• Articles

    Stroke: Strategies for Primary Prevention

    JUSTIN A. EZEKOWITZ, SHARON E. STRAUS, SUMIT R. MAJUMDAR, FINLAY A. MCALISTER

    Primary prevention of stroke includes lifestyle modifications and measures to control blood pressure, cholesterol levels, diabetes, and atrial fibrillation. The roles of angiotensin-converting enzyme inhibitors, antiplatelet therapy, and carotid endarterectomy for treatment...

    Orthostatic Hypotension

    JOHN G. BRADLEY, KATHY A. DAVIS

    Several potential causes of orthostatic hypotension include medications; non-neurogenic causes such as impaired venous return, hypovolemia, and cardiac insufficiency; and neurogenic causes such as multisystem atrophy and diabetic neuropathy. Treatment generally is aimed at...

    Diagnosis and Management of Post-traumatic Stress Disorder

    BRADLEY D. GRINAGE

    Post-traumatic stress disorder is an anxiety disorder that occurs following a traumatic event. Patient education and strong support, combined with a selective serotonin reuptake inhibitor, constitute an effective first-line treatment course.

    Evaluation and Management of Toe Fractures

    ROBERT L. HATCH, SCOTT HACKING

    Family physicians can successfully manage most toe fractures, but referral is indicated for patients with circulatory compromise, open fractures, fracture-dislocations, displaced intra-articular fractures, and fractures of the first toe, which are prone to complications.

    Inside AFP

    Introducing Two New Departments: Clinical Inquiries and STEPS

    Janis Wright

    In this issue, you'll see examples of AFP's newest departments, “Clinical Inquiries from the Family Practice Inquiries Network” (page 2437) and “STEPS” (page 2429). Editorials on pages 2340 and 2342 provide background on these two features.

    Graham Center Policy One-Pagers

    The Ecology of Medical Care for Children in the United States: A New Application of an Old Model Reveals Inequities That Can Be Corrected

    If equal and adequate access to health care for children in the United States is a goal, we are failing. That failing is most prominent in the setting where most children receive care and preventive services—the doctor's office.

    Newsletter

    Newsletter

    Matthew Neff

    CDC Reports Current Influenza Season Could Be More Severe Than Usual | AAFP Partners with Nine Companies to Provide Affordable EHR Systems | Annual Report Shows Continued Improvement in Overall Health in the United States | IOM Releases Clinical Research Directions for...

    Quantum Sufficit

    Quantum Sufficit

    Sarah Evans, Heather McNeill

    Extra weight around your middle puts a burden on your wallet as well as your health. According to a report published in Time, overweight and obese Americans spend $700 more a year on medical bills than those who are not overweight. Furthermore, life insurance premiums often...

    Editorials

    Decreasing the Morbidity, Mortality, and Cost of Stroke Through Awareness and Prevention

    MARGARET GRADISON

    Stroke is a significant medical problem that affects more than 700,000 Americans annually.1 In the United States, it is the third leading cause of death, the major cause of disability, and the primary reason for nursing home admissions.1,2 Because of the aging of the U.S....

    Clinical Inquiries from the Family Practice Inquiries Network

    JOHN EPLING, BERNARD EWIGMAN, MARK H. EBELL

    Family physicians have many questions about appropriate diagnoses and treatments of their patients. These questions sometimes go unanswered because some of us do not have ready access to efficient resources to find answers, because the answers we find are not relevant to our...

    STEPS Drug Updates

    ALLEN F. SHAUGHNESSY

    Sorting through the myriad of claims to figure out if you should add a new drug to your arsenal is not that difficult or time consuming, providing you take the right STEPS. STEPS, one of the newest additions to American Family Physician, offers an easy way to remember the...

    The Growing Mandate for Clinical Preventive Medicine

    S. EDWARDS DISMUKE

    The potential to save lives and improve the quality of life for millions of Americans through clinical preventive medicine is tremendous. In their classic paper, McGinnis and Foege1 linked one half of the mortality in the United States from the 10 leading causes of death to...

