• Articles

    Medical Advice for Commercial Air Travelers

    THOMAS N. BETTES, DAVID K. MCKENAS

    Patients with many different types of medical conditions may require assessment and medical advice before they make the decision to travel by air.

    Depression Without Sadness: Alternative Presentations of Depression in Late Life

    JOSEPH J. GALLO, PETER V. RABINS

    Alternative clinical clues are presented that may help in the diagnosis of depression in older persons who deny feeling sad or “blue.”

    HELLP Syndrome: Recognition and Perinatal Management

    MAUREEN O'HARA PADDEN

    HELLP syndrome, characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is frequently misdiagnosed at initial presentation. The mainstay of therapy is supportive management.

    Evaluation and Treatment of Weight Loss in Adults with HIV Disease

    BRUCE WILLIAMS, DEBRA WATERS, KATHERINE PARKER

    Weight loss of as little as 5 percent in patients with human immunodeficiency virus (HIV) infection is associated with an increased risk of disease progression. Early identification and aggressive treatment of wasting syndrome in HIV disease can restore the patient to...

    Evaluation of Dysuria in Men

    RICHARD G. ROBERTS, PAUL P. HARTLAUB

    The evaluation of dysuria requires a thorough history, a focused physical examination and urinalysis with both dipstick and microscopic assessment of the urine specimen. In most male patients, dysuria is caused by infection, with benign prostatic hyperplasia an important...

    Head and Neck Manifestations of Gastroesophageal Reflux Disease

    VANITA AHUJA, MYRON W. YENCHA, LORENZ F. LASSEN

    Many patients with gastroesophageal reflux disease have head and neck symptoms without heartburn. The head and neck manifestations can be diverse, and diagnosis of GERD in patients presenting with such symptoms requires a high index of suspicion.

    Assessment and Management of Concussion in Sports

    KIMBERLY G. HARMON

    The sideline physician should have a good understanding of concussion management—especially the assessment of injury severity and the risks associated with premature return to play.

    Antioxidant Vitamins and the Prevention of Coronary Heart Disease

    ALEXANDRA K. ADAMS, ELLEN O. WERMUTH, PATRICK E. MCBRIDE

    Some antioxidant vitamins appear to be important in reducing the risk of coronary heart disease. Patients with coronary heart disease would probably benefit from taking vitamins E and C.

    The Eye in Childhood

    MONTE D. MILLS

    Vision problems in early childhood, such as amblyopia, strabismus and retinopathy of prematurity, are potentially treatable. Prompt detection and timely treatment require an effective screening program during early childhood.

    Inside AFP

    University of Wisconsin Series: Tackling Problems in Diagnosis

    Janis Wright

    On page 865 of this issue, you'll find the first article in a new series appearing under the “Problem-Oriented Diagnosis” banner. The article “Evaluation of Dysuria in Men,” by Richard G. Roberts, M.D., J.D., and Paul P. Hartlaub, M.D., M.S.P.H., kicks off a series of...

    AAFP News Now: AFP Edition

    Newsletter

    Rosemarie Sweeney, Verna L. Rose

    The American Academy of Family Physicians (AAFP) is one of 46 organizations that signed onto an amicus brief to the Supreme Court supporting the right of the U.S. Food and Drug Administration (FDA) to regulate the sale and promotion of tobacco products to minors.

    Quantum Sufficit

    Quantum Sufficit

    Monica A. Preboth

    How did you do on your last report card? It may not matter. An increasing number of health plans and hospitals write “report cards,” or physician profiles, for the physicians they employ. A new study by the U.S. Agency for Health Care Policy and Research (AHCPR) questions the...

    Editorials

    Concussion in Sports

    THOMAS R. TERRELL, ANDREW M. TUCKER

    In the article on concussion in sports in this issue of American Family Physician,1 Harmon highlights many important issues related to the evaluation and treatment of concussion (mild traumatic brain injury; MTBI) in young athletes. This injury, which is common in athletes...

    The Value of Antioxidant Vitamin Supplements

    ROBERT KININGHAM

    In this issue of American Family Physician, Adams and colleagues discuss potential clinical uses of antioxidant vitamin supplementation. Interest in dietary antioxidant vitamins has been growing over the past few decades with the recognition that oxidative processes can...

