• Articles

    Diverticular Disease: Diagnosis and Treatment

    HOLLY SALZMAN, DUSTIN LILLIE

    Outpatient management is appropriate for clinically stable, uncomplicated diverticulitis. Inpatient management is necessary for patients who need intravenous fluids, or antibiotics, bowel rest, and aggressive management of symptoms.

    Hemoptysis: Diagnosis and Management

    JACOB L. BIDWELL, ROBERT W. PACHNER

    True hemoptysis usually can be differentiated from pseudohemoptysis and hematemesis by a history and focused physical examination. Some patients may require fiberoptic bronchoscopy or high-resolution computed tomography.

    Respecting End-of-Life Treatment Preferences

    MONICA K. CRANE, MARSHA WITTINK, DAVID J. DOUKAS

    Despite widespread support for advance care planning, few Americans have living wills or other advance directives. Family physicians can help integrate medical knowledge, individual values, and cultural influences into end-of-life care.

    Diagnosis and Management of G6PD Deficiency

    JENNIFER E. FRANK

    This enzyme deficiency is an X-linked inherited disorder that can cause a spectrum of disease but is rarely fatal. Clinical presentations include acute hemolytic anemia, chronic hemolytic anemia, and neonatal hyperbilirubinemia.

    Milk Thistle

    FRANCINE RAINONE

    CAM Used since ancient times to treat liver and gallbladder disease, this herb has been investigated as a cytoprotectant for the treatment and prevention of cancer and as a supportive treatment for Amanita phalloides poisoning.

    Management of Spontaneous Abortion

    CRAIG P. GRIEBEL, JOHN HALVORSEN, THOMAS B. GOLEMON, ANTHONY A. DAY

    Up to 20 percent of recognized pregnancies end in spontaneous abortion. Surgical evacuation of the uterus is the treatment of choice in unstable patients, but patient preferences should be considered for patients without complications.

    Inside AFP

    Your Feedback is Requested

    JOYCE A. MERRIMAN

    Our ability to publish the kind of journal you want and need depends on feedback from you. Your input helps us make appropriate decisions to improve the journal. The survey below was distributed at the publications booth during the recent Scientific Assembly in San Francisco....

    AAFP News Now: AFP Edition

    Newsletter

    CARRIE MORANTZ

    Selected policy and health issues news briefs from AAFP News Now.

    Quantum Sufficit

    Quantum Sufficit

    LISA GRAHAM

    New memories may erase old cravings, according to a study published in the Proceedings of the National Academy of Sciences. Researchers found they could influence people to crave strawberry ice cream less after implanting false suggestions about bad childhood experiences with...

    Graham Center Policy One-Pagers

    Physician Assistant and Nurse Practitioner Workforce Trends

    The physician assistant (PA) and nurse practitioner (NP) workforces have realized explosive growth, but this rate of growth may be declining. Most PAs work outside primary care; however, the contributions of PAs and NPs to primary care and interdisciplinary teams should not...

    Editorials

    Improving Physical Therapy Referrals

    JENNIFER JOYCE, JANICE KUPERSTEIN

    Research suggests that “primary care physicians will refer more patients to physical therapists when they have more knowledge about physical therapy, recognize physical therapists’ capabilities to diagnose, and believe in the … effectiveness of physical therapy intervention....

    Rationale for the USPSTF Recommendation on Screening for Glaucoma

    JANELLE GUIRGUIS-BLAKE

    In March 2005, the U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to recommend for or against screening adults for glaucoma.1The recommendation and associated evidence review2 updated the 1996 recommendation on this topic, for which the USPSTF also...

    Diary from a Week in Practice

    Diary

    JOHN O’HANDLEY

    Fatigue is a nonspecific symptom but a common complaint of many patients. Deidre knew something was not right, yet she wasn’t one to seek medical attention lightly. Ten months postpartum, she had lost 70 lb of her pregnancy weight and was hoping to lose more, having gained...

    Cochrane for Clinicians

    Intra-articular Corticosteroid for Treating Osteoarthritis of the Knee

    STEVEN E. ROSKOS

    An injection of the knee joint with a corticosteroid may improve the patient’s symptoms for up to three weeks after the injection (number needed to treat [NNT]= 3 to 4). There is no evidence that this intervention improves function, and there is little evidence of the...

