April 15, 2000

Breast pain, nipple discharge and a palpable mass are common breast problems that cause women to seek medical attention. In most women, these problems are the result of benign breast disease.

Knee effusions are the result of trauma, overuse and systemic processes. A meticulous physical examination coupled with appropriate imaging and diagnostic testing establishes the correct diagnosis.

Patients who abuse prescription drugs may exhibit patterns of behavior such as escalating use, losing prescriptions and doctor shopping.

Amoxicillin remains the first-line choice for treatment for acute otitis media, but higher dosages (80 mg per kg per day) may be prudent to ensure eradication of antibiotic-resistant Streptococcus pneumoniae.

A written long-term treatment plan and education can improve outcomes for patients with asthma.

Prompt treatment of herpes zoster with antiviral medications, and oral corticosteroids in selected patients, can decrease the duration of the painful rash and the subsequent risk of postherpetic neuralgia.

Swallowing may be impaired because of a variety of structural or functional disorders, such as stroke, cancer, neurologic disease and gastroesophageal reflux disease. The physical examination should include the neck, mouth, oropharynx and larynx. The nerves that control these…

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.

Three quarters of a year ago, Amy S. Weichel, D.O., joined the staff of AFP as the seventh physician to serve as the John C. Rose Medical Editing Fellow at the editorial offices at Georgetown University School of Medicine, Washington, D.C. Her fellowship started at the first of…

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

I'm a little bit country, but not a little bit pollution control? A recent study indicates that rural vehicles emit more pollutants than urban vehicles. The study looked at ppvm (pollutant per vehicle-mile), which measures the total particulate matter emission made by a vehicle…

In this issue of American Family Physician, Morrow1 discusses the evaluation of three common breast problems: breast pain, nipple discharge and breast mass. I agree with the author's assertion that the goal of the evaluation is to exclude cancer and treat symptoms.

Asthma is a serious chronic inflammatory airway disease affecting more than 15 million Americans, one third of whom are children. If managed appropriately, hospitalization is rare, yet over 40 percent of costs are related to emergency services and hospitalizations that result…

It's always hard to deliver bad news. With practice, we learn ways to soften the blow, so there won't be as many pieces to gather up afterward. Today, however, JRH dealt with perhaps his youngest case of disappointment. A weary and worn six-year-old boy arrived with his equally…

(63rd Annual Meeting of the American College of Rheumatology) Results from a pooled analysis of three identical 12-week, double-blind, placebo-controlled studies indicate that celecoxib (Celebrex) at dosages of 100 or 200 mg twice daily can significantly improve health-related…

(Canada—Canadian Family Physician, January 2000, p. 121.) Changing patterns of chloroquine resistance make malaria prevention increasingly challenging. Chloroquine alone is now inadequate for prophylaxis in most areas. Mefloquine is the leading agent for many areas but concerns…

During 1999, the Center for Drug Evaluation and Research (CDER) at the U.S. Food and Drug Administration (FDA) took 190 actions on original new drug applications. Of these actions, 83 were drug approvals that occurred in a median time of 12 months. Twenty-eight of these…

The American Heart Association (AHA) and the American College of Cardiology (ACC) have issued a report that discusses approaches to the assessment of cardiovascular risk as a tool for primary prevention of coronary disease.

Approximately 38 percent of patients who are being treated for high blood pressure may stop taking their medication because of problems with tolerance, according to results of a recent survey, which was sponsored by the Association of Black Cardiologists. Ninety-five percent of…

Breast pain is a common problem in younger women who are still having their periods (menstrual cycle). It is less common in older women. The pain can be in one breast or in both. It may come and go each month, or it may last for several weeks, or even months, and then just go…

Most people with asthma need two kinds of asthma medicine: one for quick relief and one for long-term control.

Asthma is a disease of the airways in the lungs. You can get asthma at any age. People can have asthma for many years. Often, more than one person in a family has asthma.

Shingles is another name for a condition called “herpes zoster.” It causes a painful rash. You can only get shingles if you had chickenpox in the past.