May 1, 2000

A high index of suspicion is required to identify patients who require purified protein derivative skin testing for possible tuberculosis infection. In patients with a positive skin test whose clinical history or sputum smear is consistent with active disease, prompt initiation…

An appropriately structured preparticipation athletic examination improves a physician's ability to detect patients at risk for sudden exercise-related death, as well as conditions susceptible to rehabilitation.

FIGURE 1.Patient stands straight with arms at sides, facing examiner. Normal findings: symmetry of upper and lower extremities and trunk. Common abnormalities include enlarged acromioclavicular joint, enlarged sternoclavicular joint, asymmetric waist (leg-length difference or…

A number of genetic, hormonal and environmental factors may contribute to the development of seborrheic dermatitis. Many topical agents are available to control this inflammatory disorder.

The pessary is an effective nonsurgical way to treat a variety of gynecologic problems, such as pelvic support defects and stress urinary incontinence.

Osteoporosis affects more than 28 million Americans. One class of agents used to treat osteoporosis is the bisphosphonates, which have been shown to have a strong safety and tolerability profile.

The new classification of quinolone antibiotics takes into account the expanded antimicrobial spectrum of the newer fluoroquinolones and their clinical indications. This classification can help family physicians prescribe quinolones appropriately and evaluate new drugs as they…

Hearing loss caused by occupational or recreational exposure to noise is virtually 100 percent preventable. Family physicians can educate patients to avoid potentially damaging noise, to use adequate hearing protection and to seek treatment for an existing hearing deficit.

By identifying the effects of the six neurotransmitters on which drugs of abuse act, family physicians can make accurate diagnoses and institute appropriate interventions.

Family physicians who perform employee medical surveillance must visit the work site. Many resources are available to help physicians design a comprehensive surveillance program.

Bilious vomiting, with or without abdominal distention, is the initial sign of intestinal obstruction in newborns. Duodenal atresia, midgut malrotation and volvulus, jejunoileal atresia, meconium ileus and necrotizing enterocolitis are the most common causes.

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

The article on page 2791, “Bilious Vomiting in the Newborn: Rapid Diagnosis of Intestinal Obstruction,” by Ken Kimura, M.D., and Vera Loening-Baucke, M.D., represents the last of the articles in the “Radiologic Decision-Making” series coordinated by Thomas J. Barloon, M.D…

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

Growing up in America might be harder than we think. According to a report in Time magazine, less than two thirds of American adolescent students reside with both of their parents. This number is shocking when compared with rates in other countries, such as Greece, where 91…

The medical community continues to benefit when physicians reexamine topics that have been widely written about, as authors Kurowski and Chandran have done in this issue of American Family Physician.1 However, their debate over the preparticipation physical examination deals…

I sat in the pediatrics section meeting at a local community hospital when they asked for volunteers for preparticipation sports physical examinations. As a pediatric cardiologist, I figured I might offer valuable help. When I arrived at the enormous gymnasium of the local…

After an unprecedented increase in reported cases of tuberculosis in the United States that began in 1986, the disease has been brought under control. In 1999, the number of reported cases of tuberculosis declined to an all-time low of 17,528, and the country recommitted itself…

A 24-year-old mother of two who had undergone bilateral tubal ligation visited JTL following hospitalization for the evaluation of right lower quadrant pain. The hospitalist and general surgeon concluded that her pain was likely psychogenic, because the results of the computed…

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

(Canada—Canadian Family Physician, February 2000, p. 303.) When the trabecular mesh-work is blocked at the junction of the cornea and iris, the resulting rise in intraocular pressure can reach dangerously high levels and damage the optic nerve. Acute closed-angle glaucoma…

The American College of Cardiology (ACC) and the American Heart Association (AHA) have revised their original 1991 guidelines for coronary artery bypass surgery.

Troglitazone (Rezulin), a drug used in the treatment of type 2 diabetes mellitus (formerly non–insulin-dependent diabetes mellitus), was recently removed from the market at the request of the U.S. Food and Drug Administration (FDA).

Why is such critical information about patients and their lives so frequently left unsaid? There are a myriad of possible explanations.

DB is 72 years old and recently moved into a nursing home. She has not received her yearly influenza shot. DB has numerous health problems, including diabetes mellitus, arthritis (for which she receives prednisone) and emphysema. She has a history of having influenza almost…

Also Received

Tuberculosis (say: too-burr-cue-low-sis), or TB for short, is an infection caused by a bacteria (a germ). TB usually affects the lungs, but it can spread to the kidneys, bones, spine, brain and other tissues.

Seborrhea (say: seb-uh-ree-uh) is a common skin problem. It causes a red, itchy rash and white scales. When it affects the scalp, it is called “dandruff.” It can be on parts of the face as well, including the folds around the nose and behind the ears, the forehead, and the…

A pessary is a plastic device that fits into your vagina to help support your uterus (womb), vagina, bladder or rectum.

Noise-induced hearing loss is the slow loss of hearing caused by too much noise. Hearing loss happens when too much noise hurts the hair cells in the inner ear.