Articles
Vasectomy: Common Questions and Answers
In the United States, 13% of vasectomies are performed by family physicians. Vasectomy is as safe and effective as tubal sterilization and more cost-effective.
Cardiac Rehabilitation: Indications, Benefits, and New Approaches
Cardiac rehabilitation, supervised programs to improve cardiovascular health through exercise, education, and emotional counseling for those who have had a cardiac event, involves structured exercise and lifestyle risk factor modification. It also focuses on long-term goals to…
Colorectal Cancer Screening and Prevention
Adults with average risk of colorectal cancer, but no signs or symptoms of the condition, should be screened with stool-based fecal immunochemical testing or a direct visualization method such as colonoscopy beginning at 45 years of age.
Lymphadenopathy: Evaluation and Differential Diagnosis
Because the differential diagnosis for lymphadenopathy is extensive and includes serious conditions, a stepwise approach is important. Although the cause of lymphadenopathy usually can be identified with a history and physical examination, laboratory tests, imaging, or biopsy…
Vitamin B12 Deficiency: Common Questions and Answers
Risk factors for vitamin B12 deficiency include malabsorptive processes, limited dietary intake, use of certain medications, and older age. Symptoms vary based on the severity. Although universal screening is not recommended, testing should be considered in patients with at…
Autism Spectrum Disorder in Primary Care
Diagnosis of autism spectrum disorder requires deficits in three areas of communication and social interaction, with at least two restricted or repetitive behaviors, not explained by another condition, and causing functional impairment. Treatment of children focuses on…
Inside AFP
AFP's Article of the Year: Diagnosing Common Benign Skin Tumors
The 2024 AFP Article of the Year award goes to Drs. Joy Shen-Wagner, Joel Amidon, and Stephen Carek for “Diagnosing Common Benign Skin Tumors.”
Editorials
Maximizing the Benefits of Noninvasive Colorectal Cancer Screening Tests in Primary Care
The effectiveness of noninvasive screening methods for colorectal cancer depends on the patient receiving prompt follow-up colonoscopy after a positive result.
Thinking Through Testing for Primary Thyroid Disease
Thyroid hormone testing is widely used in primary care; however, many asymptomatic patients are tested, leading to the overtreatment of subclinical disease.
Medicine by the Numbers
Parenteral Agents for Mitigating Migraine Relapse
This meta-analysis found that corticosteroids, lidocaine, ergot agents, neuroleptics, opioids, and sedatives or hypnotics reduced the risk of migraine relapse and that corticosteroids, lidocaine, and combination therapy reduced the risk of severe migraine relapse. However, due…
Cochrane for Clinicians
RSV Vaccination During Pregnancy Improves Infant Outcomes
Maternal RSV vaccination during pregnancy leads to fewer infant hospitalizations with laboratory-confirmed RSV disease compared with placebo. Maternal RSV vaccination during pregnancy likely makes little to no difference in intrauterine growth restriction or congenital…
Galantamine for Dementia due to Alzheimer Disease and Mild Cognitive Impairment
In people with mild to moderate Alzheimer disease, treatment with galantamine, 8 to 12 mg twice daily, slows the decline in cognitive function, behavioral function, and functional disability at 6 months compared with placebo. Galantamine also slows the decline in global…
Photo Quiz
Unilateral Knee Swelling
A 51-year-old man presented with a swollen right knee.
Newborn With Enlarged Bowel
A 24-hour-old infant born was evaluated for emesis that was not bilious or bloody.
STEPS
Donanemab (Kisunla) for the Slowing of Alzheimer Disease
Although donanemab offers more convenient dosing than lecanemab, it remains an expensive, difficult-to-administer option for patients with early Alzheimer disease that does not alter disease progression in a clinically significant manner compared with placebo. Oral treatments…
Point-of-Care Guides
Diagnosis of Acute Pancreatitis Using a Clinical Risk Score
Which patients with acute abdominal pain and elevated lipase levels have acute pancreatitis?
Diagnostic Tests
EpiSwitch Prostate Cancer Screening Test
Current evidence for EpiSwitch prostate screening (PSE) is limited to a single case-control study with a small sample size. No prospective screening trials have evaluated its effect on patient-oriented outcomes, such as disease-specific mortality rates. Therefore, the PSE…
FPIN's Clinical Inquiries
Oral Prostaglandins for Labor Induction
In pregnant patients with PROM, oral prostaglandins (eg, misoprostol) are as effective as intravenous (IV) oxytocin infusion for achieving vaginal delivery within 24 hours of initiation. Use of oral misoprostol is associated with similar risks of uterine hyperstimulation…
Curbside Consultation
Shame Competent Response to Medical Error
Although a medical error that leads to a procedural complication is not inherently shameful in and of itself, it brings with it a high risk of shame because the error is a clear shortcoming of the standard to first do no harm. Colleagues have an opportunity to provide shame…
POEMs
Practice Guidelines
Management of Carpal Tunnel Syndrome: Guidelines From the AAOS
The American Academy of Orthopaedic Surgeons (AAOS) has published guidelines on the management of carpal tunnel syndrome.
Letters to the Editor
Responses to Editorial on Prescribing GLP-1 Agonists for Weight Loss
Treah Haggerty, Peris Kibera, Mollie Cecil; REPLY: Madhuri Rao, Randi Sokol, Allen F. Shaughnessy
Chronic Topical Steroid Use Leading to Skin Atrophy
Letter to the Editor
Corrections
Correction
Incorrect placement of drug in treatment algorithm. In the article “Treatment of Chronic Insomnia in Adults” (February 2024, p. 154), Figure 1 (p. 156) lists doxepin as a medication for sleep onset. Doxepin should instead have been listed as a medication for sleep maintenance…