• Articles

    Fever of Unknown Origin in Adults

    Aïsha David, Jeffrey D. Quinlan

    Fever of unknown origin is defined as a clinically documented temperature of 101°F or higher on several occasions, coupled with an unrevealing diagnostic workup. The possible causes are typically categorized as infection, malignancy, noninfectious inflammatory disease, or...

    Hemoptysis: Evaluation and Management

    David O'Gurek, Hiu Ying Joanna Choi

    Hemoptysis is the expectoration of blood from the lower respiratory tract. More than 90% of hemoptysis cases are nonmassive, self-limiting, and have a good prognosis with conservative management. However, massive hemoptysis has a mortality rate of greater than 50%.

    Borderline Personality Disorder

    Megan Mendez-Miller, Julianna Naccarato, Julie A. Radico

    Borderline personality disorder is characterized by instability in affect regulation, impulse control, interpersonal relationships, and self-image. Patients may have chronic or vague somatic concerns, suicidal ideation, aggressive outbursts, high-risk sexual behaviors, and...

    Maturity-Onset Diabetes of the Young: Rapid Evidence Review

    Ravi Kant, Amanda Davis, Vipin Verma

    Maturity-onset diabetes of the young is a non–insulin-dependent form of diabetes mellitus that is most often diagnosed in nonobese young adults with a strong family history of diabetes. Lifestyle modification is the first-line treatment. Sulfonylureas are the preferred...

    Common Sleep Disorders in Children

    Prajakta Deshpande, Betzy Salcedo, Cynthia Haq

    Childhood sleep disorders can disrupt family dynamics, cause cognitive and behavior problems, and cause motor vehicle crashes in teenagers. Early recognition and management of common sleep disorders can prevent these complications.

    Cervical Ripening and Induction of Labor

    Vernon Wheeler, Ariel Hoffman, Michael Bybel

    This article updates clinical guidelines for induction of labor, including indications, assessment of cervical favorability, and timing of induction. The authors review the effectiveness and safety of inducing labor using mechanical and pharmacologic methods and their...

    Editorials: Controversies in Family Medicine

    Insufficient Evidence to Support Lowering the Starting Age

    Corey Lyon, Alexis Vosooney, Melanie D. Bird

    Colorectal cancer is the third leading cause of cancer-related death in both men and women, behind lung and breast cancers, and is second only to lung cancer when men and women are combined.1 The American Cancer Society estimates that there were 149,500 new cases of colon or...

    Yes: Lowering the Starting Age Is a Settled Issue

    Richard C. Wender

    The American Academy of Family Physicians (AAFP) recently issued an updated colorectal cancer screening guideline that disagrees with the U.S. Preventive Services Task Force (USPSTF) recommendation to begin screening average-risk individuals at 45 years of age. AAFP continues...

    AFP Clinical Answers

    Hypertension, Pertussis, Splenomegaly, Breast Cancer, SGLT2 Inhibitors, Blood Pressure Monitoring

    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

    The National Health Service Corps at 50 Years

    Adrian N. Billings, Yalda Jabbarpour, Jack Westfall

    The National Health Service Corps (NHSC) was established in 1970 to address the mal-distribution of physicians in the United States. In 1972, it placed the first clinicians (181 physicians) into rural and urban underserved communities. Since then, the NHSC has grown into a...

    Medicine by the Numbers

    Remdesivir for the Treatment of COVID-19

    Robert Allen, Matthew Turner, Ian S. deSouza

    Learn more about using remdesivir for the treatment of COVID-19.

    Cochrane for Clinicians

    Behavioral Interventions for Smoking Cessation

    Nicholas LeFevre, Joshua St. Louis

    A variety of behavioral interventions are effective for smoking cessation. Providing individual or group counseling, guaranteed financial incentives, and text message–based counseling provide the greatest benefit. Population characteristics do not consistently affect the...

    Virtual vs. In-Person Pulmonary Rehabilitation for Chronic Lung Disease

    Meghan Raleigh, Jennifer Chang

    For patients with chronic obstructive pulmonary disease, virtual pulmonary rehabilitation is equivalent to in-person pulmonary rehabilitation at reducing symptoms of breathlessness and increasing six-minute walking distance. Participants in both virtual and in-person...

    Putting Prevention Into Practice

    Behavioral Counseling Interventions for Healthy Weight and Weight Gain in Pregnancy

    Iris R. Mabry-Hernandez, Mitchell Legg

    Case study: A 23-year-old patient, J.J., presents to confirm pregnancy after a positive home pregnancy test result. The first day of the patient's last menstrual period was seven weeks ago. J.J. has no concerns, and blood pressure is 118/78 mm Hg on examination. J.J.'s...

    Photo Quiz

    Hyperpigmented Reticular Patches in a Young Adult

    Sandra Osswald, Kavina Patel, Amreen Sitabkhan

    A patient presented with faint, dark purple, hyperpigmented patches in a reticular pattern, forming several complete rings, on his dorsal thighs and a few on his lower legs and arms.

