Secondary Prevention of Coronary Heart Disease in Elderly Patients

IBRAHIM R. HANNA, NANETTE K. WENGER

Secondary preventive measures for older patients with coronary heart diseaseinclude lifestyle modification and pharmacotherapy. These interventions have afavorable impact on morbidity and mortality rates and quality of life.

Evaluation and Management of Apparent Life-Threatening Events in Children

KAREN L. HALL, BARRY ZALMAN

Children with apparent life-threatening events, which comprise a constellation ofsymptoms such as apnea and change in muscle tone, must be assessed promptly.Fifty percent of these events are idiopathic; for the remainder an underlying cause,usually digestive, can be found.

Health Issues for Surfers

TODD B. ZOLTAN, S. TAYLOR KENNETH, SURAJ A. ACHAR

Sprains, lacerations, strains, and fractures are common in surfers. Otologic problemsand wounds from jellyfish, coral, stingrays, and sharks also may occur. Mostinjuries can be treated on an outpatient basis with antibiotic therapy.

Tick-Borne Disease

ROBERT L. BRATTON, G. RALPH COREY

In patients with influenza-like symptoms, physicians should consider the possibilityof a tick-borne disease such as Rocky Mountain spotted fever, Lyme disease,ehrlichiosis, tularemia, babesiosis, Colorado tick fever, or relapsing fever.

New Series on Workforce Issues

JOYCE A. MERRIMAN

Is recruiting more physicians the answer to the workforce issues facing family medicine? Most workforce studies have concluded that there are not enough primary care physicians. The Future of Family Medicine Project set out by considering the role of family physicians rather...

Newsletter

CARRIE A. MORANTZ

Medicaid Expected to Top States’ Health Care Agendas in 2005 | NRMP Rules Out Second Residency Match | CMS Proposes New Rule on Hospice Care for Medicare Patients | Congressional Bill Encourages Use of Health Information Technology | CDC Report Finds Visits to Emergency...

Quantum Sufficit

LAURA COUGHLIN

Do you ever think of new medical breakthroughs as “space-age medicine”? According to American Medical News, researchers are developing treatments to enable humans to make the longer-than-one-year round-trip journey to Mars, and some of those treatments can help people on...

The Family Physician Workforce: Quality, Not Quantity

LARRY A. GREEN, ROBERT L. PHILLIPS, JR.

During the past 25 years, most physician workforce studies have concluded that primary care physicians were not being supplied in sufficient numbers. The most recent studies,1–4 however, present a mixed picture, in which primary care physicians may be in sufficient supply,...

Family Physicians and the Primary Care Physicians Workforce in 2004

In 2004, there were 91,600 family physicians (FPs) and general practitioners (GPs) and 222,000 primary care physicians actively caring for patients, one for every 1,321 persons. These primary care physicians represent the largest and best-trained primary care physician...

Diary

KATHY SOCH

I love to walk and have made hundreds of laps around the park in my neighborhood over the past 10 years. I use the time to relax, plan my day, and enjoy the fresh air. A doctor is always on call, and today was no exception. Across the grass, I noticed a group of children...

Primary Care Interventions to Prevent Low Back Pain in Adults: Recommendation Statement

This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on low back pain and the supporting scientific evidence and updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, 2d ed.1 In 1996, the USPSTF found...

Choosing Between Warfarin (Coumadin) and Aspirin Therapy for Patients with Atrial Fibrillation

MARK H. EBELL

What is the risk of stroke in a patient with nonvalvular atrial fibrillation, and should that patient be given warfarin (Coumadin) or aspirin?

A Healthy Woman with Right Upper Quadrant Discomfort on Deep Palpation

IOANNIS A. BLIZIOTIS, SOFIA S. KASIAKOU, MARIA BALOYANNI, MATTHEW E. FALAGAS

A 37-year-old Greek woman presented to her physician’s office for a routine physical examination. She did not complain of any symptoms or active medical problems. Her medical history was notable only for mitral valve prolapse. She did not smoke, drink alcohol, or use illicit...

Eszopiclone (Lunesta) for Treatment of Transient and Chronic Insomnia

ANDREA M. WESSELL, C. WAYNE WEART

Eszopiclone (Lunesta), a nonbenzodiazepine hypnotic agent, is indicated for the treatment of transient and chronic insomnia. Its mechanism of action is related to its activity at γ-amino-butyric acid receptors.1 Eszopiclone is an isomer of the hypnotic zopiclone (Imovane),...

Three Days of Ciprofloxacin Better for Uncomplicated UTI

DAVID SLAWSON

Divalproex Sodium an Option for Post-herpetic Neuralgia

MARK EBELL

Which Patients with Dyspepsia Should Have Urgent Endoscopy?

MARK EBELL

SSRIs Ineffective for the Management of Hot Flashes

LINDA FRENCH

Children Major Factor in Transmission of Influenza

ANNE D. WALLING

Effect of Institutionalizing Patients on Caregiver’s Health

CAROLINE WELLBERY

Reducing Operative Mortality in Aortic Aneurysm Repair

ANNE D. WALLING

Diagnosing Severe Acute Respiratory Syndrome

RICHARD SADOVSKY

Updated ACG Guidelines for Diagnosis and Treatment of GERD

LIZ SMITH

The American College of Gastroenterology (ACG) has updated its guidelines for the diagnosis and treatment of gastroesophageal reflux disease (GERD) to reflect the continuing advances in this area. The updated guidelines appear in the January 2005 issue of the American Journal...

AHRQ Data on Antibiotic Use in Children with Otitis Media

LAURA COUGHLIN

AHRQ Data on Antibiotic Use in Children with Otitis Media

AHRQ Review of Routine Episiotomy in Uncomplicated Births

LAURA COUGHLIN

AHRQ Review of Routine Episiotomy in Uncomplicated Births

Letters to the Editor

Advise Sexually Active Patients to Consider HIV Testing

Travel Immunizations: Benefits and Precautions

JOHN WALDEN

Genital Herpes Mimicked by Smallpox Vaccination Exposure

Jennifer K. Benson, David B. Benson

Physicians Should Be Trained in Handling End-of-Life Issues

Marcus C. Reeves

Safe Surfing

The most common surfing injuries are cuts, sprains, and broken bones. Most cuts are caused by a surfer’s own board. Be aware of your board and other people around you. You can buy rubber guards for the side rails and fins to keep your board from hurting you or someone else....

Ticks—How to Protect Yourself

Avoiding ticks and places where ticks may be is the best way to keep from getting sick from a tick bite. After being outside in places with ticks, carefully check yourself and family members for ticks (Figure 1). Children should be checked with extra care. Properly and...