September 15, 2000

Early diagnosis and aggressive management of the complications of sickle cell disease, including infections, acute splenic sequestration and acute chest syndrome, are important. Complications can progress quickly and become life-threatening.

Forceps are being replaced by vacuum extractors for many situations in which assistance is required to achieve vaginal delivery. Vacuum extractors should be used when indicated, usually for a nonreassuring fetal heart tracing or failure to progress in the second stage of labor.

Certain natural supplements may be helpful in the management of common medical conditions, but careful selection of patients and knowledge of side effects are critical components in effective use. The second part of this two-part article discusses the role of natural…

Primary care physicians need to differentiate the patient who has a common benign cause of proteinuria from one who has a more serious cause, such as glomerulonephritis or multiple myeloma, and who may need referral for further evaluation.

Collaboration between the patient's family physician and psychiatrist is important. The use of tricyclic antidepressants should be avoided in these patients because they may induce a rapid cycling of symptoms.

This article reviews patient-oriented evidence on the role that dietary and supplemental antioxidants and folic acid may play in the prevention of coronary disease and stroke.

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

Earlier this month, AFP held its annual editorial board meeting at the AAFP headquarters in Leawood, Kan. It's a compressed two-day event that offers AFP's editors a chance to mingle and let ideas cross-pollinate. We were particularly pleased with the achievements of this year…

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

This will only hurt a little. A team of University of Pittsburgh Medical Center and Veterans Affairs surgeons and anesthesiologists recently performed minimally invasive direct coronary bypass (MIDCAB) surgery on a 51-year-old patient. Not exactly newsworthy, you say? It is…

Vacuum extraction is an important maternity care skill for family physicians. Nationally, 82 percent of family physicians delivering infants have hospital privileges to perform vacuum extraction, which is nearly double the 44 percent who have privileges to assist delivery with…

Many patients are frustrated by the mixed messages regarding vitamin supplements. They look to their physicians for guidance, but we often have insufficient or contradictory information because of the complexities of nutritional science and incomplete evidence. Health care…

Many family physicians pay lip-service to a pillar of our specialty: continuity of care. But, in truth, much of what we do is episodic in nature. Today, an elderly man presented with a bleeding varicose vein. While JRH has seen this occur in advanced cases, he suspected the…

(13th Annual Meeting of the American Association for Geriatric Psychiatry) Results of three prospective studies demonstrated significant benefits from treatment with rivastigmine tartrate, a cholinesterase inhibitor, in patients with Alzheimer's disease who were also at high…

(Australia—Australian Family Physician, March 2000, p. 243.) Acute compression of the heart between the sternum and spine during a motor vehicle crash or following a blow to the chest wall may damage the coronary arteries. While the left descending artery is most vulnerable…

Up to one half of pre-menopausal women will have endometriosis, in which endometrial-like glands and stroma grow in an extrauterine site. The American College of Obstetricians and Gynecologists (ACOG) has updated its guidelines on the treatment of endometriosis.

The Committee on Psychosocial Aspects of Child and Family Health of the American Academy of Pediatrics (AAP) has issued a policy statement on the role of the physician in childhood bereavement. The AAP policy statement appears in the February 2000 issue of Pediatrics.

Bipolar disorder is an illness that causes extreme mood swings. This condition is also called manic-depressive illness. It may be caused by a chemical imbalance in the brain.

Cigarettes are the leading cause of preventable deaths in this country. Tobacco is toxic to your body. The nicotine in cigarettes and smokeless tobacco (snuff or chewing tobacco) makes your body release adrenaline. Adrenaline causes your blood vessels to constrict and your…

Congratulations on your decision to quit using tobacco. The nicotine patch your doctor has recommended will help make it easier to quit smoking or using smokeless tobacco. The instructions in this handout will help you use the patch the right way. Be sure to stop using tobacco…

Compared with cigarettes, smokeless tobacco (snuff or chewing tobacco) puts more nicotine into your bloodstream. For this and other reasons, people who chew or dip tobacco regularly say that quitting smokeless tobacco is even harder than quitting cigarette smoking. But many…