• Articles

    Common Causes of Vision Loss in Elderly Patients

    DAVID A. QUILLEN

    The principal causes of loss of vision in elderly patients (age-related macular degeneration, glaucoma, cataract and diabetic retinopathy) may be detected and monitored with careful annual eye examinations that include dilation.

    Ludwig's Angina in Children

    RICHARD W. HARTMANN, JR.

    Ludwig's angina is a potentially life-threatening diffuse inflammation of the submandibular and sublingual spaces. Following treatment with high doses of penicillin, most patients recover without complications.

    Prevention and Treatment of Traveler's Diarrhea

    GREGORY JUCKETT

    Judicious eating and drinking to avoid contaminated foodstuffs is essential in preventing traveler's diarrhea. The condition can usually be treated initially with loperamide; a fluoroquinolone can be added if loperamide fails to stop the diarrhea. Because drug resistance is...

    Vasectomy Techniques

    TIMOTHY L. CLENNEY, JAMES C. HIGGINS

    Isolation of the vas is key to a successful vasectomy. Techniques for managing the vasal ends include surgical clipping, cautery, fascial interposition and the open-ended technique.

    A Rational Approach to the Treatment of Hypertension in Special Populations

    W. DALLAS HALL

    Hypertension in black patients is usually characterized by a low-renin, volume-expanded and salt-sensitive state. Isolated systolic hypertension and combined systolic and diastolic hypertension are common in older patients. Diuretics and calcium channel antagonists are the...

    Responses to Questions About the Specialty of Family Practice as a Career

    JULEA G. GARNER, JOSEPH E. SCHERGER, JOHN W. BEASLEY, WM. MACMILLAN RODNEY, DAVID E. SWEE, ELIZABETH A. GARRETT, NORMAN B. KAHN, JR.

    Updated information is presented on a variety of subjects about family practice, including income, scope of the specialty, continuing medical education, board certification and residency training.

    Screening for Developmental Dysplasia of the Hip

    LINDA M. FRENCH, FREDERICK R. DIETZ

    Ultrasound imaging may have a role in the surveillance of mild hip abnormalities in infants and possibly in selective screening for developmental dysplasia.

    Prevention of Osteoporosis and Fractures

    PAUL ULLOM-MINNICH

    Some risk factors for fractures can be modified or eliminated. Based on cost-effectiveness and clinical efficacy, combined calcium and vitamin D supplementation should be first-line therapy in patients at risk for osteoporotic fractures.

    Disorders of Puberty

    RICHARD D. BLONDELL, MICHAEL B. FOSTER, KAMLESH C. DAVE

    If the clinician has an adequate working knowledge of the hypothalamic-pituitary-gonadal axis, the cause of aberrant puberty can often be identified with a focused medical history, a directed physical examination and selected diagnostic testing.

    Depression in Women: Diagnostic and Treatment Considerations

    SUBHASH C. BHATIA, SHASHI K. BHATIA

    In evaluating and treating depression in women, family physicians should consider gender-related biopsychosocial differences, as well as phases of the reproductive cycle.

    Clarification

    In a letter to the editor on the use of melatonin for insomnia (April 15, 1998, page 1783), the author, Ray Sahelian, M.D., failed to disclose that he was the author of a book on melatonin.

    Inside AFP

    Arrivals and Departures: Who's Landing at AFP Next?

    Janis Wright

    If you're a masthead watcher, you'll notice a number of changes on AFP's masthead in this issue (page 8), each with a story behind it:

    AAFP News Now: AFP Edition

    Newsletter

    Rosemarie Sweeney, Verna L. Rose

    The Center for Policy Studies in Family Practice and Primary Care of the American Academy of Family Physicians (AAFP) officially opened on June 8. Located in Washington, D.C., the policy center will have an initial staff of five people and is headed by Larry A. Green, M.D.,...

