• Articles

    Hepatitis B

    KENNETH W. LIN, JEFFREY T. KIRCHNER

    Hepatitis B is a vaccine-preventable disease, but it still affects more than 400 million persons worldwide. Medical therapies for chronic hepatitis B infection include interferon alfa-2b, lamivudine, and the nucleotide analog adefovir dipivoxil.

    Hepatitis B Infection

    Hepatitis B virus (HBV) infects the liver. You can get HBV infection from blood and body fluids such as saliva and semen. If a pregnant woman is infected with HBV, her baby also may be infected at birth.

    Pityriasis Rosea

    DANIEL L. STULBERG, JEFF WOLFREY

    Pityriasis rosea is characterized by an initial herald patch and subsequent development of a diffuse papulosquamous rash that follows Langer's lines. Although medications can be used to relieve itching, the condition usually resolves without treatment within three months.

    Pityriasis Rosea

    Pityriasis rosea is a scaly, reddish-pink skin rash. (Say: pit-ih-rye-ah-sis row-see-ah) It is most common in children and young adults.

    Diaphragm Fitting

    RICHARD E. ALLEN

    When fitted properly and used correctly and consistently, the diaphragm is an effective barrier contraceptive.

    Birth Control Using a Diaphragm

    A diaphragm (say: die-ah-fram) is a shallow cup made of latex or silicone (see picture 1.) It is used for birth control.

    Using Your Diaphragm

    For good birth control, your diaphragm (see picture 1) has to fit well. Your doctor will measure your vagina to find the correct size and fit for you.

    Vertebral Compression Fractures in the Elderly

    JERRY L. OLD, MICHELLE CALVERT

    Vertebral compression fractures are common in the elderly, especially those who have osteoporosis, and can range from mild to severe. Severe cases can result in significant pain and loss of ability to perform activities of daily living.

    Diagnostic Approach to Tinnitus

    RICHARD W. CRUMMER, GHINWA A. HASSAN

    Tinnitus is a common condition, often resulting from an otologic disorder. The severity of tinnitus varies from occasional awareness of a sound to an unbearable sound that drives some persons to contemplate suicide.

    Tinnitus

    Tinnitus (say “tin-night-us”) is a bothersome sound or noise in your ear. You might hear a ringing noise, or you may hear a roaring, buzzing, whistling, chirping, or hissing sound. Sometimes tinnitus is a symptom of a disease, like an ear infection or Meniere's disease.

    Inside AFP

    Look for Tear-Outs of the 2004 Childhood and Adolescent Immunizaton Schedules

    Janis Wright

    This issue of AFP offers for the first time a tear-out version of the updated childhood and adolescent immunization schedules. The perforated, fold-out schedules are printed in larger type and can be found in the “Practice Guidelines” section along with an editorial...

    Newsletter

    Newsletter

    Matthew Neff

    VHA Committee Makes Recommendations Concerning Chiropractor Issues | AAMC Report Shows An Increase in Medical School Applicants This Year | CDC Study Shows Overall Increase in Diagnoses of HIV Infection | HHS Launches Campaign to Educate Hispanics About Diabetes Prevention

    Quantum Sufficit

    Quantum Sufficit

    Sarah Evans, Heather McNeill

    It's official: every bit of physical activity counts. In the report of a 2001 state-based survey on physical activity in Americans, published in the Morbidity and Mortality Weekly Report, the U.S. Centers for Disease Control and Prevention (CDC) expanded its definition of...

    Editorials

    Redefining Appropriate Use of Antibiotics

    JOHN G. GUMS

    Office-based physicians in the United States write approximately 1 million prescriptions for antibiotics annually. About one half of these prescriptions are inappropriate because they are used for conditions caused by viruses, such as colds and chronic coughs, according to...

    Diary from a Week in Practice

    Diary from a Week in Practice

    During a high school basketball game, Jake took a turnaround jump shot, landed awkwardly, and twisted his left knee. Diagnosis: tear of the anterior cruciate ligament and medial meniscus. Jake had surgery and then worked hard at rehabilitating his knee during the next six...

    Cochrane for Clinicians

    Digitalis for Treatment of Congestive Heart Failure in Patients in Sinus Rhythm

    WILLIAM E. CAYLEY, JR.

    A 63-year-old man with a history of congestive heart failure (CHF) and an ejection fraction of 25 percent presents with dyspnea on moderate exertion. He has a regular heartbeat, basilar crackles, and 3+ pitting edema on both legs.

    CLINICAL EVIDENCE CONCISE: A PUBLICATION OF BMJ PUBLISHING GROUP

    Thromboembolism

    DAVID A. FITZMAURICE, RICHARD HOBBS, RICHARD J. MCMANUS

    Systematic reviews have found that low-molecular-weight heparin (LMWH) reduces the incidence of recurrent thromboembolic disease and decreases the risk of major hemorrhage compared with unfractionated heparin. One systematic review found no significant difference between long...

    Putting Prevention Into Practice

    Screening for Osteoporosis in Postmenopausal Women

    Kenneth Fink, BARBARA CLARK

    PK, a 65-year-old black woman, comes to get her annual influenza vaccination. She says she appreciates your recent visit to her mother, who is recovering from surgery following a hip fracture. PK asks if she should be screened for osteoporosis. She is healthy, weighs only 125...

