• Articles

    Cluster Headache: Rapid Evidence Review

    Omojo Odihi Malu, Jonathan Bailey, Matthew Kendall Hawks

    Patients with cluster headache experience severe unilateral pain located in the orbital, supraorbital, and/or temporal region that occurs from every other day up to eight times per day and lasts from 15 to 180 minutes. Attacks occur in clusters, are episodic or chronic, and...

    Adenomyosis: Diagnosis and Management

    Sarina Schrager, Lashika Yogendran, Crystal M. Marquez, Elizabeth A. Sadowski

    Adenomyosis is a clinical condition where endometrial glands are found in the myometrium. One in three patients with adenomyosis is asymptomatic, but the rest may present with heavy menstrual bleeding, pelvic pain, or infertility.

    Orthostatic Hypotension: A Practical Approach

    Michael J. Kim, Jennifer Farrell

    Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or more, or a decrease in diastolic blood pressure of 10 mm Hg or more within three minutes of standing from the supine position. Goals of treatment are reducing symptoms and improving...

    Transient Global Amnesia

    David Sealy, Robert J. Tiller, Katherine Johnson

    Transient global amnesia is a clinical syndrome characterized by anterograde amnesia, mild retrograde amnesia, and confusion for up to 24 hours. It most commonly occurs in patients older than 50 years and results from the temporary impairment of short-term memory formation.

    Pruritus: Diagnosis and Management

    Jedda Rupert, James David Honeycutt

    The etiology of pruritus is complex and can include histamine, serotonin, and neuropeptide release, and neuronal itch signal transmission. General management includes trigger avoidance, liberal emollient use, limiting water exposure, and administration of oral antihistamines...

    Arterial Atherosclerosis: Vascular Surgery Interventions

    Jonathon M. Firnhaber, C. S. Powell

    Atherosclerotic vascular disease is a leading cause of death worldwide. The most significant risk factors for atherosclerotic vascular disease are hypertension, diabetes mellitus, hyperlipidemia, and smoking. The U.S. Preventive Services Task Force recommends one-time...

    Editorials

    Determining When to Recommend Glucose-Lowering Drugs That Reduce Cardiovascular Risk

    Sandy Robertson

    Treatment options for patients with type 2 diabetes mellitus have increased with the addition of three new drug classes. Large clinical trials have investigated cardiovascular outcomes with all three classes in patients who have diabetes. The primary outcome was a composite...

    Preventing Cognitive Decline

    Anthony J. Viera

    Because of the lack of effective treatments, prevention remains the best strategy for reducing the burden of dementia. Rather than attempting to identify and intervene on early disease through screening, a primary prevention strategy seeks to prevent cognitive decline by...

    AFP Clinical Answers

    Obstructive Sleep Apnea, Fever in Children, Labor Pain, Mobility Devices, Lung Cancer Screening, Eggs

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

    STEPS

    Peanut Allergen Powder (Palforzia) for Peanut Allergy

    Deborah Erlich

    For individuals with severe peanut allergy, peanut allergen powder may lessen the likelihood of life-threatening consequences of accidental ingestion of small amounts of peanuts. Patients must still adhere to a peanut-avoidant diet, which likely has far bigger preventive...

    Cochrane for Clinicians

    Can Walking Lower Blood Pressure in Patients With Hypertension?

    Stephen McMullan, Christine Nguyen, Dustin K. Smith

    Walking lowers systolic blood pressure by 4.11 mm Hg. It lowers diastolic blood pressure by 1.79 mm Hg and resting heart rate by 2.76 beats per minute.

    Compression Stockings for Preventing Deep Venous Thrombosis in Airline Passengers

    Carl Bryce, Jacob Tuttle

    Compression stockings are effective at reducing asymptomatic deep venous thrombosis in airline passengers taking flights longer than five hours in both high-risk and low-risk populations.

    Putting Prevention Into Practice

    Screening for Prediabetes and Type 2 Diabetes Mellitus

    Howard Tracer, Sopan Mohnot

    A 36-year-old, D.P., presents to your clinic as a new patient for a wellness visit. D.P. has no current health concerns but states that they had gestational diabetes during their last pregnancy three years ago. The patient reports that their father has diabetes mellitus and...

    Photo Quiz

    Rapidly Progressive Erythroderma

    Summer Moon

    A man presented with a progressive pruritic rash affecting his entire body.

    Massive Scrotal Swelling

    Taryn Thomas, Jennifer Roberts-Woodbury

    A man presented with a 10-year history of severe scrotal swelling. The scrotal skin was tender, thickened, and hyperpigmented.

    Diagnostic Tests

    PrecivityAD for Diagnosis of Alzheimer Disease

    Jacob Anderson, Clayton Pierce

    The PrecivityAD test is a widely available blood test for older persons with mild cognitive impairment and is marketed to aid in the diagnosis of Alzheimer disease. The APS produced by the test is accurate in predicting the likelihood of positive PET findings, which may...

