Sickle Cell Disease in Childhood: Part I. Laboratory Diagnosis, Pathophysiology and Health Maintenance

DORIS L. WETHERS

Newborns at risk for sickle cell disease should be screened before two months of age to ensure the early institution of lifesaving preventive measures. Prophylactic penicillin initiated soon after birth, as well as the timely administration of Haemophilus influenzae type b...

Primary Care Treatment of Post-traumatic Stress Disorder

JENNIFER TRAVIS LANGE, CHRISTOPHER L. LANGE, REX B.G. CABALTICA

The psychologic sequelae of trauma known as post-traumatic stress disorder can affect a wide range of patients seen in family practice. With early identification of persons at risk of this disorder, the symptoms can be prevented or treatment started immediately.

Alternative Therapies: Part I. Depression, Diabetes, Obesity

VINCENT MORELLI, ROGER J. ZOOROB

Certain natural supplements may be helpful in the management of common medical conditions, but careful selection of patients and knowledge of side effects are critical components in effective use. In the first part of this two-part article, the role of natural supplements in...

Cervical Spondylotic Myelopathy: A Common Cause of Spinal Cord Dysfunction in Older Persons

WILLIAM F. YOUNG

Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in older persons. Although treatment guidelines remain controversial, many patients respond to surgical decompression of the spinal cord.

Polycystic Ovary Syndrome: It's Not Just Infertility

MELISSA H. HUNTER, JAMES J. STERRETT

Polycystic ovary syndrome is the most common cause of anovulatory infertility. Treatment goals include symptom management and the identification and prevention of potential cardiovascular risks. The patient's desire for fertility is also an important consideration.

Diagnosis of Vaginitis

MARI E. EGAN, MARTIN S. LIPSKY

The most common causes of vaginitis are bacterial vaginosis, vulvovaginal candidiasis and trichomoniasis. A saline wet-mount preparation, a potassium hydroxide preparation, a litmus test for vaginal pH and a whiff test can help distinguish these infections.

A Practical Approach to Uncomplicated Seizures in Children

GARY N. MCABEE, JAMES E. WARK

Febrile seizures, rolandic seizures and video game–related seizures are typically not associated with lesions on brain scans and may not require medication. Juvenile myoclonic epilepsy does not require neuroimaging but requires medication; complex partial epilepsy often...

Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation

LAWRENCE F. KIRK, JR., ROBERT B. HASH, HAROLD P. KATNER, TOM JONES

A 24-hour urine collection with analysis for urinary free cortisol excretion is the best screening test, but dexamethasone suppression tests and other methods may be required for a definitive diagnosis.

AFP 50 Years Ago

This feature is part of a year-long series of excerpts and special commentaries celebrating AFP's 50th year of publication. Excerpts from the two 1950 volumes of GP, AFP's predecessor, appear along with highlights of 50 years of family medicine.

AFP's Best Articles of the Year

Janis Wright

Among the top articles published in AFP last year were those nominated for the Kemp Award, which the AAFP presents each year to recognize the most outstanding article written by family physicians, as judged on the basis of quality of editorial presentation, scientific...

Newsletter

Rosemarie Sweeney, Toni Lapp

Members of a House-Senate conference committee for Labor/Health and Human Service appropriations reached agreement on funding levels for key health programs. The news for key programs of interest to the family medicine community is good. The health-professions program, which...

Quantum Sufficit

Lori Parry

Imagine this dilemma: you're amputating the leg of an elderly patient and discover that a rod previously implanted in the leg is made of titanium. This means the rod is impervious to any of the cutting instruments available to you in the O.R. What do you do? If you're...

Radon and Lung Cancer

ANTHONY J. VIERA

Family physicians often must counsel patients about preventive measures that may help prevent disease or prolong life. Lung cancer continues to be the leading cause of cancer deaths. While we know that cigarette smoking causes lung cancer, many physicians are not aware of the...

Diary from a Week in Practice

“Doc,” exclaimed the happy patient, “I did it myself. I'm as good as you are.” This elderly man was described by WLL in a past edition of “Diary” (September 15, 1994). He was WLL's first “cure” of benign positional vertigo (BPV) using the Epley maneuver. The “canalith...

Friable Neoplasm During Pregnancy

CARRINE A. BURNS, JULIA K. PADGETT, JOSEPH C. ENGLISH, III

A 33-year-old woman presented with an enlarging lesion on her right arm that bled easily with any form of manipulation. She was five weeks postpartum and had initially noted the lesion three to four weeks before delivery. The patient had no previous injury to the area, no...