    Medicine and Society

    Genetic Testing for Disease Susceptibility: Social, Ethical and Legal Issues for Family Physicians

    MARY TERRELL WHITE, FAITH CALLIF-DALEY, JOHN DONNELLY

    As genetic testing for disease susceptibility is incorporated into clinical practice, family physicians will increasingly provide initial genetic counseling and referrals for testing. Genetic testing for disease susceptibility is associated with numerous social, ethical and...

    Diary from a Week in Practice

    Diary from a Week in Practice

    WLL recently learned about a new digital camera device that can instantly identify eye problems in infants and toddlers. This camera may help detect conditions that are the most common causes of preventable blindness in children. The device, called EyeDx, works by using a...

    Photo Quiz

    Back Rash

    RAVI J. SHEKARAPPA, PETROS NIKOLINAKOS, TRACY BANSIDHAR, ERWINN SISTOZA, JENNIFER SMITH

    A 30-year-old man with idiopathic thrombocytopenic purpura (ITP) and idiopathic constrictive pericarditis presented with an asymptomatic skin rash on his back, neck and shoulders. The rash first appeared three days earlier on his neck and had gradually progressed to both...

    Tips from Other Journals

    Evaluating Renal Masses Using Image-Guided Biopsy

    KARL E. MILLER

    Behavior Therapy Compared with Drug Therapy for Insomnia

    GRACE BROOKE HUFFMAN

    Occult Pneumonias in Febrile Children with Leukocytosis

    RICHARD SADOVSKY

    Nighttime Ipratropium in Patients with Sleep Problems

    KARL E. MILLER

    Correctly Diagnosing Tuberculosis in Children

    RICHARD SADOVSKY

    The Role of Antihypertensive Drugs in Elderly Patients

    ANNE D. WALLING

    Corticosteroids in Patients with Polymyalgia Rheumatica

    BARBARA APGAR

    Mental Stress as a Risk Factor for Myocardial Ischemia

    KARL E. MILLER

    Length of Antibiotic Therapy After Abdominal Trauma

    ANNE D. WALLING

    Case Studies of Liver Failure Induced by Nefazodone

    RICHARD SADOVSKY

    Does Aspirin Therapy Increase the Risk of Stroke?

    ANNE D. WALLING

    Dietary Omega-3 Fatty Acids: Cardioprotective or Not?

    RICHARD SADOVSKY

    Sildenafil for Diabetes-Related Erectile Dysfunction

    GRACE BROOKE HUFFMAN

    Community-Acquired Pneumonia in Children

    RICHARD SADOVSKY

    Does Echinacea Extract Prevent or Ameliorate Respiratory Infections?

    GRACE BROOKE HUFFMAN

    Snack Foods With Olestra and Gastrointestinal Symptoms

    RICHARD SADOVSKY

    Childhood Trauma and Dissociation in Adulthood

    BARBARA APGAR

    Modafinil for Sleepiness Associated with Narcolepsy

    BARBARA APGAR

    TENS vs. PENS vs. Exercise Therapy for Low Back Pain

    GRACE BROOKE HUFFMAN

    Assessing Relapse Potential in Patients with Asthma

    KARL E. MILLER

    Aerobic Activity vs. T'ai Chi: Effects on Blood Pressure

    GRACE BROOKE HUFFMAN

    Vehicle Operation in Patients with Vasovagal Syncope

    RICHARD SADOVSKY

    Dipyridamole Thallium Scanning After Acute MI

    GRACE BROOKE HUFFMAN

    Effects of Beta Blockers and Diuretics on Lipoproteins

    BARBARA APGAR

    Can Exercise Reduce Fatigue During Chemotherapy?

    KARL E. MILLER

    Optimal Daily Methadone Dosage to Treat Opioid Dependence

    GRACE BROOKE HUFFMAN

    Percutaneous Transluminal Myocardial Revascularization

    RICHARD SADOVSKY

    Flexibility Exercise Can Decrease Overuse Leg Injuries

    KARL E. MILLER

    Why Do Physicians Treat Purulent URI with Antibiotics?

    GRACE BROOKE HUFFMAN

    Family Practice International

    Family Practice International

    Anne D. Walling

    (Great Britain—The Practitioner, March 1999, p. 164) Although elder abuse has only recently received recognition, it is estimated that a typical British family practice may have as many as 20 elderly patients who are victims of abuse. Definitions of elder abuse vary, but all...

