Canadian family physician Médecin de famille canadien
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Urinary tract infections in females are discussed, emphasizing the need for urine cultures in diagnosis, and the importance of follow-up cultures and investigation in most patients if we are to decrease the morbidity and complications. Antibiotic therapy for acute and complicated infections, the role of long-term therapy, and the risks of catheterization are discussed.
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Polyneuropathy is characterized by simultaneous bilateral symmetrical involvement of peripheral nerves. Clinical features in fully-developed cases are paresthesias, irregular 'glove and stocking' cutaneous sensory loss, loss of deep sensations, weakness of distal muscles of extremities, and absent deep tendon reflexes. The most common forms of neuropathy encountered in practice are -- alcohol-induced, Guillain-Barre syndrome, and that secondary to diabetes mellitus. Since PN has many causes, a scheme based on clinical features is presented so that the possibilities can be narrowed and pursued with further investigations.
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During the past 50 years, there has been increasing expectation by patients and physicians that serious disease is preventable by early diagnosis. Unfortunately, the value of screening by X-rays, electrocardiogram, cytologic smears, and biochemistry has yet to be proven. The family physician should concentrate his efforts more on preventable disease caused by poor diet, exercise levels, or life style and by closely monitoring blood pressure.