August 1, 2004

Type 2 diabetes is characterized by progressive beta-cell failure. Indications for exogenous insulin therapy in patients with this condition include acute illness or surgery, pregnancy, glucose toxicity, contraindications to or failure to achieve goals with oral antidiabetic…

Spinal stenosis is a narrowing of the vertebral canal that compresses spinal nerves and may cause leg pain and difficulty walking. The symptoms of degenerative lumbar stenosis commonly occur in elderly adults and can be treated conservatively with pain-relieving agents or…

Each year, more than 1 million patients are admitted to U.S. hospitals because of unstable angina and non–ST-segment elevation myocardial infarction (UA/NSTEMI). To help standardize the assessment and treatment of these patients, the American College of Cardiology and the…

In the guideline developed by the American College of Cardiology and the American Heart Association, the management of suspected unstable angina and non–ST-segment elevation myocardial infarction (UA/NSTEMI) has four components: initial evaluation and management; hospital care…

After infancy, galactorrhea usually is medication-induced. The most common pathologic cause of galactorrhea is a pituitary tumor. Other causes include hypothalamic and pituitary stalk lesions, neurogenic stimulation, thyroid disorders, and chronic renal failure. Patients with…

I’m devoting this column to three of AFP’s contributors who are reaching special milestones this summer and to whom I’d like to give my personal thanks and recognition: Kathy Mayfield, production director; LeAnn Fletcher, graphic associate; and Barrett Schroeder, senior…

Family Physician Named AMA President-Elect | AAFP Helps Develop Report Supporting Influenza Vaccine for Health Care Workers | AAFP Updates Online Tobacco Prevention and Cessation Resources | Report Indicates Cancer Incidence and Mortality Rates on Decline; Survival Rates…

“Kangaroo care,” a technique for soothing premature infants through skin-to-skin contact, also can help term infants make the transition from fetal to neonatal life. In a randomized controlled study published in Pediatrics , 47 healthy term infants were assigned to be taken…

In this issue of American Family Physician, the series of One-Pagers1–3 from the Robert Graham Center offer evidence that a primary care workforce crisis may once again be taking shape. The 1990s saw alignment of public policy and funding efforts to increase the primary care…

When a patient has been out of three blood pressure medications for four months because of no income, one would expect to see a blood pressure out of control. The young woman had lost her job and health care coverage several months earlier, and had come to the mobile clinic as…

Cardiac rehabilitation based on exercise alone and comprehensive cardiac rehabilitation reduce all-cause mortality by about one third. It is unclear which type of rehabilitation is more beneficial.

Antihistamines are of minimal to no benefit as mono-therapy for the common cold, and first-generation antihistamines may increase sedation in patients with a cold. Antihistamine-decongestant combinations reduce nasal symptoms and improve the recovery rate in older children and…

What are the effects of treatment in people without chronic respiratory disease?

Case study: JB, a 35-year-old smoker, comes to your office for a well-woman examination. Reviewing her medication list, you learn that she is taking numerous vitamin supplements, including vitamins A, C, E, and beta-carotene.

No single clinical finding can accurately diagnose DVT.

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

The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) has issued recommendations on reducing the incidence of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals…

Use of Transcranial Doppler Ultrasonography

Nausea and Vomiting in Pregnancy

Increases in Fluoroquinolone-Resistant <i>Neisseria Gonorrhoeae</i>

For physicians who realize that drug costs can be a problem, we offer some practical solutions and discussion about how to help these patients.

Your doctor has given you insulin to help control your diabetes. You need two kinds of insulin: basal and mealtime insulin. Sometimes insulin is premixed for you. Keep a record of your blood sugar and insulin shots every day so the amounts of insulin can be changed to fit your…

Sometimes a woman's breasts make milk even though she is not pregnant or breastfeeding. This condition is called galactorrhea (say: guh-lack-tuh-ree-ah). The milk may come from one or both breasts. It may leak on its own or only when the breasts are touched. Men can have…