• Articles

    Varicose Veins: Diagnosis and Treatment

    Jaqueline Raetz, Megan Wilson, Kimberly Collins

    The pathophysiology of varicose veins involves a genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure. Established risk factors include family history of venous disease, female sex, older age, chronically increased intra...

    Adolescent Substance Use and Misuse: Recognition and Management

    Jessica A. Kulak, Kim S. Griswold

    Adolescent use of illicit substances imposes burdens to all levels of society. The types of substances that adolescents use have changed over the past decade, with a decrease in alcohol and increase in marijuana and opioid use. Primary care physicians can help identify...

    Caregiver Care

    Kristine Swartz, Lauren G. Collins

    Caregiving is associated with physical, psychological, and financial burdens, and the demand for caregivers is expected to rise during the next few decades. Family physicians can offer practical, individualized interventions such as caregiver assessments that direct the...


    Rethinking Aspirin for the Primary Prevention of Cardiovascular Disease

    Kenneth W. Lin, Jennifer Middleton

    Aspirin's routine use for primary prevention has been the subject of controversy because of questionable benefits and increased bleeding risk. Aspirin therapy may reduce the relative risk of a first heart attack or stroke, but this benefit could be outweighed by the risk of...


    My Kidney Donation: Unexpected Twists

    Caroline Wellbery

    An altruistic kidney donation and an unexpected nephrectomy.

    AFP Clinical Answers

    Measles Vaccine, Acute Appendicitis, Screening for Heart Disease, Abdominal Pain, Hyperhidrosis

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

    Cochrane for Clinicians

    Anticoagulation for the Long-term Treatment of VTE in Patients with Cancer

    Michael J. Arnold, Noah Cooperstein, Christopher Jonas

    Low-molecular-weight heparin (LMWH), vitamin K antagonists, and direct oral anticoagulants, when used to prevent recurrent VTE, have a similar impact on all-cause mortality.

    Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men

    Anne L. Mounsey, Elizabeth Parks

    In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.

    Curbside Consultation

    An Unhappily Married Patient

    Matthew Alexander, Shaista Qureshi

    Overall, marriage enhances health. Men gain greater health benefits from marriage than their wives. Conversely, wives are more negatively affected by a bad marriage than their husbands. In general, the health benefit of marriage is maximized in a good marriage but negated in...

    FPIN's Help Desk Answers

    Attention-Deficit/Hyperactivity Disorder: Screening and Evaluation

    Payal Gaba, Matthew Giordanengo

    What are the best screening tools for the evaluation and diagnosis of attention-deficit/hyperactivity disorder (ADHD)?

    Photo Quiz

    A Bump on the Gum

    Nguyet-Cam Lam, Tue T. Te

    A child presented with a painful, round, erythematous lesion on the gingiva of the left upper gum above the canine tooth.


    Overview of New ACC/AHA Lipid Guidelines

    Mark H. Ebell

    These updated guidelines, made without any input from primary care physicians who manage most patients with hyperlipidemia, are more complex than the 2013 guidelines and will likely lead to even more recommendations for statins, ezetimibe (Zetia), and PSK9 inhibitors.

    Aspirin, Eicosapentaenoic Acid, and Placebo Equally Effective in Preventing Colorectal Adenomas in High-Risk Patients

    Henry C. Barry

    After 12 months, neither aspirin nor EPA, alone or in combination, are any better than placebo at preventing colorectal adenomas in patients with high-risk neoplasia.

    Probiotic Ineffective for Treatment of Acute Gastroenteritis in Young Children

    Mark H. Ebell

    Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus

    Mark H. Ebell

    The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

    Practice Guidelines

    Cancer Screening: ACS Releases Annual Summary of Recommendations

    Lisa Croke

    The American Cancer Society (ACS) provides a summary of recommendations for cancer screening each year, including any updates and recent data, and advice for when recommendations cannot be made.

    Medicine by the Numbers

    Antibiotic Prophylaxis in Patients with COPD

    Robert Murrey Brown, Rory Spiegel

    This research fails to determine whether the modest potential benefits of antibiotic prophylaxis in patients with chronic obstructive pulmonary disease outweigh the risk of resistance. Find out more.

    Letters to the Editor

    Medical Content Should Be Equitable and Inclusive of Diverse Populations

    Preoperative Nutritional Optimization in Older Patients Reduces Complications

    Information from Your Family Doctor

    Caregiver Care

    A caregiver is a friend or relative who provides unpaid care for someone with a chronic or disabling condition.



    Strength of evidence. The article, “The Pregnant Patient: Managing Common Acute Medical Problems” (November 1, 2018, p. 595), contained an error in the third sentence of the second paragraph of the “Common Symptoms During Pregnancy” section in the second column on page 597....


    Incorrect disease risk. The article, “The Pregnant Patient: Managing Common Acute Medical Problems” (November 1, 2018, p. 595), contained an error in the third sentence of the second paragraph of the “Dysuria” section in the first column on page 601 regarding the use of...


    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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