December 2024

Noninvasive cardiac testing is most commonly used in the evaluation of patients with chest discomfort, shortness of breath, or other symptoms suspicious for acute coronary syndrome. Clinical prediction rules can guide risk assessment for patients with acute or stable chest…

Elevated transaminase levels may be associated with significant underlying liver disease and increased risk of liver-related and all-cause mortality. Patients should be counseled about moderation or cessation of alcohol, weight loss, and avoidance of hepatotoxic drugs.

Bone stress injuries are reactions to stress fractures; they are indicated by localized pain and loss of function, most often in the setting of sudden load volume changes. Palpatory bony tenderness is the most significant examination finding.

Prevention of these scars focuses on avoiding elective procedures in patients at high risk, reducing tension across the lesion, and decreasing the inflammatory response. Small keloids and most hypertrophic scars may respond well to conservative therapies, but large keloids…

Anemia in children is often asymptomatic. It can be caused by nutritional deficiency, genetic hemoglobin disorders, blood loss, or infection. Universal screening in the first year of life may be considered. Treatment typically involves oral iron supplementation or consumption…

Acute abdominal pain in children is a common presentation in clinic and emergency department settings. Narrowing the differential diagnosis can be done by using the age and symptoms of the patient. History and physical examination are critical in determining which cases are…

COVID-19 federal funding tied to continuous Medicaid coverage has ended. A loss in coverage will result in children not receiving required care.

Given the growing anti-sunscreen movement and increasing rates of skin cancer, clinicians should routinely include sun protection in their prevention discussions with patients.

SGLT-2 inhibitors are a valuable tool for preventing death and heart and kidney complications in patients with comorbid CKD and diabetes. Based on the evidence, we have assigned an NNT color of green (greater benefit than harm).

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

Prescription opioids continue to be commonly used for chronic noncancer pain, despite inherent risks. Primary care physicians and advanced practice clinicians have been integral to driving change in opioid prescribing, preventing overuse, and reducing risk.

Physical interventions improve the ability of people with cancer to return to work. Multidisciplinary training also improves the ability of people with cancer to return to work. However, neither of these types of interventions improves quality of life (QOL). Psychoeducational…

Compared with no psychological intervention, psychological interventions are safe and effective for improving depression, anxiety, and mental health–related quality of life at 6 to 12 months in patients with coronary heart disease or heart failure.

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.

A 68-year-old man presented with black discoloration of his great toe.

A 61-year-old woman presented with a painful cystic lump on her thumb.

Is there an accurate tool to assess bleeding risk in patients with atrial fibrillation when starting a direct oral anticoagulant to minimize the risk of stroke?

A total body weight loss of 5.1%, or 0.24% per week, results in clinically significant improvement in pain and disability in patients with overweight or obesity and knee osteoarthritis (OA). Although weight loss improves pain caused by knee OA, there is no known minimum level…

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

POEMs

POEMs

POEMs

POEMs

The American College of Obstetricians and Gynecologists has released recommendations for the management of premenstrual disorders in reproductive-aged adults and adolescents.

The Pediatric Infectious Diseases Society and Infectious Diseases Society of America have published guidelines for evaluation and treatment of suspected acute bacterial arthritis in otherwise healthy children older than 1 month.

Letter

Reply: Grace Walter, Anam Siddiqi, Alison Huffstetler

Bone stress injuries happen when bones get damaged from too much use. They can sometimes lead to fractures. They differ from traditional broken bones that happen after trauma, such as a fall. They are most common in the bones of your leg.

Incorrect CME Quiz Answers. In the “Answers to This Issue's CME Quiz” box (October 2024, p. 443), the answers listed for the first four questions were incorrect. The corrected answer box for the October 2024 CME quiz is reprinted below. The online CME quiz was not affected by…