Articles
High Blood Pressure in Children and Adolescents
Despite the increasing prevalence and potential risks of hypertension in children, the diagnosis is often overlooked. Blood pressure should be measured annually beginning at three years of age, or at every visit if risk factors are present. A thorough history and physical…
Urinary Retention in Adults: Evaluation and Initial Management
Urinary retention is the inability to voluntarily pass an adequate amount of urine. The condition can be acute or chronic, and it primarily affects men. Causes of retention are obstructive (most common), infectious, inflammatory, iatrogenic, and neurologic in nature. Initial…
Depression: Screening and Diagnosis
Screening for depression is the cornerstone of early recognition, diagnosis, and management, although many patients are not being screened in the primary care setting. All adults should be screened regardless of risk factors, as well as children and adolescents 12 years and…
Cerumen Impaction: Diagnosis and Management
Cerumen production is a normal and protective process for the ear canal. However, cerumen should be removed when it causes symptoms or prevents assessment of the external auditory canal, tympanic membrane, or audiovestibular system. It should also be removed when it limits…
AFP News Now - AFP Edition
AAFP News: AFP Edition
AAFP Supports ACT for Better Diagnosis | U.S. Patients Pay Higher Prescription Costs, Get Fewer Days of Therapy | AAFP Introduces Telemedicine Platform for Family Physicians | Aggressively Reducing SBP in Older Persons Can Increase Risk of Falls, Syncope
Editorials
Counseling Patients About Prostate Cancer Screening
The AAFP finds that the net benefit of population screening for prostate cancer is small at best, and it does not recommend routinely discussing PSA-based screening if the patient does not request it.
FPIN's Clinical Inquiries
Morning vs. Evening Administration of Levothyroxine
The effectiveness of levothyroxine for reducing TSH levels is most dependent on the timing of meals in relation to drug administration. There is conflicting evidence. In two studies, levothyroxine taken at least two hours after eating in the evening maintained or improved TSH…
Photo Quiz
Newborn with a Hyperextended Knee
The initial examination of an infant was notable for passive hyperextension at right knee but otherwise full range of motion.
Putting Prevention Into Practice
Screening for Prostate Cancer
A.E., a 57-year-old black man, comes to your office for an annual visit. He has a history of diabetes mellitus, has never smoked, and has no family history of prostate cancer. He is current with preventive services, including screening for colorectal cancer and counseling for a…
STEPS
Recombinant Zoster Vaccine (Shingrix) for the Prevention of Shingles
Recombinant zoster vaccine is a relatively new shingles vaccine that has been shown to have greater effectiveness and protection than the existing live vaccine. Local and systemic adverse effects may occur after administration, but have been shown to resolve within one to three…
Practice Guidelines
Influenza Vaccination Recommendations for 2018–2019: Updates from ACIP
Key Points for Practice
POEMs
Ambulatory Blood Pressure Important for Decision-Making About Treatment
This study supports the guidelines recommending that treatment decisions be based on ambulatory blood pressure measurements rather than in-office blood pressure results. The difference between the two measurements in this cohort was 19/11 mm Hg, which is enough to change the…
Cannabinoids Somewhat Helpful for Nausea, Maybe Helpful for Spasticity, Probably Not Helpful for Nonneuropathic Pain
This umbrella review found a modest benefit of cannabinoids for the treatment of neuropathic pain; a greater benefit for the treatment of spasticity and nausea and vomiting; and substantial harms. The studies were extremely heterogeneous in terms of the comparators, dose…
Five-Day Nitrofurantoin Superior to Single-Dose Fosfomycin for Women with Uncomplicated UTI
A five-day course of nitrofurantoin is significantly more likely than single-dose fosfomycin to achieve both clinical and microbiologic resolution of uncomplicated lower UTI in otherwise healthy adult women.
U.S. Preventive Services Task Force
Screening for Prostate Cancer: Recommendation Statement
For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)–based screening for prostate cancer should be an individual one. Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of…