    Cochrane Briefs

    Does a Low Glycemic Index Diet Reduce CHD?

    CLARISSA KRIPKE

    Does a Low Glycemic Index Diet Reduce CHD?

    Lower- vs. Higher-Dose Estrogen for Contraception

    CLARISSA KRIPKE

    Although no difference in effectiveness has been demonstrated in existing trials, too few patients have been studied to detect small but clinically important differences in pregnancy rates. Low-dose estrogen pills have higher rates of discontinuation and bleeding disturbances.

    Clinical Evidence Handbook

    Postnatal Depression

    LOUISE HOWARD

    What are the effects of drug and nondrug treatments?

    Photo Quiz

    “Klingon Head”

    RAYMOND T. KUWAHARA, MICHAEL SWANN, CARLOS GARCIA

    A 15-year-old adolescent presented with concerns about the appearance of his scalp (see accompanying figure). The patient wished to know what was causing the skinfolds because schoolmates were teasing him, calling him “Klingon Head.” The skinfolds first appeared in late...

    FPIN's Clinical Inquiries

    Combined Oral Contraceptives for Mothers Who Are Breastfeeding

    RICHARD A. GUTHMANN, JANE BANG, JOAN NASHELSKY

    There is currently no evidence of harm; however, few patients have been studied and existing studies have many limitations. Therefore, it is not possible to definitively answer this question at this time. The existing low-quality evidence suggests that combined oral...

    POEMs

    Rehabilitation vs. Spinal Fusion for Chronic Low Back Pain

    ALLEN F. SHAUGHNESSY

    Weight Loss Interventions Have Little Effect on Quality of Life

    HENRY BARRY

    No Antibiotics Necessary for Lower Respiratory Tract Infection

    DAVID SLAWSON

    Sildenafil Equal to Bosentan in Pulmonary Hypertension Therapy

    HENRY BARRY

    Curbside Consultation

    A Sex Offender as a Patient

    ROBERT PRENTKY

    Before addressing the particulars of this scenario, it may be helpful to review the current status of notification laws, which have evolved in the last decade. It is important to keep in mind that the presumptive purpose of community notification through registration is...

    Practice Guidelines

    New AHA Recommendations for Blood Pressure Measurement

    LIZ SMITH

    The American Heart Association (AHA) has published a new set of recommendations for the measurement of blood pressure to increase accuracy of clinic readings, and in recognition of major changes over the past 10 years (including the prohibition of mercury in many countries).

    Practice Guideline Briefs

    AAP Report on Pregnancy in Adolescents

    LAURA COUGHLIN

    The American Academy of Pediatrics (AAP) recently published a clinical report on the state of adolescent pregnancy in the United States. The average age at first intercourse is 16 years for males and 17 years for females.

    Freestanding Urgent Care Facilities: Recommendations by the AAP

    LAURA COUGHLIN

    The Committee on Pediatric Emergency Medicine of the American Academy of Pediatrics (AAP) has released a policy statement that provides recommendations to guide the care of young patients in emergency situations and the timely transfer from urgent care facilities to the...

    AAP Clinical Report on Diabetic Retinopathy

    LAURA COUGHLIN

    A clinical report reviewing the risk factors and screening guidelines for diabetic retinopathy in children has been released by the American Academy of Pediatrics (AAP), in conjunction with the American Association for Pediatric Ophthalmology and Strabismus (AAPOS).

    Letters to the Editor

    Self-Inflicted Harm Is Not an Indication of Suicidal Behavior

    VICTORIA M. HAYES

    Update on Outpatient Treatment of Systolic Heart Failure

    KEVIN FISCELLA

    Tips from Other Journals

    Tension-Free Vaginal Tape for Women with Incontinence

    ANNE D. WALLING

    Is Patient Satisfaction Related to Patient Expectations?

    CAROLINE WELLBERY

    Is Glucosamine Effective for Osteoarthritis of the Knee?

