• Articles

    Diabetic Ketoacidosis

    DAVID E. TRACHTENBARG

    Diabetic ketoacidosis occurs when a patient’s plasma glucose concentration is above 250 mg per dL, pH level is less than 7.30, and bicarbonate level is 15 mEq per L orless. Treatment involves fluids, insulin, and monitoring electrolyte levels.

    Hyperosmolar Hyperglycemic State

    GREGG D. STONER

    Hyperosmolar hyperglycemic state is a life-threatening emergency caused by infections,certain medications, noncompliance, undiagnosed diabetes, substance abuse,and coexisting diseases. Vigorous correction of dehydration followed by potassiumand insulin replacement is crucial.

    Evaluation of Palpable Breast Masses

    SUSAN KLEIN

    A thorough clinical breast examination, imaging, and tissue sampling are neededfor definitive diagnosis of breast masses. Fine-needle aspiration can differentiatesolid and cystic masses. Core-needle biopsy allows histologic diagnosis and differentiatesin situ and invasive...

    Initial Evaluation of the Patient with Suspected Dementia

    ALAN M. ADELMAN, MEL P. DALY

    Dementia is a common disorder in older patients. The initial evaluation of apatient with suspected dementia includes the Mini-Mental State Examination,blood chemistry profiles, and structural neuroimaging.

    Inside AFP

    AFP Articles–Start to Finish

    JOYCE A. MERRIMAN

    Receiving AFP on your desk is routine; you probably never even think about how it gets there. Perhaps you have written a manuscript for AFP and have wondered why it takes time process that involves many people in several states. First, submitted manuscripts are evaluated by...

    Newsletter

    Newsletter

    CARRIE A. MORANTZ

    Physicians May See Decrease in Medicare Payments in 2006 | AAFP Backs Effort to Give FDA Regulatory Control of Tobacco Products | HHS Begins Initiative to Reduce Obesity in Blacks | ChiT Web Site Offers Mentoring for Electronic Health Records | National Initiative Underway to...

    Quantum Sufficit

    Quantum Sufficit

    AMBER HUNTZINGER, LAURA COUGHLIN

    Is beer beneficial to the brain? The Washington Post reports on a recent study that found women who drank light to moderate amounts of beer or wine daily for four years were about 20 percent less likely to experience mental impairment in old age. The study, published in BMJ,...

    Editorials

    Hyperglycemic Crises: Improving Prevention and Management

    ABBAS E. KITABCHI

    Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are serious metabolic emergencies that affect patients with type 1 and type 2 diabetes. DKA and HHS are responsible for about 100,000 hospital admissions per year,1 and account for one of every four...

    Diary from a Week in Practice

    Diary

    TONY MIKSANEK

    “Doesn’t his face look unusually red?” Otis’s wife asked. Her 54-year-old husband had hypertension treated with sustained-release verapamil. He didn’t smoke cigarettes or consume alcohol. His wife was right; Otis had a ruddy face. Otis reported feeling tired and experiencing...

    Cochrane for Clinicians

    Anticonvulsant Medications for Migraine Prevention

    JOSHUA STEINBERG

    Good evidence supports the use of anticonvulsants as a class with overall reduction in number of headaches per month and overall increase in patients achieving 50 percent reduction of headache frequency. Of the medications within this heterogeneous group, valproic acid and...

    Is Pharmacotherapy Useful in Social Phobia?

    CLARISSA KRIPKE

    In adults, medications may improve the symptoms of social phobia in the short term, but their usefulness may be overstated because of publication bias. Selective serotonin reuptake inhibitors (SSRIs) have the strongest evidence of efficacy and the most favorable side-effect...

    Clinical Evidence Handbook

    Fibroids (Uterine Myomatosis, Leiomyomas)

    ANNE LETHABY, BEVERLEY VOLLENHOVEN

    Gonadorelin Analogues (GnRHa) Plus Progestogen (No Significant Difference in Heavy Bleeding Compared with GnRHa Alone, but Adding Progestogen Reduces Vasomotor Symptoms and Hot Flashes Associated with GnRHa). One small randomized controlled trial (RCT) found no significant...

    Putting Prevention Into Practice

    Screening for Family and Intimate Partner Violence

    Janelle Guirguis-Blake, Clodagh Cashman

    Case study: RS, a 37-year-old woman, comes to your office with her four children and elderly mother, who lives with them, for their routine check-ups. She says that her husband has to miss his appointment that day because of work. You see RS first.

    FPIN's Clinical Inquiries

    Management of Subclinical Hypothyroidism

    ANNAMARIE D. IBAY, LYNDA M. BASCELLI, JOAN NASHELSKY

    Treatment of subclinical hypothyroidism with levothyroxine may be of most benefit to patients with symptoms suggestive of hypothyroidism and those patients with thyroid-stimulating hormone (TSH) levels higher than 10 µIU per mL (10 mIU per L) or positive anti-thyroid...

