• Articles

    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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