The Journal of family practice
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Cervical spondylosis or chronic diskogenic disease of the cervical spine is a relatively common cause of myelopathy, but it is often not recognized or is incorrectly diagnosed. The clinical presentation may mimic several types of neurological disease including multiple sclerosis and amyotrophic lateral sclerosis. ⋯ Knowledge of the pathophysiology of myelopathy due to cervical spondylosis and adequate radiographic evaluation will often lead to treatment that can prevent progressive spinal cord damage. Cervical spondylosis with myelopathy is one of the most frequently unrecognized and misdiagnosed, yet treatable, conditions affecting the nervous system.
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A form of management which has proven helpful in a developmental intervention program for handicapped infants is described. The use of ordinal rather than normative assessments when monitoring the infant's development and when teaching families about their infants is advocated. Two cases demonstrate ways to enhance the functioning of the handicapped infant and his family.
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There is a need for a measure of the overall seriousness of a given family practice workload. In the past, such measurements have been attempted in various ways. ⋯ Some examples of the uses of the system are shown. Several difficulties were encountered; these are not insuperable, and the method deserves to be developed further.
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Urticaria is a problem often as vexing to the physician as to the patient. The approach to the patient with hives first demands a search for the etiology, whether endogenous and triggered by emotions or occult systemic disease, exogenous and triggered by allergy to inhaled or ingested antigens, or physical and due to abnormal sensitivity to heat, cold, light, or pressure. ⋯ Elimination diets are of diagnostic as well as therapeutic value: pencillin-free, yeast-free, and salicylate-free diets are particularly useful. Therapeutic trials of tetracycline, nystatin and griseofulvin may be helpful, while corticosteroids and specific desensitization are rarely of value.