• Articles

    Management of Peripheral Arterial Disease

    DANIELA C. GEY, EMIL P. LESHO, JOHANNES MANNGOLD

    Peripheral arterial disease is frequently overlooked because of subtle physical findings and lack of classic symptoms. This article reviews major risk factors for peripheral arterial disease, exercise therapy, and pharmacologic treatments.

    Viral Croup

    DOUG KNUTSON, ANN ARING

    Viral croup is a common form of airway obstruction in children. New evidence suggests benefit from treatment with oral steroids in the outpatient setting.

    Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature

    MARK H. EBELL, JAY SIWEK, BARRY D. WEISS, STEVEN H. WOOLF, JEFFREY SUSMAN, BERNARD EWIGMAN, MARJORIE BOWMAN

    A new evidence rating system, the Strength of Recommendation Taxonomy (SORT), addresses the quality, quantity, and consistency of evidence. Developed by the editors of family medicine journals, it allows authors to rate bodies of evidence or single studies and is designed to...

    Treatment of Obstructive Sleep Apnea in Primary Care

    LYLE D. VICTOR

    Mild sleep apnea is managed with conservative measures such as losing weight, getting sufficient sleep, abstaining from the use of alcohol and sedatives, and avoiding a supine sleeping position. Patients with more severe obstructive sleep apnea are treated with continuous...

    Regional Anesthesia for Office Procedures: Part I. Head and Neck Surgeries

    GOHAR A. SALAM

    Most family physicians use local anesthesia because of its ease of administration, safety, and efficacy. However, other anesthetic techniques such as topical application, local infiltration, and field and nerve blocks may be considered in certain clinical situations.

    Inside AFP

    Helping Readers Sort Through the Evidence

    Janis Wright

    In this issue, AFP announces a new system for labeling the strength of evidence supporting key recommendations in clinical review articles. The article on page549 introduces a taxonomy that will help family physicians sort through the evidence that drives their clinical...

    Newsletter

    Newsletter

    Matthew Neff

    Recommended Childhood and Adolescent Immunization Schedule Is Online | FDA Issues Alert on Safety of Dietary Supplements Containing Ephedra | Summary of New Medicare Legislation Available Online | Presidential Candidates Provide Views on Various Health Issues | New Web...

    Quantum Sufficit

    Quantum Sufficit

    Sarah Evans, Heather McNeill

    A way to improve balance in older persons? The decline in somatosensory function that occurs with age has been associated with an increased risk of falling. Through a mechanism termed stochastic resonance, input noise has been shown to enhance both motor and sensory function....

    Editorials

    AFP: Doing More to Help You Get the Best Evidence

    MARK H. EBELL, JAY SIWEK

    What business are you in? If you are like most family physicians, you will probably say that you are in the healing business, the curing disease business, or maybe the keeping people well business. Another way to look at our profession is that we are in the information...

    Diary from a Week in Practice

    Diary from a Week in Practice

    Today was especially busy on the mobile clinic. Perhaps the rain prevented other activities, but it seemed as if everyone in the homeless shelter had some medical complaint. One particular patient reported four months of right upper quadrant pain. A gastroenterologist had...

    Cochrane for Clinicians

    Mefloquine for Preventing Malaria in Nonimmune Adult Travelers

    WILLIAM E. CAYLEY, JR.

    A 54-year-old woman preparing for a mission trip to Mexico asks what she should do to prevent malaria.

    CLINICAL EVIDENCE CONCISE: A PUBLICATION OF BMJ PUBLISHING GROUP

    Tinnitus

    ANGUS WADDELL, RICHARD CANTER

    One small randomized controlled trial (RCT) in people with depression and chronic tinnitus found that tricyclic antidepressants (nortriptyline) versus placebo significantly improved tinnitus-related disability, audiometric tinnitus loudness matching, and symptoms of...

    Clinical Inquiries

    Are Selective COX-2 Inhibitors as Effective as NSAIDs in Patients with Rheumatoid Arthritis?

    JOHN SMUCNY, GEORGE CHAI

    How effective are selective cyclooxygenase-2 (COX-2) inhibitors in reducing the symptoms of rheumatoid arthritis when compared with nonselective nonsteroidal anti-inflammatory drugs (NSAIDs)?

    Point-of-Care Guides

    Suspected Pulmonary Embolism: Evidence-Based Diagnostic Testing

    MARK H. EBELL

    Once it has been determined that a patient is at low, moderate, or high risk for pulmonary embolism, which tests should be ordered and how should they be interpreted?

    Putting Prevention Into Practice

    Screening for Type 2 Diabetes Mellitus in Adults

    KENNETH FINK, BARBARA CLARK

    KC, a 46-year-old woman, visits your office to refill her cholesterol-lowering medication. She says she saw a recent news feature on the “diabetes epidemic” and asks if she needs to be tested. To better counsel her, you consult the U.S. Preventive Services Task Force (USPSTF)...

