Diagnosis and Management of Ectopic Pregnancy

ANNE-MARIE LOZEAU, BETH POTTER

This high-risk condition, which is the leading cause of pregnancy-related death in the first trimester, can be treated by expectant management, medical management with methotrexate, or surgery.

Detection and Evaluation of Chronic Kidney Disease

SUSAN SNYDER, BERNADETTE PENDERGRAPH

Once chronic kidney disease is detected, the underlying causes should be identified and treated to delay or prevent progression to kidney failure.

Management of Acute Renal Failure

EDDIE NEEDHAM

The cause should be identified as prerenal, intrarenal, or postrenal, with management strategies including correction of fluid and electrolyte levels, avoidance of nephrotoxins, and kidney replacement therapy.

A Clinical Approach to Diagnosing Wrist Pain

TODD A. FORMAN, SCOTT K. FORMAN, NICHOLAS E. ROSE

A variety of diagnostic tests and a basic understanding of common causes of wrist pain can assist in evaluating patients with wrist problems.

Extrapulmonary Tuberculosis: An Overview

MARJORIE P. GOLDEN, HOLENARASIPUR R. VIKRAM

Diagnosis can be elusive and necessitates a high index of suspicion, but response to empiric therapy usually is favorable.

Medications for Treating Alcohol Dependence

STEVEN H. WILLIAMS

New evidence supports the pharmacologic treatment of alcohol dependence, with serotonergic and anticonvulsant agents potentially playing a larger role.

Assembly Attendees Offer Suggestions forAFP

JOYCE A. MERRIMAN

The 2005 Scientific Assembly drew more than 15,000 participants to San Francisco between September 28 and October 2. Physicians, other health care professionals, exhibitors, and guests had many activities to choose from, including Academy business and committee sessions,...

Newsletter

CARRIE MORANTZ

AAFP Launches Disaster Assistance Fund for Physicians and Students | Medical Community Calls on Congress to Fix Medicare Payment System | Proposals Aim to Accelerate Physicians’ Use of EHR and E-prescribing | AAFP Delegates Request Restoration of Resident, Student Commission ...

Quantum Sufficit

LISA GRAHAM

More and more high school students are finding it harder to breathe. According to a study by the Centers for Disease Control and Prevention (CDC), one in six high school students claims to have asthma. In 2003, researchers surveyed approximately 13,000 high school students...

Medical Homes: The Unsung Solution for Quality Health Care

MICHELLE PROSER

In the United States, health care reform across the political spectrum has been focused on removing cost as a barrier to health care—principally by making insurance coverage more accessible. The U.S. Census Bureau recently reported that 45 million Americans, or nearly one in...

Excess, Shortage, or Sufficient Physician Workforce: How Could We Know?

At least three models have been used to project the future physician workforce, and each produces different results. No physician workforce predictions can be relied on until there is more consideration of and agreement on desired health outcomes and what physicians must do...

Diary from a Week in Practice

TONY MIKSANEK

There are going to be occasions when doctors and patients butt heads. Mr. Zetes disappeared from my practice two years ago. I assumed he was avoiding me—not an easy thing to do when you live in a small town. I last saw him when he came for a routine checkup, and I recommended...

Psychological Interventions for Noncardiac Chest Pain

KATHERINE L. MARGO

A 35-year-old man comes to you for follow-up after his third emergency department visit for continued intermittent chest pain. He has no cardiac risk factors and his electrocardiography (ECG) and stress test results were normal in the emergency department. You suspect a...

Corticosteroids for Pulmonary Sarcoidosis

MARK H. EBELL

Do inhaled or oral corticosteroids improve outcomes for patients with pulmonary sarcoidosis?

Acute Treatment of Hyperkalemia

What is the best acute treatment of an elevated serum potassium level?

Screening for Gonorrhea: Recommendation Statement

The U.S. Preventive Services Task Force (USPSTF) recommends that physicians screen all sexually active women, including those who are pregnant, for gonorrhea if they are at increased risk for the infection (i.e., if they are young or have other individual or population risk...

Diagnosing and Treating Patients with Suspected Influenza

MARK H. EBELL

What is the best approach to diagnosing and treating a patient with suspected influenza?

Chronic Fatigue Syndrome

STEVEN REID, TRUDIE CHALDER, ANTHONY CLEARE, MATTHEW HOTOPF, SIMON WESSELY

One systematic review identified three randomized controlled trials (RCTs) that showed that a graded aerobic exercise program improved measures of fatigue and physical functioning compared with flexibility and relaxation training or general advice. The review identified one...

Screening for Gonorrhea

DAVID MEYERS

A 22-year-old woman comes to your office for her routine well-woman examination. She says that she is currently sexually active in a long-term monogamous relationship. She had a chlamydial infection two years ago. Her only concern today is that her menstrual period is late.

Antiviral Agents for Pregnant Women with Genital Herpes

CHRISTOPHER WENNER, JOAN NASHELSKY

Do antiviral medications prevent perinatal transmission of genital herpes to neonates?

A Pregnant Patient with Dyspnea

MICHAEL D. BURG, FRANK VAN DER HEIJDEN

A pregnant 26-year-old woman with a one-week history of nausea and vomiting presented to the emergency department with dyspnea and left-sided chest pain. Her heart rate was 105 beats per minute; otherwise her vital signs were normal. Her oxygen saturation was 90 percent. Her...

