• Articles

    Adolescent Idiopathic Scoliosis: Common Questions and Answers

    Angela L. Kuznia, Anita K. Hernandez, Lydia U. Lee

    Adolescent idiopathic scoliosis is defined by a Cobb angle of at least 10 degrees in the absence of underlying congenital or neuromuscular abnormalities. It may be detected via the forward bend test and should be confirmed with scoliometer measurement. Several studies have...

    Benign Anorectal Conditions: Evaluation and Management

    Mark W. Cohee, Ashlee Hurff, John D. Gazewood

    Common anorectal conditions include hemorrhoids, pruritus, anal fissures, functional pain, abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should always be considered....

    Lymphoma: Diagnosis and Treatment

    William D. Lewis, Seth Lilly, Kristin L. Jones

    Lymphoma can involve lymphatic tissue, bone marrow, or extranodal sites. Lymphoma is traditionally classified as non-Hodgkin or Hodgkin, and there are approximately 82,000 new U.S. patients diagnosed with lymphoma annually. Lymphoma typically presents as painless adenopathy,...

    Editorials

    Breast Implant–Associated Anaplastic Large Cell Lymphoma

    Binita S. Ashar, Sung W. Yoon, Steven Nagel

    In 2011, the U.S. Food and Drug Administration (FDA) identified a possible association between breast implants and the development of anaplastic large cell lymphoma (ALCL).1 At that time, the FDA knew of so few cases of the disease that it was not possible to determine which...

    AFP Clinical Answers

    Warfarin Dosages, PCOS, Varicose Veins, Gastroenteritis in Children, Plantar Fasciitis

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

    Graham Center Policy One-Pagers

    A Shrinking Primary Care Workforce in Puerto Rico

    Elizabeth Wilkinson, David Killeen, Gabriel José Pérez-López, Yalda Jabbarpour

    In 2018, two-thirds of primary care physicians in Puerto Rico were older than 55 years, compared with 43% nationwide. Meanwhile, only four out of every 10 graduates of family medicine residencies from 2011 to 2017 remained on the island in 2018, placing Puerto Rico’s new...

    Cochrane for Clinicians

    Positional Therapy for Obstructive Sleep Apnea

    Karl T. Clebak, Theodore J. Demetriou, Stephanie Carey

    Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate...

    Antepartum Omega-3 Fatty Acid Intake and Length of Gestation

    Corey Fogleman, Melody Martin

    Omega-3 fatty acids, whether taken as supplements or consumed as part of the diet, reduce the risk of preterm birth (number needed to treat = 68) and early preterm birth (number needed to treat = 55).

    FPIN's Clinical Inquiries

    Exercise to Reduce Falls in Older Adults

    Ginger Poulton, Brittany Funderburke Matney, Travis Williams, Stephen Hulkower, Sue Stigleman

    Exercise programs should be recommended for community-dwelling adults 60 years and older because they lead to fewer falls.

    Diagnostic Tests

    PLAC Test for Lp-PLA2 Activity to Predict Coronary Heart Disease

    Jennifer G. Chang

    The PLAC test is a blood test used to measure serum activity of lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme that breaks down oxidized low-density lipoprotein in the vascular wall. Higher levels of Lp-PLA2 activity are thought to promote atherosclerotic plaque...

    Photo Quiz

    Nodules on the Knuckles

    Micah Pippin

    A 55-year-old man presented with nonpainful, red masses on his knuckles that had been recurring for years. The lesions generally lasted for one month then resolved spontaneously. He was a mechanic, and job-related trauma exacerbated the condition. He also had arthralgias in...

    Curbside Consultation

    Tapering Long-Term Opioid Therapy

    Anna Lembke

    My patient is a 54-year-old construction worker who has been taking prescribed opioids for more than a decade for chronic knee and back pain.

    POEMs

    Fasting and Nonfasting Lipid Levels Similarly Predict Cardiovascular Disease Risk

    Allen F. Shaughnessy

    Guidelines recommend checking lipid levels in nonfasting patients. They are easier to obtain and are equally predictive of subsequent cardiac events. Although triglyceride levels may be higher in nonfasting patients, cholesterol levels will be similar whether the patient was...

    Adding Ultrasonography to Mammography Increases False-Positive Findings Without an Increase in Cancer Detection

    Allen F. Shaughnessy

    Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in...

    C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute Exacerbation of COPD

    Mark H. Ebell

    CRP guidance, regarding the likelihood that antibiotics will be helpful for patients with acute exacerbation of COPD, safely reduces antibiotic use (number needed to treat = 5).

    Addition of Steroids Improves Outcomes in Children and Adults with CAP

    Allen F. Shaughnessy

    Adding corticosteroid treatment to the management of CAP is beneficial for children and adults. Treatment decreases clinical failures, time in the hospital, and the risk of death in adults with severe pneumonia.

    Practice Guidelines

    Beers Criteria for Inappropriate Medication Use in Older Patients: An Update from the AGS

    Lisa Croke

    The 2019 American Geriatrics Society update of the Beers Criteria uses the five criteria outlined in 2015; these include medications that should typically be avoided in most older patients, medications that should be avoided in older patients with certain conditions,...

    Medicine by the Numbers

    Branched-chain Amino Acids for Patients with Hepatic Encephalopathy

    Ahmed Hamed, Amira Hamed, Karissa Lambert

    Hepatic encephalopathy is a brain dysfunction that can be mild with minimal confusion, or overt and severe with coma. Learn more about branched-chain amino acids for the treatment of hepatic encephalopathy.

    Letters to the Editor

    Positive Chest Radiograph Findings Are Not Enough to Warrant Antibiotics in Patients with Acute Cough

    Screening for Atrial Fibrillation to Initiate Stroke-Protective Therapy

    Physicians Can Help Patients Begin Grieving Process for Loss of a Loved One

    Information from Your Family Doctor

    Lymphoma: Diagnosis and Treatment

    Lymphoma is a cancer that affects your lymph nodes. Lymph nodes are small bean-shaped bumps under the skin. They are normally found all over your body, including your neck, armpits, and groin. Lymph nodes help your body to fight disease. There are many types of lymphoma that...



    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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