• Articles

    Gastroenteritis in Children

    Scott Hartman, Elizabeth Brown, Elizabeth Loomis, Holly Ann Russell

    Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each...

    First Trimester Bleeding: Evaluation and Management

    Erin Hendriks, Honor MacNaughton, Maricela Castillo MacKenzie

    Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy...

    Renal Cell Carcinoma: Diagnosis and Management

    Richard E. Gray, Gabriel T. Harris

    Kidney cancer is one of the 10 most common cancers in the United States with 90% being attributed to renal cell carcinoma. Men, especially black men, are more likely to be affected than women. Renal masses, either cystic or solid, are best detected with contrast-enhanced,...


    Stumbling onto Cancer: Avoiding Overdiagnosis of Renal Cell Carcinoma

    H. Gilbert Welch

    We all need to test wisely and weigh the risks and benefits of diagnostic imaging. Imaging—and testing in general—has real downsides, such as stumbling onto things you wish you had not.

    AFP Clinical Answers

    Behavior Issues, Skin Cancer, Adolescent Depression, Prostate Cancer, Deprescribing Antipsychotics

    Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

    Graham Center Policy One-Pager

    Increased Quantity but Not Proportion: U.S. Medical Schools and Family Medicine Entry 2008 to 2018

    Robert Baillieu, Andrew Bazemore, Brian Beachler

    Expansion in the number of American medical schools since 2005 led to an absolute increase in graduates matching into family medicine (FM) residency programs from 2008 to 2018. Proportionally, however, FM training has become increasingly reliant on osteopathic physicians and...

    Cochrane for Clinicians

    Complementary and Integrative Treatments for Pain Management in Labor

    Michael J. Arnold, Sukhmani Dhaliwal

    There is evidence that all of the studied interventions have some benefit in labor, but the evidence is of low to very low quality. Massage, thermal interventions (warm and cold packs), relaxation techniques, yoga, and music reduce pain during latent labor, but not during...

    Oral Immunotherapy for Egg Allergy

    Michael A. Hanak, Elizabeth Salisbury-Afshar

    Providing daily, steadily increasing doses of egg protein over an extended period of time effectively diminishes the immunoglobulin E (IgE)-mediated allergic response among children with egg allergy.


    The Cough that Would Not Quit

    Anne Walling

    Hesitancy about vaccinations and the dangers this presents.

    FPIN's Help Desk Answers

    Antibiotic Prophylaxis for UTIs in Patients with Neurogenic Bladder

    Marina Nemetalla, Kevin Frazer

    Daily antibiotic prophylaxis should not be used in patients with acute and nonacute spinal cord injuries.


    Chronic Sinusitis: Saline Irrigation Helps Somewhat; Steroid Does Not Add More Benefit

    Allen F. Shaughnessy

    This study showed that patients with chronic rhinosinusitis who continue to use a saline nasal wash (NeilMed) will often experience an improvement in symptoms that can be clinically meaningful, but the addition of the corticosteroid budesonide has yet to show an extra benefit.

    Clopidogrel Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor Stroke or TIA

    Mark H. Ebell

    This study provides support for a strategy of adding clopidogrel to aspirin for the first week or so after a minor ischemic stroke or TIA because this is when the greatest benefit occurs. Harms were spread fairly evenly throughout the study period.

    Digital Media Use Associated with ADHD Symptom Development Among Adolescents

    David Slawson

    High school students who reported a high frequency (many times per day) of digital media use (e.g., social networking, streaming movies or music, texting) were significantly more likely to self-report symptoms of ADHD over two years of follow-up (10% higher symptom reporting...

    Decompression Surgery No More Effective Than Exercise for Shoulder Impingement Syndrome

    Allen F. Shaughnessy

    Despite being one of the most common orthopedic surgeries performed, subacromial decompression is not significantly better than physical therapy to treat patients with pain and limited function caused by shoulder impingement.

    Photo Quiz

    An Asymmetrical Pupil

    Omici N. Uwagbai, Sharon Falzgraf

    A 73-year-old woman presented with asymmetrical pupils. She had no loss of vision, double vision, eye pain, light sensitivity, or abnormal sweating. The patient had a history of bilateral cataract surgery, repair of right retinal detachment, and repair of the right orbital...

    Practice Guidelines

    Urinary Incontinence: Screening Recommendation from the WPSI

    Carrie Armstrong

    Urinary incontinence adversely affects health, quality of life, and function for most women at some point in their lives. However, it is underreported because of embarrassment, stigma, or acceptance as normal. Early intervention may reduce progression, improve quality of life...

    Medicine by the Numbers

    Dyspnea Due to Acute Heart Failure Syndrome

    Ian S. deSouza, Jennifer L. Martindale

    This review concluded that the individual components of the clinical history and physical examination, electrocardiography, and chest radiography are not useful independently for confirming or excluding the diagnosis of acute heart failure syndrome in patients presenting to...

    Letters to the Editor

    Group Prenatal Care to Reduce Preterm Labor and Improve Outcomes

    Andrea Darby-Stewart, Carmen Strickland

    Reply: Kristen Rundell, Bethany Panchal

    Registered Dietitian Nutritionists Should Be Included in Patient Health Care Teams

    Mary Russell

    Reply: Amy Locke

    Point-of-Care Ultrasonography: An Effective Tool When Used Appropriately

    Mark Ebell

    Paul Bornemann

    Information from Your Family Doctor

    Gastroenteritis in Children: Treating Dehydration

    Gastroenteritis (GASS-tro-EN-ter-EYE-tiss) is another name for stomach flu. Children with stomach flu get diarrhea. They may also have upset stomach, vomiting, or fever. It is caused by germs, food poisoning, or unclean water.

    Bleeding in Early Pregnancy

    About one in every four pregnant women will have vaginal bleeding in the first few months. Mild cramping and light spotting can be normal in early pregnancy. But vaginal bleeding may be a sign of something more serious. Some of the most common causes are:




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