• Articles

    Shave and Punch Biopsy for Skin Lesions

    HEATHER PICKETT

    Shave and punch biopsies can diagnose questionable skin lesions, including possible malignancies. Approaches include the superficial shave biopsy, saucerization excision, punch biopsy, and elliptical excision. The best biopsy method for suspected melanoma remains controversial.

    Causes and Evaluation of Mildly Elevated Liver Transaminase Levels

    ROBERT C. OH, THOMAS R. HUSTEAD

    A stepwise evaluation can help identify the cause of elevated transaminase levels. If initial test results are normal, a trial of lifestyle modification with observation or further testing for less common causes is appropriate. Gastroenterology referral is recommended if...

    Update on Immunizations in Adults

    JOHN A. VAUGHN, ROGER A. MILLER

    The most recent updates to the recommended adult immunization schedule include the use of the quadrivalent human papillomavirus vaccine to prevent genital warts in males; a single dose of herpes zoster vaccine for adults 60 years and older; replacing a single dose of tetanus...

    Diagnosis and Management of Osteomyelitis

    JOHN HATZENBUEHLER, THOMAS J. PULLING

    The increased availability of sensitive imaging tests has improved the diagnosis of osteomyelitis. Sampling of the wound for culture and antimicrobial sensitivity is essential to direct treatment. The increased incidence of methicillin-resistant Staphylococcus aureus...

    AAFP News Now: AFP Edition

    AAFP News Now: AFP Edition

    AMA Letter to Supercommittee Calls for Medical Liability Reform | CMS Launches Initiative Using a Blended Payment Model Based on the PCMH | HHS Issues Final Rule on Operation of Medicaid Recovery Audit Program | ONC Launches Web Site on Health IT and EHRs, Publishes Health IT...

    Editorials

    Improving Adult Immunization Rates: Overcoming Barriers

    ALICIA APPEL

    Adult vaccinations are underutilized despite proven efficacy and cost-effectiveness. There are many barriers to immunization that are more prominent in adults than in children, including cost, lack of tracking systems, and competing demands.

    Graham Center Policy One-Pagers

    Better Integration of Mental Health Care Improves Depression Screening and Treatment in Primary Care

    ROBERT L. PHILLIPS, JR, BENJAMIN F. MILLER, STEPHEN M. PETTERSON, BRIDGET TEEVAN

    Improving screening and treatment for depression in primary care will require better mental health care integration. Depression is common in primary care, yet screening for the condition remains low. Enhanced, coordinated financial support for the integration of mental health...

    Cochrane for Clinicians

    Opioid Antagonists for the Treatment of Alcohol Dependence

    JOSEPH R. YANCEY, JAYDEE LUMBAD

    Although it does not improve overall alcohol abstinence rates, the oral formulation of the opioid antagonist naltrexone (Revia) is moderately effective in decreasing the amount and frequency of alcohol consumption in patients with alcohol dependence.

    Cochrane Briefs

    Cognitive Interventions for Improving Cognitive Function

    DEBORAH DREYFUS

    Compared with no treatment, cognitive interventions improved cognitive performance in healthy older adults and older adults with mild cognitive impairments. However, there is inadequate evidence to determine which aspects of these interventions are effective.

    Photo Quiz

    Bubbles on the Skin Following Renal Transplant

    ALEKSANDAR JANKOVIĆ, IVANA BINIĆ, SNEŽANA JANCIĆ

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

    Curbside Consultation

    Flaws in Clinical Reasoning: A Common Cause of Diagnostic Error

    CAROLINE WELLBERY

    Many medical errors have been identified as systemic and addressed with interventions, such as checklists. However, a substantial number of errors that occur in diagnosis and treatment are attributed to flaws in clinical reasoning.

    Tips from Other Journals

    Maternal Influenza Vaccine Reduces Hospitalization in Infants

    KENNETH T. MOON

    Do Antibiotics Improve the Treatment of Acute Otitis Media?

    JILLIAN S. VITTER

    Is Echinacea an Effective Treatment for the Common Cold?

    KENNETH T. MOON

    Practice Guidelines

    ACP Releases Guideline on Intensive Insulin Therapy in Hospitalized Patients

    MARA LAMBERT

    The American College of Physicians (ACP) has issued a clinical guideline on the use of intensive insulin therapy in hospitalized patients with or without diabetes mellitus to achieve glycemic control and improve health outcomes.

    FPIN's Clinical Inquiries

    Antidepressants for the Treatment of Insomnia in Patients with Depression

    MOLLY S. CLARK, PATRICK O. SMITH, BARBARA JAMIESON

    There is no single antidepressant or class of antidepressants that is most effective for the treatment of insomnia in patients with depression. The use of antidepressant medications can have a positive impact on sleep physiology, but does not seem to improve subjective...

    Letters to the Editor

    Fluoride Is an Essential Element of Childhood Oral Health

    HUGH SILK

    Histologic, Microbial Testing to Confirm Dermatologic Conditions

    Information from Your Family Doctor

    Elevated Liver Enzymes

    The liver releases several substances when it is injured. Two of these are enzymes called alanine transaminase (ALT) and aspartate transaminase (AST).

    Osteomyelitis: What You Should Know

    Osteomyelitis (OSS-tee-oh-MY-uh-LIE-tiss) is an infection in a bone. It is caused by bacteria that spread through the blood from a wound or infection somewhere else in the body. In children, it usually occurs in the arms and legs. In adults, it usually affects the feet, spine...



    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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