    Photo Quiz

    A Case of Necrotic Toes

    BRIAN IRWIN

    A 66-year-old man with alcoholism presented to the emergency department in January complaining of pain in his feet and an unsteady gait. The patient was sober, but did not remember the previous four days. Neighbors reported he was in an unheated home, smoking and drinking...

    POEMs

    Azithromycin for Persistent or Recurrent Otitis Media

    MARK EBELL

    Pelargonium sidoides Decreases Bronchitis Symptoms

    ALLEN F. SHAUGHNESSY

    PSA Screening Every Four Years as Effective as Annually

    HENRY BARRY

    Low-Dose Rofecoxib vs. High-Dose Naproxen

    ALLEN F. SHAUGHNESSY

    Tips from Other Journals

    Can Vitamins Prevent Cancer and Heart Disease?

    RICHARD SADOVSKY

    Depression in Patients with Alzheimer's Disease

    KARL E. MILLER

    Joint Infection After Therapeutic Injection

    BILL ZEPF

    Depression and Social Support Impact Myocardial Outcomes

    CAROLINE WELLBERY

    Reducing Hospitalization for Decompensated Heart Failure

    KARL E. MILLER

    Airflow Limitation Increases Smoking Cessation Rate

    KARL E. MILLER

    Causes of Impaired Consciousness While Driving

    RICHARD SADOVSKY

    Rapid MRI or Radiography for Low Back Pain?

    CAROLINE WELLBERY

    How Well Do Anti-influenza Medications Work?

    ANNE D. WALLING

    Adolescent Exposure to Smoking Depicted in Movies

    KARL E. MILLER

    Optimal Antibiotic Prophylaxis for Cesarean Delivery

    ANNE D. WALLING

    Computer Use and Carpal Tunnel Syndrome

    CAROLINE WELLBERY

    Finasteride in Preventing Prostate Cancer

    BILL ZEPF

    Paroxetine: a Nonhormonal Treatment for Hot Flushes

    CAROLINE WELLBERY

    Improving Chlamydia Screening Programs

    KARL E. MILLER

    Simvastatin Protects the Heart in Patients with Diabetes

    ANNE D. WALLING

    Prednisone After Emergency Treatment of COPD

    BILL ZEPF

    Use of Nicotine Replacement Therapy in Adolescents

    KARL E. MILLER

    Treatment of Head Lice: Therapeutic Options

    BILL ZEPF

    Osteomyelitis Outcomes After Antimicrobial Therapy

    KARL E. MILLER

    Treating Hypothyroidism Reduces Atherosclerosis Risk

    RICHARD SADOVSKY

    Guidelines for Preoperative Cardiac Evaluation

    RICHARD SADOVSKY

    Maintenance Topical Steroid Therapy for Atopic Dermatitis

    ANNE D. WALLING

    Can Phytoestrogens Reduce Climacteric Symptoms?

    ANNE D. WALLING

    Beta-Agonist Therapy and Cardiovascular Risk

    KARL E. MILLER

    Cost-Effective Management of Adults with Pharyngitis

    RICHARD SADOVSKY

    Cardiac Function vs. Depression on Health Status in CAD

    CAROLINE WELLBERY

    Using Antimyelin Antibodies to Predict Multiple Sclerosis

    BILL ZEPF

    Ticlopidine vs. Aspirin for Stroke Prevention in Blacks

    CAROLINE WELLBERY

    Should Low-Dose Combinations of Blood Pressure Drugs Be Used?

    ANNE D. WALLING

    Patients Who Decline Food and Fluids to Hasten Death

    BILL ZEPF

    High-Dose Chemo and Stem-Cell Rescue for Breast Cancer

    BILL ZEPF

    Extended Anticoagulation After Pulmonary Embolism

    RICHARD SADOVSKY

    Improving the Accuracy of Pneumonia Diagnosis

    ANNE D. WALLING

    Optimal Interval for Flexible Sigmoidoscopy Examinations

    CAROLINE WELLBERY

    Safety of Intranasal Steroids in Young Children

    CAROLINE WELLBERY

    Leisure Time Physical Activity and Atherosclerosis

    KARL E. MILLER

    Influence of Surgical Volume on Breast Cancer Survival

    ANNE D. WALLING

    Does Use of ACE Inhibitors Improve Microalbuminuria?

    BILL ZEPF

    Massage and Manipulation Can Help Persistent Back Pain

    RICHARD SADOVSKY

    Risk of Heart Failure in Patients Using Beta Agonists

    KARL E. MILLER

    Prochlorperazine vs. Sodium Valproate for Acute Migraine

    RICHARD SADOVSKY

    Management of Refractory Heartburn: a Review

    RICHARD SADOVSKY

    NSAIDs Do Not Slow the Course of Alzheimer's Disease

    CAROLINE WELLBERY

    Depression in Patients with Recent Myocardial Infarction

    KARL E. MILLER

    Long-Term Follow-up After Rapid Defibrillation

    BILL ZEPF

    Pleconaril for Treatment of the Common Cold?

