March 1, 2020

Articles

Point-of-Care Ultrasonography

Michael J. Arnold, Christopher E. Jonas, Rachel E. Carter

Point-of-care ultrasonography (POCUS) reduces cost, radiation exposure, and imaging delays, and increases patient satisfaction. POCUS is useful in resource-limited settings, and the use of POCUS in primary care is increasing. When compared with formal sonography, POCUS is as…

Sexual Health History: Techniques and Tips

Margot Savoy, David O'Gurek, Alexcis Brown-James

Family physicians should proactively provide a patient-centered approach to sexual health that includes disease identification and treatment. They also should be prepared to discuss topics such as erectile dysfunction and dyspareunia. Physicians and staff should be trained in…

Upper Gastrointestinal Bleeding in Adults: Evaluation and Management

Thad Wilkins, Brittany Wheeler, Mary Carpenter

Upper gastrointestinal bleeding is hemorrhage from the mouth to the ligament of Treitz. Common risk factors include prior upper gastrointestinal bleeding, anticoagulant use, high-dose nonsteroidal anti-inflammatory drug use, and older age. Causes include peptic ulcer bleeding…

Editorials

HIV Status, Preexposure Prophylaxis, Sexual Health, and the Critical Role of Family Physicians

Adam Visconti

Family physicians play a key role in expanding HIV testing and treatment, as well as providing sexual health services in areas where specialty sexual health services are not readily available.

AFP Clinical Answers

Colorectal Cancer Screening, Breastfeeding, Miscarriage, Eczema, Routine Screening for Children

Key clinical questions and their evidence-based answers directly from the journal's content, written by and for family physicians.

Cochrane for Clinicians

Vitamin and Mineral Supplementation for Maintaining Cognitive Functioning in Cognitively Healthy Adults

Drew C. Baird, Justin R. Stewart

Vitamin and mineral supplementation has little to no beneficial effect on preserving cognitive functioning or preventing dementia in cognitively healthy adults 40 years and older.

Music Therapy for Depression

Donna Cohen, Elizabeth Maxwell

Moderate-quality evidence shows that music therapy added to standard care is more effective in the first three months than standard care alone for depressive symptoms based on clinician-rated outcomes and patient-reported outcomes.

Curbside Consultation

Emotional Support Animals: Considerations for Documentation

Alice H. Tin, Peter Rabinowitz, Heather Fowler

Companion animals are increasingly viewed as part of the family, and studies show many mental and physical benefits of pet ownership. Federal regulations require patients to obtain health care professional documentation for emotional support animals to allow these animals to…

Photo Quiz

Tense Bullae and Pruritus

Matthew D. Vesely, Brianna A. Olamiju, Jonathan S. Leventhal

A 72-year-old man presents with a two-month history of worsening pruritic rash and painful blisters on his trunk, bilateral upper and lower extremities, face, and groin.

Diagnostic Tests

IDx-DR for Diabetic Retinopathy Screening

Margot Savoy

IDx-DR is a reliable screening tool used to diagnose diabetic retinopathy in the primary care office and may reduce barriers to screening and improve gaps in eye care for those with diabetes.

POEMs

Thromboembolism Recurrence Likely; Consider It a Chronic Disease

Allen F. Shaughnessy

Perhaps it is time to start thinking about VTE as a chronic disease. Approximately one in 10 patients that have a VTE will have a second VTE over the next 12 months and almost four in 10 will have a second VTE over 10 years.

Linagliptin and Glimepiride Equally Effective for Adults with Type 2 Diabetes Mellitus

David C. Slawson

This study found that linagliptin is noninferior to glimepiride for reducing the risk of cardiovascular death, myocardial infarction, and stroke in adults with type 2 diabetes at an increased risk of cardiovascular disease.

Fewer Severe Exacerbations in Patients with Mild to Moderate Asthma Treated with As-Needed Budesonide Plus Formoterol Compared with Maintenance Budesonide

Henry C. Barry

Patients with mild to moderate asthma only need relief treatment. In this study, patients taking the combination of budesonide/formoterol (Symbicort) as needed had slightly fewer severe exacerbations than patients treated with twice daily budesonide (Pulmicort).

Guideline for Chronic Diarrhea: Screening for IBD and Celiac Disease Is In, Screening for Ova and Parasites Is Out

Allen F. Shaughnessy

Although an algorithm to guide the workup is not offered, the American Gastroenterological Association suggests the following tests for patients with chronic diarrhea (i.e., watery diarrhea for at least four weeks): fecal calprotectin or fecal lactoferrin to screen for…

Practice Guidelines

Tuberculosis Screening, Testing, and Treatment in U.S. Health Care Professionals: CDC Releases Updated Recommendations

According to 1995–2007 surveillance data reported to the Centers for Disease Control and Prevention and National Tuberculosis Controllers Association work group, tuberculosis incidence rates in health care professionals were similar to those in the general population.

Medicine by the Numbers

Probiotics to Prevent Antibiotic-Associated Diarrhea in Children

Elizabeth A. Suniega, D. Jason Frasca

Antibiotics often disrupt the natural balance of nonpathogenic bacterial flora within the gastrointestinal tract. Learn more about the effectiveness of probiotics in preventing antibiotic-associated diarrhea in children.

FPIN's Clinical Inquiries

Tai Chi for Fibromyalgia

Lynn M. Wilson, Zahra Raza, Linda Contillo Garufi, Drew Keister, Joan Nashelsky

The practice of Yang-style tai chi for one hour twice weekly for 12 to 24 weeks is moderately effective in improving quality of life in patients with fibromyalgia.

CME Course Information

Evidence-based Medicine Toolkit

Strength of Recommendation Taxonomy

Advertising: Career Opportunities (PDF download)

Disclosures

All editors in a position to control content for this activity, AFP journal, are required to disclose any relevant financial relationships. View disclosures.

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