• Articles

    Diagnosis and Management of Gout

    JOEL R. PITTMAN, MICHAEL H. BROSS

    Clinical manifestations of gout include acute and chronic arthritis, tophi, interstitial renal disease and uric acid nephrolithiasis. The diagnosis of this disease is based on the identification of zuric acid crystals in joints, tissues or body fluids.

    Safety of Radiographic Imaging During Pregnancy

    KEVIN S. TOPPENBERG, D. ASHLEY HILL, DAVID P. MILLER

    Radiographic imaging during pregnancy is often necessary for the health of the mother and has an acceptable safety profile. Nonurgent radiologic testing, however, should be avoided between 10 and 17 weeks of gestation, the most sensitive time for central nervous system...

    Chronic Abdominal Pain in Childhood: Diagnosis and Management

    ALAN M. LAKE

    Some common presentations of chronic abdominal pain in children are reviewed, with special emphasis on etiology and management of functional abdominal pain, constipation and peptic disease.

    Health Screening in Older Women

    CHARLES P. MOUTON, DAVID V. ESPINO

    In addition to screening for cancer, cerebrovascular disease and cardiovascular disorders, women over 65 years of age should undergo recommended health screening for hearing and vision loss, functional impairment, osteoporosis, depression and other conditions that contribute...

    Adhesive Capsulitis: A Sticky Issue

    LORI B. SIEGEL, NORMAN J. COHEN, ERIC P. GALL

    Adhesive capsulitis is an idiopathic condition that restricts shoulder movement. Nonsteroidal anti-inflammatory drugs, physical therapy and local injections remain the mainstay of treatment and may improve the functional outcome.

    Caring for Infants with Congenital Heart Disease and Their Families

    REBECCA B. SAENZ, DIANE K. BEEBE, LARAMIE C. TRIPLETT

    Feeding difficulties in association with tachypnea, sweating and subcostal recession, or severe growth impairment should raise the index of suspicion for congenital heart disease.

    Topical Therapies for Glaucoma: What Family Physicians Need to Know

    PETER R. LEWIS, T. GRANT PHILLIPS, JOSEPH W. SASSANI

    Topical agents remain the mainstay of glaucoma therapy. Dorzolamide, brinzolamide, brimonidine and latanoprost are promising new agents.

    Multiple Myeloma: Recognition and Management

    ENITZA D. GEORGE, RICHARD SADOVSKY

    Multiple myeloma is the most common primary bone cancer in adults. Patients with multiple myeloma commonly present with bone pain, but a pathologic fracture is the presenting feature in up to 30 percent of cases.

    Chronic Critical Limb Ischemia: Diagnosis, Treatment and Prognosis

    JAMIE D. SANTILLI, STEVEN M. SANTILLI

    Ischemic rest pain is typically described as burning pain in the arch or distal foot that occurs while the patient is recumbent. An ankle-brachial index of 0.4 or less suggests the presence of critical limb ischemia.

    Insomnia

    MARK EDDY, GORDON S. WALBROEHL

    Despite a variety of potential etiologies, insomnia can be successfully treated with pharmacologic or behavior interventions.

    Inside AFP

    Caring for the NSO Family

    JANIS WRIGHT

    Dr. Jay Siwek, AFP's editor, and his wife, Linda, posing in front of the Emperor's palace in the Forbidden City, Beijing, during a recent tour with the National Symphony Orchestra.

    AAFP News Now: AFP Edition

    Newsletter

    Rosemarie Sweeney, Verna L. Rose

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

    Quantum Sufficit

    Quantum Sufficit

    Monica A. Preboth, Shyla Wright

    Black physicians tend to die an average of eight years earlier than white physicians, according to information cited in Family Practice News. The main causes of death in black physicians are myocardial infarction, stroke, cancer, homicide, alcohol and drug abuse, accidents...

    Editorials

    Preventive Care for the Elderly: Getting By in the Absence of Evidence

    PAUL S. FRAME

    Providing appropriate preventive care for elderly persons is a growing challenge for family physicians. In the year 2000, persons over age 65 will constitute 12.7 percent of the total U.S. population, and persons over age 85 will make up 1.5 percent of the population.1 Among...

    Diary from a Week in Practice

    Diary from a Week in Practice

    A local family physician who is a tai chi master has taught WLL and some of our patients about the health benefits of this ancient Chinese martial art. WLL became interested in tai chi after one of his elderly patients had several falls and a broken hip. Her daughter had read...

    Photo Quiz

    A Pelvic Mass

    Marc S. Berger, JAMSHID MIAN

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

    Family Practice International

    Family Practice International

    Anne D. Walling

    (Australia—Australian Family Physician, November 1998, p. 1041.) The cough reflex generates blasts of air with a velocity of up to 800 km per hour to clear the trachea and large bronchi. The reflex is activated by mechanical or chemical irritation of the respiratory...

    Curbside Consultation

    Dealing with Your Own Parent's Illness

    THOMAS L. CAMPBELL

    Larry faces a challenging and increasingly common dilemma. As the population ages and extended families are scattered far apart, many of us will have aging parents who become ill while living a long distance away. I recently had an experience similar to Larry's as I cared for...

    Special Medical Reports

    CDC Issues Revised Guidelines for the Prevention of Human Rabies

    Verna L. Rose

    The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) has revised its recommendations for the prevention of human rabies in the United States. The previous recommendations on rabies prevention were published in 1991....

    AAP Updates Its Guidelines for Evaluation of Sexual Abuse

    Sharon Scott Morey

    The Committee on Child Abuse and Neglect of the American Academy of Pediatrics (AAP) has updated the 1991 guidelines for the evaluation of children in whom sexual abuse is suspected. The guidelines are published in the January 1999 issue of Pediatrics. The following...

