February 15, 2018

Articles

Acute Migraine Headache: Treatment Strategies

Laura Mayans, Anne Walling

Migraine is a chronic condition characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen…

Vitamin D Screening and Supplementation in Community-Dwelling Adults: Common Questions and Answers

Michael L. LeFevre, Nicholas M. LeFevre

Measuring vitamin D levels and prescribing oral vitamin D supplementation are common in clinical practice, although the health benefits have not been established. Clinical trials have not found supplementation to be beneficial for chronic nonskelatal conditions, such as cancer…

Testicular Cancer: Diagnosis and Treatment

Drew C. Baird, Garrett J. Meyers, Jocelyn S. Hu

The U.S. Preventive Services Task Force recommends against routine testicular cancer screening in asymptomatic men. However, men with symptoms should receive a complete history and physical examination. Scrotal ultrasonography is the preferred initial imaging study. If a solid…

Editorials

Vitamin D Screening and Supplementation in Primary Care: Time to Curb Our Enthusiasm

Kenneth W. Lin

Evidence for vitamin D screening and supplementation in adults shows that these commonplace practices have virtually no established health benefits.

AFP News Now - AFP Edition

AAFP News: AFP Edition

MedPAC Recommends Replacing MIPS | AAFP Adopts Principles to Reduce Administrative Burden on Family Physicians | AAFP Unveils Toolkit to Screen for Social Determinants of Health | Physician Ratings, PQRS Data Added to CMS' Physician Compare Website

FPIN's Clinical Inquiries

Diabetes Education and Glycemic Control

Corey Lyon, Hannah Fields, Shannon Langner, Kristen DeSanto

Counseling by a diabetes educator or a team of educators delivered in a variety of formats may reduce A1C levels by 0.2% to 0.8% compared with usual care alone. Diabetes educators should be considered for patients who have higher baseline A1C levels (8% to 9%) because this…

Photo Quiz

Young Man with Acute Discoloration of the Left Eye

Farrakh Khawaja, Edna Cheng, Amanda Bergeron

A man with a history of intravenous drug use presented with malaise, fatigue, headache, and a redness in his left eye.

Point-of-Care Guides

Diagnosis of Urinary Tract Infections in Children

Mark H. Ebell, Christopher C. Butler, Alastair D. Hay

A recent observational study found that 2.2% of acutely ill children younger than five years met criteria for a UTI when their urine was cultured. However, in the same study, overall clinician impression that a UTI was present (fairly to very certain) identified only 28 out of…

Practice Guidelines

ACIP Releases 2018 Childhood Immunization Recommendations

Margot Savoy

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) reviews and updates the immunization schedule for children and adolescents 18 years or younger incorporating any previously published updates or corrections from the…

ACIP Releases 2018 Adult Immunization Recommendations

Margot Savoy

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) reviews and updates the adult immunization schedule annually, incorporating any previously published updates or corrections from the previous year.

POEMs

Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients with Cognitive Impairment

Henry C. Barry

In this meta-analysis, older patients with cognitive impairment who were exposed to light therapy had moderate improvements in behavioral disturbances, small improvements in sleep quality, and moderate improvements in depression. The authors did not report data on responders vs…

Lorazepam Added to Haloperidol Effective for Agitated Delirium in End-of-Life Cancer Patients

Nita Shrikant Kulkarni

Using a single dose of lorazepam in combination with haloperidol decreases agitation in end-of-life patients with cancer who had persistent agitated delirium despite scheduled haloperidol. A recent POEM reported that haloperidol increases symptoms of distress in patients with…

No Effect on Mortality with Oxygen Therapy in Nonhypoxemic Patients with Suspected MI

Nita Shrikant Kulkarni

In patients with suspected MI and normal oxygen levels, giving immediate supplemental oxygen therapy does not improve mortality at one year. Although this study was underpowered because of fewer than expected deaths in the control group, the results were consistent across all…

Single-Dose Oral Dexamethasone Decreases Sore Throat Pain

Allen F. Shaughnessy

Sore throats are rarely fatal anymore, but there is really no such thing as “just a sore throat.” Whereas antibiotics have no analgesic activity, a single low dose of a corticosteroid such as oral dexamethasone—0.6 mg per kg for children at least five years of age and up to 10…

Information from Your Family Doctor

Testicular Cancer

Testicular cancer is cancer that starts in one or both testicles. These are held inside a skin sack called the scrotum (see drawing).

CME Course Information

Evidence-based Medicine Toolkit

Strength of Recommendation Taxonomy

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Disclosures

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