AFP Clinical Answers

Nausea in Pregnancy, Knee Osteoarthritis, Hormone Replacement Therapy, Shingles


Am Fam Physician. 2019 Jan 1;99(1):10.

Welcome to AFP's newest feature.

The goal of this department is to share key clinical questions and their evidence-based answers directly from the journal's content. Our hope is that readers will find these answers useful for patient care and serve as a reminder of the topics we've covered. As I mentioned in my first editorial as editor-in-chief, I use AFP daily when seeing patients ( My reasons are that I'd prefer to use clinical information written by and for family physicians, and I don't believe in reinventing the wheel. Meaning that if I've read a good article already, I'd like to use that information again, akin to when I used to write notes in my family practice handbook. Thanks to the hard work of our authors, editors, and reviewers, AFP has a loyal following of readers who likely value the content the way I do. I'm on a mission to find ways to make this content practical and available for all aspects of patient care. If you have clinical questions, favorite articles, or tips on finding answers in AFP, please share them with us at

Sumi M. Sexton, MD

AFP Editor-in-Chief

What treatments are recommended for nausea and vomiting in pregnancy?

Treatment of nausea and vomiting in pregnancy should begin with lifestyle modifications, such as eating frequent small meals throughout the day to keep the stomach from becoming too empty or full, and avoiding foods that further slow gastric emptying (high-protein or fatty foods) or have intense smells or tastes. Other treatments, including P6 acupressure, vitamin B6 (pyridoxine), doxylamine, and prescription antiemetics, can be added as needed.

What is the clinical effectiveness of various therapies for knee osteoarthritis?

For short-term (four to 12 weeks) pain relief and/or functional improvement, beneficial interventions include transcutaneous electrical nerve stimulation (TENS), tai chi, and home-based exercise and self



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