• Articles

    Prevention of Falls in Older Patients

    SHOBHA S. RAO

    Falls, which are associated with increased morbidity and mortality, are a common threat to the independence of older persons. Strategies that involve multifactorial risk assessment and interventions are most effective in preventing falls.

    Diabetic Nephropathy: Common Questions

    MICAH L. THORP

    Diabetes has become the leading cause of end-stage renal disease in the United States. Early treatment delays or prevents the onset of diabetic nephropathy, but there is insufficient evidence to determine whether tight blood sugar control and use of angiotensin-converting...

    Health Effects of Garlic

    ELLEN TATTELMAN

    Garlic has long been used medicinally, most recently for its cardiovascular, antineoplastic, and antimicrobial properties. Side effects generally are mild and uncommon.

    Diagnosis and Management of Fragile X Syndrome

    DANIEL J. WATTENDORF, MAXIMILIAN MUENKE

    Fragile X syndrome is caused by a mutation in the Fragile X mental retardation 1 gene that can lead to mental retardation. Premature ovarian failure and ataxia may be present in some relatives of persons with fragile X syndrome. It is important to diagnose affected patients...

    Diagnosis of Acute Coronary Syndrome

    SURAJ A. ACHAR, null KUNDU, WILLIAM A. NORCROSS

    In a patient presenting with symptoms that suggest acute coronary syndrome, the initial assessment requires a focused history (including risk factor analysis), a physical examination, an electrocardiogram, and, frequently, serum cardiac marker determinations.

    Inside AFP

    Look What’s New in AFP

    JOYCE A. MERRIMAN

    This issue of AFP presents some new features that are intended to meet readers’ needs and increase the value of the publication. Please feel free to tell us how you like them; you can e-mail us atafpedit@aafp.org or mail the comment card included in every issue.

    Newsletter

    Newsletter

    CARRIE A. MORANTZ

    Five States Pass Medical Liability Reform Legislation | Physician Supply Increases in States with Caps on Malpractice Awards | HHS Approves Second Multistate Drug Purchasing Pool | AMA Primer Aims to Help Physicians Improve Immunization Rates | AHRQ Awards $8 Million in...

    Quantum Sufficit

    Quantum Sufficit

    AMBER HUNTZINGER, LAURA COUGHLIN

    When choosing a doctor, does a patient’s race influence the decision? Researchers surveyed more than 3,500 white, black, and Latino patients and found that many black and Latino patients believe racism exists in the health care system, and those who have this perception are...

    Editorials

    Genetic Testing: When to Test, When to Refer

    ROBERTA A. PAGON

    Although genetic testing includes the analysis of DNA, RNA, chromosomes, proteins, and certain metabolites, it is DNA- and RNA-based molecular genetic testing that has catapulted into mainstream medicine during the past decade.1,2 Molecular genetic testing is now available on...

    Diary from a Week in Practice

    Diary from a Week in Practice

    TONY MIKSANEK

    Competitive sports can bring out the best in people, but once in a while, athletics also bring to light something unexpected. “This is going to sound weird, but my heart’s not right,” Hailey disclosed in a previous visit. She began having episodes of rapid heart-pounding...

    Cochrane for Clinicians

    Low-Molecular-Weight Heparin for Initial Treatment of Venous Thromboembolism

    DAN BREWER

    LMWH is safer and more effective than unfractionated heparin for initial treatment of venous thromboembolism.

    Cochrane Briefs

    Antibiotics for Acute Laryngitis in Adults

    MARK H. EBELL

    Two small trials of antibiotic treatment in acute laryngitis do not support routine use of antibiotics in these patients. Most patients will feel better in five to seven days, and it is unlikely that they will experience a clinically important benefit from antibiotics.

    Follow-up After Surgically Treated Breast Cancer

    MARK H. EBELL

    The best available evidence supports clinical breast examinations every three to six months for five years and annual mammography for asymptomatic breast cancer survivors. More intensive follow-up and subspecialist visits do not improve survival.

    Clinical Evidence Concise

    Gonorrhea

    JOHN MORAN

    What are the effects of treatments for uncomplicated infections in men and nonpregnant women? What are the effects of treatments for uncomplicated infections in pregnant women? What are the effects of treatments for disseminated gonococcal infection?

