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  • Articles

    Vasectomy: Common Questions and Answers

    James J. Arnold, David Villanueva, Melissa Jane Puntkattalee

    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

    Victoria L. Boggiano, Rana Alkhaldi, Amir H. Barzin

    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...

    Colorectal Cancer Screening and Prevention

    Denise K. C. Sur, Phillip C. Brown

    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

    Nathan Falk, Rosa Joseph, Marvin Dieujuste

    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

    Hiten Patel, Rachael McGuirk

    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

    Andrea Westby, Mikaela Coburn-Pierce

    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

    Sumi Sexton

    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

    Chyke A. Doubeni, Mark H. Ebell, David Lieberman

    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

    Michelle Nelson

    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

    Brit Long, Michael Gottlieb

    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,...

    Cochrane for Clinicians

    RSV Vaccination During Pregnancy Improves Infant Outcomes

    Prakhya Bhatnagar, Elizabeth Tennant

    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

    Juan Qiu, Dongsheng Jiang

    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

    Aaron Caminos, Ryan Oliverio, Bradley Neddenriep

    A 51-year-old man presented with a swollen right knee.

    Newborn With Enlarged Bowel

    Melissa Jefferis, Bryce Ringwald

    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

    Megan Adelman, Megan L. Hull

    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

    Mark H. Ebell

    Which patients with acute abdominal pain and elevated lipase levels have acute pancreatitis?

    Diagnostic Tests

    EpiSwitch Prostate Cancer Screening Test

    Michael Partin, Seth Martin, Zakary Newberry

    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

    Samantha Pinedo, David Lin, Kris Sherwood, Jon O. Neher

    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

    William Bynum, Steven Thornton, Luna Dolezal

    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

    Fertility Treatments Might Be Associated With a Higher Incidence of Ovarian Cancer

    Linda Speer

    Fezolinetant Can Reduce Menopause Symptoms in Women Who Cannot or Will Not Take Hormone Therapy

    Allen F. Shaughnessy

    Multicancer Early Detection: Numbers Needed to Screen = 1,000 to Detect a Stage 1 or 2 Cancer, 530 to Detect Any Cancer

    Mark H. Ebell

    Treating Prediabetes With Tirzepatide Helps Obese Patients Lose Weight and Decreases Likelihood of Type 2 Diabetes

    Mark H. Ebell

    Practice Guidelines

    Management of Carpal Tunnel Syndrome: Guidelines From the AAOS

    Kerry P. Sadler, Denise R. Torbert, James K. Writer

    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

    Jeanne Spencer, Jessica Masser

    Treah Haggerty, Peris Kibera, Mollie Cecil; REPLY: Madhuri Rao, Randi Sokol, Allen F. Shaughnessy

    Racial Bias in the Medical One-Liner

    Reem Al-Atassi

    Chronic Topical Steroid Use Leading to Skin Atrophy

    Lynna J. Yang, Angela Jiang

    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...



    Disclosure

    All editors in a position to control content for this activity, AFP journal, are required to disclose any relevant financial relationships. View disclosures.


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