Articles
Impetigo: Diagnosis and Treatment
Two principal types of impetigo exist: nonbullous, which is characterized by honey-colored crusts on the face and extremities, and bullous, which is characterized by flaccid bullae and is more likely to affect intertriginous areas. Both types usually resolve within two to three…
Dog and Cat Bites
Dog and cat bite wounds should be irrigated with normal saline and explored for tendon or bone involvement and possible foreign bodies. Wounds can be closed for cosmetic reasons, unless there is a high risk of infection. Antibiotic prophylaxis should be used for high-risk bite…
Common Questions About Outpatient Care of Premature Infants
After a premature infant is discharged, the goals of the primary care physician include coordination of medical and social services, nutritional surveillance, and managing conditions associated with prematurity. Enriched formula or nutrient fortifiers may be necessary for…
AFP News Now - AFP Edition
AAFP News: AFP Edition
CMS Updates Schedule for Reviewing, Disputing Open Payments Data | Home Health Proposal Could Lighten Family Physicians' Administrative Burden | Proposed 2015 Medicare Fee Schedule Has Good and Bad News for Family Physicians | <b><i>M<sc>ed</sc>W<sc>atch</sc></i></b>: FDA Warns…
Editorials: Controversies in Family Medicine
Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Yes: Implementing the New ACC/AHA Cholesterol Guideline Will Improve Cardiovascular Outcomes
The new American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults used a strong evidence-based approach to update clinical practice recommendations for primary care…
Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Not Completely: Why It Is Right to Drop LDL-C Targets, but Wrong to Recommend Statins at a 7.5% 10-Year Risk
The new American College of Cardiology/American Heart Association (ACC/AHA) cholesterol treatment guideline moved clinical practice in the right direction, but not far enough.1 I applaud the ACC/AHA committee for dropping low-density-lipoprotein cholesterol (LDL-C) target…
STEPS
Indacaterol (Arcapta) for COPD
Indacaterol provides a similar benefit to other long-acting bronchodilators for the treatment of moderate to severe COPD, with once-daily dosing. As with other LABAs, it should be used only as add-on therapy in patients already taking inhaled corticosteroids.
Putting Prevention Into Practice
Primary Care Interventions to Prevent Child Maltreatment
A young couple comes to your clinic with their adopted four-year-old daughter for her annual well-child visit. On physical examination, the patient appears to be well developed and well nourished, and measures in the 75th percentile for her height and weight.
Photo Quiz
Chest Pain with Diffuse T-Wave Inversion
A 45-year-old man presented with worsening left-sided, sharp pleuritic chest pain that began one week earlier.
Practice Guidelines
ACC/AHA Release Updated Guideline on the Treatment of Blood Cholesterol to Reduce ASCVD Risk
The Blood Cholesterol Expert Panel from the American College of Cardiology (ACC) and the American Heart Association (AHA) issued an updated evidence-based guideline in 2013 that addresses the use of fixed doses of cholesterol-lowering drugs (statins) to reduce the risk of ASCVD…
POEMs
2013 ACC/AHA Cholesterol Guideline Greatly Increases Number Eligible for Statin Treatment
The new guideline from the ACC/AHA increases the number of adults between 40 and 75 years of age who are eligible to take statins by 12.8 million. The largest increases were among adults who would take statins for primary prevention and for adults between 60 and 75 years of age…
Immunochemical FOBTs Moderately Sensitive and Highly Specific for Colorectal Cancer
Immunochemical FOBTs, such as OC-Micro, OC-Sensor, or OC-Light, are moderately sensitive (73% to 89%) and highly specific (92% to 95%) for identifying colorectal cancer. In comparison, Hemoccult Sensa has a lower sensitivity (64% to 80%) and specificity (87% to 90…
Opioids for Chronic Back Pain: Short-Term Effectiveness, Long-Term Uncertain
Overall, in patients with chronic low-back pain, opioids are moderately more effective than placebo in the short term for pain relief and slightly more effective in the short term for improving function. However, data for long-term use are virtually nonexistent. The long-term…
FPIN's Clinical Inquiries
Cardiovascular Effects of NSAIDs
Aspirin does not elevate blood pressure. Among nonselective NSAIDs, ibuprofen increases the risk of hypertension and stroke. Diclofenac does not increase the risk of hypertension, but does increase the risk of stroke. Naproxen (Naprosyn) does not increase the risk of…
U.S. Preventive Services Task Force
Primary Care Interventions to Prevent Child Maltreatment: Recommendation Statement
The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care interventions to prevent child maltreatment. This recommendation applies to children who do not have signs or…
Graham Center Policy One-Pager
The Continued Importance of Small Practices in the Primary Care Landscape
In 2010, as many as 45% of active primary care physicians (PCPs) were practicing at sites with five or fewer physicians. This large cohort of practices faces unique challenges in meeting the increasing demands of practice transformation, payer reporting requirements, and…
Letters to the Editor
Information from Your Family Doctor
Impetigo
Impetigo (im-puh-TIE-go) is a bacterial infection of the top layer of skin. It often is around the nose or mouth, or somewhere else on the face. It may also be on the legs, arms, or diaper area. Signs include: