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  • Articles

    Management of Diabetic Ketoacidosis

    ABBAS E. KITABCHI, BARRY M. WALL

    Diabetic ketoacidosis remains a common cause of hospitalization. Use of treatment algorithms and flow sheets can prevent errors in the management of this “routine” medical emergency.

    Case Studies in International Travelers

    LYNN W. KITCHEN

    Family physicians should remain alert to the presence of unusual diseases in patients returning from travel outside the United States, including malaria, amebiasis and cutaneous larva migrans.

    Current Trends in Cervical Ripening and Labor Induction

    JEFFERSON H. HARMAN, JR., ANDREW KIM

    Current pharmacologic methods for cervical ripening and induction are reviewed, with a focus on the use of misoprostol.

    Primary Dysmenorrhea

    ANDREW S. COCO

    Primary dysmenorrhea is a common problem in young women. Nonsteroidal anti-inflammatory drugs and oral contraceptives are the treatments of choice.

    Reactive Arthritis (Reiter's Syndrome)

    WERNER F. BARTH, KINIM SEGAL

    Reactive arthritis is the most common inflammatory polyarthritis in young men. Initial treatment consists of high dosages of potent nonsteroidal anti-inflammatory drugs.

    Endogenous Endophthalmitis: Case Report and Brief Review

    CESAR F. ROMERO, MANDEEP K. RAI, CAREEN Y. LOWDER, KARIM A. ADAL

    The authors describe a patient with endogenous endophthalmitis caused by Staphylococcus aureus. A review of the literature is presented, with emphasis on diagnosis and management.

    Post-traumatic Stress Reactions Following Motor Vehicle Accidents

    DENNIS J. BUTLER, H. STEVEN MOFFIC, NICK W. TURKAL

    Every year, more than 3 million persons are injured in motor vehicle accidents. A number of victims have chronic post-traumatic stress symptoms. An awareness of patient characteristics and pre-accident functioning enhances evaluation of these symptoms.

    How to Recognize and Treat Acute HIV Syndrome

    BARBARA LEE PERLMUTTER, JORDAN B. GLASER, SAMWEL O. OYUGI

    Early identification and treatment of acute HIV syndrome may halt disease progression and restore immunocompetence.

    Peyronie's Disease: Current Management

    JAMES FITKIN, GEORGE T. HO

    In its early stages, Peyronie's disease may resolve spontaneously; however, patients with advanced disease should be referred for urologic consultation about surgical options.

    Heart Murmurs in Pediatric Patients: When Do You Refer?

    MICHAEL E. MCCONNELL, SAMUEL B. ADKINS, III, DAVID W. HANNON

    Most children with heart murmurs do not have cardiac disease. A complete examination, including precordial palpation, auscultation of the two heart sounds and listening for systolic and diastolic murmurs, can determine patients who require referral or can be followed by the...

    Soft Tissue Sarcomas: Integrating Primary Care Recognition with Tertiary Care Center Treatment

    THOMAS C. ROSENTHAL, WILLIAM KRAYBILL

    For the best outcome, a patient with a soft tissue sarcoma more than 5 cm in diameter or located in a difficult area should be sent to a cancer referral center.

    Protecting the Health and Safety of Working Teenagers

    HARRIET RUBENSTEIN, MARNA R. STERNBACH, SUSAN H. POLLACK

    Family physicians can help protect teenagers by counseling them about workplace health and safety issues.

    Inside AFP

    ADA Series and Patient Information Collections

    Janis Wright

    This issue of AFP contains two special features: a new series of articles developed in collaboration with the American Diabetes Association (ADA), and a new department containing handy collections of patient information handouts. The cover article, “Management of Diabetic...

    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

    Businesses are beginning to purchase defibrillators to enhance their first-aid kits, according to The Wall Street Journal. These automated external defibrillators (AEDs) have voice prompts and offer a computerized analysis of the victim's condition. They come with drawings...

    Editorials

    Acute HIV-1 Infection: Early Identification and Treatment

    MARTIN MARKOWITZ

    In this issue of American Family Physician, Perlmutter and colleagues1 carefully discuss the diagnosis and treatment of persons newly infected with human immunodeficiency virus (HIV-1). Certain aspects of this topic merit additional comment.