    Clinical Briefs

    Clinical Briefs

    Verna L. Rose

    Data from San Francisco's annual behavioral survey among men who have sex with men and disease reports from sexually transmitted disease clinics in San Francisco from 1994 to 1997 document significant increases in self-reporting of unprotected anal intercourse and in rates of...

    Resident and Student Voice

    Fulfilling a Social Contract: Alliance of Health Professional Students

    KEVIN CHUNG, DAVID TUPPONCE, BERNARD BIRNBAUM

    A few years ago, in his president's address to the Association of American Medical Colleges, Dr. Jordan J. Cohen shared his vision of the future of academic medicine. Among the points he stressed were the importance of establishing true partnerships between medical schools...

    Physician's Bookshelf

    Physician's Bookshelf

    DAVID M. KLEMM, KENNETH G. DAVIS, CAROLINE WELLBERY, RICHARD SADOVSKY

    Book Reviews | Book Reviews | Book Reviews | Book Reviews | Also Received

    Letters to the Editor

    Prevention of Relapse in Alcohol Dependence

    Management of Gastroenteritis in Breast-Fed Children

    Tips from Other Journals

    Pathogens Associated with Infected Dog and Cat Bites

    JEFFREY T. KIRCHNER

    Fluoxetine for Treatment of Panic Disorder

    BARBARA APGAR

    Beer, Wine or Liquor and the Risk of Myocardial Infarction

    RICHARD SADOVSKY

    Oral Cephalexin or Topical Mupirocin for Wound Infections

    GRACE BROOKE HUFFMAN

    Adherence to Treatment to Prevent Depression Relapse

    JEFFREY T. KIRCHNER

    Steroids and Response to Flu Vaccine in Pediatric Asthma

    JEFFREY T. KIRCHNER

    Can Echinacea Prevent Upper Respiratory Infections?

    JIM NUOVO

    The Role of Phototherapy for Jaundice in Breast-fed Infants

    JEFFREY T. KIRCHNER

    High- vs. Low-Dose Albuterol for Treatment of Acute Asthma

    JEFFREY T. KIRCHNER

    Challenges in Diagnosing the Cause of Breast Pain

    ANNE D. WALLING

    Is Early Surgery Preferable to US for Small Aortic Aneurysms?

    ANNE D. WALLING

    Aspirin in Patients with Diabetes Mellitus and CAD

    GRACE BROOKE HUFFMAN

    Brief, Practical Screening for Dementia in Outpatients

    GRACE BROOKE HUFFMAN

    Testosterone Therapy in Boys with Delayed Puberty

    RICHARD SADOVSKY

    Niacin and Atherosclerotic Cardiovascular Disease

    RICHARD SADOVSKY

    Blood Pressure Control by Physicians is Inadequate

    JEFFREY T. KIRCHNER

    What Is the Appropriate ACE Inhibitor Dosage in CHF?

    KARL MILLER

    Use of Haloperidol in Alzheimer's Disease

    BARBARA APGAR

    Osteoporosis and Risk of Fracture: When to Treat?

    GRACE BROOKE HUFFMAN

    Sleep Apnea, Nasal CPAP and Improved Quality of Life

    JEFFREY T. KIRCHNER

    How Should Physicians Counsel Patients About Cannabis Use?

    ANNE D. WALLING

    Acupuncture for Treatment of Back Pain: A Meta-Analysis

    BARBARA APGAR

    Infant Circumcision and Risk of Urinary Tract Infection

    ANNE D. WALLING

    Do ‘Health Products’ Really Help Athletic Performance?

    BARBARA APGAR

    Prophylactic Mastectomy to Prevent Breast Cancer

    JEFFREY T. KIRCHNER

    Allergic Rhinitis: Intranasal Steroids or Antihistamines?

    ANNE D. WALLING

    Cessation of Breast Feeding in Infants with Atopic Eczema

    RICHARD SADOVSKY

    Information from Your Family Doctor

    Gout, and What to do About It

    Gout is a kind of arthritis caused by too much uric acid in the joints. The acid causes joint pain.

    The Safety of X-rays During Pregnancy

    Yes, x-rays are generally safe in pregnancy. If your doctor finds you need x-rays for a medical problem or injury, it's OK to have them. It's better for your baby that you be healthy. In fact, your medical problem may be more harmful to your baby than the x-rays.

    Adhesive Capsulitis

    If you can't move your shoulder around like you used to, you could have adhesive capsulitis (say: add-he-sive cap-sool-eye-tis). When it hurts to move your shoulder or you don't have as much movement in your shoulder as before, your shoulder may become “frozen.” Because of...

    Coping with Congenital Heart Disease in Your Baby

    A congenital heart disease is one that a baby is born with.

    Using Glaucoma Eyedrops

    Glaucoma eyedrops are generally safe, but be sure to tell all your doctors that you're using them. These eyedrops are medicines. Like most medicines, they can have side effects (like dizziness or troubled breathing), or they might not work well with other medicines you may...

    What is Multiple Myeloma? How Is It Treated?

    Multiple myeloma (say: mull-tip-ul my-el-oh-ma) is a kind of cancer. It's caused when cells in the bone, called “plasma cells,” grow too much. When this happens, the plasma cells kill the bone around them. The plasma cells also make too much of something called ...

    Insomnia: What to Do When You Can't Sleep

    This handout describes some simple things that you can do to help your insomnia. Follow these tips each night. Don't be worried if it takes a week or two before you can tell a difference.

    Corrections

    Corrections

    Corrections



    Disclosure

    All editors in a position to control content for this activity, AFP journal, are required to disclose any relevant financial relationships. View disclosures.


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