Articles
Myocardial Infarction: Management of the Subacute Period
Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Antiplatelet therapy, renin-angiotensin…
Outpatient Management of Alcohol Withdrawal Syndrome
Symptoms of alcohol withdrawal syndrome begin six to 24 hours after the last alcohol intake, and they can become severe if the condition is not treated appropriately. Symptom severity should be assessed using a validated instrument. Most patients with mild or moderate symptoms…
Care of the College Student
Meeting the needs of the college student involves management of not only common illnesses and chronic conditions, but of behaviors and stressors that are unique to students. Concerns include attention-deficit/hyperactivity disorder, learning disabilities, anxiety, depression…
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A health care skills checklist is one recommended method to assess the needs of the patient and to develop goals for the transition to a health care model that expects assumption of adult responsibilities.
AFP News Now - AFP Edition
AAFP News Now: AFP Edition
AAFP Releases Third Installment of Choosing Wisely Recommendations | Report: Medical Education Needs Overhaul | AMA Finds Private Medical Practices Remain Strong Despite Hospital Buyouts | FDA to Scrutinize Some Medical Apps
Curbside Consultation
Talking with Children About a Parent's Serious Illness
It is not uncommon for children to have parents who have cancer. Although parents may be understandably apprehensive about discussing a serious illness, children want and need to know what is happening. It is strongly recommended that children be involved and informed in the…
Editorials
After Detoxification: Levels of Treatment for Alcohol Dependence
Detoxification is just “the tip of the iceberg,” and the postdischarge treatment program is key in determining whether patients will abstain from alcohol.
Cochrane for Clinicians
Optimal Antibiotic Regimen for Treating Lower UTI in Children
For the afebrile child with a UTI, a short course (three to seven days) of antibiotics is as effective at preventing the recurrence of symptomatic UTI as a long course (seven to 10 days). There is no clear evidence of superiority for any one antibiotic regimen.
Prevention of Herpes Zoster in Older Adults
The herpes zoster (shingles) vaccine has demonstrated effectiveness in preventing shingles in older adults. Vaccination benefit was greater in persons 60 to 69 years of age than in those 70 years and older. Local injection site reactions were common.
Photo Quiz
Diffuse, Pruritic, Papular Rash
Photo Quiz presents readers with a clinical challenge based on a photograph or other image.
POEMs
Breast Cancer Prevented in Some Women with Drug Treatment
In some postmenopausal women at higher-than-average risk of breast cancer, tamoxifen and, to a lesser extent, raloxifene (Evista) will prevent the development of breast cancer. For every 1,000 women who receive the prophylaxis, there will be seven to nine fewer cases of…
Low-Dose Penicillin Prevents Recurrent Cellulitis
For patients with at least two previous episodes of cellulitis in the previous three years, low-dose penicillin can prevent recurrence (number needed to treat = 6).
Sexual, Urinary, and Bowel Dysfunction Common After Treatment for Localized Prostate Cancer
Patients undergoing surgery had worse urinary and sexual outcomes, whereas those undergoing external beam radiation therapy (EBRT) had worse bowel symptoms. Watchful waiting (“active surveillance”) was not the subject of this study, but given the problems associated with…
Kidney Stones: Prevention Options
Increased fluid intake or decreased soft drink intake may prevent further kidney stones in patients with a single episode of a calcium stone, but other dietary interventions are not effective. Thiazides and citrates with increased fluid intake decrease recurrence in patients…
Dextrose Prolotherapy Decreases Pain and Stiffness in Knee Degenerative Joint Disease
Dextrose prolotherapy appears to be more effective in decreasing pain and stiffness, and improving function in patients with knee degenerative joint disease than saline injections and home exercise.
n-3 Fatty Acids Do Not Prevent Cardiovascular Events in High-Risk Patients
There is no evidence that n-3 fatty acids prevent cardiovascular events or death in older adults who have cardiovascular disease (or who are at risk of it but have not had a myocardial infarction).
Practice Guidelines
Management of Stable Ischemic Heart Disease: Recommendations from the ACP
The American College of Physicians (ACP) has developed a guideline on the management of stable ischemic heart disease (IHD). This summary presents recommendations related to risk factor modification (including strategies of unproven benefit), medical therapies to prevent…
Letters to the Editor
Chagas Disease Is a Consideration in Latino Patients
Corrections
Correction
Incorrect maintenance dosage for phenobarbital. The article “Management of Status Epilepticus” (August 1, 2003; p. 469) contained an error in the maintenance dosage of phenobarbital for treatment of status epilepticus in Table 2 (p. 474). The dosage should have been 1 to 3 mg…
