• Articles

    Update on Parkinson's Disease

    ROSABEL YOUNG

    The hallmark physical signs of Parkinson's disease are tremor, rigidity and bradykinesia. Levodopa remains the mainstay of treatment.

    Treatment Guidelines for Primary Nonretentive Encopresis and Stool Toileting Refusal

    BRETT R. KUHN, BETHANY A. MARCUS, SHERYL L. PITNER

    Six guidelines are presented for the management of children with primary nonretentive encopresis or stool toileting refusal, with an emphasis on practicality and ease of implementation for the family physician. An illustrative case demonstrates the efficacy and simplicity of...

    Medical Treatments for Balding in Men

    DEAN THOMAS SCOW, ROBERT S. NOLTE, ALLEN F. SHAUGHNESSY

    Male pattern baldness is considered a normal variant rather than a disease, but up to one half of balding patients have psychologic sequelae. Minoxidil, a topical treatment, and finasteride, an oral treatment, are relatively new products that are modestly effective in the...

    Plantar Fasciitis and Other Causes of Heel Pain

    STEPHEN L. BARRETT, ROBERT O'MALLEY

    Effective conservative treatment of plantar fasciitis focuses on proper biomechanics of the foot while temporary measures are instituted to provide pain relief.

    Interventions to Reduce Cardiovascular Risk Factors in Children and Adolescents

    REGINALD L. WASHINGTON

    Many of the risk factors that lead to cardiovascular disease in adulthood have their roots in childhood. Such risk factors should be identified in children and adolescents and, when possible, eliminated during the formative years.

    Special Considerations in Interpreting Liver Function Tests

    DAVID E. JOHNSTON

    The common blood liver function tests assess only liver injury. Overall hepatic function can be evaluated by applying the albumin, bilirubin and prothrombin time values in the modified Child-Turcotte grading system.

    Resolving the Common Clinical Dilemmas of Syphilis

    NINA R. BIRNBAUM, RONALD H. GOLDSCHMIDT, WENDY O. BUFFETT

    Serologic tests can be negative if they are performed at the stage when lesions are present, and the VDRL test can be negative in patients with late syphilis.

    Postpartum Major Depression: Detection and Treatment

    C. NEILL EPPERSON

    Methods of enhancing the detection of postpartum major depression and appropriate treatment modalities—usually antidepressant therapy alone or in combination with psychotherapy—can help physicians manage this debilitating disorder.

    Recognition and Management of Tourette's Syndrome and Tic Disorders

    MOHAMMED M. BAGHERI, JACOB KERBESHIAN, LARRY BURD

    Tourette's syndrome is a chronic tic disorder with onset in childhood and peak severity between nine and 11 years of age. It is characterized by motor and vocal tics. Most children have a fluctuating course.

    Inside AFP

    A Look at Parkinson's Disease

    Janis Wright

    If you've been waiting for an update on Parkinson's disease, you won't want to miss this issue's cover article on page 2155. Written by Rosabel Young, M.D., M.S., and illustrated by John Karapelou, this state-of-the-art review is not only the culmination of months of hard...

    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

    That crack in the sidewalk could really break your mother's back. A study of 50 women and 29 men who were all healthy and 65 years of age or older revealed that women are four times more likely to fall after tripping, compared with men of the same age, under equal conditions....

    Editorials

    Heart Disease Prevention Begins in Childhood

    PATRICK E. MCBRIDE

    Coronary artery disease risk factors, including systolic and diastolic blood pressures, serum lipoprotein levels, cigarette smoking, and body mass index, are directly related to the initiation and progression of atherosclerosis in children.1,2

    Confronting Antimicrobial Resistance: A Shared Goal of Family Physicians and the CDC

    DAVID M. BELL, D. PETER DROTMAN

    Because the clinical care and public health systems in the United States must be able to respond rapidly to emerging and reemerging infectious disease threats, the Centers for Disease Control and Prevention (CDC) recently published a plan, Preventing Emerging Infectious...

    Medicine and Society

    Preventing Street Gang Violence

    ALLEN L. HIXON

    A two-year-old child riding a tricycle dies, the random victim of a drive-by shooting. A pregnant woman is hit by a stray bullet in East Los Angeles. Street gang members storm the emergency department of an urban hospital to “finish off ” a rival gang member. Are these random...

    Diary from a Week in Practice

    Diary from a Week in Practice

    WLL has a patient with hepatitis C that was contracted during a blood transfusion over 10 years ago. The infection was associated with a slowly increasing alanine aminotransferase (ALT) level over the past two years. Liver biopsy showed mild to moderate inflammation with no...

    Conference Highlights

    Conference Highlights

    Verna L. Rose

    (26th Annual Meeting of the North American Primary Care Research Group) The use of intrapartum epidural anesthesia may be associated with increased rates of breast-feeding cessation soon after birth, according to a pilot study of 124 mothers of healthy infants admitted to a...

