in selective screening for developmental dysplasia.

Some risk factors for fractures can be modified or eliminated. Based on cost-effectiveness and clinical efficacy, combined calcium and vitamin D supplementation should be first-line therapy in patients at risk for osteoporotic fractures.

If the clinician has an adequate working knowledge of the hypothalamic-pituitary-gonadal axis, the cause of aberrant puberty can often be identified with a focused medical history, a directed physical examination and selected diagnostic testing.

In evaluating and treating depression in women, family physicians should consider gender-related biopsychosocial differences, as well as phases of the reproductive cycle.

In a letter to the editor on the use of melatonin for insomnia (April 15, 1998, page 1783), the author, Ray Sahelian, M.D., failed to disclose that he was the author of a book on melatonin.

This document has been endorsed by the American Academy of Family Physicians and was developed in cooperation with the American College of Medical Genetics, the Association of Professors of Human and Medical Genetics, the Association of Departments of Family Medicine, the…

If you're a masthead watcher, you'll notice a number of changes on AFP's masthead in this issue (page 8), each with a story behind it:

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

Continuous irrigation makes full range of motion possible in patients with an infected finger, reports Physician's Weekly. Seven men with purulent tenosynovitis had a butterfly catheter (with the needle removed and holes cut in the sides) inserted in the tendon sheath from the…

As a specialty choice, family practice has come of age. It is the second most popular choice of residency among medical students, second only to internal medicine. Surprising as it may seem, as a career choice family practice is number one. More office-based physicians in the…

Adequate pain relief has an obvious positive effect on a patient's quality of life. However, recent data suggest that pain control also improves morbidity and mortality, that pain relief administered before surgery and during the postoperative period improves clinical outcomes…

CAG received an excellent suggestion from our nurse practitioner, Lori White, for giving eye drops to children and adults. The patient lies supine with the eyes closed, and another person places two drops in the medial canthus of each eye. Once the eyes are opened, the medicine…

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) Women have a higher short-term mortality rate after myocardial infarction than men, but only when the myocardial infarction occurs before the age of 75 years. This is the conclusion of an analysis of data…

(Australia—Australian Family Physician, March 1999, p. 223.) Postnasal drip refers to the accumulation of mucus in the postnasal space, caused by hypersecretion from the paranasal sinuses or a disturbance of normal drainage. In addition to “congestion” and local discomfort…

This case highlights a family physician's dilemma regarding confidentiality when caring for a minor patient. This sort of scenario is not uncommon in an office practice.

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) has released recommendations for the prevention and control of influenza during the 1999–2000 influenza season. The liaison representative to ACIP from the American…

The National Stroke Association (NSA) has developed an evidence-based consensus statement on the prevention of a first stroke. Published in the March 24/31, 1999, issue of JAMA, the NSA consensus statement is based on a comprehensive literature review of guidelines, meta…

The Centers for Disease Control and Prevention (CDC) reports that most women still do not know that an adequate intake of folic acid can prevent some serious birth defects. Even fewer women know that folic acid must be taken before and during the first few weeks of pregnancy…

It was the end of a long day.

Also Received

Traveler's diarrhea is a kind of diarrhea you might get when you're traveling in less developed countries. Many countries in Africa, Asia and Central and South America are risky places for travelers' diarrhea. It's usually caused by eating food or drinking water that is…

A vasectomy is a procedure that makes a man sterile (this means he has no sperm in his semen and can't make a woman pregnant). The doctor cuts and removes part of the tube that carries sperm from the testicles to the semen. (This tube is called the “vas deferens.”)

A few babies have hip problems that can lead to dislocation of the hip bones. This means that the long bone in the upper leg comes out of the hip socket. If your baby has this problem, it's important to find out early so it can be fixed (see Picture 1).

Puberty is the time in life when a young person starts to become sexually mature.

About 20% of women have depression at least once. If you're depressed, you may have some of these symptoms: