• Articles

    Diagnosing the Cause of Chest Pain

    WILLIAM E. CAYLEY, JR.

    Chest pain presents a diagnostic challenge in outpatient family medicine. Noncardiac causes are common, but it is important not to overlook serious conditions such as an acute coronary syndrome, pulmonary embolism, or pneumonia. In addition to a thorough history and physical...

    Complications of Body Piercing

    DONNA I. MELTZER

    The trend of body piercing at sites other than the earlobe has grown in popularity in the past decade. The tongue, lips, nose, eyebrows, nipples, navel, and genitals may be pierced. Complications of body piercing include local and systemic infections, poor cosmesis, and...

    Tick-Borne Relapsing Fever

    CLAY ROSCOE, TED EPPERLY

    Tick-borne relapsing fever is characterized by recurring fevers separated by afebrile periods and is accompanied by nonspecific constitutional symptoms. It occurs after a patient has been bitten by a tick infected with a Borrelia spirochete. The diagnosis of tick-borne...

    Prevention of Meningococcal Disease

    SANFORD R. KIMMEL

    Invasive disease caused by Neisseria meningitidis has an average annual incidence of one case per 100,000 in the United States. The disease can be rapidly fatal or result in severe neurologic and vascular sequelae despite antibiotic therapy. Antibiotic chemoprophylaxis with...

    Management of the Difficult Patient

    LEONARD J. HAAS, JENNIFER P. LEISER, MICHAEL K. MAGILL, OSMAN N. SANYER

    All physicians must care for some patients who are perceived as difficult because of behavioral or emotional aspects that affect their care. Difficulties may be traced to patient, physician, or health care system factors. Patient factors include psychiatric disorders,...

    Screening for Testicular Cancer: Recommendation Statement

    This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendation on screening for testicular cancer and the supporting scientific evidence and updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, 2d ed.1 In 1996,...

    Rash During Pregnancy

    ALYSSA A. DONNELLY, null MC, ROBERT F. BUTLER, null CDR, null MC, null USN

    A 22-year-old pregnant woman at 34 weeks of gestation presented with an itchy rash that had appeared several days earlier. The rash began on her lower abdomen and slowly spread to her thigh skinfolds, armpits, breasts, back, upper arms, and legs.

    Ezetimibe/Simvastatin (Vytorin) for Hypercholesterolemia

    JENNIFER D. GOLDMAN-LEVINE, null C.D.E., LYLE G. BOHLMAN

    Ezetimibe/simvastatin (Vytorin) is a combination of ezetimibe (Zetia), which inhibits the absorption of cholesterol by the small intestine, and simvastatin (Zocor), a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, or statin. Ezetimibe/simvastatin, in conjunction...

    Inside AFP

    AFP Benefits from Medical Editing Clerkship

    JOYCE A. MERRIMAN

    American Family Physician is fortunate to have available many resources of Georgetown University Medical Center, Washington, D.C., to support our publication. Several of the medical editors are Georgetown faculty members, including the editor, Jay Siwek, M.D. In addition,...

    Newsletter

    Newsletter

    SARAH J. EVANS

    AAFP Survey Shows Increased Use of EHR Systems by FPs | AHRQ Launches New Health Care Program | AAFP Asks Members to Join Title VII Campaign | AHRQ Rewards Over $22.3 Million for Health Information Technology | Number of Malpractice Claims Filed Reduced, but Cases More Severe...

    Quantum Sufficit

    Quantum Sufficit

    MEREDITH DESMOND

    Can crocodiles save human lives? Scientists in Australia say it’s possible. The scientists began studying the immune systems of alligators and crocodiles when they realized the animals quickly healed from violent territorial attacks that often left them wounded or limb-less....

    Editorials

    Time of Hope for the Eventual Elimination of Meningococcal Strains A, C, Y, and W-135 in the United States

    RICHARD KENT ZIMMERMAN

    In this issue of American Family Physician, Dr. Kimmel expertly reviews meningococcal disease and meningococcal vaccines.1

    Trial of Labor After Cesarean Delivery: The Making of a Recommendation

    ERIC WALL, RICHARD ROBERTS, MARK DEUTCHMAN, WILLIAM HUESTON, LESLEY A. ATWOOD, BELINDA IRELAND

    The recommendations on trial of labor versus elective cesarean delivery for women with a previous cesarean delivery, summarized in this issue of American Family Physician,1 represent the work of a policy team appointed by the American Academy of Family Physicians (AAFP)...

