American family physician
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Quantifiable and measurable methods accurately assess pain severity and successfully guide physicians in determining which medications and modalities are appropriate and necessary for the treatment of chronic pain. A variety of pain assessment scales and the World Health Organization's three-step analgesic ladder can be the starting point for successful pain management.
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Helping a patient to quit smoking requires accurate identification of the problem, development of an individualized management plan and careful follow-up of the patient's response to treatment. Tools such as the Fagerstrom Test for Nicotine Dependence can help the physician learn about the patient's smoking habit and develop an effective treatment plan. Support from physicians, health care providers, family and smoking cessation groups can help patients quit smoking and maintain long-term abstinence. Nicotine replacement therapy, available in a variety of forms, is most effective when it is used as part of a smoking cessation program for the nicotine-dependent patient.
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Accurate diagnosis of elbow fractures in children requires knowledge of anatomic development. The multiple ossification centers in the elbow can be mistaken for fractures, making radiographic diagnosis difficult. Anteroposterior and lateral radiographs are most commonly used, although oblique views may help in the detection of subtle injuries. ⋯ Anterior and posterior fat pad signs indicate joint effusion, which suggests significant trauma. Intersection of the anterior humeral and central radial lines can be used to assess joint alignment. Fractures displaced less than 2 mm are considered stable and may be treated conservatively.
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American family physician · Mar 1997
ReviewSpecial health considerations in African-American elders.
Older African Americans constitute an expanding part of the elderly population in the United States. Although socioeconomic factors affect longevity and functional status more than race, African-American elders, as a whole, show poorer health status, as well as greater levels of financial strain and care-giver burden. Incidence rates of hypertension, heart disease, stroke, end-stage renal disease, dementia and prostate cancer are higher among African Americans than among the white population. ⋯ The Activities of Daily Living scale and the Short Portable Mental Status Questionnaire are two tools that have been specially tested and shown to be reliable and valid in this population group. The Geriatric Depression Scale is a useful diagnostic tool that is quick to use in a busy office practice. Taking the time during an initial visit to understand the patient's values and perceptions of health and illness builds a sense of comfort and trust that will set a positive tone for the entire doctor-patient relationship and may empower the patient to take positive steps to improve health habits.