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Articles

Abnormal Uterine Bleeding

KATHLEEN A. ORIEL, SARINA SCHRAGER

Determining the cause of abnormal uterine bleeding requires a systematic approach based on the most probable differential diagnosis for premenopausal, perimenopausal and postmenopausal age groups.

Drug Treatment of Common STDs: Part I. Herpes, Syphilis, Urethritis, Chlamydia and Gonorrhea

CAROL WOODWARD, MELANIE A. FISHER

This two-part article reviews Centers for Disease Control and Prevention guidelines for the treatment of sexually transmitted diseases. In part I, recommendations for treatment of genital ulcer diseases, urethritis and cervicitis are discussed.

Pigmented Villonodular Synovitis of the Hip and Knee

FRANK J. FRASSICA, MEENESH A. BHIMANI, EDWARD F. MCCARTHY, JAMES WENZ

Pigmented villonodular synovitis is an uncommon disease process characterized by joint effusion, elevation of the capsule, hyperplastic synovium and low signal intensity on magnetic resonance imaging. The diagnosis is confirmed through biopsy.

An Approach to Diagnosis and Initial Management of Systemic Vasculitis

DOUGLAS W. ROANE, DONALD R. GRIGER

Clinical features of systemic vasculitis depend on the organs involved and, in turn, organ involvement is largely influenced by the size of the affected blood vessels.

Chronic Insomnia: A Practical Review

VIJAY RAJPUT, STEVEN M. BROMLEY

Chronic insomnia often has multiple concurrent causes. Most patients benefit from behavioral approaches that focus on good sleep habits.

Clinical Utility of the Erythrocyte Sedimentation Rate

MALCOLM L. BRIGDEN

The erythrocyte sedimentation rate remains useful in the diagnosis and monitoring of a few conditions but should not be used as a general screening tool or as an indicator of occult disease in the absence of clinical evidence.

Parvovirus B19 Infections

CAMILLE SABELLA, JOHANNA GOLDFARB

Although parvovirus B19 infection usually causes only mild illness, it can cause arthropathy, aplastic anemia, hydrops fetalis and fetal death.

Issues in Newborn Screening for Phenylketonuria

RICHARD K. KOCH

The blood sample for phenylketonuria (PKU) screening should be obtained at least 12 hours after delivery.

Management of the Hyperosmolar Hyperglycemic Syndrome

ROBERT MATZ

In patients with uncontrolled diabetes, an altered state of consciousness is almost always due to severe hyperosmolar hyperglycemia. Treatment is the prompt, rapid administration of crystalloids, with tonicity appropriate to the level of hyperosmolarity.

The Home Visit

BRIAN K. UNWIN, ANTHONY F. JERANT

Well-planned home visits can lead to improved medical care through the discovery of unmet health care needs. A simple mnemonic device can help physicians remember the areas to assess during these visits.

Inside AFP

Contributions for ‘Practical Therapeutics’ from a Military-Based Residency

Janis Wright

“The Home Visit,” by Brian K. Unwin, MAJ, MC, USA, and Anthony F. Jerant, M.D., on page 1481 of this issue, represents the first in a new series of articles wearing the “Practical Therapeutics” label. Each year, two different medical faculties contribute articles to this...

AAFP News Now: AFP Edition

Newsletter

Rosemarie Sweeney, Verna L. Rose

Selected policy and health issues news briefs from AAFP News Now.

Quantum Sufficit

Quantum Sufficit

Monica A. Preboth

Did you know that education shapes your figure as well as your future? The Harris Poll, cited in USA Today, found that people who don't have a high school diploma are more likely to weigh 20 percent or more above the recommended weight for their height. And, those who possess...

Editorials

Thinking About Sexually Transmitted Diseases

GEORGE SCHMID

In this issue of American Family Physician, the treatment of sexually transmitted diseases (STDs) is concisely reviewed by Woodward and Fisher,1 who used for reference the “1998 Guidelines for Treatment of Sexually Transmitted Diseases,” published in January 1998 by the...

Medical Care in the Home

GEORGE TALER

Home care has enjoyed a resurgence over the past 10 years. The growth in home care has been fueled by several factors: the growth of managed care and Medicare's Prospective Payment System, which have reduced the length of hospital stays; liberalization of Medicare coverage...

Diary from a Week in Practice

Diary from a Week in Practice

“Dr. Hartman, will you see an emergency?” was the urgent request. “Sure, what is it?” JRH replied. “A young girl is wearing a ring, and the finger is starting to swell.” Thus began an interesting episode in the daily excitement of a family physician's office. The young girl,...