    Quantum Sufficit

    Quantum Sufficit

    Monica A. Preboth, Shyla Wright

    Continuous irrigation makes full range of motion possible in patients with an infected finger, reports Physician's Weekly. Seven men with purulent tenosynovitis had a butterfly catheter (with the needle removed and holes cut in the sides) inserted in the tendon sheath from...

    Editorials

    Family Practice as a Career Choice

    JAY SIWEK

    As a specialty choice, family practice has come of age. It is the second most popular choice of residency among medical students, second only to internal medicine. Surprising as it may seem, as a career choice family practice is number one. More office-based physicians in the...

    Pain, Depression and Survival

    PETER S. STAATS

    Adequate pain relief has an obvious positive effect on a patient's quality of life. However, recent data suggest that pain control also improves morbidity and mortality, that pain relief administered before surgery and during the postoperative period improves clinical...

    Diary from a Week in Practice

    Diary from a Week in Practice

    CAG received an excellent suggestion from our nurse practitioner, Lori White, for giving eye drops to children and adults. The patient lies supine with the eyes closed, and another person places two drops in the medial canthus of each eye. Once the eyes are opened, the...

    Photo Quiz

    A Finger Infection in a Pet Store Employee

    Marc S. Berger, JEFFREY J. MEFFERT

    A 35-year-old man who is employed at a pet store presented with a nodule on a finger (see the photograph). For four weeks the nodule increased in size, but it had remained the same size for the past three weeks. The patient also had a small, slightly tender epitrochlear lymph...

    Conference Highlights

    Conference Highlights

    Verna L. Rose

    (48th Annual Scientific Session of the American College of Cardiology) Women have a higher short-term mortality rate after myocardial infarction than men, but only when the myocardial infarction occurs before the age of 75 years. This is the conclusion of an analysis of data...

    Tips from Other Journals

    Distinguishing Benign From Malignant Endometrial Findings

    BARABARA APGAR

    Detection of Tuberculosis Despite Normal Chest Films

    JEFFREY T. KIRCHNER

    When to Operate on Intracranial Aneurysms?

    ANNE D. WALLING

    Diagnostic Markers for Detection of Myocardial Infarction

    JIM NUOVO

    A Novel Method of Treating Secondary Amenorrhea in Athletes

    BARBARA APGAR

    Newer Indications for Use of Permanent Pacemakers

    RICHARD SADOVSKY

    Doxycycline Is Cost-Effective for Community-Acquired Pneumonia

    BARBARA APGAR

    Using Pravastatin to Reduce Risk of Stroke After MI

    CLARISSA C. KRIPKE

    Treating Dryness Associated with Sjögren's Syndrome

    BARBARA APGAR

    Vaginal Preparations May Compromise Condom Integrity

    KARL MILLER

    Cardioversion of Paroxysmal Atrial Fibrillation

    RICHARD SADOVSKY

    A New Tool That Specifically Diagnoses Pemphigus Vulgaris

    BARBARA APGAR

    The Differential Diagnosis of Diverticulitis vs. Colon Cancer

    BARBARA APGAR

    Clinical Findings in Patients with Ectopic Pregnancy

    RICHARD SADOVSKY

    Lorazepam Prevents Recurrence of Alcohol-Related Seizures

    JEFFREY T. KIRCHNER

    Use of Antibiotic Prophylaxis in the Intensive Care Unit

    RICHARD SADOVSKY

    Two Regimens in the Treatment of Q Fever Endocarditis

    BARBARA APGAR

    Gynecologic Care, Health Issues for Lesbian Patients

    ANNE D. WALLING

    A Simplified Scale for Evaluating Stroke Patients

    RICHARD SADOVSKY

    Passive Smoking and Arterial Endothelial Dysfunction

    RICHARD SADOVSKY

    Comparison of Drugs Used to Treat Chronic Hypertension

    BARBARA APGAR

    Is CPAP Effective Against Obstructive Sleep Apnea?

