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Articles

Common Stress Fractures

BRENT W. SANDERLIN, ROBERT F. RASPA

Family physicians frequently treat patients who have stress fractures, injuries commonly associated with participation in sports that involve running, jumping, or repetitive stress.

Panax Ginseng

DAVID KIEFER, TRACI PANTUSO

Panax ginseng is a safe, well-tolerated herbal medicine that may be used in the treatment of a variety of conditions. Potential beneficial effects include improvements in psychologic function, immune system function, and conditions associated with diabetes.

Tremor

SHARON SMAGA

The most common movement disorder is tremor, a rhythmic, involuntary, oscillatory movement of body parts. The best tools for diagnosing and classifying tremor syndromes are a thorough history and physical examination.

School Refusal in Children and Adolescents

WANDA P. FREMONT, null M.D

School refusal often is associated with comorbid psychiatric disorders. Family physicians should identify problems early and make appropriate interventions to prevent further problems in children and adolescents who refuse to go to school.

Reducing Cardiovascular Disease Risk in Patients with Type 2 Diabetes: A Message from the National Diabetes Education Program

JAMES R. GAVIN, III, KEVIN PETERSON, ELIZABETH WARREN-BOULTON

Patients with diabetes have demonstrated a significant lack of knowledge of the link between diabetes and cardiovascular disease. By increasing awareness of cardiovascular risk factors, physicians can help reduce morbidity and mortality in patients with diabetes.

Repair of Obstetric Perineal Lacerations

LAWRENCE LEEMAN, MARIDEE SPEARMAN, REBECCA ROGERS

Effective repair of obstetric perineal lacerations requires a knowledge of perineal anatomy and surgical technique. Sequelae of these lacerations include chronic perineal pain, dyspareunia, urinary incontinence, and fecal incontinence.

Inside AFP

Introducing STEPS

Janis Wright

ILLUSTRATION BY WILLIAM B. WESTWOOD

Newsletter

Newsletter

Matthew Neff

AAFP Endorses Senate Bill to Change Judicial System for Malpractice Cases | Survey Indicates Health Insurance Premiums Up 13.9 Percent from 2002 | HHS Provides $1.4 Billion for Terrorism Preparedness | CDC Releases Tool Kit for Management of Mild Traumatic Brain Injury |...

Quantum Sufficit

Quantum Sufficit

Sarah Evans, Heather McNeill

Licorice root could provide a treatment for severe acute respiratory syndrome (SARS). As reported in a research letter in The Lancet, researchers in Germany assessed the antiviral activities of ribavirin, 6-azuridine, pyrazofurin, mycophenolic acid, and glycyrrhizin against...

Graham Center Policy One-Pager

The U.S. Primary Care Physician Workforce: Minimal Growth 1980–1999

Growth in the primary care physician workforce (physicians per capita) in the United States has trailed the growth of the specialist physician population in recent years. This has occurred despite calls during the same period for increased production of primary care...

The U.S. Primary Care Physician Workforce: Persistently Declining Interest in Primary Care Medical Specialties

A persistent, six-year trend in the choice of specialty training by U.S. medical students threatens the adequacy of the physician workforce of the United States. This pattern should be reversed and requires the attention of policy makers and medical educators.

The U.S. Primary Care Physician Workforce: Undervalued Service

Primary care physicians work hard, but their compensation is not correlated to their work effort when compared with physicians in other specialties. This disparity contributes to student disinterest in primary care specialties.

Editorials

Why Does a U.S. Primary Care Physician Workforce Crisis Matter?

ROBERT L. PHILLIPS, JR., BARBARA STARFIELD

In this issue of American Family Physician, the series of One-Pagers1–3 from the Robert Graham Center offer evidence that a primary care workforce crisis may once again be taking shape. The 1990s saw alignment of public policy and funding efforts to increase the primary care...

Strategies to Improve Diabetes Care

THOMAS BODENHEIMER

Family physicians might react to a new article about diabetes—such as the one by Gavin and colleagues1 in this issue of American Family Physician—by thinking, “Another diabetes article? I know how to care for diabetes. I'll skip this one.” Please don't skip this article....

Diary from a Week in Practice

Diary from a Week in Practice

“What have you done?” KS asked her patient in amazement. The 72-year-old woman held up a small jar, out of which she emptied three large toenails. KS took a fearful look at her patient's feet and saw that the right great toe was covered with a large bandage. The woman...

STEPS

Ezetimibe for Hypercholesterolemia

SPENCER MORRIS, ROB TILLER

Synopsis: Ezetimibe (Zetia) is a novel, selective cholesterol absorption inhibitor. Ezetimibe blocks the absorption of dietary and biliary cholesterol within the brush-border enzyme system of the small intestine. Ezetimibe does not appear to alter or decrease the absorption...

