August 2021

Although generally healthy, about 20% of students who attend college have special health care needs, including asthma, diabetes mellitus, and learning, mental health, and substance use disorders. Physicians can facilitate the transition of a youth to an adult model of health…

There are more than 200 types of human papillomavirus (HPV). HPV infection can be latent and subclinical, or have a presentation ranging from benign cutaneous and mucosal lesions to life-threatening clinical carcinomas. Screening for HPV infection effectively identifies…

Dysmenorrhea is common and usually independent of pelvic pathology. Secondary dysmenorrhea may present with progressive worsening of pain, abnormal uterine bleeding, or dyspareunia. Nonsteroidal anti-inflammatory drugs and hormonal contraceptives are first-line medical options…

Breast cancer is the leading cause of cancer deaths in women worldwide and the second most common cause of death from cancer in women in the United States. Primary care physicians are often the first point of contact for patients with a new diagnosis of breast cancer.

Sinus node dysfunction describes disorders related to abnormal conduction and propagation of electrical impulses at the sinoatrial node that interfere with pacemaker function. A diagnosis is made by directly correlating symptoms with a brady-arrhythmia and eliminating…

The presentation of pertussis, or whooping cough, is variable and evolves over the course of illness, which often includes a catarrhal, paroxysmal, and convalescent stage. Diagnosis should be confirmed using polymerase chain reaction testing. Immunity typically wanes two to…

Race does not have a biologic definition, but rather a political and social one that is fluid and independent of science. Nevertheless, the medical community uses race as a scientific variable in several prominent clinical situations, including calculation of atherosclerotic…

Previous Graham Center Policy One-Pagers published in AFP have provided timely perspectives on a range of topics. In 2020, the Graham Center, in collaboration with IBM Watson Health and the American Board of Family Medicine, produced a chartbook of statistics on the current…

Despite representing only one-third of the physician workforce in the United States, primary care physicians (PCPs) are the first contact with the health care system for most patients. A 2010 report by the Council on Graduate Medical Education recommended that 40% of the…

According to a meta-analysis including prospective observational studies evaluating the accuracy of ultrasonography for the diagnosis of small bowel obstruction, ultrasonography appears to be highly sensitive and specific for this use.

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

The levonorgestrel-releasing intrauterine system is more effective than other medical therapies at reducing menstrual bleeding volume, with similar rates of adverse effects. The effectiveness of the levonorgestrel-releasing intrauterine system compared with endometrial ablation…

Pioglitazone prevents or delays the incidence of type 2 diabetes in individuals with prediabetes when compared with placebo or no intervention. Compared with metformin, however, pioglitazone does not reduce the incidence of type 2 diabetes in those with prediabetes.

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

What are the benefits and harms of diagnostic testing, and what is the effectiveness of treatment options for acute colonic diverticulitis?

First-person accounts from the front lines of family medicine.

A patient presented with a red, slightly raised papule on the anterior chest wall.

A patient presented with stiffness and pain in his lower back and both thighs and an abnormal CT scan.

Chlorthalidone reduces systolic blood pressure by 10 mm Hg more than hydrochlorothiazide at equal dosages in patients using monotherapy. Low-dose chlorthalidone and controlled-release hydrochlorothiazide reduce 24-hour ambulatory systolic blood pressure and diastolic blood…

Physical activity appears to be associated with a lower risk of developing depression and depressive symptoms.

SGLT2 inhibitors, the diabetes medications ending in -flozin, and GLP-1 receptor agonists, the -tide medications, decrease cardiovascular and renal outcomes to a greater extent than placebo or other treatments. They should be considered in addition to metformin and other…

This study found that more than one-half of the adults (51%) who had been hospitalized for COVID-19 reported a significant amount of persistent symptoms four months after discharge.

Inhaled budesonide, 800 mcg twice daily, significantly reduces the likelihood that patients with early COVID-19 will require emergency department evaluation or hospitalization (number needed to treat = 7 to 8). This is a widely available, relatively inexpensive drug with the…

Orthostatic hypotension, a drop of 20 mm Hg systolic or 10 mm Hg diastolic after moving from sitting to standing, was not associated with more intensive treatment of blood pressure and may be less likely to occur with intensive treatment.

The American College of Rheumatology published updated guidelines for gout management focused on improving prevention of flare-ups.

The American Gastroenterological Association developed guidelines for the evaluation of IDA in adults.

Reply: Elizabeth Salisbury-Afshar

Reply: John M. Wilkinson, Don (Chamil) Codipilly, Robert P. Wilfahrt

Many people have some crampy pain with their periods, especially as teenagers. The pain often is low in the pelvis and starts just before your period or at the beginning of your period. It often lasts one to three days. The pain can be bad enough to keep you from doing things…