Clinical Contributions

 

Exercise-Induced Asthma.
Robert Lawrence, MD; Ken Ettinger, MD; Michael Barrett, MD; Kuo Chang, MD; Fred Gill, MD; Jean Carney, MD

This common and poorly understood condition is manifested by bronchospasm occurring 5-10 minutes into sustained activity or several minutes after activity ends. Diagnosis is reached by conducting therapeutic trial of appropriate pharmacological agents or by ventilatory measurements during exercise. This article discusses management, with the objective of enabling the afflicted patient to maintain the desired healthy lifestyle.
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Practitioner Prescribing Habits for Pharyngitis: Implications for Evaluation and Management.
Harry S. Miller, MD; William A. Gardiner; Aracelis D. Fernandez, MD

Assuming that increasing development of bacterial resistance to antibiotics reflects, in part, inappropriate prescription of these drugs, the authors studied prescribing patterns of physicians who were awaiting throat culture results. Contrary to the recommendations of several national groups, more than half were treated pending culture reports, and physicians were less likely to treat than Nurse Practitioners or Physician Assistants. Factors influencing noncompliance and methods of improving compliance with recommendations are discussed.
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Prostate Cancer Screening: Exploring the Debate.
Howard Backer, MD, MPH

The author presents the controversial subject of the current role of screening for prostate cancer largely in the context of conflict between the perspectives of public health authorities and of individual practitioners. The article reviews much of the relevant data. Sections discuss the public as informed consumers, ethical issues, medical quality, and health care policy.
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Esthesioneuroblastoma: What Family Practitioners Should Know.
Asdghig D. Daderian, MD, FAAP; M. Roy Thomas, MD, FACP; Loucine M. Huckabay, PhD

This brief report is a case presentation and discussion of a rare nasal cavity tumor, curable if diagnosed early. Emphasis is placed on the need for constant vigilance by primary care providers, especially when common symptoms persist after treatment.
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Bedside Ultrasonography Done in Emergency Department Expedites Diagnosis of Abdominal Aortic Aneurysms: Three Case Studies.
Jeff Miller, MD, FACEP; Janna Chao, MD; Peter Grimes, MD

Using three cases of ruptured abdominal aneurysm diagnosed within an eight-month period as examples, the authors recommend routine use of physician-performed ultrasound examination in older patients with abdominal pain. The authors state that diagnostic accuracy and appropriate management of this surgical emergency are enhanced by this procedure.
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