    FPIN’s Clinical Inquiries

    Raloxifene for Prevention of Osteoporotic Fractures

    SABINA DIEHR, SARA MIJAL, MEDICAL STUDENT, JOAN NASHELSKY

    Raloxifene (60 mg daily for three years) will prevent one vertebral fracture, including asymptomatic fractures, for every 46 postmenopausal women with osteoporosis or presence of previous vertebral fractures. Raloxifene has not been shown to prevent nonvertebral fractures. It...

    Putting Prevention Into Practice

    Screening for Genital Herpes

    JANELLE GUIRGUIS-BLAKE, TRACY A. WOLFF

    Case study: MS, a 26-year-old woman, has arrived for her first prenatal visit. She is in the eighth week of her third pregnancy. Her previous pregnancies were uncomplicated with normal-term deliveries. Although she has never had any sexually transmitted diseases or symptoms...

    Photo Quiz

    Multiple Erythematous Plaques of the Trunk

    BRIAN B. ADAMS, VITALY BLATNOY

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

    Graham Center One-Pager

    The Family Physician Workforce: The Special Case of Rural Populations

    People living outside metropolitan areas, especially those living in rural counties, depend on family physicians. Resolving the disparities in physician distribution nationwide will require solutions to make rural practice a viable option for more health care workers.

    POEMs

    Melatonin Effective for Some Sleep Disorders

    ALLEN F. SHAUGHNESSY

    St. John’s Wort vs. Paroxetine in Moderate to Severe Depression

    ALLEN F. SHAUGHNESSY

    Once-Daily Topical Steroid Dosing Just as Effective for Atopic Eczema

    MARK EBELL

    Milk Intake and Increased Risk of Acne in Teenage Patients

    DAVID SLAWSON

    Celecoxib Increases Risk of Cardiovascular Complications

    MARK EBELL

    Tips from Other Journals

    Prevention of Breast Cancer with Tamoxifen

    ANNE D. WALLING

    Inappropriate Prescribing for Older Patients

    KARL E. MILLER

    Selecting Patients for Cardiac Resynchronization

    RICHARD SADOVSKY

    New Concepts in Bell’s Palsy Improve Treatment Options

    ANNE D. WALLING

    Androgen Therapy for Effects of Aging in Older Men

    RICHARD SADOVSKY

    Practice Guidelines

    ACOG Guidelines on Urinary Incontinence in Women

    CARRIE A. MORANTZ

    Recommendations on the diagnosis and treatment of urinary incontinence in women have been released by the American College of Obstetricians and Gynecologists (ACOG).

    Practice Guideline Briefs

    ACOG Guidelines on the Management of Human Papillomavirus Infection

    CARRIE A. MORANTZ

    The American College of Obstetricians and Gynecologists (ACOG) has released guidelines on the clinical management of women with human papillomavirus (HPV) infection.

    Which Patients Benefit from CRT?

    LAURA COUGHLIN

    The American Heart Association has published a science advisory on selecting patients for cardiac resynchronization therapy (CRT).

    Letters to the Editor

    Discussion of Protective Effects of Hydrochlorothiazide

    Weighing the Risks and Benefits of Emergency Contraception

    Long-Term Standard-Dose Warfarin to Prevent Thrombosis

    PATRICK J. DEPENBROCK

    Imiquimod to Treat Basal Cell and Squamous Cell Carcinomas

    CURTIS D. KELLER

    Information from Your Family Doctor

    How to Prevent Falling

    Older people who fall can hurt themselves badly. Injuries from a fall can range from bruises and cuts to more serious problems like a broken hip. Falls may keep an older person from living alone. Some older people may not do certain things because they are afraid of falling.

    Diabetic Nephropathy

    Diabetes can affect many parts of the body, including the kidneys. Blood vessels in the kidneys clean the blood. These vessels can be damaged if diabetes is not controlled. This can cause kidney disease, also called nephropathy (say: nef-RAH-puh-thee). If the damage is bad...

    Corrections

    Correction



    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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