Photo Quiz

White Patch on Back

Marc S. Berger, SYLVIA HSU

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

Family Practice International

Family Practice International

Anne D. Walling

(Canada—Canadian Family Physician, May 1999, p. 1229.) Bipolar disease is uncommon in community-based elderly persons, but it is associated with significant morbidity and mortality. The prevalence in this group is estimated to be less than 0.1 percent, compared with at least...

Curbside Consultation

Approaching a Terminally Ill Patient in Denial

KAREN OGLE

Denial is a common coping mechanism for those facing a terminal illness—most people use denial to one degree or another, denying some aspects of their illness at least some of the time.

Special Medical Reports

ACC, AHA and ACP–ASIM Develop Guidelines for Angina

Sharon Scott Morey

The American College of Cardiology (ACC), the American Heart Association (AHA) and the American College of Physicians–American Society of Internal Medicine (ACP–ASIM) have developed recommendations for the management of chronic stable angina. The new guidelines encourage...

Clinical Briefs

Clinical Briefs

Verna L. Rose

No strong evidence is available to recommend routine cord blood banking for an infant's future use, according to a policy statement from the American Academy of Pediatrics (AAP) that was published in the July 1999 issue of Pediatrics. The AAP states that no accurate estimates...

Resident and Student Voice

‘Be the Doctor, Always’

JAMES D. TOOMBS

Often, I tell my friends and classmates that anything I do somehow relates to either flying or medicine. Before I decided to become a family physician, I enjoyed a minor career as an Army pilot. As I pursue my medical career, I am often surprised at how many situations relate...

Physician's Bookshelf

Book Reviews

NINA R. BIRNBAUM, SYLVIA M. DOBO

Also Received

Letters to the Editor

Clinical Criteria as a Preliminary Screen for Cervical Spine Injury

Speech and Language Problems in International Adoptees

Tips from Other Journals

Does Soy Protein Provide the Same Benefits as Estrogen?

BARBARA APGAR

Small Breast Carcinoma and Lymph Node Dissection

KARL E. MILLER

Effect of Thyroid Hormone Treatment on Bone Density

RICHARD SADOVSKY

Prevention of First Stroke: Current Recommendations

GRACE BROOKE HUFFMAN

Single-Dose Ceftriaxone for Acute Otitis Media

RICHARD SADOVSKY

Adverse Effects of Inhaled Corticosteroid Therapy

BARBARA APGAR

Evaluating Bruising in Toddlers and Infants

JEFFREY T. KIRCHNER

Oxybutynin in the Treatment of Urge Incontinence

KARL E. MILLER

Considering Futility of Care: Report of a Fair Process

GRACE BROOKE HUFFMAN

Varicella-Zoster Virus Infection: Recent Advances

RICHARD SADOVSKY

Diagnosing and Treating Lichen Sclerosus

ANNE D. WALLING

Comparing Therapies for Chronic Plaque-Like Psoriasis

BARBARA APGAR

Is Asymmetric Breast Tissue a Sign of Malignancy?

BARBARA APGAR

How Safe and Effective Are Sunscreen Products?

BARBARA APGAR

Digital Rectal Examination in Children with Constipation

JEFFREY T. KIRCHNER

Selecting an Antibiotic for Acute UTI in Women

GRACE BROOKE HUFFMAN

Diagnosing Pneumonia Using Physical Examination

BARBARA APGAR

Detection of Intrauterine Pathology Before HRT

BARBARA APGAR

Dehydroepiandrosterone Replacement in Older Patients

RICHARD SADOVSKY

Managing Low High-Density Lipoprotein Cholesterol Levels

RICHARD SADOVSKY

Should We Revise Anemia Parameters for the Elderly?

GRACE BROOKE HUFFMAN

Bedrails in the Hospital: Are They a Necessary Evil?

GRACE BROOKE HUFFMAN

Combination Therapy for Rheumatoid Arthritis

ANNE D. WALLING

An Overall Review of Functional Somatic Syndromes

RICHARD SADOVSKY

Vertical Transmission of HIV and Mode of Delivery

JEFFREY T. KIRCHNER

Information from Your Family Doctor

When You Have Abnormal Uterine Bleeding

In many women, a hormone imbalance causes bleeding. These women may have too much estrogen or not enough progesterone. Polyps or fibroids (small and large growths) in the uterus can also cause bleeding. Cancer of the uterus and infection of the cervix are other causes of...

Pigmented Villonodular Synovitis

Pigmented villonodular synovitis (called PVNS for short) is a joint problem that usually affects the hip or knee. It can also occur in the shoulder, ankle, elbow, hand or foot.

When You Can't Sleep

Sleep is a necessary part of life, like food and water. Your body refreshes itself during sleep, so it can work well during the day. The word “insomnia” means “unable to sleep.”

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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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