    Photo Quiz

    “My Rings Won’t Fit Anymore”

    MICAH R. CHAN, MONICA ZIEBERT, DIANA L. MAAS, PENNAPA S. CHAN

    A 58-year-old woman presented to establish a primary care relationship. Her chief complaints were chronic pain of the hip and knee and excessive daytime sleepiness. Over the past few years, she felt that her body had been changing. She reported polyuria, excessive...

    POEMs

    Aerobic Exercise Effective for Mild to Moderate Depression

    DAVID SLAWSON

    Metoclopramide for Pain and Nausea in Patients with Migraine

    ALLEN F. SHAUGHNESSY

    Approach to Non-ST-Segment Elevation Acute Coronary Syndromes

    DAVID SLAWSON

    Hyperbaric Oxygen Therapy in Patients with Chronic Wounds

    HENRY BARRY

    Clinical Decision Rules and Stroke Risk in Atrial Fibrillation

    MARK EBELL

    Aspirin Plus PPI or Clopidogrel in Patients with GI Bleeding?

    MARK EBELL

    Popular Diets Equally Effective for Losing Weight

    DAVID SLAWSON

    Estrogen Increases the Risk of Gallbladder Disease

    DAVID SLAWSON

    Practice Guidelines

    AHRQ Releases Practice Guidelines for Celiac Disease Screening

    KAREN HELLEKSON

    The Agency for Healthcare Research and Quality has issued a systematic review of the evidence regarding screening patients for celiac disease. Celiac disease is also referred to as celiac sprue, gluten-sensitive enteropathy, and non-tropical sprue.

    Practice Guideline Briefs

    Practice Guideline Briefs

    MATTHEW J. NEFF

    AAP Releases Updated Breastfeeding Recommendations

    Practice Guideline Briefs

    MATTHEW J. NEFF

    Cesarean and Vaginal Birth After Previous Cesarean Delivery

    Curbside Consultation

    HIV Testing on Demand

    ANN HARVEY, RONALD H. GOLDSCHMIDT

    Two valuable questions are raised by this clinical dilemma in primary care. The first is whether it is appropriate to perform tests at a patient’s request without clear indications. The second is whether billing the insurance carrier for these tests is proper.

    Letters to the Editor

    Should Asymptomatic Bacterial Vaginosis Be Treated?

    Marjolin’s Ulcer in Chronic Hidradenitis Suppurativa

    VICTORIA A. CRAIN, SALIL GULATI, SATYANARAYANAN BHAT, STEPHEN M. MILNER

    Tips from Other Journals

    Disappointing Outcomes with Alzheimer’s Medication

    ANNE D. WALLING

    Negative LEEP Is Not Reassuring

    ANNE D. WALLING

    Standard-Dose Amoxicillin for Acute Otitis Media

    CAROLINE WELLBERY

    Steroids or Valacyclovir for Vestibular Neuritis

    BILL ZEPF

    Muscle Weakness as a Risk Factor for Falls in the Elderly

    CAROLINE WELLBERY

    Adolescent Exposure to Magazine Alcohol Advertising

    KARL E. MILLER

    Effect of Four Healthy Lifestyle Factors on Mortality Rates

    CAROLINE WELLBERY

    Use of Cephalosporin with Penicillin Hypersensitivity

    RICHARD SADOVSKY

    Management of Chronic Diarrhea

    RICHARD SADOVSKY

    Adverse Effects Associated with Use of Beta Blockers

    KARL E. MILLER

    Treatments for Acne Vulgaris Based On Severity

    CAROLINE WELLBERY

    Hypertension: Gaps Between Guidelines and Practice

    KARL E. MILLER

    American Ginseng Reduces Efficacy of Warfarin

    RICHARD SADOVSKY

    Cardiovascular Disease and Air Travel Safety

    RICHARD SADOVSKY

    Nebulized Lidocaine and Nasogastric Tube Insertion

    RICHARD SADOVSKY

    Soft Drinks Add to Weight Gain and Diabetes Risk

    CAROLINE WELLBERY

    Guidelines Unclear on Screening for Osteoporosis

    CAROLINE WELLBERY

    Efficacy of Psychotherapy Delivered by Telephone

    CAROLINE WELLBERY

    Information from Your Family Doctor

    Diabetic Ketoacidosis: What It Is and How to Prevent It

    Diabetic ketoacidosis (say: key-toe-acid-OH-sis), or DKA for short, happens when your body has high blood sugar (also called glucose) and a build-up of acid. If it isn’t treated, it can lead to coma and even death. It mainly affects persons with type 1 diabetes. But, it can...



    Disclosure

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


    Tag Legend

    Legend

    CME Continuing Medical Education Credit
    POC Point-of-Care Resource
    FREE Free Access
    Alg Algorithm
    DDx Differential Diagnosis
    PtEd Patient Education