• Articles

    Common Hyperpigmentation Disorders in Adults: Part I. Diagnostic Approach, Café au Lait Macules, Diffuse Hyperpigmentation, Sun Exposure, and Phototoxic Reactions

    DANIEL L. STULBERG, NICOLE CLARK, DANIEL TOVEY

    Common hyperpigmentation disorders include freckles and lentigines, caféau lait macules, and phototoxic reactions to plants or medications. Diffuse hyperpigmentation may be caused by medication side effects or by systemic conditions such as Addison's disease, hemochromatosis,...

    Common Hyperpigmentation Disorders in Adults: Part II. Melanoma, Seborrheic Keratoses, Acanthosis Nigricans, Melasma, Diabetic Dermopathy, Tinea Versicolor, and Postinflammatory Hyperpigmentation

    DANIEL L. STULBERG, NICOLE CLARK, DANIEL TOVEY

    Localized hyperpigmentation disorders such as melasma, diabetic dermopathy, and postinflammatory hyperpigmentation are relatively benign but often concern patients. Acanthosis nigricans is associated with insulin resistance, and sudden onset of acanthosis nigricans or...

    Common Problems in Patients Recovering from Chemical Dependency

    EDNA MARIE JONES, DOUG KNUTSON, DANELL HAINES

    When physicians are caring for patients who are recovering from chemical dependency, the treatment goal should be to avoid relapse. First-line therapy should be nonpharmacologic, but when medication is necessary, physicians should avoid prescribing drugs that have the...

    Breast Cyst Aspiration

    JAMEE H. LUCAS, D. LINDSIE CONE

    Breast cyst aspiration is a simple, cost-effective, minimally invasive procedure. It is an appropriate first step in the care of women who present with a dominant breast mass suspected of being a cyst.

    The 2001 Bethesda System Terminology

    BARBARA S. APGAR, LAUREN ZOSCHNICK, THOMAS C. WRIGHT, JR.

    The 2001 Bethesda System for reporting cervical or vaginal cytologic diagnoses provides revisions in statements of adequacy, general categorization, and interpretation/results.

    Primary Immunodeficiencies

    MEGAN A. COOPER, THOMAS L. POMMERING, KATALIN KORÁNYI

    Primary immunodeficiencies include a variety of disorders that render patients more susceptible to infections. Early recognition and diagnosis can alter the course of these disorders significantly.

    Inside AFP

    Wrapping up the 2003 ACF on Prevention

    Janis Wright

    On page 1992 of this issue, you will find an article that exemplifies the 2003 Annual Clinical Focus on Prevention, an educational initiative of the American Academy of Family Physicians. The initiative is conducted in cooperation with the following organizations: the Agency...

    Newsletter

    Newsletter

    Matthew Neff

    AAFP Congress of Delegates Changes Name of Specialty to Family Medicine | HHS Report Shows Increases in Life Expectancy, Incidence of Diabetes | CDC, AAFP to Work Together on Immunization Project | AHRQ Releases Pocket Guides for Health Care Consumers | ‘Physicians with Heart...

    Quantum Sufficit

    Quantum Sufficit

    Sarah Evans, Heather McNeill

    No smoking? No problem! Creating a smoke-free area in bars and restaurants does not result in loss of income, and customers consider it a health-protective measure, according to a survey conducted in five European countries and reported in BMJ. Coordinated by Belgium's...

    Editorials

    Primary Care and Primary Immunodeficiencies

    KATHLEEN E. SULLIVAN

    In this issue of American Family Physician, Cooper and associates1 provide a timely review of the diagnostic considerations of common primary immunodeficiencies. This is an exciting time in the field of immunology. It is worth reflecting on a few recent advances and...

    Public Health—the Role of Family Physicians

    THOMAS L. SCHWENK

    In its recent report on educating health professionals to keep the public healthy, the Institute of Medicine (IOM) produced a thorough and scholarly assessment of public health problems and proposed educational solutions.1 The following are paraphrased examples of some of the...

    DNA, Nobel Prizes, and Succinct Writing

    JAY SIWEK

    Fifty years ago, Watson and Crick1 reported the double-helical structure of DNA that would eventually earn them the Nobel Prize. Given the far-reaching implications of their report, it was notable in its brevity—occupying a single page in Nature,1 and weighing in at only 903...

    Diary from a Week in Practice

    Diary from a Week in Practice

    A cough, vomiting, and belly pain bring 80-year-old Mrs. Conte to the emergency room this morning. Mrs. Conte has advanced nonalcoholic cirrhosis and recurrent bouts of hepatic encephalopathy. As I examine her, I'm dazzled by her smile, which is warm, gentle, and sad. Today's...

