Clinical Practice Guidelines for Chronic Kidney Disease in Adults: Part I. Definition, Disease Stages, Evaluation, Treatment, and Risk Factors

CYNDA ANN JOHNSON, ANDREW S. LEVEY, JOSEF CORESH, ADEERA LEVIN, JOSEPH LAU, GARABED EKNOYAN

Early identification and treatment of chronic disease can prevent or delay some adverse outcomes. It is important to identify patients who are at risk for developing chronic kidney disease.

Diagnosis and Management of Scaphoid Fractures

T. GRANT PHILLIPS, ANDREW M. REIBACH, W. PAUL SLOMIANY

A high index of suspicion of scaphoid fracture and a thorough history and physical examination are necessary because the fracture may not be visible on early imaging. Snuffbox tenderness is highly sensitive for fracture; scaphoid compression pain and tenderness of the...

Asthma Update: Part I. Diagnosis, Monitoring, and Prevention of Disease Progression

MATTHEW MINTZ

Despite updated evidence-based guidelines from the National Asthma Education and Prevention Program, diagnosing and classifying patients with asthma remain challenging. Written action plans for patients are recommended, and monitoring of peak expiratory flow may offer further...

Community-Acquired Pneumonia in Infants and Children

MICHAEL OSTAPCHUK, DONNA M. ROBERTS, RICHARD HADDY

The cause of community-acquired pneumonia in infants and children is often difficult to determine. Laboratory tests are seldom helpful, especially in outpatients. The age of the child and the findings of the history and physical examination are the best information for...

AFP’s Editors Look Forward to Seeing You at Assembly

JANIS WRIGHT

AFP’s editors will be standing by to meet with you at the upcoming Annual Scientific Assembly of the American Academy of Family Physicians (AAFP). This year’s assembly, which will be held in conjunction with the 17th World Conference of Family Doctors, is scheduled for...

Newsletter

GENEVIEVE RESSEL

HHS Announces New Policy on Medicare Coverage for Obesity | NCHC Issues Report About Health Coverage for All Americans | HHS Releases Report at Summit on Health Information Technology | NIH Issues New Blood Pressure Guide for Children and Adolescents | CDC Reports That...

Quantum Sufficit

SARAH EVANS

There are two new Web sites from the U.S. Food and Drug Administration (FDA). As reported in FDA Consumer, FDA Heart Health Online (www.fda.gov/hearthealth) lists information on products for the prevention, diagnosis, and treatment of heart disease. Drugs@FDA (www.accessdata...

Creating Practice Guidelines for Chronic Kidney Disease: An Insider’s View

CYNDA ANN JOHNSON

Evidenced-based guidelines are still subjective. That statement summarizes the rather frightening conclusion I made after my first involvement in a large-scale effort to engage in literature review, synthesis, and preparation of evidenced-based guidelines as part of the...

Management of Patients with Newly Diagnosed Epilepsy: A Systematic Literature Review

SUSAN ROSS, RHONDA P. ESTOK, SAMEER S. CHOPRA, JACQUELINE FRENCH

As part of a multiphase project under contract with the Agency for Healthcare Research and Quality (AHRQ) and a topic nomination by the Centers for Disease Control and Prevention, we conducted a systematic review of the literature on interventions in patients with newly...

Diary

TONY MIKSANEK

“My elbow is giving me fits,” Wes proclaimed. “It’s gotten so bad in the last couple of weeks that it hurts just to lift a half gallon of milk out of the fridge.” The middle-aged man was a meat cutter who loved to golf. Wes’s right lateral epicondyle was very tender, and...

Home Oxygen Therapy for Treatment of Patients with Chronic Obstructive Pulmonary Disease

R. EUGENE BAILEY

There is good evidence that the addition of home long-term continuous oxygen therapy for COPD increases survival rates in patients with severe hypoxemia (i.e., O2 saturation of less than 90 percent or partial pressure of arterial oxygen [PaO2] of less than 8 kPa per 60 mm Hg)...

Cochrane Briefs

MARK H. EBELL

Effect of Exercise Intensity on Osteoarthritis

Cochrane Briefs

CLARISSA KRIPKE

Intensive Management of Gestational Diabetes

Genital Herpes

EVA M. JUNGMANN

What are the effects of interventions to prevent transmission and which reduce the impact of recurrence? What are the effects of treatments in people with a first episode of genital herpes? What are the effects of treatments in people with genital herpes and HIV infection?

Which Patients with Atrial Fibrillation Do Not Need Anticoagulation Therapy with Warfarin?