    Tips from Other Journals

    Effectiveness of Gabapentin for Postherpetic Neuralgia

    GRACE BROOKE HUFFMAN

    Respiratory Syncytial Virus: A Cause of Acute Otitis Media

    JEFFREY T. KIRCHNER

    Inhaler That Delivers Both Ipratropium and Albuterol

    BARBARA APGAR

    Uncommon Symptoms of Mild Primary Hyperparathyroidism

    JEFFFREY T. KIRCHNER

    The Duration of Anticoagulation After Electrical Cardioversion

    RICHARD SADOVSKY

    Changes in Uterine Volume from GnRH Agonist Therapy

    BARBARA APGAR

    Using SaO2 Values as a Predictor of Fetal Acidosis

    BARBARA APGAR

    Home Exercise for Elderly Persons with Disabilities

    JEFFREY T. KIRCHNER

    Assessing the Risk of Rupture with Intracranial Aneurysms

    JEFFREY T. KIRCHNER

    Maternal and Neonatal Injury with High Degrees of Forceps Rotation

    BARBARA APGAR

    Vitamin K Reduces Warfarin's Anticoagulation Effect

    JEFFREY T. KIRCHNER

    Discontinuing Prophylaxis for PCP in HIV-Infected Patients

    ANNE D. WALLING

    Presentations of Some Common Types of Vertigo

    ANNE D. WALLING

    Should Antibiotics Be Used to Treat Acute Bronchitis?

    GRACE BROOKE HUFFMAN

    Can Gabapentin Effectively Treat Diabetic Neuropathy?

    GRACE BROOKE HUFFMAN

    Laparoscopic Cholecystectomy vs. Open Surgery in the Elderly

    ANNE D. WALLING

    Long-Term Effects of Oral Contraceptives on Mortality

    ANNE D. WALLING

    Nicotine Spray and Patch Are Effective in Combination

    ANNE D. WALLING

    Do Antiseptic Catheters Reduce Risk of Bloodstream Infection?

    GRACE BROOKE HUFFMAN

    Determining Need for Imaging in Young Children After a Fall

    JEFFFREY T. KIRCHNER

    Reducing the Risk of Stroke in Women with Migraine

    ANNE D. WALLING

    Atovaquone and Dapsone for PCP Prophylaxis

    JEFFREY T. KIRCHNER

    Treating H. pylori Does Not Affect Nonulcer Dyspepsia

    JEFFFREY T. KIRCHNER

    5-mg vs. 10-mg Doses in the Initiation of Warfarin Therapy

    BARBARA APGAR

    Observation After Stopping Intravenous Antibiotics

    GRACE BROOKE HUFFMAN

    Can Palpation Reliably Detect Abdominal Aortic Aneurysm?

    GRACE BROOKE HUFFMAN

    A Cost-Effective Evaluation of Gynecomastia in Men

    ANNE D. WALLING

    Active Training vs. Physical Therapy for Adductor Pain

    ANNE D. WALLING

    Family Practice International

    Family Practice International

    Anne D. Walling

    (Great Britain—The Practitioner, December 1998, p. 836.) The prevalence of cataracts rises exponentially with age and is accelerated in patients with diabetes mellitus. Patients usually complain of decreased vision, especially in bright environments, but many cases are...

    Special Medical Reports

    CDC Releases Updated Plan for Emerging Infectious Diseases

    Verna L. Rose

    In 1994, the Centers for Disease Control and Prevention (CDC) launched the first phase of a nationwide effort to protect the public from infectious diseases. This past fall, the CDC released an updated document titled “Preventing Emerging Infectious Diseases: A Strategy for...

    ACOG Issues Report on the Medical Management of Tubal Pregnancy

    Verna L. Rose

    The American College of Obstetricians and Gynecologists (ACOG) has issued a practice bulletin on the medical management of tubal pregnancy. ACOG Practice Bulletin No. 3 was published in the December 1998 issue of Obstetrics and Gynecology. The seven-page practice bulletin was...

    Clinical Briefs

    Clinical Briefs

    Verna L. Rose

    In a policy statement published in the January 1999 issue of Pediatrics, the American Academy of Pediatrics (AAP) strongly recommends that physicians encourage parents who have school-age children and adolescents with human immunodeficiency virus (HIV) infection to tell those...

    Letters to the Editor

    Understanding Patients with Multiple Chemical Sensitivity

    Information from Your Family Doctor

    Parkinson's Disease

    In Parkinson's disease, the brain cells that control your muscles are damaged. This causes symptoms like these:

    When Your Toddler Doesn't Want to Use the Toilet

    Most children have the skills for toilet training between 24 and 30 months of age. Some children may not be ready until they are three years old or more. It's different for each child.

    Treating Baldness in Men

    Male pattern baldness is hair loss that happens because the male hormone testosterone (say: tess-toss-ter-own) changes the hair roots.

    Syphilis: What It Is and How It's Treated

    Syphilis (say: siff-uh-liss) is a serious infection. It's passed from one person to another during sex. It's caused by a bacteria (germ). You could get syphilis by touching the blood or sores of a person who has syphilis, especially sores on the person's mouth, penis, vagina...

    Postpartum Depression and the “Baby Blues”

    After having a baby, many women have mood swings. One minute they feel happy, the next minute they start to cry. They may feel a little depressed, have a hard time concentrating, lose their appetite or find that they can't sleep well even when the baby is asleep. These...

    Understanding Tics and Tourette's Syndrome

    Tics are movements or sounds that are repeated over and over. A person with a tic can't control the movement or sounds. Tics usually last less than a year. Throat clearing and eye squinting are common tics. Tics are often worse when a person is stressed, tired or anxious....



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