Common Questions About the Initial Management of Hypertension

ROBERT LANGAN, KRISTEN JONES

Treatment of hypertension reduces the risk of heart failure, myocardial infarction, cerebrovascular disease, and death. Several lifestyle modifications are associated with improvements in blood pressure, including the Dietary Approaches to Stop Hypertension diet, sodium...

Cesarean Delivery: Counseling Issues and Complication Management

JEFFREY D. QUINLAN, NEIL J. MURPHY

Compared with spontaneous vaginal delivery, cesarean delivery is associated with increased maternal and neonatal morbidity and mortality. Post–cesarean delivery complications include pain, endomyometritis, wound separation/infection, urinary tract infection, gastrointestinal...

Diagnosis and Treatment of Seborrheic Dermatitis

GARY W. CLARK, SARA M. POPE, KHALID A. JABOORI

Seborrheic dermatitis is a clinical diagnosis based on the location and appearance of lesions. Treatment with antifungal agents such as topical ketoconazole is the mainstay of therapy for seborrheic dermatitis of the face and body. Because of possible adverse effects, anti...

AAFP News: AFP Edition

CMS Considers Changes to Federal Health Insurance Exchanges | Survey: Many Physicians Are Leery of Using Opioids for Noncancer Pain | Groups Urge Restrictions on E-Cigarettes | AAMC Offers Three Free Publications on Medical School Admissions

Improving Quality by Doing Less: Overdiagnosis

MARK EBELL, JESSICA HERZSTEIN

The second in a series of AFP editorials that addresses the related issues of over-screening, overdiagnosis, and overtreatment. Overdiagnosis occurs when a disease is diagnosed and treated, even though that disease never would have harmed the patient if left untreated.

Alpha Blockers to Speed Ureteral Stone Passage

NATHAN HITZEMAN, SARAH WILLIAMS

Compared with patients receiving standard therapy (e.g., fluids, analgesics), placebo, or calcium channel blockers, patients receiving alpha blockers had about three fewer days to ureteral stone expulsion and were less likely to be hospitalized. Adverse effects of alpha...

Buprenorphine Maintenance vs. Methadone Maintenance or Placebo for Opioid Use Disorder

ELIZABETH SALISBURY-AFSHAR

At dosages greater than 2 mg per day, buprenorphine maintains treatment retention better than placebo. When flexible dosing (doses adjusted based on patient symptoms) is used, the effectiveness of buprenorphine is comparable to that of methadone in suppressing opioid use.

Teaching Health Center GME Funding Instability Threatens Program Viability

ELIZABETH BROWN, KATHLEEN KLINK

The Teaching Health Center Graduate Medical Education (THCGME) program, funded since 2011 and set to expire in 2015, has increased the numbers of primary care physicians and dentists training to care for under-served populations nationwide. Without continued federal funding,...

Screening for Suicide Risk in Adolescents, Adults, and Older Adults in Primary Care: Recommendation Statement

The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for suicide risk in adolescents, adults, and older adults in primary care.

Prevention of Dental Caries in Children from Birth Through Five Years of Age: Recommendation Statement

The U.S. Preventive Services Task Force (USPSTF) recommends that primary care clinicians prescribe oral fluoride supplementation starting at six months of age for children whose water supply is deficient in fluoride.

Benzodiazepines and Alzheimer Disease

JILL ENDRES, MARK A. GRABER, ROBERT DACHS

Benzodiazepine exposure over the preceding five years seems to be associated with an increased likelihood of an Alzheimer disease diagnosis. A dose-response gradient also seems to exist.

Angiotensin-Converting Enzyme Inhibitors vs. Angiotensin Receptor Blockers

BACHIR TAZKARJI, AMBIKA GANESHAMOORTHY, BETH AUTEN

ACE inhibitors should be used in patients with hypertension because they reduce all-cause mortality, whereas ARBs do not.

Vesicular Rash in a College Student

ASHLEY S. MARTIN, DIANA BOLOTIN, MARA BEVERIDGE

A 19-year-old college student presented with erythematous papules and vesicles on an erythematous base that were scattered over his face, scalp, trunk, and upper extremities. The lesions appeared in multiple stages, some with crusting and excoriation.

Planning for Labor and Vaginal Birth After Cesarean Delivery: Guidelines from the AAFP

LISA HAUK

This guideline from the American Academy of Family Physicians (AAFP), which provides information on health outcomes associated with labor after cesarean delivery/vaginal birth after cesarean delivery (LAC/VBAC), replaces the 2005 guideline on trial of labor after cesarean...

Treating Newly Diagnosed High Blood Pressure

Treatment is important because having high blood pressure increases your risk of heart attack, stroke, and heart failure.