March 15, 2000

The most important step in the successful management of gallstone disease is the accurate differentiation of gallstone-induced biliary colic from other abdominal diseases.

Spontaneous abortion may result in acute stress disorder or post-traumatic stress disorder in a small proportion of women.

New antiviral medications offer increased treatment options for genital herpes. However, the convenient oral dosing regimens of famciclovir and valacyclovir may not offset the additional expense when compared with acyclovir.

Alcoholism and alcohol abuse are common but underrecognized problems in older adults.

A number of factors must be considered when choosing an antibiotic for the treatment of bacterial endocarditis.

Family physicians should be alert for drug interactions and should have appropriate resources to help them avoid or manage these interactions. Drug interactions may be encountered with such commonly used medications as antibiotics, warfarin, antidepressants and oral…

Colorectal cancer has a long asymptomatic period during which it can be diagnosed at a stage that is amenable to treatment. Early identification and treatment improve survival. Screening guidelines and techniques are reviewed.

In most patients, low back pain responds to conservative measures, including medications, physical therapy modalities and exercise. Low back pain is usually caused by muscle strain, but it can also be caused by infection, malignancy, rheumatologic diseases and neurologic…

Simple oral analgesics, such as acetaminophen or low dosages of nonsteroidal anti-inflammatory drugs (NSAIDs), remain the first line of treatment for uncomplicated osteoarthritis. Other treatments are higher dosages of NSAIDs, agents such as the new cyclo-oxygenase-2 inhibitors…

This feature is part of a year-long series of excerpts and special commentaries celebrating AFP's 50th year of publication. Excerpts from the two 1950 volumes of GP, AFP's predecessor, appear along with highlights of 50 years of family medicine.

As part of a multifaceted approach to gathering feedback from readers, AFP periodically conducts focus groups to get a close-up view of reader perceptions. Typically, a facilitator leads a group of 10 to 12 readers through a series of questions that help us get a feel for areas…

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

Gunfire claimed the lives of almost 80,000 young persons between 1979 and 1997 in the United States, reports USA Today. Statistics recently released by the National Center for Health Statistics rated 1994 as the most tragic year, with 5,793 young people dying of gunfire-related…

In this issue of American Family Physician, Rudy and Zdon1 review the benefits of early detection of colorectal cancer. Citing a previously published model,2 they estimate that screening 100,000 persons with fecal occult blood testing, sigmoidoscopy, barium enema or colonoscopy…

In this issue of American Family Physician, Ament and colleagues1 highlight several important drug interactions and also raise an ongoing health care concern: How can morbidity and mortality from drug interactions be reduced?

How often have you heard this maxim: “When you hear hoof beats, think of horses, not zebras?” In fact, JRH found himself repeating these words to himself today after his first patient encounter. The young male patient of 28 years arrived, complaining of sores on the shaft of…

(27th Annual Meeting of the North American Primary Care Research Group) According to a randomized controlled trial, the interventions of practice profiling feedback and patient education had little impact on promoting appropriate prescribing of antibiotics for pediatric upper…

(Australia—Australian Family Physician, November 1999, p. 1109.) Most conventional joint prostheses are made of metal and plastic and are fixed to the skeleton with polymethylmethacrylate cements. Wear and cement breakdown can cause these devices to deteriorate. Because of…

The American College of Cardiology (ACC) and the American Heart Association (AHA) have updated guidelines for the management of myocardial infarction. The guidelines cover a wide scope, from management in the field, emergency department and hospital to predischarge evaluation…

The Committee on Obstetric Practice of the American College of Obstetricians and Gynecologists (ACOG) has issued an opinion paper (Committee Opinion no. 228) on the induction of labor with misoprostol. The opinion paper appears in the November 1999 issue of Obstetrics and…

Letter

The gallbladder is a small “bag” just under your liver. It stores digestive juices that are made by the liver. Sometimes these juices become solid and form stones, called gallstones.

No vaccine can protect you from HSV infection, but you can do some things to keep from getting infected.

Genital herpes is a viral infection. It is caused by the herpes simplex virus, which is called HSV for short. One form of the herpes virus causes “cold sores” around the mouth or lips. This kind can be passed around if someone touches the cold sore and then touches another…

Bacterial endocarditis (BE) is an infection of the valves and inner lining of the heart. It happens when bacteria from the skin, mouth or intestines enter the bloodstream and infect the heart valves and lining.

Colorectal cancer is cancer of the colon or rectum. The colon is the large intestine, and the rectum is the part of the large intestine that is closest to the anus (the outside opening to the intestine).

Most often, low back pain is caused by a stretched or strained muscle. This muscle hurts when you move while it is healing.

The decision to stop using alcohol or other drugs (as well as a history of previous use) is very important to your health. If your doctor knows that you have made this decision, he or she can help you in your recovery. By working with your doctor, you can increase your chance…

If you don't have a drinking problem, it's probably safe for you to drink a limited amount of alcohol without affecting your health. A sensible drinking limit for people who don't have a problem with alcohol is:

Alcohol withdrawal syndrome is a set of symptoms (health conditions) that people get when they suddenly stop drinking after using alcohol for a long time. Some people have mild shakiness and sweats. Some people hallucinate—they hear and see things that don't exist. The worst…

TV and radio make it sound easy to “just say no”, but it may not be so easy for you. You have some real pressures. Maybe your friends want you to drink with them. Maybe you are stressed out at home, at school or at work. You may be looking to alcohol as a way to make people…

“Smoking isn't a bigger problem for people in recovery than it is for anyone else. You're just trying to scare me.”

Yes. Most experts agree that alcoholism is a disease, just as high blood pressure, diabetes and arthritis are diseases. Like these other diseases, alcoholism tends to run in the family. Alcoholism is a chronic disease. “Chronic” means that it lasts for a long time or comes back…