November 1, 2004

Acute rhinosinusitis is one of the most common conditions that physicians treat in ambulatory practice. Although often caused by viruses, it sometimes is caused by bacteria, a condition that is called acute bacterial rhinosinusitis. The signs and symptoms of acute bacterial…

Although most cases of acute rhinosinusitis are caused by viruses, acute bacterial rhinosinusitis is a fairly common complication. Even though most patients with acute rhinosinusitis recover promptly without it, antibiotic therapy should be considered in patients with prolonged…

Tympanometry provides useful quantitative information about the presence of fluid in the middle ear, mobility of the middle ear system, and ear canal volume. Its use has been recommended in conjunction with more qualitative information (e.g., history, appearance, and mobility…

Childhood bullying has potentially serious implications for bullies and their targets. Bullying involves a pattern of repeated aggression, a deliberate intent to harm or disturb a victim despite the victim's apparent distress, and a real or perceived imbalance of power…

Over-the-counter dietary supplements to treat obesity appeal to many patients who desire a 'magic bullet' for weight loss. Asking overweight patients about their use of weight-loss supplements and understanding the evidence for the efficacy, safety, and quality of these…

The 2005 Annual Clinical Focus (ACF) of the American Academy of Family Physicians (AAFP) was launched last month at the Academy’s 2004 Annual Scientific Assembly in Orlando. The upcoming year’s focus is on genomics and the role that family physicians have in preventive…

Manufacturer Will Not Ship Influenza Vaccine as Expected | SAMHSA Releases Findings of 2003 National Survey on Drug Use and Health | AAFP Supports Legislation on FDA-Sanctioned Drug Imports | AHRQ Releases Study on Medication Usage in Chronic Illness | Robert Graham Center…

The nation is on its way toward meeting a national health objective. A study published in the Morbidity and Mortality Weekly Report showed that between 1999 and 2003, lifetime cigarette use (anyone who has ever tried smoking) declined from 70.4 percent to 58.4 percent. Current…

The dawning of the genome era is changing the scope of care for family physicians, with significant implications for the design of future health care delivery systems. Many consider the imminent introduction of genomics into clinical medicine to be the most significant advance…

Antibiotics are no longer first-line treatment for many upper respiratory tract infections. Currently, the American Academy of Pediatrics and the American Academy of Family Physicians are promoting new guidelines for treatment of acute otitis media, proposing that antibiotics…

Donna never dreamed that one day she would be an organ donor. Of course, she never imagined that her mother, Isabell, would need a kidney transplant either. Despite heart problems most of her life, Isabell always gave a maximal effort. Her family bragged that she had the…

The topical antibiotic mupirocin is as effective or possibly more effective than oral treatment in patients with limited disease. For practical reasons, oral antibiotics such as penicillins, cephalosporins, and macrolides often are used in patients with extensive disease, but…

Donepezil in the Treatment of Vascular Dementia

NSAIDs vs. Opiates for Pain in Acute Renal Colic

What are the effects of empirical treatment?

Case study: MN, a 25-year-old woman, visits your office for evaluation of insomnia. As part of her social history, she tells you that she is a “social drinker.” Further questioning reveals that she drinks about as much as she did during college. You want to better assess her…

While there is strong agreement among experts and evidence in the literature to recommend that women 50 to 69 years of age undergo screening with mammography for breast cancer, the question of screening women 40 to 49 years of age is controversial. The results of most studies…

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

The American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines recently issued a joint executive summary of guidelines for the management of ST-elevation myo-cardial infarction (STEMI). This “Practice Guideline” will focus on two…

The Committee on Practice Bulletins—Obstetrics of the American College of Obstetricians and Gynecologists (ACOG) has released a new guideline entitled, “Management of Postterm Pregnancy.”

This scenario is becoming less common in primary care practice because the most common place of death (in nearly 80 percent of cases) in the United States has changed from the patient’s home to a hospital or long-term care facility. This shift in death location means that…

Sinuses are open spaces behind the bones around your nose and eyes. The walls, or linings, of the sinuses make mucus. When you breathe air in through your nose, the mucus adds moisture to the air in your nose, traps dust, and helps fight infections.

A bully is someone who does or says mean things to get power over another person. Bullying is not just hitting, shoving, or kicking. A bully might call someone names or say bad things about them. A bully also might leave people out of activities on purpose or refuse to talk to…

The Letter to the Editor, “Tolerance and Dependence Risk with the Use of Carisoprodol,” by Craig Heacock, M.D., and Mark S. Bauer, M.D. (April 1, 2004, page 1622), incorrectly stated that meprobamate is a schedule IV barbiturate with a long history of abuse. The second sentence…