March 1, 2012

Modalities of labor analgesia include spinal and epidural analgesia, opioid analgesia, continuous labor support, pudendal blocks, and water immersion, among others. Physicians should be familiar with the contraindications and potential complications of each method. Patient…

Advance directive discussions can be initiated with patients 50 to 65 years of age at a routine checkup, and readdressed at selected stages of the patient's life and as health status changes. Interactive advance directive interventions that include repeated conversations…

Early upper endoscopy is recommended in most patients with upper gastrointestinal bleeding because it confirms the diagnosis and allows for targeted endoscopic treatment, including epinephrine injection, thermocoagulation, application of clips, and banding. Rebleeding can occur…

The clinical course of bipolar disorders includes symptoms of mania, hypomania, psychosis, or depression interspersed with periods of relative wellness. Pharmacotherapy involves antipsychotics and mood stabilizers. Behavior therapy is also beneficial. Patients and their support…

ABFM Enhances Program for Maintenance of Certification for Family Physicians | AAFP Develops Tool to Help FPs Receive Payment for Medicare Preventive Services | CMS Rule Change Allows PAs to Perform Nursing Facility Level of Care Certifications | HealthCare.gov Helps Same-Sex…

Invitation letters are the most studied method of encouraging cervical cancer screening, and they are effective (relative risk [RR] = 1.44; 95% confidence interval [CI], 1.24 to 1.52).1–3 Invitation letters may be more cost-effective than more intensive recruitment efforts (e.g…

Rates of HIV transmission are at least three times lower in HIV-discordant couples in which the partner with infection is receiving antiretroviral therapy, compared with HIV-discordant couples in which the partner with infection is not receiving therapy. Among HIV-discordant…

Medical uncertainty (i.e., not knowing how to proceed with a patient-related problem) can stem from any number of potential situations in daily clinical practice. The causes of uncertainty are many, but the feeling of stress or discomfort it creates is a familiar constant…

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

Caring for patients with diabetes mellitus requires addressing many issues beyond glycemic control. To help physicians provide optimal care for these patients, the American Diabetes Association (ADA) releases annual revisions to its clinical practice recommendations for…

In this report, the American Academy of Pediatrics (AAP) reviews the effectiveness of antipyretics for the treatment of fever in children. Fever in children often leads to unscheduled physician visits, telephone calls from parents to physicians for consultation, and the…

Letter

There is no way to know what your labor will be like. Pain during childbirth is different for every woman and depends on several things. Some women need little or no pain relief. Others find that pain medicine gives them better control over their labor and delivery.

An advance directive is a legal document that says how you want to be cared for if you are unable to make decisions. You can include what medical treatments you would want and who you would trust to make decisions for you.

They are mental conditions that cause different types of mood changes (episodes). The cause of bipolar disorders is unclear, but they may run in families. Bipolar disorders can cause depression. They can also cause symptoms of mania, which can make you feel energized and…