Postgraduate medicine
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Headache is a common affliction of humanity. The physician evaluating a patient who happens to have a history of headaches may naturally consider them as part of the disease when formulating a diagnosis, thus attributing undue significance to ordinary functional headaches. ⋯ The presence of headache may aid in or hinder diagnosis. Clues that a headache may indicate cerebrovascular disease are onset after the age of 35; pain described as "the worst headache ever"; persistent localization and progressive worsening of pain; and risk factors for cerebrovascular disease, such as advancing age, hypertension, bruits, and heart disease.
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Much attention has been focused on cigarette smoking and its health implications. Numerous campaigns have been launched to help people stop smoking or prevent them from starting. While smoking has been receiving this attention, use of smokeless tobacco has been increasing at an alarming rate. ⋯ Oropharyngeal cancer and erosive effects on the oral structures are known hazards, but the long-term total-body effects have yet to be determined. Physicians need to identify patients who use smokeless tobacco so that intervention strategies can be employed. Preventive techniques, especially those aimed at children, may be the most effective means of controlling this health threat.