July 15, 2020

Articles

Shoulder Dystocia: Managing an Obstetric Emergency

D. Ashley Hill, Jorge Lense, Fay Roepcke

Shoulder dystocia is an obstetric emergency where normal traction on the fetal head does not lead to delivery of the shoulders. It can cause neonatal brachial plexus injuries, hypoxia, and maternal trauma. Most cases occur without warning, but prior shoulder dystocia and…

Syphilis: Far from Ancient History

Jason Ricco, Andrea Westby

Rates of primary, secondary, and congenital syphilis are increasing in the United States, and reversing this trend requires renewed vigilance on the part of family physicians. Prompt diagnosis can be challenging because not all infected patients have common manifestations. All…

Asymptomatic Bacteriuria

Richard Colgan, Gregory A. Jaffe, Lindsay E. Nicolle

Asymptomatic bacteriuria, defined as the presence of bacteria in the urine in the absence of urinary symptoms, is a common clinical finding that often warrants a decision about whether to initiate antimicrobial therapy. Treatment is not beneficial for most patients, and…

Editorials

Closing Primary and Prenatal Care Gaps to Prevent Congenital Syphilis

Kenneth W. Lin

Family physicians can prevent congenital syphilis by following national screening guidelines; taking accurate, detailed sexual histories; providing evidence-based interventions to people who use injection drugs; and advocating to reduce structural barriers to care.

AFP Clinical Answers

Venous Ulcers, Dementia Care, SARS-CoV-2 Swabs, Telehealth

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

U.S. Preventive Services Task Force

Screening for Bacterial Vaginosis in Pregnant Persons to Prevent Preterm Delivery: Recommendation Statement

The USPSTF recommends against screening for bacterial vaginosis in pregnant persons who are not at increased risk for preterm delivery.

Photo Quiz

Inflamed, Purulent Axillary Nodules

Afsaneh Alavi, Monica Shah, Na-Young Cindy Kang

A man presented with several years of recurrent painful cysts and scarring, accompanied by severe pruritus and malodorous purulent discharge.

FPIN's Help Desk Answers

Acetaminophen for Pain Relief in Osteoarthritis

David M. Siebert, Marie Cadwell Meyer, Eric Jensen

Acetaminophen is no better than placebo for relief of hip or knee pain due to osteoarthritis. Although acetaminophen does provide some pain relief, the effect is small and not clinically significant.

STEPS

Dapagliflozin (Farxiga) for Preventing Hospitalization for Heart Failure

Jeffrey Tingen, John D. Gazewood

Dapagliflozin can be added to existing treatment to reduce the risk of hospitalization for heart failure in patients with type 2 diabetes who have established CVD or are at high risk of CVD. It may also decrease the risk of renal disease progression and death from renal failure.

POEMs

Mailing gFOBT or FIT Directly to Patients Increases Uptake of Colorectal Cancer Screening

Mark H. Ebell

Mailed outreach significantly increases rates of colorectal cancer screening, with four tests needing to be mailed to screen one person.

Increasing the d-Dimer Threshold for Patients with Low Clinical Pretest Probability Effectively Rules Out PE

Nita Shrikant Kulkarni

The Pulmonary Embolism Graduated d-Dimer strategy increases the number of patients in the emergency department and outpatient setting who have PE ruled out via d-dimer testing, thus decreasing the need for chest imaging.

No Cow's Milk Formula for the First Three Days of Life Prevents Food Allergies

Henry C. Barry

In infants at increased risk of atopy, restricting cow's milk supplementation for the first three days of life is associated with a significantly lower risk of developing a cow's milk allergy or food allergies by 24 months of age.

Mind-Body Treatments Enhance Opioid Treatment of Patients with Acute or Chronic Pain

Allen F. Shaughnessy

Using mindfulness, meditation, hypnosis, therapeutic suggestion, and cognitive behavior therapy, in addition to opioid treatment of acute or chronic pain, provides an additional benefit to patients by reducing pain scores.

Practice Guidelines

Community-Acquired Pneumonia: Updated Recommendations from the ATS and IDSA

Carrie Armstrong

The American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) recently updated their recommendations on the diagnosis and treatment of community-acquired pneumonia.

Letters to the Editor

Differential Diagnosis of Muscle Weakness in Adults

Josef Finsterer

Reply: Jason Wilbur, Scott T. Larson

Skin Disorders in Patients with Skin of Color

Manasa Irwin, Amy Crawford-Faucher

Reply: Kenny Lin

Case Report: Flavored Vaping–Associated Hypokalemia

Sateesh Sakhamuri, Sanjeeva Goli, Surujpal Teelucksingh

Letters to the Editor from AFP reader regarding flavored vaping–associated hypokalemia.

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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