American family physician
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Except for benign pleural effusion, asbestos-related pulmonary complications, including asbestosis, malignant mesothelioma and bronchogenic carcinoma, usually occur more than 20 years after exposure. Pleural plaques and pleural thickening serve as markers for asbestos exposure, but they are not associated with an increased risk of malignancy. ⋯ A history of dyspnea, pleuritic chest pain, fatigue, weight loss and pleural effusion in a former asbestos worker is suggestive of mesothelioma. Cigarette smoking greatly increases the risk of lung cancer in asbestos workers.
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Family physicians should be aware of the potential effects and complications of vasectomy so they can appropriately counsel patients seeking sterilization. Vasectomy produces anatomic, hormonal and immunologic changes and, although not substantiated by clinical studies, has been reputed to be associated with atherosclerosis, prostate cancer, testicular cancer and urolithiasis. Complications of vasectomy include overt failure, occasional sperm in the ejaculate, hematoma, bleeding, infection, sperm granuloma, congestive epididymitis, antisperm antibody formation and psychogenic impotence. Compared with tubal ligation, vasectomy has fewer serious complications and a comparable failure rate.
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The nausea and vomiting that often accompany early pregnancy may be ameliorated if the patient eats small portions of food at frequent intervals, increases the amount of carbohydrates and decreases the amount of fat, and avoids bothersome food odors. When these strategies fail, antiemetic drugs such as pyridoxine and phosphorated carbohydrate solution may help, as well as doxylamine, promethazine or trimethobenzamide. When drugs are considered for use in pregnant patients, the safety of the patient and the fetus must always come first.