Family Medicine Research in the United States From the late 1960s Into the Future.

When the new field of family medicine research began a half century ago, multiple individuals and organizations emphasized that research was a key mission. Since the field's inception, there have been notable research successes for which family medicine organizations, researchers, and leaders-assisted by federal and state governments and private foundations-can take credit. Research is a requirement for family medicine residency programs but not individual residents, and multiple family medicine departments offer research training in various forms for learners at all levels, including research fellowships.

Fatigue: an overview.

Fatigue, a common presenting symptom in primary care, negatively impacts work performance, family life, and social relationships. The differential diagnosis of fatigue includes lifestyle issues, physical conditions, mental disorders, and treatment side effects. Fatigue can be classified as secondary to other medical conditions, physiologic, or chronic.

The medical home: growing evidence to support a new approach to primary care.

Introduction: A medical home is a patient-centered, multifaceted source of personal primary health care. It is based on a relationship between the patient and physician, formed to improve the patient's health across a continuum of referrals and services. Primary care organizations, including the American Board of Family Medicine, have promoted the concept as an answer to government agencies seeking political solutions that make quality health care affordable and accessible to all Americans.

Managing Alzheimer dementia tomorrow.

Background: Acetylcholinesterase inhibitors are the first drugs to alter the devastating effects of Alzheimer disease. The next generation of drugs will prevent the beta-amyloid plaques and neurofibrillary tangles or block enzymes that lead to neuron destruction. Effective use of these medications will require early identification of patients at risk.

Prealbumin: a marker for nutritional evaluation.

Determining the level of prealbumin, a hepatic protein, is a sensitive and cost-effective method of assessing the severity of illness resulting from malnutrition in patients who are critically ill or have a chronic disease. Prealbumin levels have been shown to correlate with patient outcomes and are an accurate predictor of patient recovery. In high-risk patients, prealbumin levels determined twice weekly during hospitalization can alert the physician to declining nutritional status, improve patient outcome, and shorten hospitalization in an increasingly cost-conscious economy.