• Articles

    Insomnia: Assessment and Management in Primary Care

    Although about 10 percent of adult patients experience persistent insomnia, most do not report the problem during routine office visits. Asking sleep-related questions while taking the general history may help to identify these patients.

    Case Studies in International Medicine

    LYNN W. KITCHEN

    Case studies are presented to acquaint family physicians with five diseases that are common in immigrants: strongyloidiasis, hookworm infestation, cysticercosis, clonorchiasis and tropical pancreatitis.

    Cutaneous and Systemic Manifestations of Mastocytosis

    WILLIAM A. ALTO, LISA CLARCQ

    Mastocytosis is a cutaneous disorder or a systemic disease with symptoms ranging from a pruritic rash to vascular collapse. The diagnosis can easily be overlooked.

    Endometrial Cancer

    TIMOTHY P. CANAVAN, NIPA R. DOSHI

    Endometrial cancer is a common malignancy in women but, with risk screening and endometrial sampling, it can be identified at an earlier stage, when treatment is highly successful.

    Colorectal Cancer: Risk Factors and Recommendations for Early Detection

    THOMAS E. READ, IRA J. KODNER

    The detection and treatment of early-stage cancers and adenomatous polyps can reduce the mortality rate for colorectal cancer. Current screening recommendations are reviewed.

    Kawasaki Disease

    KATHRYN A. TAUBERT, STANFORD T. SHULMAN

    Kawasaki disease is a leading cause of acquired heart disease in children. Criteria for early diagnosis are described, and acute treatment modalities are reviewed.

    Managing Somatic Preoccupation

    ELISABETH L. RIGHTER, RANDY A. SANSONE

    Patients with physically unexplainable symptoms present a genuine clinical challenge. Few patients in primary care meet the strict criteria for somatoform disorder; the family physician is more likely to be faced with somatic preoccupation.

    Evaluation and Management of the Child with Speech Delay

    ALEXANDER K.C. LEUNG, C. PION KAO

    Timely detection and appropriate intervention may mitigate the adverse effects of speech delay and improve the outcome in children with this disability.

    Angiotensin-II Receptor Antagonists: Their Place in Therapy

    JULIENNE K. KIRK

    Angiotensin-II receptor antagonists are effective in the treatment of hypertension. These drugs have a favorable side effect profile and are well tolerated by most patients.

    Inside AFP

    Keeping in Touch with the Journal Keepers

    Janis Wright

    Over 400 scientific editors and other members of the Council of Biology Editors (CBE) recently met in Montreal, Quebec, for a forum on communicating science in the 21st century. Several AFP staff members and representatives of other journals from the United States, Canada and...

    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

    Just a spoonful of sugar helps the electronic data-recording pill go down? Astronaut John Glenn swallowed an electronic pill that took measurements of his vital signs on his recent space mission, and doctors will soon be using such devices in corrective fetal surgery. The...

    Editorials

    Screening Options for Colorectal Cancer

    THEODORE G. GANIATS, HERBERT F. YOUNG

    Colorectal cancer is a significant disease in both men and women. The American Academy of Family Physicians (AAFP) in 1996 established policy recommending routine screening of persons age 50 years and over for colorectal cancer.1 More recently, the AAFP participated in...

    Labeling the Somatically Preoccupied: Have We Gone Too Far?

    MARGARET E. MCCAHILL

    In their article on somatically preoccupied patients in this issue of American Family Physician,1 Righter and Sansone point out that patients who have multiple, physically unexplainable symptoms are a heterogeneous group presenting great challenge and, sometimes, frustration...

    Diary from a Week in Practice

    Diary from a Week in Practice

    Everyone cheers when a ballplayer steps up to the plate and hits a home run the first time at bat, or when the underdog rallies in the final lap and wins the race. Would you cheer in this case? Today a 44-year-old man visited JRH for the first time. He was accompanied by his...

    Photo Quiz

    Chronic Non-healing Ulcers

    Marc S. Berger, R.J. SHEKARAPPA, JAIME RUIZ-MONTERO

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

    Conference Highlights

    Conference Highlights

    Verna L. Rose

    (48th Annual Scientific Session of the American College of Cardiology) Azimilide, an investigational anti-arrhythmic drug, shows promise in significantly prolonging the arrhythmia-free period in patients with atrial fibrillation, according to the results of three randomized,...

    Family Practice International

    Family Practice International

    Anne D. Walling

    (Great Britian—The Practitioner, January 1999, p. 39) Parkinson's disease usually progresses slowly over 15 to 20 years, and the classic symptoms of rigidity and hypokinesia (with or without tremor) may be caused by several neurologic processes, making diagnosis difficult....

    Curbside Consultation

    An HIV-Positive Patient Who Avoids Treatment

    JILL J. LEGG, RONALD H. GOLDSCHMIDT

    It is always frustrating when patients withhold important medical information or are not trusting or honest with their physicians. In these situations, it is helpful to first look at the possible reasons for the lack of forthrightness.

    Special Medical Reports

    American Thoracic Society Issues Consensus Statement on Dyspnea

    Verna L. Rose

    The American Thoracic Society (ATS) has issued a consensus statement on the mechanisms, assessment and management of dyspnea. Published in the January 1999 issue of the American Journal of Respiratory and Critical Care Medicine, the 19-page statement, developed by an 18...

    Treatment Guidelines for Heart Failure Stress Multidrug Approach

    Sharon Scott Morey

    A group of more than 150 cardiologists has issued recommendations for the treatment of chronic heart failure. The recommendations were developed on behalf of a not-for-profit organization called the Advisory Council to Improve Outcomes Nationwide in Heart Failure (ACTION HF)....