First Bowel-Specific Serotonin Receptor for IBS

ANNE D. WALLING

Herpes Simplex Virus Type 2 in Asymptomatic Persons

JEFFREY T. KIRCHNER

New Sheffield Table for Assessing Coronary Risks

ANNE D. WALLING

Making Preventive Medicine Part of Primary Care

AMY S. WEICHEL

Metoprolol CR/XL in Patients with Chronic Heart Failure

GRACE BROOKE HUFFMAN

Preventing the Emergence of Resistant Bacilli in Neonates

ANNE D. WALLING

Serum Creatinine Levels and Renal Insufficiency

BARBARA APGAR

Amiodarone for the Treatment of Atrial Fibrillation

JEFFREY T. KIRCHNER

Antinausea Drug Promising in Treatment of Bulimia Nervosa

ANNE D. WALLING

Evidence-Based Review of Contraception for Adolescents

RICHARD SADOVSKY

Sterol-Containing Margarines and Lower Cholesterol Levels

ANNE D. WALLING

Link Between Disease and Silicone Breast Implants

JEFFREY T. KIRCHNER

Does Glycemic Control Correlate with Erectile Dysfunction?

KARL E. MILLER

Guidelines: Prescribing Exercise for the Older Patient

GRACE BROOKE HUFFMAN

Update on Management of Carcinoma of the Anal Canal

JEFFREY T. KIRCHNER

Posthospitalization Management of High-Risk Coronary Patients

RICHARD SADOVSKY

Family Practice International

Anne D. Walling

(Canada—Canadian Family Physician, April 2000, p. 801.) Although caffeine clearance from the body is usually normal during the first trimester of pregnancy, it is significantly delayed later in pregnancy, extending the half-life of caffeine to more than 10 hours from a normal...

Colonoscopy: Procedural Skills

Dennis V. Worthington

Colonoscopy is an indispensable part of modern medical practice and one of the most commonly used invasive medical procedures. Like other endoscopic procedures, it has become “despecialized” in recent years and is now performed by physicians in many specialties, including...

ACOG Guidelines on Antepartum Fetal Surveillance

Monica Preboth

The Committee on Practice Bulletins–Obstetrics of the American College of Obstetricians and Gynecologists (ACOG) has developed clinical management guidelines on antepartum fetal surveillance. According to the committee, the goal of antepartum fetal surveillance is to prevent...

Clinical Briefs

Monica Preboth

Diabetes is one of the most common chronic diseases of childhood, affecting about 125,000 persons 19 years or younger in the United States. Because the majority of these young persons attend school and/or some type of day care, a knowledgeable staff is required to provide a...

The Seductive Patient

CHERYL WINCHELL

A 44-year-old woman who was new to my clinic presented for a routine annual checkup with breast and pelvic examinations. As usual, I performed the examination with my female medical assistant present. The patient requested a prescription for an oral contraceptive and was...

Book Reviews

JAMES H. MOLLER, RAYMOND A. MARTIN

Book Reviews

Measurement of Alcohol Withdrawal

Suggested Technique for the Clinical Breast Examination

JOHN R. DYKERS, JR.

Tips for the GI Prep Based on a Physician's Own Experience

JOHN W. RICHARDS, JR.

Sickle Cell Disease

Sickle cell disease is a blood disease that children inherit from their parents. The disease causes the red blood cells to make abnormal hemoglobin. Hemoglobin is the part of blood that carries oxygen in the body.

Post-traumatic Stress Disorder—What It Is and What It Means to You

Post-traumatic stress disorder (PTSD) is a type of anxiety problem. It can happen after your life is threatened or you see a traumatic event. Usually, the event makes you feel very afraid or helpless. Some examples of the events are war, rape, or a severe car crash.

Cervical Spondylotic Myelopathy (CSM)

Cervical spondylotic myelopathy (CSM) is a compression of the spinal cord in the neck. CSM often affects older adults. In people with CSM, changes in the bones, discs and ligaments of the spine cause pressure on the spinal cord. Some changes are because of normal aging. Some...

Polycystic Ovary Syndrome

If your hormones don't work in the normal way, your ovaries might make too many eggs. Those eggs turn into many cysts. The cysts (say: sists) are like little balloons filled with liquid.

Cushing's Syndrome and Cushing's Disease

“Cushing's syndrome” is the name for what happens when your body makes too much cortisol. Cortisol is a natural steroid hormone that's like the “cortisone” in some medicines. Your body might make too much cortisol or you might take too much cortisone-like drugs and end up...

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Corrections