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.

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

MARK H. EBELL

Pooled data from randomized trials show that warfarin reduces the risk of stroke from 4.5 percent to 1.4 percent per year in patients with nonvalvular atrial fibrillation and no history of stroke or transient ischemic attack (TIA).

A Healthy Woman with Right Upper Quadrant Discomfort on Deep Palpation

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

Photo Quiz presents readers with a clinical challenge based on a photograph or other image.

Eszopiclone (Lunesta) for Treatment of Transient and Chronic Insomnia

ANDREA M. WESSELL, C. WAYNE WEART

Similar to other hypnotic drugs, eszopiclone treats the symptom of insomnia and not the underlying cause. It offers no advantage over other nonbenzodiazepine hypnotic agents for transient insomnia and it therefore should be considered a second-line agent.

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.

AHRQ Data on Antibiotic Use in Children with Otitis Media

LAURA COUGHLIN

As part of its Medical Expenditure Panel Survey, the Agency for Healthcare Research and Quality (AHRQ) examined the use of antibiotics to treat otitis media in children.

AHRQ Review of Routine Episiotomy in Uncomplicated Births

LAURA COUGHLIN

A review of the use of routine episiotomy in uncomplicated vaginal births is now available from the Agency for Healthcare Research and Quality (AHRQ).

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...