    Diary from a Week in Practice

    Diary from a Week in Practice

    “You have not been able get my name off of the lawsuit?” KS echoed in disbelief to her attorney. Several weeks earlier, a constable showed up in the waiting room during a busy morning clinic to deliver a notice of suit. KS remembered how distraught she had been trying to read...

    U.S. Preventive Services Task Force

    Routine Vitamin Supplementation to Prevent Cancer and Cardiovascular Disease: Recommendations and Rationale

    This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on routine vitamin supplementation to prevent cancer and cardiovascular disease and the supporting scientific evidence. Explanations of the ratings and of the strength of overall...

    STEPS

    Adefovir (Hepsera) for Chronic Hepatitis B Infection

    MONIKA N. DAFTARY

    Synopsis: Adefovir dipivoxil, a nucleotide analog, is the third agent approved for the treatment of chronic hepatitis B, along with interferon alfa-2b and lamivudine. Similar to lamivudine, it has activity against both human immunodeficiency virus (HIV) reverse transcriptase...

    Photo Quiz

    Headache

    JUSTIN Q. LY

    A 20-year-old woman with an unremarkable medical history presented to the emergency department with a right-sided headache and weakness of the left arm. She had felt warm intermittently during the previous week. She had no history of migraines, visual disturbances, neck...

    Clinical Inquiries

    Is Fluoxetine an Effective Therapy for Weight Loss in Obese Patients?

    JOHN EPLING

    In patients who are obese, are selective serotonin reuptake inhibitors (SSRIs) more effective than placebo or other therapies for weight loss?

    POEMs and Tips

    Coenzyme Q10 Decreases Cardiac Events

    ALLEN F. SHAUGHNESSY

    Nail Plate Biopsy for Diagnosing Onychomycosis

    DAVID SLAWSON

    Antibiotics Ineffective for Typical Sinusitis

    ALLEN F. SHAUGHNESSY

    Local Active Warming Decreases Renal Colic Pain

    DAVID SLAWSON

    A Systematic Review of Low-Carbohydrate Diets

    CAROLINE WELLBERY

    Effect of Male Hypogonadism on Bone Architecture

    RICHARD SADOVSKY

    Topical NSAIDs Relieve the Pain of Mastalgia

    RICHARD SADOVSKY

    Oculorespiratory Syndrome: Adverse Effect of Flu Vaccine

    BILL ZEPF

    Practice Guidelines

    The 2004 Recommended Adult Immunization Schedule

    RICHARD K. ZIMMERMAN

    The cooperation continues between the American Academy of Family Physicians (AAFP), the Advisory Committee on Immunization Practices (ACIP), and the American College of Obstetricians and Gynecologists (ACOG) with the publication of the Recommended Adult Immunization Schedule,...

    Clinical Briefs

    Clinical Briefs

    Carrie Morantz, Brian Torrey

    Recommendations on Cervical Cancer Screening | Public Awareness Campaigns on Antibiotic and OTC Drug Safety | Childhood and Adolescent Tobacco Risk Assessment | Cancer Statistics for Hispanics

    Letters to the Editor

    Maggot Debridement Therapy for Diabetic Necrotic Foot

    Information from Your Family Doctor

    How to Prevent a Stroke

    A stroke happens when there is a problem with the blood supply to a part of the brain. The area of the brain that does not get enough blood becomes damaged.

    What You Should Know About Post-traumatic Stress Disorder

    PTSD is an illness (sometimes called an anxiety disorder) that can happen after a traumatic event. The event may be a serious car crash, a natural disaster such as a hurricane or an earthquake, military combat, or a crime such as rape.

    Corrections

    Correction

    The article “The Nature and Management of Labor Pain: Part 1. Nonpharmacologic Pain Relief” (September 15, 2003, page 1109) contained an error in the series editor attribution. The article is one in a series coordinated by the University of Utah School of Medicine, Salt Lake...



    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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