September 2024

Articles

Hair Loss: Diagnosis and Treatment

MaryAnn Dakkak, Klive M. Forde, Howard Lanney

Hair loss is characterized as diffuse, patterned, or focal. Androgenetic alopecia is the most common form, for which topical minoxidil is first-line treatment.

Urinary Catheter Management

Kyle J. Fletke, Dae Hyoun Jeong, Alexander V. Herrera

The three main types of urinary catheters are external urinary devices, clean intermittent catheterization, and indwelling urinary catheterization. Family physicians often aid in initial catheter choice, provide routine care, and address complications.

CMEAlgDDxArrhythmias

Palpitations: Evaluation, Management, and Wearable Smart Devices

Robert L. Gauer, Melanie F. Thomas, Ryan A. McNutt

The presence of palpitations is associated with a low mortality rate, but routine palpitations can impair quality of life. A detailed history, focused physical examination, directed laboratory studies, and electrocardiography are often sufficient to identify the etiology of…

Cushing's Syndrome: Rapid Evidence Review

David L. Maness, Grant Studebaker, Christopher M. Knight

Family physicians have an important role in recognizing the symptoms of Cushing's syndrome, ordering initial tests, referring patients to the appropriate specialists, and following up with patients and their families.

Alzheimer Disease: Treatment of Cognitive and Functional Symptoms

Ecler Ercole Jaqua, Mai-Linh N. Tran, Mary Hanna

Approximately 6.9 million people in the United States 65 years and older live with Alzheimer disease, a number expected to double by 2060. Although there is no cure for Alzheimer disease, treatments are available to manage symptoms.

Inside AFP

FREE

AFP's Article of the Year

Sumi Sexton

We are pleased to honor authors for their excellent scholarly contributions to family medicine by presenting the AFP Article of the Year Award, which is selected based on the most online views and highest ratings from the AFP editors.

Editorials

Familial Hypercholesterolemia: Screening, Diagnosis, and Treatment

Brian V. Reamy

Screening for and diagnosing familial hypercholesterolemia in childhood can lead to treatment with lifestyle changes and medication, reducing the serious vascular effects of this dyslipidemia.

FREEAlgHepatitis

Testing Infants and Children With Perinatal Exposure to Hepatitis C Virus

Amy L. Sandul, Carolyn Wester, Lakshmi Panagiotakopoulos

Early identification of hepatitis C exposure in infants can significantly improve outcomes.

Medicine by the Numbers

Decision Aids for Patients Facing Health Treatment or Screening Decisions

Kento Sonoda, Jiti Uppugunduri

Given the benefits of aids on decision-making without any significant harms, a color recommendation of green (benefits greater than harms) has been assigned for the use of decision aids for patients facing health treatment or screening decisions.

Cochrane for Clinicians

Surgical vs. Nonsurgical Treatment for Carpal Tunnel Syndrome

Bless Jung, Jeffrey Leggit, Patient Perspective by John James

Surgery for carpal tunnel syndrome probably results in some clinical improvement compared with splinting in the long term (more than 3 months), but it does not appear to lead to clinically significant improvement in symptoms or hand function. Similarly, surgery does not appear…

Treatment Options for Morton Neuroma

Dongsheng Jiang, Juan Qiu, Patient Perspective by John James

In patients with Morton neuroma, combined corticosteroid/local anesthetic injection does not improve pain, function, or quality of life at 3 to 6 months vs. local anesthetic injection alone. More adverse events, including skin and plantar fat pad atrophy and hypopigmentation…

AFP Clinical Answers

Putting Prevention Into Practice

Screening for Lipid Disorders in Children and Adolescents

Brandy Peaker, Patrick Dideum, Irina Arkhipova-Jenkins, Evan Finlay

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

U.S. Preventive Services Task Force

Screening for Lipid Disorders in Children and Adolescents

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger.

Diagnostic Tests

CCTA to Evaluate for Coronary Artery Stenosis in Intermediate-Risk Patients With Stable Chest Pain

Allison Karlan Kaplan, Nicholas Whitbeck

CCTA is preferred over ICA for evaluation of stable chest pain in intermediate-risk patients without known CAD because it is noninvasive, widely available, and has high patient satisfaction and lower procedural complications.

Lown Right Care

Routine Vitamin D Testing: Unnecessary and Ineffective

Andy Lazris, Alan Roth, Patient perspective by Helen Haskell, John James

A collaboration between AFP and the Lown Institute promotes a vision of delivering health care that is based on the evidence, balanced in its approach, and focused on the patient.

Point-of-Care Guides

PREVENT Equations for Assessing Cardiovascular Risk

Mark H. Ebell

Using demographic and laboratory data, what is the best way to assess the likelihood that a patient will experience a cardiovascular event in the next 10 or 30 years?

FPIN's Clinical Inquiries

Intra-Articular Steroids for Adhesive Capsulitis

Andrew K. Cunningham, Chih Kai (Kevin) Yang

Intra-articular steroid injections inconsistently improve pain and function when used to treat adhesive capsulitis in the short term (less than 12 weeks) and medium term (less than 6 months). Ultrasound guidance improves accuracy of injection into the glenohumeral joint, but…

Photo Quiz

Nail Abnormality for Several Months

Faith M. Butler

A 73-year-old woman presented with a nail abnormality.

Clavicle Deformity

Cheyenne Smith, Andrew Wood, Morteza Khodaee

A 20-year-old man presented with right shoulder pain.

STEPS

Resmetirom (Rezdiffra) for the Treatment of Noncirrhotic Nonalcoholic Steatohepatitis With Moderate to Advanced Fibrosis

Smriti Ohri, Maria Summa

Resmetirom may be considered in some patients with NASH, but it has not yet been shown to impact patient-oriented outcomes. Resmetirom is more expensive than alternative treatments and is not likely to be covered by all insurance plans.

POEMs

Practice Guidelines

Management of Chronic Coronary Disease: Guidelines From the American College of Cardiology and American Heart Association

Andrew Buelt, Mitchell Selco, Bristal Thompson

In 2023, the American College of Cardiology and American Heart Association released guidelines for management of chronic coronary disease, primarily for primary care physicians and cardiologists who provide care in the outpatient setting.

Otitis Media With Effusion in Children: Guidelines From NICE

Michael J. Arnold

The UK National Institute for Health and Care Excellence (NICE) released guidelines for the evaluation and treatment of otitis media with effusion.

CME Course Information

Evidence-based Medicine Toolkit

Strength of Recommendation Taxonomy

Advertising: Career Opportunities (PDF download)

Disclosures

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