November 1, 2016

Patients who are diagnosed with community-acquired pneumonia are typically very young or very old. Inpatient and outpatient management strategies require consideration of a patient's risk factors and severity of illness. Validated prediction scores help guide initial decisions…

Family physicians and other primary care clinicians commonly provide long-term comprehensive care for persons with human immunodeficiency virus (HIV) infection. This article describes the scope of initial care, including obtaining a thorough history; physical examination for…

Epididymitis is a common presentation in the outpatient setting that can affect adults and children. The condition causes unilateral swollen, tender epididymis, with an anatomically normal testis. In sexually active males 14 to 35 years of age, epididymitis is most often caused…

AAFP Joins Other Medical Groups in Supporting ACA Contraceptive Mandate | Check Quality Reports to Avoid Pay Cuts | Agency Proposes Primary Care Role in Federal Diabetes Program | AAFP Teams Up with CDC, Other Groups to Promote Responsible Antibiotic Use

In this issue of American Family Physician, we present an article on initial management of patients with human immunodeficiency virus (HIV) infection.1 Among the issues we did not address are studies showing that clinicians with more experience in the management of HIV…

The overall risk of MI and ischemic stroke is increased in women who use combined oral contraceptives. The relative risk of MI and ischemic stroke increases as estrogen dose rises, increasing by 60% with doses of 20 mcg and more than doubling when doses of 50 mcg or more are…

Although not a substitute for an implantable cardioverter-defibrillator (ICD), amiodarone is effective for the primary prevention of sudden cardiac death when compared with placebo (number needed to treat [NNT] = 47; 95% confidence interval [CI], 33 to 100), but it does not…

Although rates of uninsured Americans are declining because of the Affordable Care Act (ACA), there is growing concern about out-of-pocket expenditures associated with private high-deductible insurance plans.

Topical antifungal agents are effective in treating onychomycosis, with a number needed to treat (NNT) of 7 to 17.

A man presented with a history of rash on his back, chest, and upper extremities that occurred after activities, such as exercise or yard work.

A 16-year-old girl and her parents presented to my office for her wellness evaluation. The patient has generalized anxiety disorder with comorbid major depression, for which she has been prescribed a serotonergic antidepressant. She is a high school student, lives with her…

Otitis media with effusion (OME) is defined as the presence of fluid in the middle ear in the absence of signs or symptoms of acute ear infection. This practice guideline from the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) provides recommendations to…

This study found that graduated extinction (increasing intervals between comforting the infant) and sleep fading (putting the child to bed progressively later until the parent finds the sweet spot) are both effective at decreasing sleep latency and the number of awakenings and…

Effective pain control in patients with low back pain is still elusive. Approximately one-half of all patients with low back pain who take an opioid analgesic will stop treatment because of ineffectiveness or adverse effects. Patients staying the course will experience, on…

There is very good agreement between arterial and venous measurements of pH and bicarbonate, and fairly good agreement at higher levels between arterial and peripheral measures of oxygen saturation. These authors suggest an algorithm for patients with acute exacerbation of COPD…

Evidence supports current guideline recommendations on the use of valproate medications to prevent migraine.

The epididymis is a tube attached to the back of the testicles that holds the sperm. If you have epididymitis, the epididymis is tender and swollen. Your scrotum may also be red and swollen, usually on one side, and it may hurt to urinate.