• Articles

    Diagnosis and Treatment of Community-Acquired Pneumonia

    M. NAWAL LUTFIYYA, ERIC HENLEY, LINDA F. CHANG, STEPHANIE WESSEL REYBURN

    When a patient presents with suspected community-acquired pneumonia, the physician should first assess the need for hospitalization, then choose an appropriate, cost-effective treatment using a mortality prediction tool combined with clinical judgment.

    Nonhormonal Therapies for Hot Flashes in Menopause

    DANA G. CARROLL

    The risks of hormone therapy prompt many women with hot flashes to look for alternatives. Selective serotonin reuptake inhibitors and venlafaxine appear to be effective options; soy isoflavones, red clover, and black cohosh may be helpful, but the results of trials are...

    Evaluation and Treatment of Constipation in Infants and Children

    WENDY S. BIGGS, WILLIAM H. DERY

    In most children, constipation is functional and the result of stool retention. However, family physicians should remain alert for warning signs that may indicate the presence of an organic cause of constipation. Treatment of functional constipation involves disimpaction...

    Pancreatic Cancer: Diagnosis and Management

    ROBERT FREELOVE, ANNE D. WALLING

    Computed tomography is the first-line imaging and staging tool for pancreatic cancers. For those cancers advanced at the time of diagnosis, palliation is the best treatment. Pain can be managed with opioid analgesics, radiation therapy, chemotherapy, or celiac plexus neurolysis.

    Corrections

    Corrections

    Medicare Part D: Who Wins, Who Loses?

    The Medicare Part D prescription drug benefit aims to relieve the burden of out-of-pocket prescription drug costs for persons older than 65 years, but its effects will vary. Persons with low income and those without prior prescription coverage are projected to save the most,...

    Out-of-Pocket Prescription Costs a Continuing Burden Under Medicare Part D

    Of 29 million expected Part D beneficiaries, 6.9 million are projected to have annual out-of-pocket medication expenses greater than $750. Accounting for one fourth of all Part D enrollees, these beneficiaries also are most likely to have high aggregate health care costs,...

    Mind the Gap: Medicare Part D’s Coverage Gaps May Affect Patient Adherence

    Medicare Part D will lower medication expenditures for many older patients. However, its complex design incorporates a staggered series of cost-sharing mechanisms that create gaps in coverage and may have a negative impact on medication adherence.

    Nonsteroidal Anti-inflammatory Drugs

    PETER C. GØTZSCHE

    Are there any important differences between available nonsteroidal anti-inflammatory drugs (NSAIDs)? What are the effects of cotreatments on reducing the risk of the adverse gastrointestinal effects of NSAIDs? What are the effects of topical NSAIDs?

    Vaginal Misoprostol for Cervical Ripening in Term Pregnancy

    SALLY P. WEAVER, JESSICA COOK, JOAN NASHELSKY

    Low-dose (25 mcg) intravaginal misoprostol appears to be safe and effective for cervical ripening in term pregnancy for patients without a history of cesarean section. Compared with other cervical ripening methods, misoprostol has an increased rate of vaginal delivery within...

    Inside AFP

    Survey Results Guide Quality Improvement Efforts

    JOYCE A. MERRIMAN

    Everyone involved with AFP is dedicated to continuous quality improvement. We want and need to know what AFP readers want in their publication. One of the many ways we obtain input from readers is by conducting a survey of visitors to the publications booth at the American...

    Newsletter

    Newsletter

    LIZ SMITH

    HHS Awards $56.9 Million to Eliminate Health Disparities | FDA and AHRQ Collaborate to Strengthen Research and Communication | AAFP Board Releases List of Desired Retail Health Clinic Attributes | Fogarty Center Awards $6.5 Million to Drug Discovery Research Projects | Texas...

    Quantum Sufficit

    Quantum Sufficit

    LISA GRAHAM

    The trauma experienced by victims of stalking is often underestimated, according to a study published in the British Journal of Psychiatry. Authors of the study sent 3,700 surveys to men and women living in Victoria, Australia. Of the 1,844 people who completed and returned...

    Editorials

    Medicare Part D: Practical and Policy Implications for Family Physicians

    GIRIDHAR MALLYA, ANDREW BAZEMORE

    The Medicare Part D prescription drug benefit offers financial relief for many beneficiaries. However, it has attracted criticism for its complex structure, its onerous cost-sharing provisions, and its sizable taxpayer burden—the program’s expenses are estimated at $724...

