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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.

Inside AFP

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,...

AAFP News Now: AFP Edition

Newsletter

CARRIE MORANTZ

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

Quantum Sufficit

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...

Editorials

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...

Graham Center Policy One-Pager

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

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...

Cochrane for Clinicians

Psychological Interventions for Noncardiac Chest Pain

KATHERINE L. MARGO

Noncardiac chest pain can be caused by gastroesophageal reflux disease (GERD), panic disorder, or a number of other psychological conditions. Psychotherapy, particularly cognitive behavior therapy, has been shown to reduce the number of days with chest pain significantly over...

Corticosteroids for Pulmonary Sarcoidosis

MARK H. EBELL

Patients who take oral corticosteroids are more likely to show improvement in their chest radiographs than those taking placebo, although improvements in symptoms and lung function are less certain. The typical dosage used in randomized trials was 20 mg daily or 40 mg every...

Acute Treatment of Hyperkalemia

According to disease-oriented evidence, insulin and intravenous glucose, inhaled albuterol (Ventolin), and dialysis are the best treatment options; the first two may be given in combination. Bicarbonate or resins are not recommended for routine use, particularly without one...

U.S. Preventive Services Task Force

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...

Point-of-Care Guides

Diagnosing and Treating Patients with Suspected Influenza

MARK H. EBELL

During the winter months, influenza is one of the most common illnesses among patients of primary care physicians, with as many as one in five adults infected each year.

Clinical Evidence Handbook

Chronic Fatigue Syndrome

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

What are the effects of treatments?

Putting Prevention Into Practice

Screening for Gonorrhea

DAVID MEYERS

Case study: 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...

FPIN's Clinical Inquiries

Antiviral Agents for Pregnant Women with Genital Herpes

CHRISTOPHER WENNER, JOAN NASHELSKY

There is no evidence that the use of antiviral agents in women who are pregnant and have a history of genital herpes prevents perinatal transmission of herpes simplex virus (HSV) to neonates.

Photo Quiz

A Pregnant Patient with Dyspnea

MICHAEL D. BURG, FRANK VAN DER HEIJDEN

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

POEMs

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

Curbside Consultation

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...

Practice Guidelines

AAN Releases Recommendations for Managing Essential Tremor

AMBER HUNTZINGER

Evidence-based recommendations for the initiation of pharmacologic and surgical therapies for patients with essential tremor have been released by the Quality Standards Subcommittee of the American Academy of Neurology (AAN).

Practice Guideline Briefs

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).

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.

Letters to the Editor

Follow-Up Care of Patients with Fully Resected Colon Cancer

Nasal Irrigation to Treat Acute Bacterial Rhinosinusitis

Tips from Other Journals

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

Information from Your Family Doctor

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...



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