Transient Ischemic Attacks: Part I. Diagnosis and Evaluation

NINA J. SOLENSKI

Transient ischemic attack is considered to be a critical harbinger of impending stroke. Rapidevaluation and treatment are essential to prevent permanent disability or death.

Transient Ischemic Attacks: Part II. Treatment

NINA J. SOLENSKI

Risk-factor management includes aggressive control of blood pressure, cholesterol levels, and diabetes mellitus, along with smoking cessation and weight loss as indicated. Aspirin is the preferred agent for stroke prevention in patients who do not require anticoagulation.

Evaluation and Management of Suspected Retinal Detachment

RAY F. GARIANO, CHANG-HEE KIM

Retinal detachment is a relatively uncommon disorder. Early intervention may prevent permanentvision loss.

Atypical Pathogens and Challenges in Community-Acquired Pneumonia

KRISTOPHER P. THIBODEAU, ANTHONY J. VIERA

Empiric treatment of community-acquired pneumonia must include antibiotics that are effective against atypical pathogens, which are implicated in up to 40 percent of cases. Challenges, in addition to misdiagnosis, include failure of outpatient management and missed...

Shoulder Dystocia

ELIZABETH G. BAXLEY, ROBERT W. GOBBO

Although shoulder dystocia often occurs without warning, calm and effective management of theemergency, including the use of the HELPERR mnemonic, usually leads to successful delivery.

AFP Adds Henry Barry, M.D., M.S., as Editorial Contributor

Janis Wright

AFP recently reinforced its efforts in evidence-based medicine (EBM) with the addition of a new contributing editor, Henry C. Barry, M.D., M.S., who will help evaluate and apply the SOR (strength of recommendation) labeling taxonomy to review articles. The SOR taxonomy was...

Newsletter

Genevieve Ressel

FDA Releases Report on Counterfeit Drug Alert Network | AAFP Supports Racial Disparities Bill | AAFP Makes EHR Presentation at Congressional Staff Briefing | AAFP Presents Testimony on ‘Care Management Fee’ Concept | HHS Awards $595 Million for AIDS Care in Major Urban Areas ...

Quantum Sufficit

Sarah Evans, Heather McNeill

Your patients with allergies may not be thrilled that prescription-strength allergy medication is now over-the-counter (OTC), according to survey findings cited in American Medical News. Of 239 adults surveyed, more than one half said they spent more money on allergy...

The ALSO Article Series

MARK DEUTCHMAN, CHARLES J. CARTER, BARBARA APGAR

In this issue of American Family Physician, we begin an article series based on the Advanced Life Support in Obstetrics (ALSO®) course with an article on shoulder dystocia by Baxley and Gobbo.1 The ALSO program was developed initially at the University of Wisconsin by two...

Health Effects from Pesticide Exposure

GEOFFREY M. CALVERT

All Americans are exposed to pesticides. Among approximately 1,900 subjects selected in 1999 and 2000 from the National Health and Nutrition Examination Survey (NHANES) to represent the United States population six to 59 years of age, at least 90 percent of these persons had...

Diary from a Week in Practice

Afterthoughts can often make the difference in arriving at the proper diagnosis. Sarah, a patient with diabetes, was having low back pain and diarrhea. Her pain increased during each bowel movement, and never went away entirely. She had no nausea, and no dysuria or increased...

What Is the Best Collection Device for Screening Cervical Smears?

MICHAEL SCHOOFF, ANDREA LAWLOR

A 30-year-old woman comes in for an annual examination and Papanicolaou (Pap) smear. You want to collect the sample in a way that ensures the best possibility of finding any abnormal cells.

Bipolar Disorder

JOHN R. GEDDES

One randomized controlled trial (RCT) in people with bipolar type I disorder experiencing a manic episode found that lithium increased the proportion of people who responded after three to four weeks compared with placebo. One systematic review found that lithium increased...

Screening for Prostate Cancer

KENNETH FINK, BARBARA CLARK

DS, a 55-year-old African-American man, comes into your office for a physical examination. While talking about his family history, you learn that his father had prostate cancer. DS asks if he should be tested for prostate cancer. Before counseling him, you review the U.S....