    The Conundrum of Early HIV Infection

    JAY SIWEK, CLARISSA C. KRIPKE

    On the surface, it seems reasonable to advise physicians to suspect early human immunodeficiency virus (HIV) infection when clinically indicated and to be prepared to intervene with antiretroviral therapy. However, this premise is fraught with pitfalls and challenges for...

    Current Trends in Cervical Ripening and Labor Induction

    BARBARA S. APGAR

    In recent years, there has been recognition that if the cervix is unfavorable, labor will rarely progress successfully to a vaginal delivery. Bishop attempted to define parameters of successful or failed labor induction with a cervical scoring system. Successful outcomes of...

    Diary from a Week in Practice

    Diary from a Week in Practice

    WLL has found that many patients who participate in outdoor activities do not take precautions against poison ivy, poison oak and poison sumac before they go into potentially contaminated areas. He has found that most patients do not realize that there are steps they can take...

    Photo Quiz

    Food Intolerance

    Marc S. Berger, NADEEM HUSSAIN

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

    Conference Highlights

    Conference Highlights

    Verna L. Rose

    (71st Annual Scientific Sessions of the American Heart Association) Results from the Atorvastatin Versus Revascularization Treatments (AVERT) trial revealed that patients with stable coronary artery disease receive significant cardiovascular benefit through aggressive...

    Family Practice International

    Family Practice International

    Anne D. Walling

    (Great Britain—The Practitioner, March 1999, p. 203.) Pruritus is common in older patients, with 29 to 50 percent of persons 75 years of age reporting chronic or recurrent skin irritation and itching. Localized pruritus in elderly patients usually involves the scalp, trunk,...

    Curbside Consultation

    Female Circumcision

    JEAN L. FOURCROY

    Girls in Somalia are circumcised before the age of five years, usually by female family members, although it is also performed legally there in some hospitals. Uncircumcised women are seen as unclean.

    AAFP Core Educational Guidelines

    Adolescent Health

    This document has been endorsed by the American Academy of Family Physicians and was developed in cooperation with the Society for Adolescent Medicine, the Association of Departments of Family Medicine, the Association of Family Practice Residency Directors and the Society of...

    Special Medical Reports

    AAP Issues Guidelines for Urinary Tract Infections in Infants and Toddlers

    Sharon Scott Morey

    The American Academy of Pediatrics (AAP) has released guidelines for the diagnosis, treatment and follow-up evaluation of urinary tract infections in infants and toddlers. Published in the April 1999 issue of Pediatrics, the recommendations apply specifically to children two...

    Eleven National Medical Associations Join to Prevent Pneumonia

    Verna L. Rose

    The American Academy of Family Physicians (AAFP), the American Medical Association (AMA) and nine other medical societies have issued a joint health alert calling for more extensive use of immunization to combat increasingly resistant strains of bacteria that cause pneumonia....

    Clinical Briefs

    Clinical Briefs

    Verna L. Rose

    The percentage of American teenagers who are practicing abstinence or who use condoms is increasing, according to a survey from the Centers for Disease Control and Prevention (CDC) published in the June 4, 1999, issue of Morbidity and Mortality Weekly Report. The CDC analyzed...

    Physician's Bookshelf

    CD-ROM Review

    JAMES G. RICCA, MARY JEWELL

    Book Review | Also Received

    Letters to the Editor

    Provocation-Neutralization in the Treatment of Food Allergy

    The Family Physician as a Hospitalist

    JIM GUYN, TOM GUYN

    Tips from Other Journals

    Transmission of Human Papillomavirus at Birth

    ANNE D. WALLING

    Effective Pain Control for Patients with Advanced Cancer

    KARL MILLER

    Do Memory Complaints Predict Alzheimer's Disease?

    KARL MILLER

    Budesonide Inhalation Suspension in Young Children with Asthma

    GRACE BROOKE HUFFMAN

    Breast Symptoms in Women Visiting Primary Care Offices

    RICHARD SADOVSKY

    Problems from Chinese Herbal Skin Medications

    ANNE D. WALLING

    Is Benign Breast Disease a Contraindication for ERT?

