American family physician
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Sudden infant death syndrome is the leading cause of death among healthy infants, affecting 0.57 per 1,000 live births. The most easily modifiable risk factor for sudden infant death syndrome is sleeping position. To reduce the risk of sudden infant death syndrome, parents should be advised to place infants on their backs to sleep and avoid exposing the infant to cigarette smoke. ⋯ Supine sleeping position has increased the incidence of flattening of the occiput (deformational plagiocephaly), but this condition can be prevented and treated by encouraging supervised "tummy time," meaning that when awake, infants should spend as much time as possible on their stomachs. All apparent deaths from sudden infant death syndrome should be carefully investigated to exclude other causes of death, including child abuse. Families who have an infant die from sudden infant death syndrome should be offered emotional support and grief counseling.
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Zinc is an essential micronutrient for human metabolism that catalyzes more than 100 enzymes, facilitates protein folding, and helps regulate gene expression. Patients with malnutrition, alcoholism, inflammatory bowel disease, and malabsorption syndromes are at an increased risk of zinc deficiency. Symptoms of zinc deficiency are nonspecific, including growth retardation, diarrhea, alopecia, glossitis, nail dystrophy, decreased immunity, and hypogonadism in males. ⋯ Current data do not support zinc supplementation as effective for upper respiratory infection, wound healing, or human immunodeficiency virus. Zinc is well tolerated at recommended dosages. Adverse effects of long-term high-dose zinc use include suppressed immunity, decreased high-density lipoprotein cholesterol levels, anemia, copper deficiency, and possible genitourinary complications.
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American family physician · May 2009
Generalized anxiety disorder: practical assessment and management.
Generalized anxiety disorder is common among patients in primary care. Affected patients experience excessive chronic anxiety and worry about events and activities, such as their health, family, work, and finances. The anxiety and worry are difficult to control and often lead to physiologic symptoms, including fatigue, muscle tension, restlessness, and other somatic complaints. ⋯ However, evidence suggests that the effects of cognitive behavior therapy may be more durable. Although complementary and alternative medicine therapies have been used, their effectiveness has not been proven in generalized anxiety disorder. Selection of the most appropriate treatment should be based on patient preference, treatment success history, and other factors that could affect adherence and subsequent effectiveness.