• Articles

    Common Stress Fractures

    BRENT W. SANDERLIN, ROBERT F. RASPA

    Family physicians frequently treat patients who have stress fractures, injuries commonly associated with participation in sports that involve running, jumping, or repetitive stress.

    Panax Ginseng

    DAVID KIEFER, TRACI PANTUSO

    Panax ginseng is a safe, well-tolerated herbal medicine that may be used in the treatment of a variety of conditions. Potential beneficial effects include improvements in psychologic function, immune system function, and conditions associated with diabetes.

    Tremor

    SHARON SMAGA

    The most common movement disorder is tremor, a rhythmic, involuntary, oscillatory movement of body parts. The best tools for diagnosing and classifying tremor syndromes are a thorough history and physical examination.

    School Refusal in Children and Adolescents

    WANDA P. FREMONT, null M.D

    School refusal often is associated with comorbid psychiatric disorders. Family physicians should identify problems early and make appropriate interventions to prevent further problems in children and adolescents who refuse to go to school.

    Reducing Cardiovascular Disease Risk in Patients with Type 2 Diabetes: A Message from the National Diabetes Education Program

    JAMES R. GAVIN, III, KEVIN PETERSON, ELIZABETH WARREN-BOULTON

    Patients with diabetes have demonstrated a significant lack of knowledge of the link between diabetes and cardiovascular disease. By increasing awareness of cardiovascular risk factors, physicians can help reduce morbidity and mortality in patients with diabetes.

    Repair of Obstetric Perineal Lacerations

    LAWRENCE LEEMAN, MARIDEE SPEARMAN, REBECCA ROGERS

    Effective repair of obstetric perineal lacerations requires a knowledge of perineal anatomy and surgical technique. Sequelae of these lacerations include chronic perineal pain, dyspareunia, urinary incontinence, and fecal incontinence.

    Inside AFP

    Introducing STEPS

    Janis Wright

    ILLUSTRATION BY WILLIAM B. WESTWOOD

    Newsletter

    Newsletter

    Matthew Neff

    AAFP Endorses Senate Bill to Change Judicial System for Malpractice Cases | Survey Indicates Health Insurance Premiums Up 13.9 Percent from 2002 | HHS Provides $1.4 Billion for Terrorism Preparedness | CDC Releases Tool Kit for Management of Mild Traumatic Brain Injury |...

    Quantum Sufficit

    Quantum Sufficit

    Sarah Evans, Heather McNeill

    Licorice root could provide a treatment for severe acute respiratory syndrome (SARS). As reported in a research letter in The Lancet, researchers in Germany assessed the antiviral activities of ribavirin, 6-azuridine, pyrazofurin, mycophenolic acid, and glycyrrhizin against...

    Graham Center Policy One-Pagers

    The U.S. Primary Care Physician Workforce: Minimal Growth 1980–1999

    Growth in the primary care physician workforce (physicians per capita) in the United States has trailed the growth of the specialist physician population in recent years. This has occurred despite calls during the same period for increased production of primary care...

    The U.S. Primary Care Physician Workforce: Persistently Declining Interest in Primary Care Medical Specialties

    A persistent, six-year trend in the choice of specialty training by U.S. medical students threatens the adequacy of the physician workforce of the United States. This pattern should be reversed and requires the attention of policy makers and medical educators.

    The U.S. Primary Care Physician Workforce: Undervalued Service

    Primary care physicians work hard, but their compensation is not correlated to their work effort when compared with physicians in other specialties. This disparity contributes to student disinterest in primary care specialties.

    Editorials

    Why Does a U.S. Primary Care Physician Workforce Crisis Matter?

    ROBERT L. PHILLIPS, JR., BARBARA STARFIELD

    In this issue of American Family Physician, the series of One-Pagers1–3 from the Robert Graham Center offer evidence that a primary care workforce crisis may once again be taking shape. The 1990s saw alignment of public policy and funding efforts to increase the primary care...

    Strategies to Improve Diabetes Care

    THOMAS BODENHEIMER

    Family physicians might react to a new article about diabetes—such as the one by Gavin and colleagues1 in this issue of American Family Physician—by thinking, “Another diabetes article? I know how to care for diabetes. I'll skip this one.” Please don't skip this article....

    Diary from a Week in Practice

    Diary from a Week in Practice

    “What have you done?” KS asked her patient in amazement. The 72-year-old woman held up a small jar, out of which she emptied three large toenails. KS took a fearful look at her patient's feet and saw that the right great toe was covered with a large bandage. The woman...

    STEPS

    Ezetimibe for Hypercholesterolemia

    SPENCER MORRIS, ROB TILLER

    Synopsis: Ezetimibe (Zetia) is a novel, selective cholesterol absorption inhibitor. Ezetimibe blocks the absorption of dietary and biliary cholesterol within the brush-border enzyme system of the small intestine. Ezetimibe does not appear to alter or decrease the absorption...

