• Articles

    Onychomycosis: Rapid Evidence Review

    Winfred Taylor Frazier, Zuleica M. Santiago-Delgado, Kenneth C. Stupka, II

    Onychomycosis is a chronic fungal infection of the fingernail or toenail bed, causing brittle, discolored, and thickened nails. Confirming the diagnosis with a potassium hydroxide preparation is recommended before initiating treatment, which can include oral or topical...

    Hepatitis A

    Robert C. Langan, Andrew J. Goodbred

    Serologic testing for immunoglobulin M anti–hepatitis A virus antibodies is used for diagnosis. Supportive care is often sufficient for treatment. Routine immunization is recommended for all children 12 to 23 months of age, persons at high risk of contracting the infection,...

    Bioterrorism

    Nicholas A. Rathjen, S. David Shahbodaghi

    Bioterrorism is the deliberate release of viruses, bacteria, toxins, or fungi with the goal of causing panic, mass casualties, or severe economic disruption. Treatment includes proper isolation and administration of antimicrobial or antitoxin agents in consultation with...

    Diabetes-Related Foot Infections: Diagnosis and Treatment

    Eric M. Matheson, Scott W. Bragg, Russell S. Blackwelder

    In 40% of diabetes mellitus–related foot ulcers, related infections occur causing significant morbidity. Indicators of infection include erythema, induration, tenderness, warmth, and drainage. Antibiotic treatment duration is typically one to two weeks and is longer for...

    Osteomyelitis: Diagnosis and Treatment

    David C. Bury, Tyler S. Rogers, Michael M. Dickman

    Osteomyelitis is an inflammatory condition of bone secondary to an infectious process. Diagnosis is usually based on imaging and laboratory findings. Bone biopsy and microbial cultures offer definitive diagnosis. Antibiotics are the primary treatment option. Surgical bony...

    Medical Advice for Commercial Air Travel

    Nicole Powell-Dunford, Joseph R. Adams, Christopher Grace

    Air travel is generally safe, but it can pose physiologic challenges to some. To optimize health outcomes, communication between the traveler, family physician, and airline carrier should occur when there is any doubt about fitness for air travel.

    Editorials

    Racial Disparities at the End of Life

    Daniel Dierfeldt, Kerstin Knopf, Linda Jackson

    The COVID-19 pandemic has drawn greater attention to the continuing discrimination that racial minorities face within the medical system. Often these disparities are considered in the context of patients who are not actively dying. However, care delivered at the end of life...

    Physicians Should Refuse Pharmaceutical Industry Gifts

    Steven R. Brown

    Knowing that the high price of drugs is a major detriment to public health in the United States and that the pharmaceutical industry spends vast sums marketing to health care professionals, physicians should refuse visits, gifts, payments, and drug samples from pharmaceutical...

    Graham Center Policy One-Pagers

    Physician Employment Eclipses Practice Ownership: The Ongoing Trend and Its Effect on Family Medicine

    Julie Hyppolite, Brian Antono, Stephen Petterson, Yalda Jabbarpour

    In 2016, for the first time, less than one-half of practicing physicians had an ownership stake in their own practices. The most recent American Medical Association Physician Practice Benchmark Survey reveals that this trend continues. More physicians are identifying as...

    AFP Clinical Answers

    Depression, Cervical Myelopathy, Diagnostic Imaging, Eating Disorders, Vitamin K Antagonists

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

    Cochrane for Clinicians

    Schizophrenia: Use of Antipsychotic Drugs for Maintenance Therapy

    Elizabeth Salisbury-Afshar

    Compared with placebo, using antipsychotic drugs for maintenance therapy in patients with schizophrenia is associated with relapse prevention at seven to 12 months.

    Interventions to Improve Use of CPAP Machines in Adults with Obstructive Sleep Apnea

    Dustin K. Smith, Nadine Barksdale, Spencer Dean

    Behavioral interventions increase CPAP use compared with usual care. These interventions also increase CPAP adherence, measured by participants using their machine four or more hours per night, from 371 to 501 per 1,000 patients.

    Putting Prevention Into Practice

    Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors

    Justin Mills, Nolan O'Dowd

    A 36-year-old patient, L.B., with a history of hypertension presents for a wellness visit. The patient's mother had a stroke at 65 years of age and the patient's older brother recently had a heart attack. L.B. has an estimated 10-year cardiovascular risk of 6%, and L.B.'s...

