Appropriate Use of Antibiotics for URIs in Children: Part I. Otitis Media and Acute Sinusitis

SCOTT F. DOWELL, BENJAMIN SCHWARTZ, WILLIAM R. PHILLIPS

The first part of this two-part article reviews the principles of antibiotic use in the treatment of otitis media and acute sinusitis in children, and ways in which antibiotic use could be curtailed without compromising patient care.

Postexercise Systolic Blood Pressure Response: Clinical Application to the Assessment of Ischemic Heart Disease

ALLEN J. TAYLOR, GEORGE A. BELLER

A three-minute systolic blood pressure ratio of greater than 0.90 has a diagnostic accuracy of about 75 percent for the detection of coronary artery disease. Higher values for this ratio are associated with more extensive coronary artery disease and an adverse prognosis after...

Herbal ‘Health’ Products: What Family Physicians Need to Know

THERESE ZINK, JODI CHAFFIN

Family physicians can benefit from knowing about some of the popular herbal preparations their patients are taking and from becoming familiar with what is currently known about their effectiveness, dosages, side effects, toxicities and drug interactions.

Evaluating Proteinuria in Children

MAHMOUD LOGHMAN-ADHAM

Proteinuria is a common laboratory finding in children. It can be identified as either a transient or persistent finding and can represent benign conditions or serious disease.

Breast Cancer in Older Women

LODOVICO BALDUCCI, D. MELESSA PHILLIPS

Screening mammography is recommended in women up to 85 years of age who have a life expectancy of three years. Several options for the management of localized and metastatic breast cancer are available to older women.

New Drugs for Alzheimer's Disease

VINCENT W. DELAGARZA

Two cholinesterase-inhibiting medications are now available to delay the progression of Alzheimer's disease, and many other agents are presently being studied in the search for ways to minimize the ravages of this all-too-common disorder.

Newsletter

Rosemarie Sweeney, Verna L. Rose

Samuel R. Dismond, Jr., M.D., Flint, Mich., was named 1999 Family Physician of the Year by the American Academy of Family Physicians (AAFP) at the annual scientific assembly in San Francisco. Dr. Dismond earned his medical degree from Howard University in Washington, D.C....

Family Practice International

Anne D. Walling

(Hong Kong—Hong Kong Practitioner, May 1998, p. 291.) Refusal of food is common in children and may be the result of physical, emotional or social factors. Food refusal may occur rarely after episodes of choking or as a manifestation of abuse or prepubertal anorexia nervosa....

Curbside Consultation

JANIS WRIGHT

In your day-to-day encounters with patients, how do you navigate through the complicated medical, ethical, legal and economic issues that arise, not to mention the family matters and cross-cultural concerns that come up? How do you handle delicate family issues when one of...

Quantum Sufficit

Monica A. Preboth, Shyla Wright

Cigars may be hip, but they aren't harmless. A study by Kaiser Permanente comparing 225 cigar-smoking men with 14,200 nonsmokers showed that cigar smokers had a 25 percent higher mortality rate. Men who smoked two cigars per day had an 87 percent higher risk of dying of...

Herbal Medicines and the Family Physician

BENJAMIN KLIGLER

Why should we as family physicians take on the difficult and perplexing task of learning about herbal medicines? There are several reasons. First, with approximately 60 million adult Americans regularly using herbal supplements,1 the principles of patient-centered and...

Drug Treatment for URIs: Back to the Drawing Board

CAROLINE WELLBERY

Mallory's now legendary explanation of why he was climbing Mt. Everest, “Because it's there,” may also be the only good reason that we have for using antibiotics or other drugs in the treatment of most upper respiratory tract infections (URIs). As is meticulously documented...

Diary from a Week in Practice

When it rains in Florida, there is grass to be cut, hedges to be trimmed and plenty of other yard work. Today, a young woman came to the office sporting a unique attraction that she had acquired while working in her garden: a grid-like pattern from an insect bite on her...

Waist No Time

Marc S. Berger, JEFFREY J. MEFFERT

A 34-year-old man presented to his physician with an intensely pruritic eruption at his waist and groin that had continued to worsen over the past five years (see the accompanying photograph). He had previously experienced some erythema on his neck and axilla but seldom the...

Intellectual and Behavioral Outcomes After Febrile Seizures

JEFFREY T. KIRCHNER

Diabetic Ketoacidosis and Venous Blood Gas Values

RICHARD SADOVSKY

Management of Children with Closed Head Trauma

GRACE BROOKE HUFFMAN

Annual Mammographic Screening in Older Women

KARL MILLER

Iatrogenic Hyperthyroidism in Patients Receiving Levothyroxine

JEFFREY T. KIRCHNER

Removal of Foreign Bodies from Children's Ears

GRACE BROOKE HUFFMAN

Pulmonary Embolism or Venous Thrombosis and Risk of Cancer

JEFFREY T. KIRCHNER

False-Positive Screening Results for Breast Cancer

JEFFREY T. KIRCHNER

Evaluation of Recent Advances in the Treatment of Vaginitis

GRACE BROOKE HUFFMAN

Warfarin Therapy and Joint Aspiration and Injection

JEFFREY T. KIRCHNER

Calcium Channel Blockers and Cardiovascular Mortality

JIM NUOVO

Colorectal Cancer Screening with Flexible Sigmoidoscopy

JEFFREY T. KIRCHNER

Improving Diagnosis of Deep Venous Thrombosis

GRACE BROOKE HUFFMAN

Understanding Anger in Parents of Dying Children

LINDA S. GROSSMAN

During my internship, I took care of a seven-year-old girl with a rare form of lymphoma. Admittedly I was inept in some respects, but I was not prepared for the mother's reaction to me. It seemed that no matter what I did, she questioned my competence. The first day I entered...

Guidelines from the American Geriatric Society Target Management of Chronic Pain in Older Persons

Verna L. Rose

The American Geriatrics Society (AGS) has published the first clinical practice guidelines to focus specifically on the management of chronic pain in older persons. The guidelines were published in the May 1998 issue of the Journal of the American Geriatrics Society.

AAP Releases Hepatitis C Screening Recommendations

Verna L. Rose

A policy statement on hepatitis C virus from the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) calls for the screening of all persons who have risk factors for hepatitis C virus infection to identify those who may have the disease. Hepatitis C...

Clinical Briefs

Verna L. Rose

The American College of Sports Medicine (ACSM) has issued a statement emphasizing that children can participate in strength training programs if they have the emotional maturity to accept and follow directions. The ACSM defines strength training as a systematic program of...

Physician's Bookshelf

DOUGLAS PILE, GRACE BROOKE HUFFMAN

Also Received

Use of Cytochrome P450 and Prolonged Prothrombin Time

Occupational Lead Poisoning

Otitis Media with Effusion

Otitis media with effusion is an ear infection with fluid in the middle (inner) ear. (Effusion is another word for fluid.) This fluid usually doesn't bother children. It almost always goes away on its own. So, this kind of ear infection doesn't have to be treated with...

Proteinuria in Children

Proteins are essential in our bodies. Normally, proteins move around in our blood, carrying food, hormones and medicine to all parts of the body. They also help keep water inside tiny blood vessels.

Correction