Galactorrhea: Rapid Evidence Review.

Galactorrhea is the production of breast milk that is not the result of physiologic lactation. Milky nipple discharge within one year of pregnancy and the cessation of breastfeeding is usually physiologic. Galactorrhea is more often the result of hyperprolactinemia caused by medication use or pituitary microadenomas, and less often hypothyroidism, chronic renal failure, cirrhosis, pituitary macroadenomas, hypothalamic lesions, or unidentifiable causes.

Hypothyroidism: Diagnosis and Treatment.

Clinical hypothyroidism affects one in 300 people in the United States, with a higher prevalence among female and older patients. Symptoms range from minimal to life-threatening (myxedema coma); more common symptoms include cold intolerance, fatigue, weight gain, dry skin, constipation, and voice changes. The signs and symptoms that suggest thyroid dysfunction are nonspecific and nondiagnostic, especially early in disease presentation; therefore, a diagnosis is based on blood levels of thyroid-stimulating hormone and free thyroxine.

Primary care patients' personal illness models for depression: relationship to coping behavior and functional disability.

Objective: The applicability and clinical utility of Leventhal et al.'s model of illness cognition were evaluated in depressed primary care patients. The intercorrelations of illness beliefs and the mediational effects of coping behavior on these beliefs were also evaluated.

Missed opportunities to vaccinate older adults in primary care.

Objective: During the 2000 to 2001 influenza season, distribution of influenza vaccine was delayed, and national self-reported vaccination rates declined. The purposes of this study were to characterize missed opportunities for adult vaccinations and assess the impact of the vaccine delay on missed opportunities for influenza vaccination as recorded in medical records.

Methods: In a cross-sectional analysis, medical record data from 217 adult patients aged > or =65 years in primary care practices that received influenza vaccine supplies late in 2000 were used to assess rates and missed opportunities to vaccinate.

Effects of the year 2000 influenza vaccine delay on elderly patients' attitudes and behaviors.

Background: A substantial delay in distribution of influenza vaccine occurred in the 2000-2001 influenza season. Our objective was to quantify the impact of this delay on immunization rates, location of receipt of immunization, and patient attitudes and beliefs about the influenza vaccine.

Methods: Inner-city and suburban medical practices that received influenza vaccine supply on-time or late in the season (late-receipt) were selected.