    Bill Zepf

    Salmeterol and Cardiovascular Events in Patients with COPD

    KARL E. MILLER

    Management of COPD in the Emergency Department

    CAROLINE WELLBERY

    Cholesterol-Lowering Diet vs. Treatment with Lovastatin

    CAROLINE WELLBERY

    Pulmonary Rehabilitation in Patients with COPD

    KARL E. MILLER

    Magnesium Proves a Useful Adjunct in Acute Asthma

    ANNE D. WALLING

    Acarbose Treatment Decreases Risk of Cardiovascular Disease

    Caroline Wellbery

    Importance of Reporting Home Age for Lead Screening

    KARL E. MILLER

    How Should Biliary Colic Without Stone Be Treated?

    ANNE D. WALLING

    Cognitive Impairment Effect on Heart Failure Mortality

    KARL E. MILLER

    Safety of Polyethylene Glycol for Children's Constipation

    KARL E. MILLER

    Nerve Stimulation Relieves Nausea During Pregnancy

    ANNE D. WALLING

    Chlamydia trachomatis Exposure in Newborns

    KARL E. MILLER

    Corticosteroids vs. Hyaluronic Acid for Knee Osteoarthritis

    RICHARD SADOVSKY

    Treatment of Depression in Low-Income Minority Women

    CAROLINE WELLBERY

    Nebulized Epinephrine for Infants with Bronchiolitis

    BILL ZEPF

    Electrical Stimulation and Stress Incontinence

    CAROLINE WELLBERY

    Can Daily Aspirin Prevent Colorectal Adenomas?

    RICHARD SADOVSKY

    Practice Guidelines

    ACOG Releases Guidelines for Prophylactic Antibiotic Use in Labor and Delivery

    Carrie A. Morantz

    The American College of Obstetricians and Gynecologists (ACOG) has released a practice bulletin about the use of prophylactic antibiotics during labor and delivery. The bulletin presents a review of clinical situations in which prophylactic antibiotics frequently are...

    AAP Releases Policy Statement on Poison Treatment in the Home

    Genevieve W. Ressel

    A subcommittee for the American Academy of Pediatrics (AAP) has released a statement about poisoning in the home. The full-length report was published in the November 2003 issue of Pediatrics. According to the American Association of Poison Control Centers, approximately 1.2...

    Clinical Briefs

    Clinical Briefs

    Carrie Morantz, Brian Torrey

    CDC Guidance Plan on SARS | ACEP Recommendations on Fever in Children | Physical Activity Among Adults | CDC Report on Rabies | Progesterone to Prevent Preterm Birth

    Curbside Consultation

    A One-Stop Health Care Request

    GREG OGRINC, SUNITA MUTHA

    I work in a multispecialty clinic that serves underinsured and immigrant patients. Recently a woman brought her father to my office for the first time for a “check-up.” The elderly man, who had been visiting from Ethiopia for several months, had a blood glucose level that was...

    Letters to the Editor

    Possible Drug Interactions Among Quinolones

    BEATA M. DOMAGALA, SIMON LEUNG, RANDOLPH E. REGAL

    Herbal Products Should Be Regulated for Quality Control

    Walter L. Larimore, Dónal P. O'Mathúna

    Information from Your Family Doctor

    Peripheral Arterial Disease

    Peripheral arterial disease (PAD) is a clogging of the arteries usually caused by atherosclerosis (say: ath-air-o-sklair-o-sis). Arteries are blood vessels that take oxygen-rich blood from the heart to all parts of the body. Atherosclerosis is a hardening and narrowing of the...

    What Should I Know About Croup?

    Croup is a common infection that causes swelling in the trachea (windpipe) and larynx (voice box).

    CPAP for Sleep Apnea

    In some people, the tongue and the uvula at the back of the throat block airflow to the lungs during sleep. This is called obstructive sleep apnea (see Picture 1).

    Testicular Cancer

    The body is made up of many kinds of cells. Normally, cells grow, divide, and die. Sometimes, cells change and begin to grow and divide more quickly than normal cells. Rather than dying, these abnormal cells clump together to form tumors. If these tumors are cancerous, they...

    Penile Cancer

    The body is made up of many kinds of cells. Normally, cells grow, divide, and die. Sometimes, cells change and begin to grow and divide more quickly than normal cells. Rather than dying, these abnormal cells clump together to form tumors. If these tumors are cancerous, they...

    Prostate Cancer

    This is a corrected version of the handout that appeared in print.

    Corrections

    Correction



    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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