    Graham Center Policy One-Pagers

    Who Will Have Health Insurance in 2025?

    If current trends continue, U.S. health insurance costs will consume the average household’s annual income by 2025. As health care becomes unaffordable for most people in the United States, it will be necessary to implement innovative models to move the system in a more...

    Diary from a Week in Practice

    Diary

    PAUL GROSS

    The last time I started a new job was 14 years ago. Just out of residency, I accepted a faculty position in a community hospital because I thought it would be fun to teach, because I liked the idea of varied responsibilities, and because I wanted time at home with our brand...

    POEMs

    Role of Vitamin E in Preventing Cancer or Cardiovascular Disease

    DAVID SLAWSON

    Atomoxetine Does Not Slow Height and Weight Growth

    ALLEN F. SHAUGHNESSY

    Tips from Other Journals

    Impact of Depression Treatment on Functioning in Older Adults

    CAROLINE WELLBERY

    Macrolide Resistance in Streptococcus Pneumoniae

    ANNE D. WALLING

    Early Diagnosis of Imperforate Hymen May Prevent Morbidity

    CAROLINE WELLBERY

    Antimicrobial Prophylaxis for Surgical-Site Infections

    ANNE D. WALLING

    Diagnosis and Treatment of Pertussis in Adults

    CHUCK CARTER

    Adjuvant Chemotherapy Benefits All Breast Cancer Patients

    CAROLINE WELLBERY

    CBT and Medication for Panic Disorder

    KARL E. MILLER

    Prescribing Smoking Cessation Medications at Well-Child Visit

    CAROLINE WELLBERY

    Assessing Older Patients’ Ability to Drive Safely

    ANNE D. WALLING

    Effects of Clopidogrel in ST-Segment Elevation MI

    CHUCK CARTER

    Antipsychotic Use and Cardiac Events

    KARL E. MILLER

    Do Structured Home Visits Prevent Functional Decline?

    CAROLINE WELLBERY

    New Medication for Reducing Obesity Shows Promise

    ANNE D. WALLING

    School Suicide Screening Does Not Promote Suicidal Thoughts

    CAROLINE WELLBERY

    Adjuvant Steroid Therapy for Managing Pharyngitis

    ANNE D. WALLING

    Does Vaginal Candidiasis Affect Genital HIV Shedding?

    KARL E. MILLER

    Subjective Cognitive Complaints Predict Cognitive Decline

    CAROLINE WELLBERY

    Practice Guidelines

    AAFP Releases Guidelines on Trial of Labor After Cesarean Delivery

    ERIC WALL, RICHARD ROBERTS, MARK DEUTCHMAN, WILLIAM HUESTON, LESLEY A. ATWOOD, BELINDA IRELAND

    The American Academy of Family Physicians (AAFP) has released an evidence-based clinical practice guideline on trial of labor after cesarean delivery (TOLAC). The recommendations replace the AAFP clinical recommendation on trial of labor versus elective repeat cesarean...

    Practice Guideline Briefs

    CDC Reports on Illnesses in Hurricane Katrina Evacuees and Relief Workers

    CARRIE A. MORANTZ

    Hurricane Katrina struck the U.S. Gulf Coast on August 29, 2005, resulting in extensive structural damage and severe flooding from breached levees in and around New Orleans. In the four weeks after the hurricane made landfall, a total of 7,508 illnesses and injuries were...

    Letters to the Editor

    Letters to the Editor

    Tramadol for Acute Pain: A Review of the Evidence

    Letters to the Editor

    Encounter Form for Patients with Acute Knee Injuries

    Case Report: Expanding the Differential Diagnosis of Intractable Cough

    RAHUL K. SHAH, MICHAEL DITKOFF, COLLIN S. KARMODY

    Information from Your Family Doctor

    Body Piercing: What You Should Know

    Body piercing is when a hole is made in your skin so you can add a piece of jewelry for decoration.

    Tick-Borne Relapsing Fever: What You Should Know

    Tick-borne relapsing fever (or TBRF, for short) is an illness caused by a bite from ticks that have a germ called Borrelia (say: buh-REL-ee-uh). If you have TBRF, you probably have fevers that come and go. You also might have headaches and stomachaches. Your body might be...

    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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