• Articles

    Mildly Elevated Liver Transaminase Levels: Causes and Evaluation

    ROBERT C. OH, THOMAS R. HUSTEAD, SYED M. ALI, MATTHEW W. PANTSARI

    The most common causes of elevated transaminase levels are nonalcoholic fatty liver disease and alcoholic liver disease. Evaluation begins with a focused history, physical examination, and laboratory testing. If nonalcoholic fatty liver disease is suspected, lifestyle...

    Hoarseness in Adults

    STEVEN A. HOUSE, ERIC L. FISHER

    The causes of hoarseness range from simple inflammatory processes to serious systemic, neurologic, or cancerous conditions. Medication-induced hoarseness is common and should be considered as a possible etiology. Laryngoscopy should be performed if symptoms last longer than...

    Hyperosmolar Hyperglycemic State

    GREGG D. STONER

    Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Causes include underlying infections, certain medications, nonadherence to therapy, undiagnosed diabetes mellitus,...

    AAFP News: AFP Edition

    AAFP News: AFP Edition

    Panelists: Congress Must Fund Public Health Prevention Campaigns | AAFP Responds to Proposed HHS Strategy | CDC Advises Physicians on Treating Patients Affected by Hurricanes | AAFP Responds to Proposed VA Rule Expanding Telehealth Services

    Editorials

    USPSTF Recommendations: New and Updated in 2016

    MARK H. EBELL

    In 2016, the USPSTF updated 14 previous recommendation statements and added a new recommendation on screening for autism spectrum disorder. Several updated recommendations are notable for having significant changes.

    Cochrane for Clinicians

    Oral Rehydration Solutions for the Treatment of Acute Watery Diarrhea

    JENNIFER G. CHANG

    Oral rehydration solutions are distinguished by high or low osmolarity and by whether they are made with complex (i.e., polymer) or simple (i.e., glucose) carbohydrates. When oral rehydration solutions with high osmolarity (310 mOsm per L or greater) are compared, polymer...

    Close-ups

    Hypertrophic Cardiomyopathy: An Often Silent Disorder with Delayed Diagnosis

    ROBERT GAUER

    It's my senior year of high school. I have been the leading scorer for my basketball team the past two years. We are undefeated in the conference, and I am the favorite to be Player of the Year and to make the All-State team. Two colleges plan to offer me athletic scholarships.

    Photo Quiz

    Concurrent Painless Weeping Nodule and Targetoid Lesion on the Hand

    ANDY CHERN, SHAYNA C. RIVARD, KENT HANDFIELD

    A man presented with skin lesions his hand and finger a few weeks after sustaining a minor laceration while skinning slaughtered sheep.

    POEMs

    Transdermal Estrogen and Progestogen Most Effective to Reduce Menopausal Vasomotor Symptoms

    LINDA SPEER

    Transdermal estrogen plus progestogen, or oral estrogen plus progestogen, is the treatment most likely to effectively reduce the frequency of vasomotor symptoms among menopausal women. Isoflavones and black cohosh were found to be better than placebo.

    Practice Guidelines

    Acute Gout: ACP Provides Guideline on Diagnosis

    JENNIFER WILKES

    The diagnostic standard for acute gout is joint aspiration with synovial fluid analysis for monosodium urate crystals; however, many patients are seen in a primary care or emergency medicine situation where synovial fluid analysis is rarely performed. The American College of...

    Medicine by the Numbers

    Topical Capsaicin for Treatment of Chronic Neuropathic Pain in Adults

    PAUL CRAWFORD, YOU XU

    Based on low-quality evidence, high-concentration capsaicin patches reduce neuropathic pain from herpes and human immunodeficiency virus infection by 30% to 50% compared with the low-concentration capsaicin control group.

    FPIN's Help Desk Answers

    Screening Tools for Unhealthy Alcohol Use

    WILLIAM MILLER, JAMES WEST, HOLLIE MILLS

    A single-question alcohol use screen and the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) can be used to detect unhealthy alcohol use and alcohol use disorder. Their performance is similar between sexes and across races.

    Local Anesthesia for IUD Insertion or Endometrial Biopsy

    KEHINDE ENIOLA

    Topical application of lidocaine/prilocaine cream to the cervix reduces mean pain scores during IUD insertion. Intrauterine instillation of liquid anesthesia reduces median pain scores during endometrial biopsy.

    Letters to the Editor

    Potential Benefits of L-Carnitine as Dietary Supplement

    Information from Your Family Doctor

    Elevated Liver Enzymes

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



    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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