October 2021

Onychomycosis is a chronic fungal infection of the fingernail or toenail bed, causing brittle, discolored, and thickened nails. Confirming the diagnosis with a potassium hydroxide preparation is recommended before initiating treatment, which can include oral or topical…

Serologic testing for immunoglobulin M anti–hepatitis A virus antibodies is used for diagnosis. Supportive care is often sufficient for treatment. Routine immunization is recommended for all children 12 to 23 months of age, persons at high risk of contracting the infection, and…

Bioterrorism is the deliberate release of viruses, bacteria, toxins, or fungi with the goal of causing panic, mass casualties, or severe economic disruption. Treatment includes proper isolation and administration of antimicrobial or antitoxin agents in consultation with…

In 40% of diabetes mellitus–related foot ulcers, related infections occur causing significant morbidity. Indicators of infection include erythema, induration, tenderness, warmth, and drainage. Antibiotic treatment duration is typically one to two weeks and is longer for slowly…

Osteomyelitis is an inflammatory condition of bone secondary to an infectious process. Diagnosis is usually based on imaging and laboratory findings. Bone biopsy and microbial cultures offer definitive diagnosis. Antibiotics are the primary treatment option. Surgical bony…

Air travel is generally safe, but it can pose physiologic challenges to some. To optimize health outcomes, communication between the traveler, family physician, and airline carrier should occur when there is any doubt about fitness for air travel.

The COVID-19 pandemic has drawn greater attention to the continuing discrimination that racial minorities face within the medical system. Often these disparities are considered in the context of patients who are not actively dying. However, care delivered at the end of life is…

Knowing that the high price of drugs is a major detriment to public health in the United States and that the pharmaceutical industry spends vast sums marketing to health care professionals, physicians should refuse visits, gifts, payments, and drug samples from pharmaceutical…

In 2016, for the first time, less than one-half of practicing physicians had an ownership stake in their own practices. The most recent American Medical Association Physician Practice Benchmark Survey reveals that this trend continues. More physicians are identifying as…

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

Compared with placebo, using antipsychotic drugs for maintenance therapy in patients with schizophrenia is associated with relapse prevention at seven to 12 months.

Behavioral interventions increase CPAP use compared with usual care. These interventions also increase CPAP adherence, measured by participants using their machine four or more hours per night, from 371 to 501 per 1,000 patients.

Series of short reports and quizzes based on guidelines from the USPSTF.

A patient presented with a polypoid, unpigmented mass on the top of the head that was raised and asymmetrical with slightly irregular borders.

A patient presented with a pruritic, nonscaly, ring-like rash on the dorsa of both hands.

Light therapy appears to be mildly effective in treating depression in older adults, but ideal wavelength, intensity, and length of treatment are unknown.

The available evidence does not support screening adults 65 years and older for visual impairment in the primary care setting.

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

The study found no significant difference in the rate of memory decline among older adults with CAD who are undergoing coronary revascularization with CABG or PCI.

Like the U.S. Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, this large and long U.K. study found no reduction in ovarian cancer mortality with screening using ultrasonography or a multimodal CA 125–based screening strategy.

This study found no significant difference between the standard-dose and high-dose regimens of amoxicillin/clavulanate for treating acute sinusitis in adults. It is important to note that both doses are minimally superior to placebo.

This propensity score–matched analysis (not funded by industry) concluded that an SGLT2 inhibitor is preferred over a sulfonylurea for patients with type 2 diabetes who are already taking a GLP-1 receptor agonist, with favorable effects on the likelihood of hospitalization for…

The American Heart Association released minor updates to neonatal resuscitation recommendations with only minor changes to the previous algorithm.

The American Society of Hematology has updated recommendations for management of VTE, which includes deep venous thrombosis (DVT) and pulmonary embolism (PE).

Learn more about ultrasound guidance for the placement of peripheral intravenous catheters.

Letter to the Editor

Reply: John R. McConaghy, Malvika Sharma, Hiten Patel

Reply: Ronald Goldschmidt, Carolyn Chu

Osteomyelitis (OSS-tee-oh-MY-uh-LIE-tiss) is an infection in a bone. It is caused by bacteria that spread through the blood from a wound or infection somewhere else in the body. In children, it usually occurs in the arms and legs. In adults, it usually affects the feet, spine…