Medical Practice

Magazine articles on medical practice and technical issues of treatment.

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American Family Physician October 1, 2003 Tallia & Cardone	Diagnostic and Therapeutic Injection of the Ankle and Foot Joint and soft tissue injection of the ankle and foot region is a useful diagnostic and therapeutic tool for the family physician. This article reviews the injection procedure for the plantar fascia, ankle joint, tarsal tunnel, interdigital space, and first metatarsophalangeal joint.
American Family Physician October 1, 2003 Vincent W. Delagarza	Pharmacologic Treatment of Alzheimer's Disease: An Update Alzheimer's disease is characterized by the development of senile plaques and neurofibrillary tangles, which are associated with neuronal destruction, particularly in cholinergic neurons. Drugs that inhibit the degradation of acetylcholine within synapses are the mainstay of therapy.
American Family Physician September 15, 2003 Perkins et al.	Serum Tumor Markers Because family physicians are assuming a greater role in caring for patients with cancer, an understanding of tumor markers is becoming increasingly important.
American Family Physician September 15, 2003 Isaacson & Vora	Differential Diagnosis and Treatment of Hearing Loss More than 28 million Americans have some degree of hearing impairment. A thorough history and a careful physical examination are essential to the diagnosis and treatment of hearing loss.
American Family Physician September 15, 2003 Robert S. Fawcett	Ivermectin Use in Scabies Scabies is a skin disease caused by infestation with the mite Sarcoptes scabiei. There may be a particular role for oral ivermectin in refractory infestations and immunocompromised patients, or when compliance with head-to-toe topical therapy is difficult.
American Family Physician September 15, 2003 Seehusen et al.	Cerebrospinal Fluid Analysis Primary care physicians frequently perform lumbar puncture, because cerebrospinal fluid is an invaluable diagnostic window to the central nervous system. Commonly performed tests on CSF include protein and glucose levels, cell counts and differential, microscopic examination, and culture.
American Family Physician September 15, 2003 Leeman et al.	The Nature and Management of Labor Pain: Part I. Nonpharmacologic Pain Relief Pain in labor is a nearly universal experience for childbearing women. A recent evidence-based symposium on the nature and management of labor pain brought together family physicians, obstetricians, midwives, obstetric anesthesiologists, and childbirth educators.
American Family Physician September 15, 2003 Leeman et al.	The Nature and Management of Labor Pain: Part II. Pharmacologic Pain Relief Parenteral opioids provide modest pain relief in labor, and little evidence supports the use of one agent over another. Epidural analgesia is used during labor in most large U.S. hospitals, and its use is rapidly increasing in small hospitals.
American Family Physician September 15, 2003 Scott Moses	Pruritus Pruritus is a common dermatologic problem that increases in incidence with age. In some patients, the condition may be so severe that it affects sleep and quality of life. While pruritus most commonly occurs in skin disorders, it may be an important dermatologic clue to the presence of an underlying systemic disease.
American Family Physician September 15, 2003 Richie & Francis	Diagnostic Approach to Polyarticular Joint Pain Polyarticular joint pain (i.e., pain in more than four joints) poses a diagnostic challenge because of the extensive differential diagnosis. Consequently, family physicians need to keep the diagnosis open in evaluating patients who present with pain in multiple joints.
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