February 15, 2001

Newer and more effective antifungal agents have made onychomycosis easier to treat. Orally administered terbinafine and itraconazole are the therapeutic agents of choice, with fluconazole showing promise based on early efficacy data.

Assessment of impairment and subsequent disability in patients seeking sick notes for the workplace is best made on the basis of objective data by use of a biopsychosocial model to ensure that the expression of disability does not mask other unaddressed health, psychologic or…

Classifying a patient's headache as primary (migraine, tension-type or cluster) or secondary (headache with an organic cause) can facilitate evaluation and management. The family physician's primary task is to determine whether the headache has an organic, potentially life…

Chronic vulvovaginal symptoms are relatively common occurrences that can be frustrating for the patient and the physician. Establishing a proper diagnosis can lay the foundation for an effective therapeutic plan.

As more treatment options for dementia become available, it will become increasingly important to diagnose dementia at an early stage.

For the past nine years, “Diary from a Week in Practice” has been written by contributors from a private practice in Kissimmee, Fla., and coordinated by Walter L. Larimore, M.D., along with John R. Hartman, M.D. The feature, which highlights day-to-day family practice, debuted…

HCFA Offers Answers to Questions on Referral Regulations | HHS Issues Confidentiality Regulations | New Rules Mandate Faster Resolution of HMO Appeals | Family Physicians Eye Legislative Priorities for 2001 | CDC Creates Registries for Childhood Diabetes | Patient Education…

From the “new year/new diet” file: a British restaurateur asked her chefs their secret to staying slim. They told her that after smelling food all day while it cooked, they lost their appetite. She tested this theory by placing a patch scented with vanilla on her hand; each…

As physician screening for dementia becomes more widespread, an increasing number of elderly patients will be identified who do not meet the diagnostic criteria for dementia but nonetheless have significant memory impairment. These patients, who have received a variety of…

My first attempt at instigating smoking cessation was in 1959, when at age nine I tried to convince my mother to quit. Despite our “good rapport” and “repeated visits,” and despite exhausting every known smoking cessation strategy I could muster over the next 36 years, my…

WLL has found that two of his asthmatic patients have pH monitor-proven gastroesophageal reflux disease (GERD) and with treatment have been able to reduce their asthma attacks and medications. Now the data reveal that despite an absence of symptoms, GERD may be common in…

Vaccine Program Reduces Referral Rate of Uninsured Children | Inpatient Tobacco Cessation Programs Can Be Effective | Interdisciplinary Approach Helps Patients Lower Cholesterol Levels | Leflunomide Is Effective in the Treatment of Rheumatoid Arthritis

(Great Britain— The Practitioner, November 2000, p. 938.) The most common cause of bad breath in elderly patients is volatile sulfur compounds produced by gram-negative anaerobes in the oral flora. Certain foods can cause changes in breath that last up to 72 hours after…

The American Academy of Pediatrics (AAP) has issued recommendations for infection control in physicians' offices. These include guidelines for the delivery of health care, standard precautions that should be taken in the physician's office, office design, disinfection and…

AAP Statement on Prenatal Exposure to Alcohol | Use of Hypoallergenic Infant Formulas | FDA Approval of Single-Test for HbA_1c | NIH Statement on Antenatal Corticosteroids

Letter

A fingernail or toenail infection that is caused by a fungus is called onychomycosis (say: on-ee-koh-my-ko-sis). The infection is more likely in toenails than in fingernails.

Dementia is a brain problem. People with dementia find it hard to remember, learn and communicate. After a while, this makes it hard for them to take care of themselves.