Photo Quiz

Fever, Leg Pain, and a Rash

STEVEN T. OLIVE

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

POEMs and Tips

Do Antioxidants Prevent Heart Disease?

HENRY BARRY

Tapering Steroids Effective in Chronic Stable Asthma

ALLEN F. SHAUGHNESSY

Tapering Steroids Effective in Chronic Stable Asthma

ALLEN F. SHAUGHNESSY

Low-Carbohydrate Diets and Weight Loss

MARK EBELL

Herbal Treatment for Chronic Heart Failure

ALLEN F. SHAUGNESSY

Effects of Montelukast in RSV Postbronchiolitis

CHUCK CARTER

Itch: Etiology, Evaluation, and Available Treatments

ANNE D. WALLING

Hypoestrogenemia Is a Risk Factor for CAD in Women

KARL E. MILLER

ACE Inhibitor vs. Diuretic for Hypertension Therapy

BILL ZEPF

Combining Beta2 Agonists and Corticosteroids in COPD

ANNE D. WALLING

Plasma Homocysteine Levels and Congestive Heart Failure

CAROLINE WELLBERY

Plasma Homocysteine Levels and Congestive Heart Failure

CAROLINE WELLBERY

Predicting Life Expectancy in Patients with Dementia

KARL E. MILLER

Adefovir for Treatment of Chronic Hepatitis B Infection

BILL ZEPF

Diagnosis and Treatment of Cough-Related GERD

KARL E. MILLER

A Visual Tool to Aid Diabetes Control in Inner City Patients

CAROLINE WELLBERY

CT Does Not Improve Ability to Diagnose Appendicitis

ANNE D. WALLING

Clinical Prediction Rules for Streptococcal Pharyngitis

CAROLYN MOSER

Impact of Chronic Sinusitis on Patients with Asthma

KARL E. MILLER

Effect of Home Assessment on Fall Prevention

CAROLINE WELLBERY

Smoking Cessation at Pediatric Clinics for Low-Income Women

KARL E. MILLER

Screening for Congenital Cardiovascular Malformations

SUMI M. SEXTON

Alcohol Consumption and Risk for Dementia

CAROLINE WELLBERY

ECG to Identify Patients with CAD Who Need Intervention

KARL E. MILLER

Practice Guidelines

AAP Releases Policy Statement on Eye Examinations

Genevieve W. Ressel

The American Academy of Pediatrics (AAP) has released a policy statement on eye examinations in infants, children, and young adults. The report focuses on the importance of early detection and prompt treatment of ocular disorders in children to avoid permanent visual impairment.

Clinical Briefs

Clinical Briefs

Carrie Morantz, Brian Torrey

Update on Automated Defibrillator Use for Children | AHRQ Reports on Coronary Heart Disease in Women | CDC/ATS Recommendations on Latent Tuberculosis | NIA Releases Publications on Alzheimer's Disease | FDA Approval

Letters to the Editor

Hormone Therapy to Prevent Hip Fractures in Elderly

Information from Your Family Doctor

Essential Tremor

Essential tremor, sometimes called benign or familial tremor, is an uncontrollable shaking of the hands and forearms. You might notice this tremor when your arms are extended in front of your body. Tremor affects each person differently. Some people hardly notice it, but it...

What to Do When Your Child Refuses to Go to School

Children with school refusal are scared to go to school. They may be so scared that they won't leave the house. School refusal is most common in 5- and 6-year-olds and in 10- and 11-year-olds, but it can start at any age.

Diabetes and Heart Disease

If you have diabetes, you have a high risk for having a heart attack or a stroke. You are more likely to get heart disease—and at an younger age—than someone without diabetes.

Eczema

Eczema (say: “ex-zuh-mah”) is an itching, scaling, swelling rash on the skin. The upper layers of the skin turn red and swell (inflame), and form dry or greasy scales (skin flakes). In severe cases, yellow and red pimples form on the skin, behind the ears, in the ear canal,...

Psoriasis

Psoriasis (say: “sor-eye-ah-sus”) is a skin problem that causes thick red marks like scales on your skin. The thick scaling is probably caused by an increase in the number of skin cells. Sometimes pus-filled blisters form. Most of the time, the skin on the elbows and knees is...

Rosacea

Rosacea (say: “rose-ay-she-ah”) is a disease that affects the skin on the face. It often begins as redness that looks like a blush across the nose, cheeks, chin, or forehead. As time goes on, red pimples and pus-filled bumps may appear. Some people notice small blood vessels...

Seborrheic Dermatitis

Seborrheic dermatitis is a disease that causes flaking of the skin (say: seb-oh-ree-ick). It usually affects the scalp. In teenagers and adults, it is commonly called “dandruff.” In babies, it is called “cradle cap.”



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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