    KARL E. MILLER

    Treating Mild to Moderate Inflammatory Acne Vulgaris

    ANNE D. WALLING

    Social and Cultural Barriers to Cervical Cancer Screening

    ANNE D. WALLING

    Zafirlukast Treatment in Patients with Acute Asthma

    KARL E. MILLER

    Predicting the High Cost of Obesity

    CAROLINE WELLBERY

    How Well Does Ultrasonography Diagnose Cholecystitis?

    ANNE D. WALLING

    Clinical Findings in Outpatient Anorexia Nervosa

    CAROLINE WELLBERY

    Antiepileptic Drugs and Brain Tumor–Related Seizures

    ROXANA DIBA

    Will Linezolid Eradicate MRSA from Surgical Sites?

    ANNE D. WALLING

    Betamethasone Ineffective for Rotator Cuff Tendinosis

    KARL E. MILLER

    Warfarin Use in Patients with Atrial Fibrillation

    KARL E. MILLER

    Do Antibiotics Reduce Morbidity When Used After PROM?

    ANNE D. WALLING

    Does Cholesterol Affect Heart Disease Risk in Older Patients?

    CAROLINE WELLBERY

    Spiral CTPA in Patients with Suspected PE

    KENNETH LIN

    Progesterone Reduces Preterm Birth in High-Risk Mothers

    ANNE D. WALLING

    Routine Varicella Vaccination Reduces Mortality

    CHUCK CARTER

    Can Hemoglobin A1C Levels Predict Diabetes Risk?

    CAROLINE WELLBERY

    Degree of Cardiovascular Risk from Use of Rofecoxib

    ANNE D. WALLING

    Fetal Pulse Oximetry Reduces Operative Deliveries

    KARL E. MILLER

    Evaluation and Treatment of Brown Recluse Spider Bites

    CHUCK CARTER

    Discontinuing NSAIDs Increases Risk for Acute MI

    KARL E. MILLER

    Attitudes About Elective Primary Cesarean Delivery

    ANNE D. WALLING

    Intervention in Childhood Improves Adult Functioning

    KARL E. MILLER

    Aspirin and NSAIDs: Role in Fecal Occult Blood Testing

    KARL E. MILLER

    Can Examination Findings Predict Osteoporosis Risk?

    CAROLINE WELLBERY

    Does Mifepristone Induce Labor in Term Pregnancies?

    KARL E. MILLER

    Information from Your Family Doctor

    Diverticular Disease: What You Should Know

    Diverticular (say: die-ver-TICK-yoo-ler) disease affects the bowel. It is caused by pouches called diverticula (say: die-ver-TICK-yoo-luh) that can form in the wall of the large intestine (see drawing).

    Advance Directives

    An advance directive is a plan for how you would make health care choices if you became very sick. If you became too sick to make decisions, your doctor would look at your advance directive to know what you would want. There are two types of advance directives. One is called...

    Sleepwalking in Children

    Sleepwalking happens when a child partly wakes up during the night. If your child sleepwalks, he or she may walk or do other things and not remember them the next day. Your child may sit up in bed and rub his or her eyes or fumble with clothes. The child may get out of bed...

    Insomnia: How to Get a Good Night’s Sleep

    People who have insomnia (say: “in-SOM-nee-uh”) may not be able to fall asleep. They may wake up at night and not be able to fall back asleep, or they may wake up too early in the morning.

    Sleep Changes in Older Adults

    Most adults need about eight hours of sleep to feel fully alert when they’re awake. This usually is true for people 65 years or older. But as you get older, you might have more trouble sleeping. Many things can get in the way of sleeping well or sleeping long enough to be...

    Sleep Apnea

    People with sleep apnea (say: AP-nee-uh) stop breathing for 10 to 30 seconds at a time while they are sleeping. This can happen hundreds of times every night. If you have sleep apnea, you may wake up from deep sleep. Sleep apnea keeps you from getting enough rest and can...

    Nightmares and Night Terrors in Children

    Nightmares are scary dreams. Most children have them from time to time. One out of every four children has nightmares more than once a week. Most nightmares happen between 4 a.m. and 6 a.m. Your child may wake up and come to you for comfort. He or she might be able to tell...



    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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