    STEPS

    Desloratadine for Allergic Rhinitis

    SHARON SEE

    Desloratadine is somewhat effective for the treatment of seasonal allergic rhinitis and may decrease nasal congestion. It also is effective for chronic urticaria. Desloratadine is similar in effectiveness to fexofenadine and would be expected to produce results similar to...

    U.S. Preventive Services Task Force

    Screening for High Blood Pressure: Recommendations and Rationale

    This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for high blood pressure and the supporting scientific evidence.1 It updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, second edition...

    Photo Quiz

    Violaceous Plaques of the Face and Scalp

    JAMES S. TAYLOR

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

    POEMs and Tips

    Mediterranean Diet and Lower All-Cause Mortality

    MARK EBELL

    Bed and Pillow Covers Ineffective for Asthma

    MARK EBELL

    Role of Candesartan in the Treatment of Acute Stroke

    HENRY BARRY

    Use of Iron in Nonanemic, Fatigued Women

    ALLEN F. SHAUGHNESSY

    Aspirin Resistance in Patients with Cardiovascular Disease

    KARL E. MILLER

    Falls in the Elderly

    CAROLINE WELLBERY

    Colorectal Cancer Screening Methods: A Review

    CAROLINE WELLBERY

    Some Thrombophilias Are Associated with Fetal Loss

    ANNE D. WALLING

    Is It Time to Reconsider Use of ECT for Depression?

    ANNE D. WALLING

    ACE Inhibitors Effective in Preventing Heart Failure

    CHUCK CARTER

    Initiation of HAART in Patients with HIV

    BILL ZEPF

    Blood Lead and Hypertension in Postmenopausal Women

    CAROLINE WELLBERY

    Polyurethane Condoms Are Less Effective than Latex

    ANNE D. WALLING

    Early Treatment of Vaginosis Improves Pregnancy Outcomes

    ANNE D. WALLING

    Potential Positive Effects of Multivitamins and Minerals

    RICHARD SADOVSKY

    Predicting Functional Decline in Elderly Adults

    CAROLINE WELLBERY

    Surgery for Crohn's Disease Improves Quality of Life

    RICHARD SADOVSKY

    Azithromycin vs. Levofloxacin for Acute Chronic Bronchitis

    KARL E. MILLER

    Antibiotic Therapy After Acute Myocardial Infarction

    SUMI M. SEXTON

    Practice Guidelines

    ACOG Releases Guidelines on Cervical Cytology Screening

    Genevieve W. Ressel

    The American College of Obstetricians and Gynecologists (ACOG) recently published a clinical management guideline on cervical cytology screening. In the United States, cervical cancer remains the third most common gynecologic malignancy.

    Clinical Briefs

    Clinical Briefs

    Carrie Morantz, Brian Torrey

    AAP Guidelines on Taking Medication in School | AHRQ Report on Sudden Cardiac Death | Adverse Events After Smallpox Vaccination | CDC Web Site on Diethylstilbestrol

    Letters to the Editor

    Helpful Hints for Injections of Wrist and Hand Region

    Is Duct Tape Occlusion Therapy an Effective Treatment of Warts?

    JAMES BRADLEY SUMMERS, JOSEPH KAMINSKI

    Information from Your Family Doctor

    Breast Cyst Aspiration

    A breast cyst is a fluid-filled sac, like a tiny balloon, inside the breast. Breast cysts are common in women. They can cause a little pain, but they are usually benign (not cancer).

    Warning Signs of Primary Immunodeficiency

    A primary immunodeficiency is a genetic problem with the immune system. The immune system protects the body against infection—and fights infection when it happens.

    Ulcers and Helicobacter pylori Infection

    An ulcer is an opening in the lining of the stomach or in the duodenum (the first part of the small intestine). Ulcers cause a gnawing or burning pain in the stomach. However, most people who have stomach pain do not have an ulcer. Your doctor can do tests to decide if your...

    Heartburn

    Despite its name, heartburn does not affect the heart. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste in the throat and mouth. Heartburn also is called acid reflux disease, or gastroesophageal reflux disease (GERD). You might get...

    Dyspepsia

    Dyspepsia (say this: dis-pep-see-ah) is a burning pain or uncomfortable feeling in the upper middle part of your stomach. The pain might come and go, but usually it is there most of the time. Some people also feel bloated (a full feeling in their stomach), have heartburn,...



    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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