ACP Medicine

Medical practice is constantly changing. Almost daily there is important new information regarding basic disease mechanisms and new therapies. There is a constant need to reconsider how we diagnose and treat both common and rare diseases. The way that hospitals and clinics are organized, how we pay for health care, and how our services are […]

Contemporary Ethical And Social Issue in Medicine

In the past, medical ethics was thought to refer solely to proscriptions against physicians advertising their services and fees or engaging in questionable economic arrangements such as fee-splitting. Within the past 20 years, however, medical ethics has evolved into a discipline in which clinicians (physicians, nurses, and other health professionals), philosophers, theologians, and social scientists […]

Reducing Risk of Injury and Disease Part 1

Prevention: A Brief Overview During the past 2 decades, disease and injury prevention has occupied an expanding share of medical practice. Public interest in prevention is very high, driven by a steady accumulation of high-quality evidence that preventive interventions do reduce cause-specific death rates. The purpose of these interventions is to eliminate the root causes […]

Reducing Risk of Injury and Disease Part 2

Alcohol abuse Habitual excessive alcohol consumption causes 100,000 deaths annually in the United States.1 Although more than one million adults are under treatment for alcoholism, a far greater number engage in drinking that injures their health or has social consequences. The Institute of Medicine estimates that 20% of the population of the United States are […]

Diet and Exercise Part 1

Many chronic diseases result from unhealthful eating and a sedentary lifestyle. Poor nutrition and inadequate exercise substantially increase the risk of such maladies as coronary artery disease, hypertension, stroke, diabetes, obesity, osteoporosis, and certain cancers and account for about 300,000 deaths in the United States each year.1 Dietary factors also contribute to cholelithiasis, hemorrhoids, hernias, […]

Diet and Exercise Part 2

Vitamin and mineral consumption Vitamins Vitamins are either fat soluble or water soluble. Vitamins A, D, E, and K are fat soluble. They are found in fatty foods and are absorbed, transported, and stored with fat. Because excretion is minimal and storage in fat is abundant, deficiencies of fat-soluble vitamins are rare, but toxic amounts […]

Diet and Exercise Part 3

Diet and health Much remains to be learned about the complex relation between nutrition, health, and disease. Dietary preferences are no less complex and individual. Despite these uncertainties, a dietary pattern characterized by a high intake of vegetables, fruits, legumes, whole grains, fish, and poultry is associated with major health benefits for men87 and women.30,88 […]

Diet and Exercise Part 4

Exercise and longevity Primary Prevention of Atherosclerosis Exercise training can favorably modify many of the conditions associated with an increased risk of coronary artery disease, including hypercholesterolemia, elevated blood pressure, glucose intolerance, obesity, and the less firmly incriminated traits of hypertriglyceridemia, hyperinsulinemia, hyperfibrino-genemia, and psychological stress. Studies conducted in men, women, and children demonstrated a […]

Adult Preventive Health Care Part 1

Over the past 20 years, prevention has become a major activity in primary care. During a typical day, primary care clinicians spend much of their time managing asymptomatic conditions in which the main goal is to prevent death or complications (e.g., hypertension, hyperlipidemia, osteoporosis). Many topics in ACP Medicine include information on screening or prevention […]

Adult Preventive Health Care Part 2

Clinical Breast Examination The USPSTF could not determine the benefits of clinical breast examination (CBE) alone or the incremental benefit of adding CBE to mammography (grade I recommendation). No screening trial has examined the benefits of CBE alone (without accompanying mammography). Four of the eight trials of screening used mammography alone, and four used mammog-raphy […]