November 1, 1999

When available tests are nondiagnostic, empiric anticoagulation should be considered until the diagnosis can be confirmed or ruled out by further studies.

Tight control of serum glucose levels in patients with type 1 diabetes may decrease the risk of serious complications, including retinopathy, neuropathy, stroke, heart disease and peripheral vascular disease.

Because exercise-related syncope may be the only symptom preceding a sudden cardiac death in young athletes, it is a condition that always requires investigation.

Questions remain to be answered about the etiology and treatment of patellofemoral pain syndrome. Most patients respond well to conservative treatment measures, including stretching and strengthening exercises, and temporary activity modification.

Appendicitis is common, with a lifetime occurrence of 7 percent. Delay in diagnosing appendicitis increases the risk of perforation and complications that are much more serious in children and the elderly.

A burner can result in prolonged weakness that causes time lost from sports participation, and reinjury can occur.

Failure to pass meconium within 24 hours of birth may signal intestinal obstruction. Hirschsprung's disease, anorectal malformations and meconium plug syndrome are among the disorders that can cause intestinal obstruction in the neonatal period.

The rates of morbidity and mortality associated with influenza have led the American Academy of Family Physicians to recommend a lower age for universal influenza vaccination—50 years instead of 65 years of age.

By choosing an appropriate pill formulation, the family physician can minimize negative side effects and maximize noncontraceptive benefits for individual patients.

This issue features the first in a series of “Problem-Oriented Diagnosis” articles by a new group of contributors, from the Department of Family Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Md. The article, “Exercise-Related Syncope in the…

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

Deaths caused by the acquired immunodeficiency virus syndrome (AIDS) have decreased by 50 percent since 1996, reports USA Today. Statistics from the Centers for Disease Control and Prevention show that 49,351 persons died of AIDS in 1995 alone. This number drastically decreased…

The management of patients with type 1 diabetes mellitus (formerly known as juvenile-onset or insulin-dependent diabetes mellitus) poses a number of challenges to the practicing physician. These challenges include helping patients maintain optimal blood glucose control…

Influenza continues to be a major cause of morbidity and mortality in the United States. Each year, approximately 20,000 deaths and 110,000 hospitalizations occur because of influenza.1 Rates of infection are highest in children, but rates of serious morbidity and mortality are…

In a previous Diary entry (August 1994), WLL reported the anecdotal success of a supersaturated boric acid solution applied to the toenails twice a day for six to 12 months to treat onychomycosis. Today, he learned of another topical treatment for this problem when he saw a…

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

(Great Britain—The Practitioner, August 1999, p. 608.) After a traumatic event, some persons experience post-traumatic stress disorder (PTSD), characterized by recurrent, distressing and intrusive thoughts, images or dreams. According to the Diagnostic and Statistical Manual of…

The case study described above outlines a situation that is far too common in families dealing with Alzheimer's disease.

The National Comprehensive Cancer Network (NCCN) and the American Cancer Society (ACS) have unveiled the first-ever patient-friendly version of the NCCN's clinical breast cancer treatment guidelines. The 17-member institutions of the NCCN develop cancer practice guidelines for…

Recommendations for the use of the Lyme disease vaccine (Lymerix) have been issued by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC). The recommendations were reported in the June 4, 1999, issue of Morbidity and…

The American Academy of Pediatrics (AAP) has issued a new policy statement on the dangers of sun exposure to infants. According to the statement, which appeared in the August 1999 issue of Pediatrics, it may be safe to use sunscreen on infants younger than six months of age…

Also Received

Type 1 diabetes is sometimes called juvenile diabetes, or insulin-dependent diabetes. It means that your body can't make insulin. Insulin helps your body use the sugar it makes from the food you eat. Your body uses this sugar for energy. We need insulin to live. Without insulin…

Patellofemoral pain is a common knee problem. If you have this condition, you feel pain under and around your kneecap. The pain can get worse when you're active or when you sit for a long time. You can have the pain in only one knee, or you can have pain in both knees.

A “burner” is an injury to one or more nerves between your neck and shoulder. It is also called a “stinger.” It usually happens in sports like football. It's not a serious neck injury.

Influenza (also called “the flu”) is a viral infection in the nose, throat and lungs. About 10 to 20 percent of Americans get the flu each year. Some people get very sick. Each year, about 130,000 people go to a hospital with the flu, and 20,000 people die because of the flu…