November 1, 2005

This high-risk condition, which is the leading cause of pregnancy-related death in the first trimester, can be treated by expectant management, medical management with methotrexate, or surgery.

Once chronic kidney disease is detected, the underlying causes should be identified and treated to delay or prevent progression to kidney failure.

The cause should be identified as prerenal, intrarenal, or postrenal, with management strategies including correction of fluid and electrolyte levels, avoidance of nephrotoxins, and kidney replacement therapy.

A variety of diagnostic tests and a basic understanding of common causes of wrist pain can assist in evaluating patients with wrist problems.

Diagnosis can be elusive and necessitates a high index of suspicion, but response to empiric therapy usually is favorable.

New evidence supports the pharmacologic treatment of alcohol dependence, with serotonergic and anticonvulsant agents potentially playing a larger role.

The 2005 Scientific Assembly drew more than 15,000 participants to San Francisco between September 28 and October 2. Physicians, other health care professionals, exhibitors, and guests had many activities to choose from, including Academy business and committee sessions…

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

More and more high school students are finding it harder to breathe. According to a study by the Centers for Disease Control and Prevention (CDC), one in six high school students claims to have asthma. In 2003, researchers surveyed approximately 13,000 high school students…

In the United States, health care reform across the political spectrum has been focused on removing cost as a barrier to health care—principally by making insurance coverage more accessible. The U.S. Census Bureau recently reported that 45 million Americans, or nearly one in…

At least three models have been used to project the future physician workforce, and each produces different results. No physician workforce predictions can be relied on until there is more consideration of and agreement on desired health outcomes and what physicians must do to…

There are going to be occasions when doctors and patients butt heads. Mr. Zetes disappeared from my practice two years ago. I assumed he was avoiding me—not an easy thing to do when you live in a small town. I last saw him when he came for a routine checkup, and I recommended a…

Noncardiac chest pain can be caused by gastroesophageal reflux disease (GERD), panic disorder, or a number of other psychological conditions. Psychotherapy, particularly cognitive behavior therapy, has been shown to reduce the number of days with chest pain significantly over a…

Patients who take oral corticosteroids are more likely to show improvement in their chest radiographs than those taking placebo, although improvements in symptoms and lung function are less certain. The typical dosage used in randomized trials was 20 mg daily or 40 mg every two…

According to disease-oriented evidence, insulin and intravenous glucose, inhaled albuterol (Ventolin), and dialysis are the best treatment options; the first two may be given in combination. Bicarbonate or resins are not recommended for routine use, particularly without one of…

The U.S. Preventive Services Task Force (USPSTF) recommends that physicians screen all sexually active women, including those who are pregnant, for gonorrhea if they are at increased risk for the infection (i.e., if they are young or have other individual or population risk…

During the winter months, influenza is one of the most common illnesses among patients of primary care physicians, with as many as one in five adults infected each year.

What are the effects of treatments?

Case study: A 22-year-old woman comes to your office for her routine well-woman examination. She says that she is currently sexually active in a long-term monogamous relationship. She had a chlamydial infection two years ago. Her only concern today is that her menstrual period…

There is no evidence that the use of antiviral agents in women who are pregnant and have a history of genital herpes prevents perinatal transmission of herpes simplex virus (HSV) to neonates.

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

In my walk-in office I see many patients with respiratory ailments, and I usually have reasonable and successful conversations with them about antibiotic use. However, the patients that I find most difficult to deal with are those who are looking specifically for an antibiotic…

Evidence-based recommendations for the initiation of pharmacologic and surgical therapies for patients with essential tremor have been released by the Quality Standards Subcommittee of the American Academy of Neurology (AAN).

The American Heart Association (AHA) has released an advisory statement to highlight the findings of the Public Access Defibrillation Trial, which studied the effects of lay rescuer automated external defibrillators (public access defibrillation).

The Committee on Practice Bulletins–Obstetrics of the American College of Obstetricians and Gynecologists (ACOG) has released a practice bulletin on screening for and managing hemoglobinopathies during pregnancy.

An ectopic (say: ek-TOP-ik) pregnancy is when the baby grows in the wrong place in the body. In a normal pregnancy, the baby grows in the uterus. In an ectopic pregnancy, the baby grows outside the uterus (see drawing), which is not safe. It is important to find the ectopic…

The kidneys clean the blood by removing waste and extra fluid. The waste then passes out of the body in urine. The kidneys also help control blood pressure, keep bones strong, and help make red blood cells.

A tension headache is a dull, achy feeling on both sides of the head. Some people with tension headaches also have a tight feeling in their head or neck muscles. Tension headaches start slowly, usually in the middle of the day. Another name for this type of headache is “stress…

Migraine headaches seem to be caused by changes in the amount of a chemical called serotonin (say: sair-uh-TONE-in) you have in your body. When serotonin levels are high, your blood vessels shrink. When serotonin levels are low, your blood vessels swell. This swelling can cause…

A cluster headache is a rare type of headache that is more common in men. Cluster headaches start suddenly. The pain is usually behind or around one eye and is very bad. If you have a cluster headache, your nose and eye on the same side as the pain may get red, swollen, and…