Ovarian cancer strategies for nurse practitioners.

Purpose: To review and outline practical strategies for the effective detection and prevention of ovarian cancer.

Data Sources: Selected scientific literature, government consensus findings, and the author's experience.

Conclusions: Ovarian cancer is the fourth most common cause of cancer death in American women, ranking behind lung, breast, and colorectal cancer.

Job satisfaction of family practice residents.

Background And Objectives: As new market forces and expanding responsibilities strongly influence our specialty, it is vital to understand issues that affect resident recruitment, retention, and performance. This study evaluated family practice residents' satisfaction with their chosen careers, their individual programs, and many of the other factors that potentially influence and contribute to job satisfaction.

Methods: Data were collected using a 56-item questionnaire that included demographic information and specific questions regarding residency job satisfaction.

Urinary tract infections during pregnancy in South Carolina.

This study presents evidence that over 20 percent of pregnant women with a UTI in South Carolina did not have an antibiotic pharmacy claim within 14 days of diagnosis. Untreated maternal UTI in pregnancy was associated with a 22 percent increased risk for MR/DD in the infant compared to the risk for women who had a UTI and a pharmacy claim for an antibiotic and 31 percent increased risk compared to women who did not have a UTI. The importance of medications compliance should be emphasized in the care of pregnant women.

American Indians with HIV/AIDS: health and social service needs, barriers to care, and satisfaction with services among a Western tribe.

This study investigated the health care and social service needs, barriers to care and satisfaction with services among American Indians with HIV/AIDS in a western tribe. Individual interviews were conducted with 28 respondents, which constituted nearly the entire population obtaining HIV/AIDS medical services from the IHS in the target area. The survey found that expressed need for services in this frontier rural area were lower than urban counterparts, but that access to needed services was lower.

A teaching unit in primary care sports medicine for family medicine residents.

The authors describe their experience in setting up a sports medicine teaching unit within a family practice center of a teaching hospital. The unit's patient population more closely resembles that of a typical family practice than that of a traditional musculoskeletal teaching clinic (e.g.

Community-oriented primary care: historical perspective.

Background: Community-oriented primary care (COPC) is a systematic approach to health care based upon principles derived from epidemiology, primary care, preventive medicine, and health promotion. We describe the development of COPC from an historical perspective. A critical assessment of current trends and implication for physician education and practice of COPC will be discussed in a companion article in the next issue of The Journal.

Predictors of treatment dropout from a spouse abuse abatement program.

This study evaluated predictors of dropout among men who began and attended at least 1 session of a cognitive-behavioral, skills training oriented spouse abuse abatement counseling program. Based on prior research, a number of demographic, criminal justice, partner violence pattern, and personality characteristics were studied. Dropout prediction was assessed at 2 phases of program participation, during assessment (early drop) and during intervention (late drop).

Vasectomy. A safe, effective, economical means of sterilization.

Vasectomy is a common office procedure that is a permanent, safe, and effective form of birth control. It is less expensive and safer than tubal ligation. Physicians who wish to perform the procedure should be aware of the potential complications and explain them to the patient.

Case studies in partner violence.

Interpersonal violence and abuse, especially between relatives and domestic partners, are leading causes of morbidity and mortality. Family physicians and other professionals who provide primary care health services must deal with acute presentations and chronic sequelae of this epidemic. Many victims of abuse hesitate to seek help, while those who batter are often difficult to identify.

The in vitro isolation of Blastomyces dermatitidis from a woodpile in north central Wisconsin, USA.

Environmental isolations of the dimorphic fungus, Blastomyces dermatitidis, the aetiologic agent of blastomycosis are rare, and have usually involved animal inoculation techniques. We report the in vitro isolation of B. dermatitidis from a woodpile in November 1997, from a private property in a highly endemic area of north central Wisconsin, USA.

Scripted role play: a technique for teaching sexual history taking.

Many inexperienced physicians are uncertain as to how to go about gathering a sexual history. They have had courses in basic history taking, but they do not know how to go about obtaining the information in a nonthreatening way. Their opportunities for interaction with real patients have typically been limited.

Junior high school students' perceptions regarding nonconsensual sexual behavior.

This study assessed early adolescents' attitudes and perceptions regarding nonconsensual sexual activity. A total of 371 surveys (94% return rate) was completed. More than one-third of respondents (35%) reported they had engaged in sexual intercourse; 17% reported having been sexually coerced by a teen-ager; 19% reported feeling pressure from their friends to have intercourse; 7% reported having been sexually coerced by an adult; and 6% reported having sexually coerced someone else.

Office care of the premature infant: Part II. Common medical and surgical problems.

Medical problems associated with prematurity are frequently complex, and a multidisciplinary approach is often required. Some common problems include the following: (1) anemia, which can be reduced by iron supplementation, (2) cerebral palsy or mental retardation as a result of intraventricular hemorrhage or periventricular leukomalacia, (3) respiratory problems, including bronchopulmonary dysplasia and apnea, (4) visual problems, such as those associated with retinopathy of prematurity, (5) gastroesophageal reflux and (6) surgical problems, including inguinal or umbilical hernia and cryptorchidism. Monitoring of growth and development includes recording the infant's head circumference, weight and length on a growth chart for premature infants.

Polypharmacy: a case report and new protocol for management.

Background: Polypharmacy is an important issue in primary care, yet few data are available concerning its prevalence, complications, and management in clinical medicine. The following case illustrates the clinical perils of polypharmacy and serves as a point for critical discussion.

Methods: MEDLINE was searched, using the key word "polypharmacy," from 1994 to the present.

Antiviral drugs in healthy children.

Several antiviral agents are available to treat viral illnesses in healthy children. In some children, treatment with acyclovir is an alternative to vaccination for the treatment and prevention of chickenpox. Acyclovir also can be useful in the treatment or prevention of herpes simplex infections in neonates.

Identification of Blastomyces dermatitidis in the stool of a dog with acute pulmonary blastomycosis.

We report the identification of Blastomyces dermatitidis by microscopic examination of a direct faecal smear from a dog with pulmonary blastomycosis. A simultaneously obtained faecal culture grew Blastomyces dermatitidis. The fungus was also cultured from a transtracheal sample from this same dog.

Undocumented smokeless tobacco use in a family practice population.

Background: Smokeless tobacco (ST) use is associated with significant health risks and is increasing in prevalence in the United States. This study examined the prevalence of ST use among patients seen in two family practice centers and the documentation of that ST use in the medical record.

Methods: A survey of 209 patients seen in two family practice centers in northeast Tennessee was done to determine current and former smoking and ST use.