    Curbside Consultation

    Disclosing the Truth About a Medical Error

    CHANTAL BRAZEAU

    As soon as my patient told me she was having heavy, prolonged menstrual periods and fatigue, I realized my mistake. Two months earlier, I had checked her thyroid-stimulating hormone (TSH) level to monitor her response to the treatment of hyperthyroidism. She had been doing...

    Special Medical Reports

    ACC and AHA Update Guidelines for Coronary Angiography

    Sharon Scott Morey

    The American College of Cardiology (ACC) and the American Heart Association (AHA) have updated their guidelines for coronary angiography. The executive summary and recommendations are published in the May 4, 1999, issue of Circulation. The entire guidelines are published in...

    AAP Recommends the Development of Universal Newborn Hearing Screening Programs

    Verna L. Rose

    The Task Force on Newborn and Infant Hearing of the American Academy of Pediatrics (AAP) has issued a new policy statement recommending development of universal newborn hearing screening programs nationwide. The statement, published in the February 1999 issue of Pediatrics,...

    Clinical Briefs

    Clinical Briefs

    Verna L. Rose

    The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) have issued a joint statement in support of a recommendation from the Institute of Medicine for universal testing for human immunodeficiency virus (HIV) infection with...

    AAFP Core Educational Guidelines

    Care of the Surgical Patient: 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 Association of Departments of Family Medicine, the Association of Family Practice Residency Directors and the Society of Teachers of Family Medicine.

    Physician's Bookshelf

    Book Reviews

    JEFF WEINFELD, ELIAS BAUMGARTEN

    Book Reviews | Also Received

    Letters to the Editor

    The Potential Postfertilization Effect with Use of the IUD

    Sarcoidosis and Vasculitis

    AVINASH K. SHETTY, ABRAHAM GEDALIA

    Monitoring Warfarin Therapy

    Information from Your Family Doctor

    Genetic Testing: What You Should Know

    Genes are long molecules called DNA that are present in every cell in your body. DNA controls growth and helps you stay healthy. If your DNA is abnormal or damaged, it may not work properly, which may lead to disease. Some genetic abnormalities, or “gene mutations,” may run...

    Tips on Safe Air Travel

    Most people don't have any problems when they fly, but it's possible to make airplane travel safer and more comfortable. Here are some tips:

    HELLP Syndrome and Your Pregnancy

    HELLP syndrome is a rare but serious illness in pregnancy. This illness can start quickly, most often in the last three months of pregnancy (the “third trimester”). It can also start soon after you have your baby.

    Nutrition and Exercise When You Have HIV

    Even though you have HIV, you don't have to lose weight. Good nutrition and exercise can improve your health and slow down your HIV infection.

    Gastroesophageal Reflux Disease: More Than Heartburn

    Gastroesophageal reflux disease (or GERD, for short) is what happens when liquids and food in your stomach go “the wrong way,” or back up into your throat. When this happens, the foods and liquids can irritate your throat.

    Concussion

    A concussion is an injury to the brain. It's usually caused by a blow to the head. Most of the time it doesn't involve a loss of consciousness.

    Can Vitamins Help with Heart Disease?

    Several things can lower your risk of heart disease:

    What Is Amblyopia and How Is It Treated?

    Amblyopia (say this: am-blee-oh-pee-ah) is an eye problem that causes poor vision in children. The problem starts when the pathways of vision in the brain don't develop, or grow, strong enough. Pathways are a little like roads—they carry vision messages from eye to brain....

    Diabetic Neuropathy: What You Can Do About It

    Diabetes makes your blood sugar level higher than normal. High blood sugar levels can damage the nerves in your body. When diabetes damages the nerves, it's called diabetic neuropathy.

    Eye Care for People with Diabetes

    Diabetes makes your blood sugar level higher than normal. High blood sugar levels can weaken your blood vessels, including the small blood vessels in the retina. (The retina is the part of the eye that's sensitive to light and helps you see.) This damage is called diabetic...

    Foot Care for People with Diabetes

    Diabetes makes your blood sugar level higher than normal. A high blood sugar level can damage your blood vessels and nerves. Damage to the blood vessels in your feet may mean that your feet get less blood. Damage to the nerves may cause you to lose some of the feeling ...

    Gestational Diabetes: What It Means for You and Your Baby

    Gestational diabetes is a kind of diabetes that starts during pregnancy. (The word gestational means “during pregnancy.”) If you have gestational diabetes, your body isn't able to use the sugar (glucose) in your blood as well as it should, so the level of sugar in your blood...



    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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