    Inflammation of the Eye

    Richard M. Rubin, Ayodeji Alaketu

    A patient presented with dilated right eye, with incomplete constriction to light, and a small collection of white fluid in the anterior chamber of the affected eye.

    Implementing AHRQ Effective Health Care Reviews

    Cervical Ripening in the Outpatient Setting

    Tyler S. Rogers, Ben Lampe, Stephanie Skelly

    What is the effectiveness and what are the harms of cervical ripening methods in the outpatient vs. inpatient setting?

    FPIN's Clinical Inquiries

    Topical Nitroglycerin for Lower Extremity Tendinopathy

    Jeremy Loescher, Paul Waclawski, Richard Guthmann

    In non-insertional Achilles tendinopathy, topical NTG patches are minimally better than placebo at 24 weeks. Topical NTG plus physical therapy is not superior for pain relief or functional improvement compared with placebo patches plus physical therapy. In chronic patellar...

    Diagnostic Tests

    Multitarget Stool DNA Testing (Cologuard) for Colorectal Cancer Screening

    Karl T. Clebak, Sarah Nickolich, Megan Mendez-Miller

    MT-sDNA testing is a stool-based screening method that is recommended by the U.S. Preventive Services Task Force and covered by most insurance plans. It has higher sensitivity than FIT or FOBT for advanced adenomas but leads to more false-positive results, has a higher...

    Diary of a Family Physician

    Diary of a Family Physician

    Annette Chavez

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

    POEMs

    Telephone-Based Cognitive Behavior Therapy for Insomnia Is Effective

    Allen F. Shaughnessy

    In patients with clinical insomnia and chronic pain, CBT for insomnia delivered via telephone over six sessions leads to relief of sleeplessness that is sustained for at least one year. In this study, general education also provided insomnia relief to many patients.

    Amoxicillin Does Not Improve Outcomes for Nonpneumonia Lower Respiratory Tract Infection in Children

    Mark H. Ebell

    A high dosage of amoxicillin (50 mg per kg per day, in three divided doses) did not significantly improve outcomes for children with a lower respiratory tract infection that is not pneumonia.

    Every-Other-Year FIT Is at Least as Effective as a Single Sigmoidoscopy to Detect Colorectal Cancer

    Allen F. Shaughnessy

    Fecal immunochemical testing (FIT) every other year, over at least six years, identified fewer cancers and advanced adenomas initially, but surpassed a single sigmoidoscopy in detection after three rounds of testing. The increased detection may be because of greater...

    Clopidogrel Monotherapy More Effective Than Aspirin to Prevent Coronary Events After PCI With Drug-Eluting Stents

    Henry C. Barry

    In this study, clopidogrel monotherapy caused fewer subsequent events compared with aspirin monotherapy in stable patients who completed dual antiplatelet therapy after PCI with drug-eluting stents.

    Practice Guidelines

    Antibiotic Courses for Common Infections: Recommendations From the ACP

    MaryAnn Dakkak, Mallika Sabharwal

    After reviewing clinical guidelines, systematic reviews, and individual studies, the American College of Physicians has released recommendations for common antibiotic prescribing situations in primary care.

    Diagnosis and Management of Hypertrophic Cardiomyopathy: Updated Guidelines From the ACC/AHA

    Jeffrey C. Leggit, Daniel Whitaker

    These guidelines from the American College of Cardiology and American Heart Association update the previous guidance released by these organizations in 2011.

    U.S. Preventive Services Task Force

    Behavioral Counseling Interventions for Healthy Weight and Weight Gain in Pregnancy

    The USPSTF recommends that clinicians offer pregnant persons effective behavioral counseling interventions aimed at promoting healthy weight gain and preventing excess gestational weight gain in pregnancy.

    Letters to the Editor

    Case Report: Four-Month-Old With Failure to Thrive and a Rash

    David A. Shafique, Shannan McCann, Kate Kimes

    Information from Your Family Doctor

    Fever of Unknown Origin in Adults

    It's a fever of 101°F (or 38.3°C) or higher that occurs several times. Even after you see your doctor, there's not a clear reason for the fevers.

    Maturity-Onset Diabetes of the Young: What You Need to Know

    Maturity-onset diabetes of the young, or MODY for short, is an uncommon type of diabetes that people get as children or young adults. It runs in families.

    What You Need to Know About Sleep for Your Child

    Sleep is important so your child can grow healthy and happy. Six out of 10 children in middle school and seven out of 10 in high school do not get the amount of sleep they need.

    Corrections

    Correction

    Clarification of clinical quality measure. In the article, “Home Blood Pressure Monitoring,” (September 2021, p. 237) the third paragraph of the Best Practices for Home Blood Pressure Monitoring section on page 241 discussed the clinical quality measures related to home blood...



    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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