RICHARD A. GUTHMANN

Anticoagulation therapy with warfarin is not indicated for use in patients with non-valvular atrial fibrillation who are at low risk for embolic cerebral vascular events. The classification of “low risk for embolic stroke” is defined as a 1 percent annual risk for stroke or...

Swollen, Discolored Toes

BRIAN K. CROWNOVER, HEATHER M. JONES

Photo Quiz presents readers with a clinical challenge based on a photograph or other image.

Topiramate Prevents Migraines Better than Placebo

HENRY BARRY

Imiquimod Cream Is Effective for Basal Cell Carcinoma

DAVID SLAWSON

Cardiac Resynchronization for Advanced Heart Failure

MARK EBELL

Quality of Life in Patients with Multiple Sclerosis

HENRY BARRY

Efficacy of Various Interventions for Treatment of Infant Colic

ALLEN F. SHAUGNESSY

Patients Prefer Traditionally Dressed Physicians

ALLEN F. SHAUGHNESSY

Ginkgo Biloba Not Effective for Tinnitus

MARK EBELL

Tegaserod Effective for IBS Without Diarrhea

MARK EBELL

Low-Fat, High-Carbohydrate Diet in Older Patients

KARL E. MILLER

Prednisolone in Children with Respiratory Disease

RICHARD SADOVSKY

Effect of Juices on Nutritional Absorption of Iron in Children

KARL E. MILLER

Comparing Statin Effects on Lipoprotein Characteristics

RICHARD SADOVSKY

Predicting Healing in Diabetic Neuropathic Foot Ulcers

KARL E. MILLER

Sildenafil Is Safe and Effective in Men with Stable CAD

RICHARD SADOVSKY

Over-the-Counter Niacin Preparations for Dyslipidemia

RICHARD SADOVSKY

Memantine for Treatment of Alzheimer’s Disease

CAROLINE WELLBERY

No Cancer Mortality Benefit from Low-Tar Cigarettes

ANNE D. WALLING

Brain Natriuretic Peptide Marks Cardiac Causes of Syncope

RICHARD SADOVSKY

Impact of Seat-Belt Use on Other Car Occupants

CAROLINE WELLBERY

Exercise in Patients with Gestational Diabetes

KARL E. MILLER

Counseling About Smoking Cessation with Young Patients

KARL E. MILLER

Diagnosis of Cytomegalovirus in the Immunocompetent

BILL ZEPF

Ranolazine in Patients Taking Antianginal Medications

CAROLINE WELLBERY

Adjuvant Chemotherapy with Cisplatin for Lung Cancer

BILL ZEPF

Graded Exercise for Low Back Pain Reduces Work Absence

RICHARD SADOVSKY

How Does Maternal Asthma Affect Pregnancy Outcomes?

ANNE D. WALLING

CDC Issues Recommendations for Diagnosing, Managing, and Reporting Foodborne Illnesses

GENEVIEVE W. RESSEL

The Centers for Disease Control and Prevention (CDC) has issued new recommendations for diagnosing, managing, and reporting foodborne illnesses, in collaboration with the American Medical Association (AMA), American Nurses Association-American Nurse Foundation (ANA-ANF), the...

Practice Guideline Briefs

CARRIE MORANTZ, BRIAN TORREY

Update on Pneumococcal Conjugate Vaccine Shortage

Practice Guideline Briefs

CARRIE MORANTZ, BRIAN TORREY

Neuroimaging Tests for Cerebral Palsy

Clarification of Prostate Cancer Screening Recommendations

DAN MERENSTEIN

Milk-Like Serum Suggests Markedly Elevated Triglycerides

TERESA M. ALLEN, ANTHONY J. VIERA

Appearance of Pityriasis Rosea in Patients with Dark Skin

SHARON A. BRANGMAN

Foot Care for People with Diabetes

Diabetes causes the amount of sugar in your blood to be higher than normal. Over time, this can damage the nerves, arteries, and veins in your body. Nerve damage may cause burning pain or numbness in some part of your body. Damage to the arteries and veins means that your...

Ingrown Toenails

When a toenail is ingrown, the sides or corners of the nail curl under and dig into the skin at the side of the toe. This causes swelling, pain, and redness.

Fungal Infections of the Nails

A fingernail or toenail infection that is caused by a fungus is called onychomycosis (say: “on-ee-ko-my-ko-sis”). Toenails are more likely than fingernails to become infected. This infection can make your nails thick and discolored.