    CLARISSA C. KRIPKE

    Effect of HRT on Thickness of the Left Ventricular Wall

    RICHARD SADOVSKY

    Celecoxib for Patients with Arthritis and Osteoarthritis

    BARBARA APGAR

    Fomepizole for the Treatment of Ethylene Glycol Poisoning

    JEFFREY T. KIRCHNER

    Family Practice International

    Family Practice International

    Anne D. Walling

    (Australia—Australian Family Physician, March 1999, p. 223.) Postnasal drip refers to the accumulation of mucus in the postnasal space, caused by hypersecretion from the paranasal sinuses or a disturbance of normal drainage. In addition to “congestion” and local discomfort,...

    Curbside Consultation

    A Troubled Teen: Matters of Confidentiality

    SUBHASH C. BHATIA

    I met the patient, a 15-year-old girl accompanied by her older sister, during a check-up. The girl's mother, waiting outside the examination room, told me that her daughter had recently run away from home, and she wanted the girl to have a thorough gynecological examination.

    AAFP Core Educational Guidelines

    Medical Genetics: Recommended Core Educational Guidelines for Family Practice Residents

    This document has been endorsed by the American Academy of Family Physicians and was developed in cooperation with the American College of Medical Genetics, the Association of Professors of Human and Medical Genetics, the Association of Departments of Family Medicine, the...

    Special Medical Reports

    Advisory Committee on Immunization Practices Issues Recommendations for the 1999–2000 Influenza Season

    Verna L. Rose

    The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) has released recommendations for the prevention and control of influenza during the 1999–2000 influenza season. The liaison representative to ACIP from the American...

    National Stroke Association Develops a Consensus Statement on Prevention of Stroke

    Sharon Scott Morey

    The National Stroke Association (NSA) has developed an evidence-based consensus statement on the prevention of a first stroke. Published in the March 24/31, 1999, issue of JAMA, the NSA consensus statement is based on a comprehensive literature review of guidelines, meta...

    Clinical Briefs

    Clinical Briefs

    Verna L. Rose

    The Centers for Disease Control and Prevention (CDC) reports that most women still do not know that an adequate intake of folic acid can prevent some serious birth defects. Even fewer women know that folic acid must be taken before and during the first few weeks of pregnancy,...

    Resident and Student Voice

    My Needlestick

    RONA SCHWARTZ

    It was the end of a long day.

    Physician's Bookshelf

    Book Reviews

    JAN FLATTUM-RIEMERS, GARY GRAY, MARY JEWELL

    Also Received

    Letters to the Editor

    Physician Reimbursement Issues in Home Health Care

    Male Dyspareunia in the Uncircumcised Patient

    RABBI JACOB SHECHET, BARTON TANENBAUM, STANLEY M. FRIED

    Hypnosis in the Treatment of Hyperemesis Gravidarum

    ERIC P. SIMON

    Information from Your Family Doctor

    Preventing and Treating Traveler's Diarrhea

    Traveler's diarrhea is a kind of diarrhea you might get when you're traveling in less developed countries. Many countries in Africa, Asia and Central and South America are risky places for travelers' diarrhea. It's usually caused by eating food or drinking water that is...

    Having a Vasectomy

    A vasectomy is a procedure that makes a man sterile (this means he has no sperm in his semen and can't make a woman pregnant). The doctor cuts and removes part of the tube that carries sperm from the testicles to the semen. (This tube is called the “vas deferens.”)

    Infant Hip Problems

    A few babies have hip problems that can lead to dislocation of the hip bones. This means that the long bone in the upper leg comes out of the hip socket. If your baby has this problem, it's important to find out early so it can be fixed (see Picture 1).

    When Your Child Is Close to Puberty

    Puberty is the time in life when a young person starts to become sexually mature.

    Depression in Women

    About 20% of women have depression at least once. If you're depressed, you may have some of these symptoms:

    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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