    Photo Quiz

    Fever, Leg Pain, and a Rash

    STEVEN T. OLIVE

    A five-year-old boy was brought to the office in mid-July by his parents. He had a nine-day history of fever as high as 39.4°C (103°F), headache, and malaise. During the past two days, he complained of pain in his right lower extremity. He could bear full weight and walked...

    POEMs and Tips

    Do Antioxidants Prevent Heart Disease?

    HENRY BARRY

    Tapering Steroids Effective in Chronic Stable Asthma

    ALLEN F. SHAUGHNESSY

    Tapering Steroids Effective in Chronic Stable Asthma

    ALLEN F. SHAUGHNESSY

    Low-Carbohydrate Diets and Weight Loss

    MARK EBELL

    Herbal Treatment for Chronic Heart Failure

    ALLEN F. SHAUGNESSY

    Effects of Montelukast in RSV Postbronchiolitis

    CHUCK CARTER

    Itch: Etiology, Evaluation, and Available Treatments

    ANNE D. WALLING

    Hypoestrogenemia Is a Risk Factor for CAD in Women

    KARL E. MILLER

    ACE Inhibitor vs. Diuretic for Hypertension Therapy

    BILL ZEPF

    Combining Beta2 Agonists and Corticosteroids in COPD

    ANNE D. WALLING

    Plasma Homocysteine Levels and Congestive Heart Failure

    CAROLINE WELLBERY

    Plasma Homocysteine Levels and Congestive Heart Failure

    CAROLINE WELLBERY

    Predicting Life Expectancy in Patients with Dementia

    KARL E. MILLER

    Adefovir for Treatment of Chronic Hepatitis B Infection

    BILL ZEPF

    Diagnosis and Treatment of Cough-Related GERD

    KARL E. MILLER

    A Visual Tool to Aid Diabetes Control in Inner City Patients

    CAROLINE WELLBERY

    CT Does Not Improve Ability to Diagnose Appendicitis

    ANNE D. WALLING

    Clinical Prediction Rules for Streptococcal Pharyngitis

    CAROLYN MOSER

    Impact of Chronic Sinusitis on Patients with Asthma

    KARL E. MILLER

    Effect of Home Assessment on Fall Prevention

    CAROLINE WELLBERY

    Smoking Cessation at Pediatric Clinics for Low-Income Women

    KARL E. MILLER

    Screening for Congenital Cardiovascular Malformations

    SUMI M. SEXTON

    Alcohol Consumption and Risk for Dementia

    CAROLINE WELLBERY

    ECG to Identify Patients with CAD Who Need Intervention

    KARL E. MILLER

    Practice Guidelines

    AAP Releases Policy Statement on Eye Examinations

    Genevieve W. Ressel

    A subcommittee for the American Academy of Pediatrics (AAP) has released a policy statement on eye examinations in infants, children, and young adults. The report focuses on the importance of early detection and prompt treatment of ocular disorders in children to avoid...

    Clinical Briefs

    Clinical Briefs

    Carrie Morantz, Brian Torrey

    Update on Automated Defibrillator Use for Children | AHRQ Reports on Coronary Heart Disease in Women | CDC/ATS Recommendations on Latent Tuberculosis | NIA Releases Publications on Alzheimer's Disease | FDA Approval

    Letters to the Editor

    Hormone Therapy to Prevent Hip Fractures in Elderly

    Information from Your Family Doctor

    Essential Tremor

    Essential tremor, sometimes called benign or familial tremor, is an uncontrollable shaking of the hands and forearms. You might notice this tremor when your arms are extended in front of your body. Tremor affects each person differently. Some people hardly notice it, but it...

    What to Do When Your Child Refuses to Go to School

    Children with school refusal are scared to go to school. They may be so scared that they won't leave the house. School refusal is most common in 5- and 6-year-olds and in 10- and 11-year-olds, but it can start at any age.

    Diabetes and Heart Disease

    If you have diabetes, you have a high risk for having a heart attack or a stroke. You are more likely to get heart disease—and at an younger age—than someone without diabetes.

    Eczema

    Eczema (say: “ex-zuh-mah”) is an itching, scaling, swelling rash on the skin. The upper layers of the skin turn red and swell (inflame), and form dry or greasy scales (skin flakes). In severe cases, yellow and red pimples form on the skin, behind the ears, in the ear canal,...

    Psoriasis

    Psoriasis (say: “sor-eye-ah-sus”) is a skin problem that causes thick red marks like scales on your skin. The thick scaling is probably caused by an increase in the number of skin cells. Sometimes pus-filled blisters form. Most of the time, the skin on the elbows and knees is...

    Rosacea

    Rosacea (say: “rose-ay-she-ah”) is a disease that affects the skin on the face. It often begins as redness that looks like a blush across the nose, cheeks, chin, or forehead. As time goes on, red pimples and pus-filled bumps may appear. Some people notice small blood vessels...

    Seborrheic Dermatitis

    Seborrheic dermatitis is a disease that causes flaking of the skin (say: seb-oh-ree-ick). It usually affects the scalp. In teenagers and adults, it is commonly called “dandruff.” In babies, it is called “cradle cap.”



    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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