    FPIN's Clinical Inquiries

    Is the Use of Hormonal Contraception Associated With Suicide and Suicide Attempts?

    Jennifer Weakley, Viviane Sachs, Kimberly Crosby, Helga Skaftason, Alyssa Migdalski

    There may be an association between the use of hormonal contraception and suicide. Women using oral contraceptives had an increase in completed suicides and suicidal behaviors (i.e., suicidal thoughts and suicide attempts without success).

    FPIN's Help Desk Answers

    Platelet-Rich Plasma for Androgenic Alopecia

    Jeremias Georgiadis, John H. Phillips, Timothy Mott

    Platelet-rich plasma injections more effectively increase hair density vs. usual treatment in men with androgenic alopecia.

    Curbside Consultation

    Harm Reduction for Patients With Substance Use Disorders

    Christopher J. Frank, Leigh Morrison

    Patients engaged in high-risk activities are often ambivalent about changing their behavior. Harm reduction is an approach that focuses on limiting harm and improving quality of life for patients who persist with high-risk behaviors; the foundations of harm reduction are...

    POEMs

    Guidelines for When to Consider Mortality-Reducing Treatments for Patients With Type 2 Diabetes Mellitus

    Allen F. Shaughnessy

    The guidelines give clear guidance on selecting an SGLT2 inhibitor, a GLP-1 receptor agonist, or neither in patients with type 2 diabetes. The guidelines are a bit conservative to some, but guideline development is a two-step process: determining the evidence and then...

    Provided Infant Carriers Increase the Rate of Sustained Breastfeeding

    Allen F. Shaughnessy

    Giving an infant carrier to mothers before or at delivery increases sustained breastfeeding from three to six months following birth. The authors speculate that this outcome is caused by increased physical contact.

    A Single Corticosteroid Burst in Children Is Associated With Harms

    Henry C. Barry

    Although corticosteroid bursts have potential for improving outcomes for many acute illnesses, this study shows that the potential harms are not trivial.

    Evidence of Benefit Is Lacking for Low Back Pain Relief With Muscle Relaxants

    Allen F. Shaughnessy

    Nonsteroidal anti-inflammatory drugs are a better choice for the treatment of low back pain. Despite benzodiazepine and nonbenzodiazepine muscle relaxants being used for almost 50 years to treat low back pain, the supporting evidence is of low certainty. None of the...

    Practice Guidelines

    Behavioral and Psychological Treatments for Chronic Insomnia Disorder: Updated Guidelines From the American Academy of Sleep Medicine

    Michael J. Arnold

    Chronic insomnia is a common sleep disorder that causes impairment, and treatment historically has been limited to sleep hygiene recommendations. The American Academy of Sleep Medicine has updated its clinical practice guidelines on behavioral treatments for chronic insomnia...

    Secondary Prevention of Ischemic Stroke: Updated Guidelines From AHA/ASA

    Brian Ford, Suman Peela, Caroline Roberts

    Stroke is a common source of morbidity and mortality in the United States. The American Heart Association and American Stroke Association (AHA/ASA) published updated guidelines for preventing recurrent ischemic stroke, focusing on overall cardiovascular risk reduction and...

    U.S. Preventive Services Task Force

    Screening for Prediabetes and Type 2 Diabetes

    The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions.

    Medicine by the Numbers

    Reduction in Saturated Fat Intake for Cardiovascular Disease

    Adriane E. Bell, Phillip A. Culp

    Learn more about the effects of reducing saturated fat intake on cardiovascular disease risk.

    Letters to the Editor

    Risks of and Indications for Mifepristone for Medication Abortion

    Weight-Based Levothyroxine Dosage Adjustment for Hypothyroidism

    Family Physicians Should Treat Pregnant Patients With Hypothyroidism

    Information from Your Family Doctor

    Cluster Headache

    A cluster headache is a rare type of headache that causes pain on one side of the head, often around the eye. These headaches could happen every other day or as often as eight times in a single day. The pain can last from 15 minutes to three hours, and it often comes back...

    Adenomyosis

    Adenomyosis (say: ADD-uh-no-mai-OH-sis) is when the tissue that lines your uterus (endometrium) grows into the next layer (myometrium) of your uterus.

    Orthostatic Hypotension

    Orthostatic hypotension (ORTH-oh-sta-tik HI-po-TEN-shun) happens when your blood pressure drops right after you sit up or stand. This can make you feel dizzy, like you are about to pass out, or have blurred vision. You may feel weak or sick to your stomach, or have chest pain...

    Pruritus: Why Am I Itching?

    Pruritus (proo-RYE-tis) is itchy skin or a feeling that you need to scratch. It might hurt and can cause sleep problems and depression if it becomes severe.

    Corrections

    Correction

    Error in algorithm. In the article, “Urethritis: Rapid Evidence Review,” (May 1, 2021, p. 553) the next steps in Figure 1 (page 556) after “Trichomonas vaginalis infection suspected based on risk factors or local prevalence?” were inadvertently switched. The next step after...



    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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