February 2024

This article discusses types of foot fractures, common mechanisms of injury, nonsurgical management, and indications for orthopedic referral.

This article reviews current evidence and recommendations to manage hypertension, diabetes mellitus, alcohol withdrawal syndrome, and venous thromboembolism risk in hospitalized patients.

The number of deaths from poisonings increased 36% between 2019 and 2021, likely because of the public health crises of the opioid epidemic and the worsening of mental health associated with the COVID-19 pandemic. Family physicians may be involved in the triage, stabilization…

Cognitive behavior therapy is the first-line treatment for chronic insomnia; if it is not available or effective, short-term pharmacologic treatment may be considered. Physicians must also treat any underlying conditions that may be contributing.

Treatment of abnormal uterine bleeding in those using hormonal contraception can include adjustment of drug dosage and formulation, adding nonsteroidal anti-inflammatory drugs, and changing contraceptive methods.

The typical presentation of a urinary tract infection (UTI) includes frequency, urgency, dysuria/burning sensation, nocturia, and suprapubic pain or tenderness. More than 80% of UTIs occur in women. Clinical decision aids that integrate clinical findings with urine findings can…

There is much hope for patients with chronic insomnia given the expanding pipeline of medications and access to cognitive behavior therapy for insomnia.

Black patients with chronic kidney disease (CKD) are almost four times more likely to progress to end-stage renal disease (ESRD) than their White counterparts. The inequity in access to quality CKD and ESRD management and kidney transplants is multifactorial.

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

The Association of American Medical Colleges reported a shortage of 45,000 primary care phy-sicians in 2020 and projects shortages of 65,000 by 2025 and 104,900 by 2030. The shortage has been exacerbated by physician retirement due to the COVID-19 pandemic.

The review presents moderate- to high-certainty data that brexpiprazole is effective as an adjunct for treatment-resistant depression in adults 18 to 65 years of age. Based on these results and limitations, we have assigned a color recommendation of yellow (uncertain benefits).

Infliximab, bimekizumab (Bimzelx), ixekizumab (Taltz), and risankizumab (Skyrizi) are the most effective medications for achieving a 90% reduction in symptoms among patients with moderate to severe plaque psoriasis.

Does cannabis improve cancer-related pain control in adults compared with placebo or other standard analgesics?

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening performed by primary care clinicians for oral health conditions, including dental caries, in children and adolescents aged 5 to 17 years. The USPSTF…

Lp(a) measurement can characterize a patient’s risk of ASCVD beyond conventional risk calcu-lators, but there are no data from randomized tri¬als showing that direct Lp(a) reduction decreases ASCVD events.

What are the effectiveness, benefits, and harms of management strategies for hypertensive disorders of pregnancy during the postpartum period?

Exercise is beneficial for treating depression in adults older than 60 years. Exercise training is recommended for healthy older adults because it significantly decreases depressive symptoms.

A 35-year-old man presented with discomfort in his left eye.

A man presented with intermittent shortness of breath and paroxysmal cough.

POEMs

POEM

POEM

POEMs

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

These disorders can be difficult to recognize, and the American Psychiatric Association (APA) has released guidelines aimed to reduce the harm from eating disorders.

The American Society of Colon and Rectal Surgeons has released guidelines for the treatment of anal fissures.

Reply: Chyke A. Doubeni, Philip E. Castle

Letter

A urinary tract infection (UTI for short) is an infection in your bladder. It is also called cystitis (sis-TIE-tis). If you have a bladder infection, you may feel pain or burning when urinating or have an unusually strong urge to urinate. You may also urinate more often, see…

Incorrect Grading Scale. In the article “Bell Palsy: Rapid Evidence Review” (April 2023, p. 415), one of the grades in the House-Brackman scale for classifying symptom severity of Bell palsy was inadvertently omitted in the right column of page 416. The last two grades should…

Table Columns Switched. In the article “Growth Faltering and Failure to Thrive in Children” (June 2023, p. 597), the information in the “Water (oz)” and “Formula” columns was inadvertently switched in the “Liquid Formula” section of Table 4 (p. 601). Also, in the last sentence…

Incorrect Statistic. In the article “Preventing CVD in Women: Common Questions and Answers” (December 2023, p. 595), the numbers of cardiovascular events occurring in relation to age at onset of menopause were inadvertently listed in the wrong order in the first paragraph of…

Misplaced Figures. In the article “Nontraumatic Subarachnoid Hemorrhage and Ruptured Intracranial Aneurysm: Recognition and Evaluation” (October 2023, p. 386), the images in the left column of Figure 2 (p. 389) were placed incorrectly, resulting in the accompanying figure…