• Articles

    Controversies in Pulmonary Embolism and Deep Venous Thrombosis

    BRUCE L DAVIDSON

    When available tests are nondiagnostic, empiric anticoagulation should be considered until the diagnosis can be confirmed or ruled out by further studies.

    Educational Guidelines for Achieving Tight Control and Minimizing Complications of Type 1 Diabetes

    STEPHEN HAVAS

    Tight control of serum glucose levels in patients with type 1 diabetes may decrease the risk of serious complications, including retinopathy, neuropathy, stroke, heart disease and peripheral vascular disease.

    Exercise-Related Syncope in the Young Athlete: Reassurance, Restriction or Referral?

    FRANCIS G. O'CONNOR, RALPH G. ORISCELLO, BENJAMIN D. LEVINE

    Because exercise-related syncope may be the only symptom preceding a sudden cardiac death in young athletes, it is a condition that always requires investigation.

    Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment

    MARK S. JUHN

    Questions remain to be answered about the etiology and treatment of patellofemoral pain syndrome. Most patients respond well to conservative treatment measures, including stretching and strengthening exercises, and temporary activity modification.

    Acute Appendicitis: Review and Update

    D. MIKE HARDIN, JR.

    Appendicitis is common, with a lifetime occurrence of 7 percent. Delay in diagnosing appendicitis increases the risk of perforation and complications that are much more serious in children and the elderly.

    The “Burner”: A Common Nerve Injury in Contact Sports

    GEOFFREY S. KUHLMAN, DOUGLAS B. MCKEAG

    A burner can result in prolonged weakness that causes time lost from sports participation, and reinjury can occur.

    Failure to Pass Meconium: Diagnosing Neonatal Intestinal Obstruction

    VERA LOENING-BAUCKE, KEN KIMURA

    Failure to pass meconium within 24 hours of birth may signal intestinal obstruction. Hirschsprung's disease, anorectal malformations and meconium plug syndrome are among the disorders that can cause intestinal obstruction in the neonatal period.

    Lowering the Age for Routine Influenza Vaccination to 50 Years: AAFP Leads the Nation in Influenza Vaccine Policy

    RICHARD KENT ZIMMERMAN

    The rates of morbidity and mortality associated with influenza have led the American Academy of Family Physicians to recommend a lower age for universal influenza vaccination—50 years instead of 65 years of age.

    Update on Oral Contraceptive Pills

    SYLVIA L. CEREL-SUHL, BRYAN F. YEAGER

    By choosing an appropriate pill formulation, the family physician can minimize negative side effects and maximize noncontraceptive benefits for individual patients.

    Inside AFP

    Solving Diagnostic Puzzles with the Uniformed Services University of the Health Sciences

    Janis Wright

    This issue features the first in a series of “Problem-Oriented Diagnosis” articles by a new group of contributors, from the Department of Family Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Md. The article, “Exercise-Related Syncope in the...

    AAFP News Now: AFP Edition

    Newsletter

    Rosemarie Sweeney, Verna L. Rose

    On October 7, the House of Representatives passed the Bipartisan Consensus Managed Care Improvement Act, HR 2723. The vote on the bill was 275 to 151 with 68 Republicans joining in the positive vote. The measure, which covers all health plans, provides several patient...

    Quantum Sufficit

    Quantum Sufficit

    Jessica Greene

    Deaths caused by the acquired immunodeficiency virus syndrome (AIDS) have decreased by 50 percent since 1996, reports USA Today. Statistics from the Centers for Disease Control and Prevention show that 49,351 persons died of AIDS in 1995 alone. This number drastically...

    Editorials

    The Costs of Helping Patients with Type 1 Diabetes Achieve Tight Control

    JIM NUOVO, JENNIFER NUOVO

    The management of patients with type 1 diabetes mellitus (formerly known as juvenile-onset or insulin-dependent diabetes mellitus) poses a number of challenges to the practicing physician. These challenges include helping patients maintain optimal blood glucose control,...

    Influenza Vaccine for Adults 50 to 64 Years of Age

    RICHARD CLOVER

    Influenza continues to be a major cause of morbidity and mortality in the United States. Each year, approximately 20,000 deaths and 110,000 hospitalizations occur because of influenza.1 Rates of infection are highest in children, but rates of serious morbidity and mortality...

    Diary from a Week in Practice

    Diary from a Week in Practice

    In a previous Diary entry (August 1994), WLL reported the anecdotal success of a supersaturated boric acid solution applied to the toenails twice a day for six to 12 months to treat onychomycosis. Today, he learned of another topical treatment for this problem when he saw a...

    Photo Quiz

    A Numb Skin Eruption

    Marc S. Berger, SYLVIA HSU, JANNA NUNEZ

    A 23-year-old man presented with a five-month history of a slightly pruritic eruption on his right elbow (see the accompanying figure). He had taken a 15-day course of itraconazole (Sporanox), in a dosage of 200 mg per day, and had applied econazole (Spectazole) cream twice a...

    Tips from Other Journals

    P. carinii Prophylaxis in Patients with HIV

    JEFFFREY T. KIRCHNER

    Pulmonary Emboli in Patients with Negative Doppler Studies

    JEFFFREY T. KIRCHNER

    Comparison of Pharmacologic Treatments for Alcoholism

    GRACE BROOKE HUFFMAN

    Risk of Complications During Gynecologic Laparoscopy

    ANNE D. WALLING

    Review of the Diagnosis and Treatment of Spinal Stenosis

    RICHARD SADOVSKY

    Perineal Lacerations During Subsequent Vaginal Delivery

    ANNE D. WALLING

    Shoulder Complaints and Long-term Effects of Treatment

    ANNE D. WALLING

    Treating Coronary Artery Stent Restenosis

    RICHARD SADOVSKY

    Risedronate vs. Etidronate for Paget's Disease of Bone

    GRACE BROOKE HUFFMAN

    Evaluating Infants With Possible Pyloric Stenosis

    GRACE BROOKE HUFFMAN

    Vitamin C Intake: What's the Right Amount?