    Photo Quiz

    Cutaneous Manifestation of a Systemic Disease

    JACQUELINE REARDON JONES, CHRISTOPHER L. PARMAN

    A 40-year-old man presented with erythematous and lavender nodules, as well as ulcerations on the nasal and malar areas of his face (see accompanying figure). These lesions had slowly enlarged during the previous eight years. His initial presentation was remarkable only for...

    POEMs

    Candesartan Reduces Mortality for CHF

    HENRY BARRY

    Candesartan in CHF Patients with Normal LV Function

    HENRY BARRY

    Candesartan Plus ACE Inhibitor for CHF

    HENRY BARRY

    Uncertain Benefit of Barrett's Esophagus Surveillance

    MARK EBELL

    Tips from Other Journals

    Outpatient Use of Insulin in Patients with Diabetes

    CAROLINE WELLBERY

    Folate Use in Patients with Sickle Cell Anemia

    BILL ZEPF

    Concussions in High School and College Athletes

    RICHARD SADOVSKY

    Six-Minute Walk Test to Assess COPD Patients

    Management of Smaller Abdominal Aortic Aneurysms

    BILL ZEPF

    Alendronate and Hormone Therapy to Prevent Bone Loss

    CAROLINE WELLBERY

    Effects of an Atkins-Type Diet on Weight Loss in the Obese

    BILL ZEPF

    Wound Irrigation in Children: Tap Water or Saline Solution?

    RICHARD SADOVSKY

    Interpreting Natural Fluctuations in PSA Levels

    CAROLINE WELLBERY

    PENS with Physical Therapy Eases Chronic Low Back Pain

    CAROLINE WELLBERY

    Enfuvirtide: A Unique Approach to HIV Treatment

    BILL ZEPF

    Does Assisted Reproduction Cause Spontaneous Abortion?

    ANNE D. WALLING

    Persistent Fetal Occiput Posterior Position

    ANNE D. WALLING

    Value of EBT in Assessing Cardiovascular Risk

    CAROLINE WELLBERY

    Population-Based Results for Pneumococcal Conjugate Vaccine

    BILL ZEPF

    Multidimensional Care of Patients with Colostomy

    ANNE D. WALLING

    Tricyclic Antidepressants vs. SSRIs in Depressed Patients

    ANNE D. WALLING

    Topiramate in the Treatment of Alcohol Dependence

    ANNE D. WALLING

    Quality End-of-Life Care in Patients with Dementia

    KARL E. MILLER

    Intravenous Epinephrine in Life-Threatening Asthma

    RICHARD SADOVSKY

    Hormone Therapy and Increased Risk of Stroke

    CAROLINE WELLBERY

    Dietary Fiber Decreases Risk for Colorectal Cancer

    ANNE D. WALLING

    Practice Guidelines

    Recommended Childhood and Adolescent Immunization Schedule, United States, January to June, 2004 and Update on Childhood Immunizations

    RICHARD KENT ZIMMERMAN

    The 2004 Recommended Childhood and Adolescent Immunization Schedule (see accompanying charts) is similar to the 2003 schedule. Three changes should be noted: (1) the dates of the schedule reflect the first one half of the year because of the anticipated addition of influenza...

    Clinical Briefs

    Clinical Briefs

    CARRIE MORANTZ, BRIAN TORREY

    Clinical Performance Measures for Cardiovascular Disease | Report on Outbreaks of Aseptic Meningitis | AHRQ Report on Inhaled Anthrax and Influenza

    Curbside Consultation

    Should Doctors Call in Sick?

    MARIAN L. SWINKER

    Even when I'm not feeling well, I usually choose to work at the clinic rather than call in sick, which would force my patients to cancel their appointments or add to my colleagues' workloads. Often, I just have a mild viremia with no symptoms other than headache and fatigue....

    Letters to the Editor

    Causes of Benign Asymptomatic Pneumoperitoneum

    LAURA E. MYRE, SUSAN PINON, WALTER B. FORMAN

    Information from Your Family Doctor

    Painful Urination

    Painful urination can be caused by several things. A common cause is a urinary tract infection (also called a UTI or bladder infection). Urination may hurt if your bladder is inflamed. Inflammation can happen even if you do not have an infection. Some medicines can inflame...

    Urinary Reflux

    Urinary reflux is when urine in the bladder backs up into the kidneys. Urine normally goes only one way—from the kidneys down into the bladder. So when urine flows backwards from the bladder, bacteria (germs) can get into the kidneys. This can lead to infection in the urinary...

    Urinary Tract Infections in Children

    A urinary tract infection (UTI) is an infection in the kidneys, the bladder, or the urethra. The kidneys are two bean-shaped organs that lie against the spine in the lower back. Blood flows through the kidneys. Waste products from the blood are removed in the kidneys and...

    Urinary Tract Infections During Pregnancy

    Urinary tract infections (UTIs) are caused by bacteria (germs). The most common kind of UTI is a bladder infection. Other kinds of UTIs are kidney infections and infections of the urethra. The urethra is the small tube that goes from the bladder to the outside of your body.

    Urinary Tract Infections in Adults

    A urinary tract infection (UTI) is an infection in the kidneys, bladder, or urethra. Any part of your urinary tract can become infected. The kidneys are two bean-shaped organs that lie against the spine in the lower back. Blood flows through the kidneys. Waste products from...



    Disclosure

    All editors in a position to control content for this activity, AFP journal, are required to disclose any relevant financial relationships. View disclosures.


    Tag Legend

    Legend

    CME CME
    POC POC
    FREE Free
    Alg Alg
    DDx DDx
    PtEd PtEd