December 15, 2010

Articles

Diagnosis of Secondary Hypertension: An Age-Based Approach

ANTHONY J. VIERA, DANA M. NEUTZE

The prevalence of secondary hypertension, which usually has an underlying, potentially correctable cause, varies by age group. This article identifies the most common causes and best diagnostic approaches.

Perioperative Antiplatelet Therapy

PIERRE GUY CHASSOT, CARLO MARCUCCI, ALAIN DELABAYS, DONAT R. SPAHN

The decision of when, or if, to interrupt perioperative antiplatelet therapy depends on the patient's cardiovascular and surgical-bleeding risk levels. Patients should not undergo elective operations before completing the indicated duration of dual antiplatelet therapy.

Diagnosis, Initial Management, and Prevention of Meningitis

DAVID M. BAMBERGER

Diagnosis of meningitis requires evaluation of cerebrospinal fluid. Patients with suspected bacterial meningitis should receive prompt empiric antimicrobial therapy. Conjugate vaccines have been shown to be effective in reducing the incidence of bacterial meningitis.

Managing Adverse Effects of Hormonal Contraceptives

NANCY GROSSMAN BARR

Adverse effects of hormonal contraceptives usually resolve with continued use. Depo-Provera is the only method consistently associated with weight gain. Breakthrough bleeding is common in the first months of combined oral contraceptive use. There are no significant differences…

Inside AFP

Plagiarism — What Is It? How to Avoid It

JOYCE A. MERRIMAN

One of the best compliments a publication can receive is the desire of others to use its content for their own purposes, whether in a second publication or in informal sharing with colleagues. Unfortunately, the line between the compliment of borrowing and the fault of…

AFP News Now - AFP Edition

AAFP News Now: AFP Edition

Primary Care Groups Release Joint ACO Principles, AMA Adopts Related Principles | AAFP, Other Organizations Address Flaws in DEA Policy on Schedule II Drugs | CMS Announces New Innovation Center, Demonstration Project Promoting PCMHs | Joint Commission Develops Primary Care…

Clinical Evidence Handbook

End-stage Renal Disease

MAAZ ABBASI, GLENN CHERTOW, YOSHIO HALL

What are the effects of different doses for peritoneal dialysis? What are the effects of different doses and membrane fluxes for hemodialysis? What are the effects of interventions aimed at preventing secondary complications?

Photo Quiz

Unusual Case of Pharyngitis

JOHN PEASE, ANH T. NGUYEN

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

U.S. Preventive Services Task Force

Folic Acid for the Prevention of Neural Tube Defects: Recommendation Statement

The U.S. Preventive Services Task Force (USPSTF) recommends that all women planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 mcg) of folic acid.

Putting Prevention Into Practice

Folic Acid for the Prevention of Neural Tube Defects

KENNETH W. LIN, EILEEN BIRMINGHAM

Case study: A 36-year-old recently married woman comes to your office for a routine gynecologic examination. She tells you that she has been in generally good health since her last visit.

STEPS

Bivalent HPV Recombinant Vaccine (Cervarix) for the Prevention of Cervical Cancer

STEPHANIE SCHAUNER, COREY LYON

Cervarix is effective in preventing known cytologic and histologic precursors of cervical cancer, although, as with Gardasil, it has not been shown to decrease rates of cervical cancer. This protection has been shown to last for six years, but it is unclear if a booster dose is…

FPIN's Clinical Inquiries

Thiazolidinedione Therapy for Managing Metabolic Syndrome

MICHAEL D. GEURIN, LEILANI ST. ANNA

There is no patient-oriented evidence supporting the use of TZD therapy in patients in the general population who have metabolic syndrome. Rosiglitazone (Avandia) use decreases cardiovascular morbidity and mortality in patients with metabolic syndrome who are undergoing…

Practice Guidelines

Updated Recommendations on Daily Aspirin Use in Patients with Diabetes

CARRIE ARMSTRONG

To address the uncertainties about aspirin use in persons with diabetes, experts from the American Diabetes Association, American Heart Association, and American College of Cardiology Foundation reviewed the current evidence and updated the 2007 recommendations.

Letters to the Editor

Information from Your Family Doctor

PtEd

Constipation

It is a common digestive problem. It may be hard for you to have a bowel movement, or your bowel movements may not be regular. Your stools may be very hard, making them so difficult to pass that you have to strain. Or you may feel an uncomfortable fullness even after you've had…

PtEd

Irritable Bowel Syndrome: Controlling Your Symptoms

Irritable bowel syndrome (IBS) is a common problem with the intestines. The cause is unknown, but it may have to do with the movement of the intestines, sensitivity of the intestine to pain or nerve signals, or changes in the bacteria that live in the gut. IBS usually begins…

PtEd

Heartburn

It is a burning feeling in the lower chest, with a sour or bitter taste in the throat and mouth. It usually occurs after eating a big meal or while lying down. The feeling can last for a few minutes or a few hours.

PtEd

Dyspepsia: What It Is and What to Do About It

It is a pain or an uncomfortable feeling in the upper middle part of your stomach area. The pain might come and go, but it's there most of the time. You might feel too full after a meal or too full to finish a meal. You can get it at any age.

Side Effects of Hormonal Contraceptives

Hormonal contraceptives are medicines or devices that can reduce your risk of getting pregnant. They contain hormones called estrogen (ESS-tro-jen) and progestin (pro-JEST-tin). Some contraceptives contain a combination of these hormones, and others contain only progestin. Some…

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