    KARL MILLER

    Latex Allergy: A Serious Risk to Patient and Health Worker

    ANNE D. WALLING

    Pulse Pressure as a Predictor of Congestive Heart Failure

    GRACE BROOKE HUFFMAN

    Chest Pain and Prognostic Value of ECG Features of Ischemia

    GRACE BROOKE HUFFMAN

    Pesticide Exposure and Non-Hodgkin's Lymphoma

    KARL E. MILLER

    Left Bundle Branch Block and ECG Evidence of Infarction

    GRACE BROOKE HUFFMAN

    Psychologic Stress in Women After Abnormal Mammograms

    KARL MILLER

    Effectiveness of Salmeterol in Treating COPD

    KARL MILLER

    Daily Treatment Regimens for H. pylori Infections

    KARL MILLER

    Risk Factors for Perinatal Brachial Plexus Injury

    ANNE D. WALLING

    Can the Development of Eating Disorders Be Predicted?

    ANNE D. WALLING

    Homocysteine Levels in Coronary Artery Disease

    RICHARD SADOVSKY

    The Role of Band Counts in Bacterial and Viral Infections

    JEFFREY T. KIRCHNER

    Risk of Hemorrhage and Scarring in Placenta Accreta

    ANNE D. WALLING

    Gastroesophageal Reflux Disease as a Cause of Cough

    ANNE D. WALLING

    Cost-Efficient Guidelines for Preoperative Testing

    GRACE BROOKE HUFFMAN

    Diabetic Nephropathy Screening by Primary Care Physicians

    GRACE BROOKE HUFFMANN

    Information from Your Family Doctor

    Facts About Labor Induction

    Sometimes it's safer to deliver your baby before you go into natural labor. Your doctor could use medicines to make your labor start “early,” so you can deliver your baby vaginally. This is called “labor induction.” Or it might be better for you not to go into labor at all...

    What You Should Know About Reactive Arthritis

    Reactive arthritis is an uncommon disease that can make your joints hurt and swell. It can also cause rash, fever, weight loss, heart problems, red eyes and blurry vision. Since pain in the joints is one of the most common symptoms, this condition is called reactive arthritis...

    After a Traffic Accident

    Each year over 3 million Americans have traffic accidents. If you've had an accident, you might have had a lot of reactions at the time of the accident and in the days following it. Some of these reactions might be:

    Acute HIV Syndrome

    HIV syndrome is a name for the early stage of HIV infection, when you first get infected with the HIV virus. HIV stands for human immunodeficiency virus. These are some of the symptoms of acute HIV syndrome:

    Peyronie's Disease

    Peyronie's disease is a big name for a curve in the penis. (Peyronie's is said this way: pay-roneees.) It can be painful at times, most often during sex. In some men, Peyronie's disease is a mild problem without symptoms. Other men with Peyronie's disease may have pain during...

    Heart Murmurs in Children—What Parents Should Know

    A heart murmur is just a noise that the blood makes as it flows through the heart. It's like the noise water makes when it flows through a hose. Many healthy people have heart murmurs. About 80 percent of all children have a heart murmur at some time.

    Health and Safety Issues for Working Teens

    Yes, you may be. Every year about 70 teens in the United States die as a result of injuries at work. Another 70,000 teens are hurt on the job and have to go to a hospital or emergency department. Teens are often injured on the job because of unsafe equipment, because they...

    Diabetes: What You Need to Know

    Diabetes is a disease that occurs when your body doesn't make enough insulin or doesn't use insulin the right way. Insulin is a hormone that helps your body use sugar (glucose) for energy. Because your body has a problem with insulin, sugar builds up in your blood. Your body...

    Diabetes: How to Use Insulin

    Insulin is a hormone that controls the level of blood sugar (also called glucose) in your body. People with diabetes may not have enough insulin or may not be able to use it properly. The sugar builds up in the blood and overflows into the urine, passing out of your body...

    Diabetes and Exercise

    Exercise can help control your weight and may lower your blood sugar level. It also lowers your risk of heart disease, which is common in people who have diabetes. Regular exercise can also improve your overall health and well-being.

    Diabetes and Nutrition

    What you eat affects your blood sugar level, so you need to make wise food choices. Work with your doctor to develop a diet that meets your needs. For most people, a healthy diet consists of 40 to 60% of calories from carbohydrates, 20% from protein, and 30% or less from fat.

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    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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