    AAP Releases Recommendations on Use of Inactivated and Live Oral Polio Vaccines

    Sharon Scott Morey

    The American Academy of Pediatrics (AAP) Committee on Infectious Diseases has released the complete AAP recommendations for the use of inactivated poliovirus vaccine (IPV) and live oral poliovirus vaccine (OPV). The recommendations are published in the January 1999 issue of...

    Clinical Briefs

    Clinical Briefs

    Verna L. Rose

    The findings in a report from the Centers for Disease Control and Prevention (CDC), published in the March 19, 1999, issue of Morbidity and Mortality Weekly Report, document the continuing hazard of lead exposure as an occupational health problem. The report presents...

    Physician's Bookshelf

    Book Reviews

    TOM ROSENTHAL

    Also Received

    Letters to the Editor

    The Role of Government in Controlling the HIV Epidemic

    NAYVIN GORDON

    Prophylaxis for STDs After Sexual Assault

    EDWARD L. FIEG, null MAJOR

    Sister (Mary?) Joseph's Node

    ANTHONY J. VIERA, TIMOTHY L. CLENNEY

    Peripartum Emergencies

    Tips from Other Journals

    Three Treatment Regimens for Women with Hirsutism

    KARL MILLER

    Children With Pseudoseizures: Psychiatric Aspects and Outcomes

    JEFFREY T. KIRCHNER

    The Medical Literature on Raloxifene for Osteoporosis

    RICHARD SADOVSKY

    Neonatal Jaundice: Does Human Milk or Type of Formula Matter?

    JEFFREY T. KIRCHNER D.O.

    Vaccinations and Other Health Care Measures for Foreign Travel

    RICHARD SADOVSKY

    Nocturnal Asthma Controlled With Long-Acting Beta Agonist

    KARL MILLER

    Managing First Trimester Spontaneous Abortion

    JEFFREY T. KIRCHNER

    Comparison of Carvedilol and Metoprolol in Stable Angina

    RICHARD SADOVSKY

    Do Three Indicators Correlate with Severity of Asthma?

    KARL MILLER

    Which Treatment Is Best for Urinary Stress Incontinence?

    ANNE D. WALLING

    Repeat Vasectomy Reversal Effective After Prior Failures

    KARL MILLER

    Community-Acquired Pneumonia: New Guidelines

    KARL MILLER

    How Parents Make the Decision About Circumcision

    JEFFREY T. KIRCHNER

    Combination Therapy to Improve Control of COPD

    KARL MILLER

    Oral and Insulin Antidiabetic Regimens in Type 2 Diabetes

    RICHARD SADOVSKY

    Can RSV Infection Be Prevented in At-Risk Infants and Children?

    BARBARA APGAR

    Are Calcium Channel Blockers Safe in Diabetic Hypertension?

    JEFFREY T. KIRCHNER

    Guidelines for Managing Chronic Renal Failure

    CLARISSA C. KRIPKE

    Risk of Mural Thrombus After a Brief Period of Atrial Fibrillation

    KARL MILLER

    Does Two Weeks of Bed Rest Bring About Relief from Sciatica?

    JEFFREY T. KIRCHNER

    Quality-of-Life Scores After Laparoscopic Antireflux Surgery

    RICHARD SADOVSKY

    Bupropion With or Without Patches for Smoking Cessation

    JEFFREY T. KIRCHNER

    ACE Inhibitors and Mortality Following Myocardial Infarction

    KARL MILLER

    Angioplasty and Stent Placement in Multiple-Vessel Disease

    KARL MILLER

    Montelukast vs. Beclomethasone for Control of Persistent Asthma

    RICHARD SADOVSKY

    Biliary Symptoms and Predictors of Common Bile Duct Stones

    RICHARD SADOVSKY

    Oral vs. Intravenous Ciprofloxacin for Severe Urinary Tract Infection

    BARBARA APGAR

    New Equation for Estimating Glomerular Filtration Rate

    RICHARD SADOVSKY

    Oral Doxycycline for Facial Palsy Related to Lyme Disease

    JEFFREY T. KIRCHNER

    Stopping Ticlopidine Two Weeks After Stent Placement

    CLARISSA C. KRIPKE

    Albumin-to-Creatinine Ratio for Detection of Microalbuminuria

    JAMES NUOVO

    Benefits of Exercise Training in Patients with Heart Failure

    CLARISSA KRIPKE

    Clinical Features of Patients with HIV-Associated Fever

    JEFFERY T. KIRCHNER

    Twice-Weekly Etanercept for Active Rheumatoid Arthritis

    RICHARD SADOVSKY

    Famciclovir for Herpes Simplex Labialis Induced by Sunlight

    ANNE D. WALLING

    Information from Your Family Doctor

    Mastocytosis: What It Is and How It's Diagnosed and Treated

    Mastocytosis (say “mas-toe-sigh-toe-sis”) is a rare disease of the skin (the most common form), or of other parts of the body (very rare), like the stomach, the intestines and the bone marrow. It's caused by having too many mast cells. Mast cells are a kind of blood cell.

    Endometrial Cancer—Diagnosis and Treatment

    Endometrial cancer is an out-of-control growth of the lining of the uterus. It happens most often in women 50 to 60 years old. It is the fourth most common cause of cancer in women, after breast, lung and colon cancer.

    Kawasaki Disease

    Kawasaki disease (say: kah-wuh-sock-ee) is an illness that young children can get (usually children under age 5). It can cause any of these symptoms:

    Speech and Language Delay: What Does This Mean for My Child?

    If your child doesn't talk as much as most children of the same age, the problem may be speech delay. Your doctor may think your child has speech delay if he or she isn't able to do these things:

    Corrections

    Correction



    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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