American family physician
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American family physician · Jul 1994
ReviewPrimary hypertension: the role of individualized therapy.
Approximately 50 million persons in the United States either have elevated blood pressure or take antihypertensive medication. Many other persons have risk factors predisposing them to hypertension. Current therapy for hypertension consists of lifestyle modification and pharmacologic regimens. ⋯ Several classes of drugs are effective in lowering blood pressure. The patient's personal characteristics, the presence of concomitant disease, and the physiologic side effects and cost of medications are factors to consider in the process of selecting a drug regimen. Successful management of hypertension is personally rewarding and decreases mortality, morbidity and the cost of medical care.
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Epidemiologic data suggest that obsessive-compulsive disorder is the fourth most common mental disorder, after phobias, substance abuse and depression, and is nearly as common as asthma and diabetes mellitus. The understanding of obsessive-compulsive disorder and its treatment have significantly improved over the past decade. ⋯ Treatment of obsessive-compulsive disorder includes drug therapy, behavior therapy and family therapy. The family physician can play a key role in recognizing the clinical markers of obsessive-compulsive disorder and negotiating a treatment plan that significantly lessens the psychosocial morbidity associated with it.
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American family physician · Jan 1994
ReviewHealth care for the homeless: a family medicine perspective.
Many factors contribute to the health problems of homeless persons, including exposure to adverse weather, trauma and crime, overcrowding in shelters, unusual sleeping accommodations, poor hygiene and nutritional status, alcoholism, drug abuse and psychiatric illness. It is common for homeless adults to have skin ailments, respiratory infections, traumatic injuries and chronic gastrointestinal, vascular, dental and neurologic disorders. ⋯ Special attention should be given to examination of the skin, teeth and feet. Supplemental food, immunizations, psychologic counseling and social service referrals should be considered for homeless pediatric patients.