Primary care
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Each type of male genital cancer has features that are unique in diagnosis and treatment. The incidences of these cancers are related to age, race, and environment. Early diagnosis and treatment are documented as important for all male genital cancers except prostate cancer, where this remains a subject of controversy.
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Primary care clinicians treat patients with cancer and cancer pain. It is essential that physicians know how to effectively manage pain including assessment and pharmacologic and nonpharmacologic treatment modalities. ⋯ Pharmacologic regimens are based on the World Health Organization's "ladder of analgesia," beginning with nonopioid medications and adding the opioid narcotics and adjuvant medications as necessary. Inclusion of nonpharmacologic treatments, physical and psychological are important for effective management.
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Cigarette smoking is responsible for enormous health consequences. Lung cancer is fatal in over 80% of cases, and effective treatment is limited. The medical impact of cigarette smoking will diminish with effective measures to prevent smoking and nicotine addiction and to promote smoking cessation. Efforts should focus on the teenage population, with a combination of social, economic, and legislative interventions.
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Motor vehicle-related accidents and firearm-related violence are the first and second leading causes of adolescent morbidity and mortality. Fortunately, considerable progress has been made in reducing motor vehicle-related injuries and death through state-level legislation designed to decrease alcohol use and increase seat belt use. ⋯ Family violence and the epidemic of gang activity also contribute significantly to both; violence portrayed on television, in movies, and in adolescent music also has become a more significant part of teen life. Family physicians are encouraged to implement preventive strategies for combating the problems of injury and violence in their offices, their communities, and on the broader states of medical education and public policy.
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Some clinician physicians who provide perinatal care find that they have the motivation and practice volume to learn diagnostic ultrasonographic skills. These skills may be limited to labor and delivery applications or may extend to performance of the standard antepartum obstetric ultrasound examination. Limited skills include the diagnosis of fetal life number, presentation, amniotic fluid assessment, and placental localization. The standard antepartum obstetric ultrasound examination adds fetal biometry and a detailed assessment of fetal anatomy.