Book excerpt: Thoroughly updated by a new editorial team, this Spiral� Manual provides practical, accessible information on the full spectrum of clinical problems in primary care. Written from the family physician's perspective, the book emphasizes ambulatory care, plus pertinent hospital-based and home-based problems, and focuses on disease prevention and health maintenance. Topics include diagnostic challenges such as amenorrhea and fatigue, common disorders such as diabetes mellitus and hypertension, and selected procedures such as obstetric ultrasound and nasolaryngoscopy. New topics covered in this edition include bronchospasm and chest pain, drug addiction, sleep disorders, hematuria, metabolic syndrome, and acute and chronic pain management.