Do Vitamin C Supplements Reduce Cardiovascular Disease Mortality?

DOUG AUKERMAN

Do vitamin C supplements reduce mortality in patients with cardiovascular disease?

Sinusitis and Renal Failure in an Elderly Patient

DINKAR KAW, DOUGLAS WASHING, KULWANT SINGH MODI, PANDURANGA S. RAO

A 78-year-old woman presented to the emergency department with complaints of malaise, decreased urine output, and lower extremity swelling for one month. She said that she looked “different” (Figure 1). She was treated for sinusitis two months earlier with ciprofloxacin and...

Anorexia Nervosa

Eating Disorders

Sports and Women Athletes: The Female Athlete Triad

Intra-articular Hyaluronic Acid for Knee Osteoarthritis

DAVID SLAWSON

Does Adding Liothyronine to Levothyroxine Help Patients?

DAVID SLAWSON

Follow-up Culture in Children with UTI Yields Nothing

HENRY BARRY

Are Antidepressants Effective for Chronic Low Back Pain?

HENRY BARRY

Long-Term Sequelae of Breast Cancer Treatment

BILL ZEPF

Exercise Testing as a Predictor of Mortality in Women

CAROLINE WELLBERY

Using Guggulipid to Lower High Cholesterol Levels

CAROLINE WELLBERY

Update: Giant Cell Arteritis and Polymyalgia Rheumatica

RICHARD SADOVSKY

Managing Ovarian Cysts in Postmenopausal Women

ANNE D. WALLING

Risk Classification for Stroke, Death, and Atrial Fibrillation

CAROLINE WELLBERY

Inhaled Flunisolide for Management of Acute Asthma

KARL E. MILLER

Improving Osteoporosis Care Following Hip Fracture

Richard Sadovsky

Local Anesthesia Preferred for Groin Hernia Repair

ANNE D. WALLING

Long-Term Effect of Intensive Treatment on Nephropathy

CAROLINE WELLBERY

Role of Pneumatic Otoscopy in Diagnosing Ear Infections

CAROLINE WELLBERY

Dyslipidemia in Patients on HIV Drug Therapy

BILL ZEPF

Good News and Bad News on Screening for Alcohol Abuse

ANNE D. WALLING

No Role for Influenza Vaccine in Preventing Otitis Media

CAROLINE WELLBERY

Preventing Running Injuries

ANNE D. WALLING

Low-Dosage Oral Morphine Relieves Refractory Dyspnea

ANNE D. WALLING

Candesartan Improves Outcomes in Chronic Heart Failure

ANNE D. WALLING

A Watchful Waiting Prescription for Otitis Media

CAROLINE WELLBERY

Erythropoietin Improves Anemia but Not Cancer Control

ANNE D. WALLING

Anticoagulation Risks in Atrial Fibrillation

BILL ZEPF

HAART and Patients with HIV Infection

ANNE D. WALLING

Effect of Cannabinoid on Chronic Neuropathic Pain

CAROLINE WELLBERY

ACS Releases Guidelines on Nutrition and Physical Activity During and After Cancer Treatment

Matthew J. Neff

The American Cancer Society (ACS) issued a report discussing optimal nutrition and physical activity issues during the phases of cancer treatment and recovery, living after recovery from treatment, and living with advanced cancer. The full report appeared in the September...

Clinical Briefs

Carrie Morantz, Brian Torrey

Update on Pneumococcal Conjugate Vaccine Shortage | Strength Training Among Older Adults | Pneumonia Calculator for PDAs | Strength Training Recommendations for Older Adults

Conflict with a Consultant

RICHARD W. LORD

I have a 26-year-old patient whose first child was born at 30 weeks and survived; she then lost a second child in a miscarriage at 18 weeks. Currently, she is 20 weeks pregnant, and she very much wants this pregnancy to progress successfully. So far, everything has gone well...

Tolerance and Dependence Risk with the Use of Carisoprodol

CRAIG HEACOCK, MARK S. BAUER

Atypical Laryngeal Dystonia Caused by an Antiemetic

OLIVER FREUDENREICH

Strokes and TIAs

A stroke happens when too little blood flows to the brain. With too little blood flow, the brain does not get enough oxygen and important nutrients.