    Photo Quiz

    Growing Mass in an Adolescent

    Courtney Humphrey, Bronson Shetayh

    A patient presented with a polypoid, unpigmented mass on the top of the head that was raised and asymmetrical with slightly irregular borders.

    Recalcitrant Annular Rash

    Michael Layne, Kristen Gogoli

    A patient presented with a pruritic, nonscaly, ring-like rash on the dorsa of both hands.

    FPIN's Clinical Inquiries

    Does Light Therapy Decrease Depression in Older Adults?

    Joshua Felton Gilens, Molly Hoss, Corey Lyon, Kristen DeSanto

    Light therapy appears to be mildly effective in treating depression in older adults, but ideal wavelength, intensity, and length of treatment are unknown.

    FPIN's Help Desk Answers

    Community Vision Screening in Older Adults

    Aaron Warning, Tori Applegren, Krystal Foster

    The available evidence does not support screening adults 65 years and older for visual impairment in the primary care setting.

    Diary of a Family Physician

    Diary of a Family Physician

    Annette Chavez, Karlynn Sievers

    First-person accounts from the front lines of family medicine.

    POEMs

    No Difference in Cognitive Decline in Older Patients with Coronary Artery Disease Undergoing CABG or PCI

    David C. Slawson

    The study found no significant difference in the rate of memory decline among older adults with CAD who are undergoing coronary revascularization with CABG or PCI.

    Screening for Ovarian Cancer with CA 125 and Ultrasound Algorithm Does Not Reduce Mortality

    Mark H. Ebell

    Like the U.S. Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, this large and long U.K. study found no reduction in ovarian cancer mortality with screening using ultrasonography or a multimodal CA 125–based screening strategy.

    High-Dose Amoxicillin/Clavulanate No Better than Standard Dose for Acute Sinusitis in Adults

    Henry C. Barry

    This study found no significant difference between the standard-dose and high-dose regimens of amoxicillin/clavulanate for treating acute sinusitis in adults. It is important to note that both doses are minimally superior to placebo.

    For Patients with Type 2 Diabetes Mellitus Who Are Taking a GLP-1 Receptor Agonist, an SGLT2 Inhibitor May Be Preferred to a Sulfonylurea as Add-on Therapy

    Mark H. Ebell

    This propensity score–matched analysis (not funded by industry) concluded that an SGLT2 inhibitor is preferred over a sulfonylurea for patients with type 2 diabetes who are already taking a GLP-1 receptor agonist, with favorable effects on the likelihood of hospitalization...

    Practice Guidelines

    Neonatal Resuscitation: Updated Guidelines from the American Heart Association

    Noa C. Hammer, John J. Koch, Hilary C. Hopkins

    The American Heart Association released minor updates to neonatal resuscitation recommendations with only minor changes to the previous algorithm.

    Venous Thromboembolism: Management Guidelines from the American Society of Hematology

    Michael J. Arnold

    The American Society of Hematology has updated recommendations for management of VTE, which includes deep venous thrombosis (DVT) and pulmonary embolism (PE).

    Medicine by the Numbers

    Ultrasound Guidance for the Placement of Peripheral Intravenous Catheters

    Michael Gottlieb, Brit Long

    Learn more about ultrasound guidance for the placement of peripheral intravenous catheters.

    Letters to the Editor

    Case Report: Second-Trimester Maternal COVID-19 Infection and Tetralogy of Fallot

    Shiv Dalla, Michael Rausch, Rick Kellerman

    Administering COVID-19 Vaccines During Preparticipation Physical Examinations

    Jason M. Matuszak

    Case Report: Disseminated HSV Infection in a Well-Appearing Neonate

    Phuong B. Le, Nancye McCowan, Ross L. Pearlman

    Previous ECG Criteria (Including STEMI Criteria) Overlook Too Many Acute MIs Due to Acute Coronary Occlusion

    Management of Syphilis in People with HIV Infection

    Information from Your Family Doctor

    Osteomyelitis: What You Should Know

    Osteomyelitis (OSS-tee-oh-MY-uh-LIE-tiss) is an infection in a bone. It is caused by bacteria that spread through the blood from a wound or infection somewhere else in the body. In children, it usually occurs in the arms and legs. In adults, it usually affects the feet, spine...



    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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