    Identifying Effective Alternative Therapies for Common Conditions

    JANE L. MURRAY

    Increasingly, our patients ask us about alternatives to prescription drugs for managing common conditions. This issue of American Family Physician features an article about nonhormonal therapies for hot flashes1—a concern we regularly encounter in our patients who are...

    Cochrane for Clinicians

    Are Alpha-glucosidase Inhibitors Effective for Control of Type 2 Diabetes?

    DAN BREWER

    The use of alpha-glucosidase inhibitors has a modest effect on intermediate diabetes-control endpoints such as postprandial blood glucose, postprandial insulin levels, and A1C levels. There is no evidence, however, of improvement in mortality, morbidity, or quality of life....

    Cochrane Briefs

    Gabapentin for Pain: Balancing Benefit and Harm

    MARK EBELL

    At high dosages, gabapentin is moderately effective for neuropathic pain, although adverse effects are experienced as often as benefit.

    Adalimumab for Rheumatoid Arthritis?

    CLARISSA KRIPKE

    Combined with methotrexate, subcutaneous adalimumab at a dosage of 40 mg every two weeks slows the progression of rheumatoid arthritis at one year. The combination is more effective than adalimumab monotherapy. Limited evidence suggests that adalimumab is also safe and...

    U.S. Preventive Services Task Force

    Screening for Peripheral Arterial Disease: Recommendation Statement

    This statement summarizes the USPSTF recommendations on screening for peripheral arterial disease and the supporting scientific evidence and updates the 1996 recommendations contained in theGuide to Clinical Preventive Services, 2nd ed.

    Photo Quiz

    Asymptomatic Penile Rash

    GARY N. FOX, JULIE M. STAUSMIRE

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

    POEMs

    Influenza Vaccine Effective for Older Patients

    HENRY BARRY

    Magnetic Insoles Ineffective for Nonspecific Foot Pain

    ALLEN F. SHAUGNESSY

    Positive Feedback Is Effective for Decreasing Stuttering

    ALLEN F. SHAUGHNESSY

    Tips from Other Journals

    Acupuncture Benefits Patients with Chronic Low Back Pain

    KENNETH LIN

    Screening and Counseling for Obesity in Children

    CAROLINE WELLBERY

    Adherence to Medications for Reducing CVD

    KARL E. MILLER

    Progestin-Releasing IUDs for Women with Diabetes

    ANNE D. WALLING

    Curbside Consultation

    At-Home Genetic Tests

    PHYLLIS FROSST, DANIEL J. WATTENDORF

    Current genetic tests for complex diseases are not diagnostic. They instead provide important information about susceptibility and can be key in prevention.

    Practice Guidelines

    AHA Releases Dietary Recommendations for Children and Adolescents

    CARRIE A. MORANTZ

    The American Heart Association (AHA) has released revised nutritional guidelines for children and adolescents, with new focuses on total caloric intake and eating behaviors. This is in response to significant changes in the prevalence of cardiovascular risk factors and...

    Practice Guideline Briefs

    CDC Recommendations to Reduce Central Line Infections

    MEREDITH DESMOND

    The Centers for Disease Control and Prevention (CDC) has released a report detailing interventions to help prevent central line bloodstream infections in hospitals.

    ACSM Recommendations for Endurance Athletes

    MEREDITH DESMOND

    The American College of Sports Medicine (ACSM) has released evidence-based recommendations for athletes to prevent hyponatremia and dehydration during sporting events.

    Letters to the Editor

    Jellyfish Species Distinction Has Treatment Implications

    CEDRIC M. YOSHIMOTO

    Dysmorphic Findings in Persons with Fragile X Syndrome

    Information from Your Family Doctor

    Nonhormonal Options for Hot Flashes

    For most women, a hot flash is a warm feeling from the chest up to the head. During a hot flash, you may have a headache or flushed skin, or feel your heart beating faster. You may also start to sweat or feel queasy or dizzy.

    Chronic Constipation in Your Child

    Constipation is when bowel movements happen less often than every two days.

    Help for Your Child’s Constipation

    If your child has constipation or stool leakage, it is important for you to maintain a positive attitude. Getting angry or making your child feel ashamed can make matters worse.



    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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