    GRACE BROOKE HUFFMAN

    Effectiveness of Encouraging Beta Blocker Use After an AMI

    GRACE BROOKE HUFFMAN

    Does Low-Potency Estrogen Carry a Risk of Endometrial Cancer?

    ANNE D. WALLING

    Oral Contraceptives Are Safe and Effective

    KARL E. MILLER

    Postexposure HIV Prophylaxis After Sexual Assault

    GRACE BROOKE HUFFMAN

    Removal of Aspirated Foreign Bodies in Children and Adults

    JEFFERY T. KIRCHNER

    Stroke Prevention in Patients With Atrial Fibrillation

    GRACE BROOKE HUFFMAN

    Gastrointestinal Findings in Elderly Patients Lacking Iron

    GRACE BROOKE HUFFMAN

    New Surgical Technique Proved Dangerous to Patients

    ANNE D. WALLING

    Recognizing and Treating Lyme Disease

    RICHARD SADOVSKY

    Outpatient Management of Lower Extremity DVT

    JEFFREY T. KIRCHNER

    Using NCPAP for Management of Obstructive Sleep Apnea

    ANNE D. WALLING

    Treatment of Patients with Refractory Seizures

    JEFFREY T. KIRCHNER

    Prolonged Anticoagulation in Patients With Acute DVT

    JEFFREY T. KIRCHNER

    Does Metoprolol Improve Survival in CHF?

    ANNE D. WALLING

    Manifestations of Pertussis in Immunized Children and Adults

    JEFFREY T. KIRCHNER

    Does Inhaled Budesonide Produce Benefits in COPD?

    ANNE D. WALLING

    Once-Daily Valacyclovir for Suppression of Genital Herpes

    ANNE D. WALLING

    Ultrasound Therapy for Calcific Tendonitis of the Shoulder

    JEFFREY T. KIRCHNER

    Family Practice International

    Family Practice International

    Anne D. Walling

    (Great Britain—The Practitioner, August 1999, p. 608.) After a traumatic event, some persons experience post-traumatic stress disorder (PTSD), characterized by recurrent, distressing and intrusive thoughts, images or dreams. According to the Diagnostic and Statistical Manual...

    Curbside Consultation

    Caretaker Burnout: Supporting Families of Patients with Alzheimer's Disease

    SAM FAZIO, TRISHA BARTELT

    A 45-year-old laborer lives with his aging mother, who has Alzheimer's disease. Recently, she has become increasingly agitated. She frequently awakens during the night and wanders, sometimes out of the house. She is easily led back to her bed, but 30 minutes later she's up...

    Special Medical Reports

    NCCN and ACS Collaborate on a Patient's Version of the NCCN Practice Guidelines for Breast Cancer

    Verna L. Rose

    The National Comprehensive Cancer Network (NCCN) and the American Cancer Society (ACS) have unveiled the first-ever patient-friendly version of the NCCN's clinical breast cancer treatment guidelines. The 17-member institutions of the NCCN develop cancer practice guidelines...

    ACIP Issues Recommendations for Lyme Disease Vaccine

    Sharon Scott Morey

    Recommendations for the use of the Lyme disease vaccine (Lymerix) have been issued by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC). The recommendations were reported in the June 4, 1999, issue of Morbidity and...

    Clinical Briefs

    Clinical Briefs

    Verna L. Rose, Monica Preboth

    The American Academy of Pediatrics (AAP) has issued a new policy statement on the dangers of sun exposure to infants. According to the statement, which appeared in the August 1999 issue of Pediatrics, it may be safe to use sunscreen on infants younger than six months of age...

    Physician's Bookshelf

    Book Reviews

    CLARISSA C. KRIPKE, PATRICIA EVANS

    Also Received

    Letters to the Editor

    Cost of Inactivated vs. Oral Poliovirus Vaccine

    Antibiotic Therapy for Viral Infections in Children

    Preventing Unnecessary Hypospadias Repair

    MOHEL RABBI JACOB SHECHET, BARTON TANENBAUM

    Information from Your Family Doctor

    What You Should Know About Type 1 Diabetes

    Type 1 diabetes is sometimes called juvenile diabetes, or insulin-dependent diabetes. It means that your body can't make insulin. Insulin helps your body use the sugar it makes from the food you eat. Your body uses this sugar for energy. We need insulin to live. Without...

    Patellofemoral Pain Syndrome

    Patellofemoral pain is a common knee problem. If you have this condition, you feel pain under and around your kneecap. The pain can get worse when you're active or when you sit for a long time. You can have the pain in only one knee, or you can have pain in both knees.

    Burners

    A “burner” is an injury to one or more nerves between your neck and shoulder. It is also called a “stinger.” It usually happens in sports like football. It's not a serious neck injury.

    Influenza Vaccine

    Influenza (also called “the flu”) is a viral infection in the nose, throat and lungs. About 10 to 20 percent of Americans get the flu each year. Some people get very sick. Each year, about 130,000 people go to a hospital with the flu, and 20,000 people die because of the flu...

    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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