October 1, 2000

Family physicians struggle with helping patients and families make end-of-life care decisions. Withholding and withdrawing life-sustaining treatment is appropriate and ethical in many situations.

Serum ferritin is the most useful test for differentiating iron deficiency anemia from anemia of chronic disease. Determination of the serum methylmalonic acid level may be useful in the diagnosis of vitamin B12 deficiency.

Fibromyalgia is a common chronic condition that is usually best managed with low-dose antidepressant therapy and exercise.

Generalized anxiety disorder is a common condition that may present significant diagnostic and therapeutic challenges for family physicians.

Methotrexate is used in the treatment of various immunologic diseases, such as psoriasis and rheumatoid arthritis. Although methotrexate is often prescribed by subspecialists, family physicians may assume responsibility for monitoring therapy with this highly effective but…

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.

Patient education can be defined as the process of influencing patient behavior and producing the changes in knowledge, attitudes and skills necessary to maintain or improve health. The Latin origin of the word doctor,“docere,” means “to teach,” and the education of patients…

“Treating Fibromyalgia,” an article by Paul J. Millea, M.D., M.S., and Richard L. Holloway, Ph.D., on page 1575 of this issue, starts off a new series of “Practical Therapeutics” articles contributed by the Department of Family and Community Medicine at the Medical College of…

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

Picture this: a family gathered together at the dinner table—it's a good way for parents to be sure the kids are eating properly, right? Actually, that concept is supported in a recent Nutrition and Health News Alert published by the National Dairy Council. The newsletter cited…

In this issue of American Family Physician, Millea and Holloway1 provide an excellent overview of the treatment of fibromyalgia. As the authors indicate, it is important for primary care physicians to be able to recognize this entity because it is a condition that occurs…

Anxiety is a common symptom in family practice, with approximately 15 percent of patients meeting research criteria for any anxiety disorder.1,2 The medical literature often suggests that anxiety and depression are underdiagnosed and undertreated in the primary care setting…

JTL had an interesting experience while on rounds visiting his hospitalized patients this morning. As he reviewed charts at the nursing station, he had the opportunity to interact with other health care professionals making rounds, specifically, the registered nurse making…

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

(Australia—Australian Family Physician, April 2000, p. 328.) In adolescent patients, anorexia nervosa often begins with moderate dieting, but then they become driven to be in control of their diet because they feel they have little control in other areas of their life. The…

Guidelines on the use of computed tomography (CT) or magnetic resonance imaging (MRI) in patients presenting with migraine have been developed by the U.S. Headache Consortium.

In a new discussion paper, the Institute for Safe Medication Practices (ISMP) calls for the widespread use of handheld prescribing technology as a way to prevent dangerous medication errors that result from illegible handwritten prescriptions. The recently published discussion…

What is the role of a consultant in the referral process?

Book Reviews | Geriatrics Review Syllabus | Also Received

If a patient isn't able to swallow because of a temporary medical problem, artificial feeding and fluids can be given until they recover.

CPR may be done when a person stops breathing or the heart stops beating (like when a person has a heart attack). When it's possible that the person may recover, CPR is important.

Fibromyalgia is a common condition that causes pain in muscles, joints, ligaments and tendons. People with fibromyalgia often feel tired and stiff. They may also have trouble sleeping and may feel depressed. The symptoms of fibromyalgia are a little different in every person…

Generalized anxiety disorder (GAD) causes people to be worried or tense most of the time. Sometimes, they think something terrible will happen even though there's no reason to think that it will. They may also worry about health, money, family or work. They may feel tense…

Methotrexate is a medicine that makes your immune system less active. Methotrexate is used to treat rheumatoid arthritis, psoriasis, Crohn's disease and other diseases that are associated with an immune system that is too active.

Advance directives tell your doctor what kind of care you want if you become unable to make medical decisions (if you are in a coma, for example). If you are admitted to the hospital, the staff will probably talk to you about advance directives.

An autopsy is an exam of the body after a person has died. The purpose of an autopsy is to answer any questions about the person's illness or the cause of death. In addition, autopsies provide valuable information that helps doctors save the lives of others.

Grief is a normal, healthy response to different types of losses. One of the greatest losses that can occur is the death of someone you love. Other losses that may cause grief include the loss of your health or the health of someone you care about, or the end of an important…

Breast pain is a common problem in younger women who are still having periods (menstrual cycles). 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.

It is not known exactly what causes breast cancer, but there are certain risk factors that seem to increase a person's chance of getting the disease. It's estimated that about 10 percent of breast cancer cases are hereditary (run in the family). In many of these cases, a person…

Whole-grain breads and cereals