Statins Not Associated with Decreased Risk of Dementia

HENRY BARRY

Low Testosterone Not Linked with Female Sexual Dysfunction

DAVID SLAWSON

Hyaluronic Acid Unproven for Osteoarthritis of the Knee

MARK EBELL

Should Women with Dysuria and Negative Dipstick Test Be Treated?

ALLEN F. SHAUGHNESSY

Does Adolescent Obesity Affect Quality of Life?

CAROLINE WELLBERY

Smoking Cessation Intervention Saves Lives

KENNETH W. LIN

Amiodarone vs. ICD for Treatment of CHF

CHUCK CARTER

Labor Induction Options in Women with PROM

KARL E. MILLER

Hemoglobin Not an Accurate Test for Iron Deficiency

CAROLINE WELLBERY

Deciding on Hospitalization for Patients with DVT

ANNE D. WALLING

Does One Drink a Day Help Keep Dementia Away?

KENNETH W. LIN

Montelukast Therapy in Children with Asthma

KARL E. MILLER

Venlafaxine Relieves Menopausal Hot Flashes

ANNE D. WALLING

What Information Is Most Relevant to Hospice Patients?

CAROLINE WELLBERY

DMPA and Bone Loss in Young Women

KARL E. MILLER

SSRI Use for Treatment of Depression During Pregnancy

ANNE D. WALLING

Low Cholesterol Levels Associated with Increased Mortality

CAROLINE WELLBERY

Options for Breast Cancer Screening

CAROLINE WELLBERY

An Office-Based Intervention Reduces High-Risk Drinking

CAROLINE WELLBERY

Rate vs. Rhythm Control in Atrial Fibrillation

KARL E. MILLER

Is Early Surgery Beneficial for Intracerebral Hemorrhage?

ANNE D. WALLING

Breastfed Infants and the Risk of Obesity Later in Life

CAROLINE WELLBERY

Intensive Lipid Lowering in Stable Coronary Disease

CHUCK CARTER

Relapse After Drug Treatment Among Health Care Professionals

CAROLINE WELLBERY

Estrogen Therapy and the Risk of Cognitive Decline

KARL E. MILLER

A Call to End Routine Episiotomy, No Maternal Benefit

CAROLINE WELLBERY

Outpatient Treatment for Low-Risk Pneumonia Is Safe

KENNETH W. LIN

Suicide Rates and Use of Antidepressants

KARL E. MILLER

Treatment Options for Patients with Vaginal Prolapse

CAROLINE WELLBERY

Medication May Improve Symptoms in Parkinson’s Disease

ANNE D. WALLING

Treatment of Patients with Chronic Anal Fissure

ANNE D. WALLING

Calcium from Milk Products May Not Improve Bone Health

CAROLINE WELLBERY

Patients’ Preconceptions and Convictions About Antibiotics

RALPH GONZALES

In my walk-in office I see many patients with respiratory ailments, and I usually have reasonable and successful conversations with them about antibiotic use. However, the patients that I find most difficult to deal with are those who are looking specifically for an...

AAN Releases Recommendations for Managing Essential Tremor

AMBER HUNTZINGER

The Quality Standards Subcommittee of the American Academy of Neurology (AAN) has released evidence-based recommendations for the initiation of pharmacologic and surgical therapies for patients with essential tremor. The recommendations are based on a systematic literature...

AHA Advisory Statement on Public Access Defibrillator

AMBER HUNTZINGER

The American Heart Association (AHA) has released an advisory statement to highlight the findings of the Public Access Defibrillation Trial, which studied the effects of lay rescuer automated external defibrillators (public access defibrillation). The trial was funded by the...

ACOG Guidelines for Treating Prenatal Hemoglobinopathy

AMBER HUNTZINGER

The Committee on Practice Bulletins–Obstetrics of the American College of Obstetricians and Gynecologists (ACOG) has released a practice bulletin on screening for and managing hemoglobinopathies during pregnancy. Practice Bulletin Number 64, “Hemoglobinopathies in Pregnancy,”...

Follow-Up Care of Patients with Fully Resected Colon Cancer

Nasal Irrigation to Treat Acute Bacterial Rhinosinusitis

Ectopic Pregnancy: What You Should Know

An ectopic (say: ek-TOP-ik) pregnancy is when the baby grows in the wrong place in the body. In a normal pregnancy, the baby grows in the uterus. In an ectopic pregnancy, the baby grows outside the uterus (see drawing), which is not safe. It is important to find the ectopic...

Chronic Kidney Disease

The kidneys clean the blood by removing waste and extra fluid. The waste then passes out of the body in urine. The kidneys also help control blood pressure, keep bones strong, and help make red blood cells.

Tension Headaches: What You Should Know

A tension headache is a dull, achy feeling on both sides of the head. Some people with tension headaches also have a tight feeling in their head or neck muscles. Tension headaches start slowly, usually in the middle of the day. Another name for this type of headache is ...

Migraine Headaches: How to Deal with the Pain

Migraine headaches seem to be caused by changes in the amount of a chemical called serotonin (say: sair-uh-TONE-in) you have in your body. When serotonin levels are high, your blood vessels shrink. When serotonin levels are low, your blood vessels swell. This swelling can...

Cluster Headaches: What You Should Know

A cluster headache is a rare type of headache that is more common in men. Cluster headaches start suddenly. The pain is usually behind or around one eye and is very bad. If you have a cluster headache, your nose and eye on the same side as the pain may get red, swollen, and...