July 2021

Unintentional weight loss in people older than 65 years is associated with increased morbidity and mortality. Treatment should focus on feeding assistance, addressing contributing medications, providing appealing foods, and social support.

The annual installment of this series summarizes the top studies of 2020. These studies were summarized as POEMs (patient-oriented evidence that matters) and were highly rated by Canadian Medical Association members for their clinical relevance. This group of the highest-rated…

Complex regional pain syndrome is a rare, chronic disorder that leads to pain that may last for years. The disease typically develops four to six weeks after direct trauma, such as an injury or surgery. Diagnosis is made clinically using standardized diagnostic criteria. The…

Strategies to prevent mother-to-child transmission include maternal and infant antiretroviral therapy and formula-feeding instead of breastfeeding. All infants born to mothers with HIV infection should receive antiretroviral postexposure prophylaxis within six to 12 hours after…

Acetaminophen and nonsteroidal anti-inflammatory drugs are the first-line treatment options for most patients with mild to moderate acute pain. Severe acute pain may necessitate reserved short-term use of opioids with attention to minimizing risk.

Costochondritis is a common cause of chest pain. The diagnosis is largely based on history and a physical examination that demonstrates reproduction of pain through palpation of the parasternal region of the chest wall, performance of a crowing rooster maneuver, and/or a…

Can prioritizing primary care save the U.S. health care system?

To share its perspective on the state of the science, the FDA has published a table of pharmacogenetic associations related to genetic variants that can affect drug concentrations, therapeutic responses, or adverse events.

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

A Cochrane review compared the levonorgestrel-releasing intrauterine system with progesterone for the treatment of endometrial hyperplasia.

Surgical treatment for AC joint dislocation of the shoulder does not appear to be superior to conservative management in adults. Surgical therapy increases the risk of hardware complications, infection, and continued discomfort.

SARS-CoV-2 antigen tests have an average sensitivity of 68.9% and an average specificity of 99.6%. Accuracy depends on symptom status, time from symptom onset, and test brand.

This PPIP quiz is based on the recommendations of the USPSTF.

A patient develops erythema and warmth on the arm two weeks after receiving the first dose of the mRNA-1273 vaccine against the SARS-CoV-2 virus.

A patient with multiple medical conditions presented with nonpurulent cellulitis and MRSA bacteremia.

Social isolation and loneliness are increasingly recognized as complex clinical and public health problems, particularly in older adults, leading to adverse mental and physical health outcomes. The COVID-19 pandemic has led to physical distancing policies, which have…

The GeneSight test may assist in drug selection and dosing for individuals having difficulty finding an effective option or who have had intolerable adverse effects after trials of several drugs. However, because only a small population of patients are expected to have genetic…

Selective serotonin reuptake inhibitors and risperidone are moderately effective at decreasing agitation in all types of dementia. Olanzapine and risperidone reduce dementia-related agitation much longer than placebo. Dextromethorphan/quinidine may be effective at reducing…

More comparative data are needed to justify the use of clascoterone over less expensive, currently available therapies for moderate to severe acne. However, systemic absorption of clascoterone is low, and it may serve as a safe alternative for patients 12 years and older who…

Patients with type 2 diabetes can try cutting out bread and pasta, leaving the skin on chicken, or eating nuts and avocados to lower their blood glucose levels. Six months of a low-carbohydrate diet (less than 26% of calories from carbohydrates) was more likely than other diets…

A single dose of opioid analgesics provides similar acute pain relief compared with a single dose of a combination of acetaminophen and ibuprofen in patients with acute musculoskeletal pain in the emergency department.

Once-weekly subcutaneous semaglutide used as an adjunct to intensive behavioral therapy significantly improves the likelihood that adults without diabetes who are overweight or obese will lose at least 5% of their baseline body weight compared with placebo.

Initial cryoablation for patients with paroxysmal AF is superior to initial antiarrhythmic drug therapy. Another study in the same issue of New England Journal of Medicine compared cryoablation with medical therapy and had similar findings.

The U.S. Department of Veterans Affairs and U.S. Department of Defense published guidelines for the primary care management of COPD.

The American Academy of Family Physicians has published guidelines for treating acute exacerbations of COPD based on a systematic review.

The American Thoracic Society published guidelines for pharmacologic management of COPD and long-term oxygen therapy for COPD and interstitial lung disease based on systematic reviews.

The American Academy of Family Physicians has published guidelines for treating acute exacerbations of COPD.

Reply: Balraj Sing, Parminder Kaur

Reply: David A. Klein, Jillian Sylvester, Natasha A. Schvey

Letter

Reply: Heather L. Paladine, Himabindu Ekanadham, Daniela C. Diaz

HIV is the virus that causes AIDS. It is possible to have HIV infection for a long time before developing AIDS.