N onsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat inflammation, pain, and fever by decreasing prostaglandin synthesis through blockage of the cyclooxygenase (COX) enzyme. Table 1 lists NSAID dosages and monthly costs. There is little evidence to support differences in effectiveness for pain treatment when comparing all NSAIDs. Aspirin is used for primary and secondary pr...

T he number of adults in North America who have congenital heart disease (CHD) has steadily increased over the past 30 years. Although this increase is partly because of the growth of the adult population, it may be more attributable to improvements in surgical management, which have resulted in a greater than 90 percent 10-year survival rate in persons with CHD. Between 1979 and 1997, mortalit...

BACKGROUND Community health centers (CHCs) receive $2.9 billion in federal funding to provide primary care to 20 million people annually, and these numbers are increasing. Understanding of physician satisfaction in CHCs may help guide recruitment and retention efforts aimed at expanding CHC programs. The objective of this study was to contrast the satisfaction of family physicians working in CH...

A ccurate diagnosis of the generalized rash can be difficult because of the nonspecific appearance of many rashes. If the diagnosis is not obvious, the physician must resist the common tendency to prematurely close the diagnostic process and instead generate an inclusive differential diagnosis. Part I of this two-part article discusses the common, uncommon, and rare causes of generalized rashes...

Several clinical studies have shown that valerian is effective in the treatment of insomnia, most often by reducing sleep latency. A double-blind, placebo-controlled trial compared a 400-mg aqueous extract of valerian and a commercial valerian/hops preparation with placebo of encapsulated brown sugar. A total of 128 volunteers completed a subjective study evaluating the effects of single doses ...

CONTEXT Data collected in 1998 on primary physician performance, including Health Plan Employer Data and Information Set (HEDIS) measures, were the basis of reports distributed quarterly to 194 primary care physicians at 25 medical centers in Group Health Cooperative. Here, we summarize results of research designed to assess reliability of measures of physician performance and to identify pract...

despite the relative success of the health system and the promotion of health indicators over the last two decades, iran's health system still faces serious problems. one of the most important of them, is the inequity in access to health. theoretical studies and empirical evidences indicate that implementation of the referral system and family physician plan, is one of the main strategies ...