• Articles

    Sacroiliac Joint Dysfunction: Diagnosis and Treatment

    David P. Newman, Adam T. Soto

    Sacroiliac joint dysfunction is a common cause of low back pain. A set of provocation tests that together have high sensitivity and specificity can help differentiate sacroiliac joint dysfunction from other causes of back and lower extremity pain. Manipulation combined with...

    Heart Murmurs in Children: Evaluation and Management

    Brian Ford, Sebastian Lara, James Park

    The lifetime incidence of murmurs in children is high. The presence of a murmur can indicate conditions ranging from no discernable pathology to acquired or congenital heart disease. All infants, with or without a murmur, should have pulse oximetry screening to detect...

    Health Care–Associated Infections: Best Practices for Prevention

    Stephen D. Cagle, Jr., Brett L. Hutcherson, Anna T. Wiley

    Health care–associated infections are a significant cause of morbidity and mortality in the United States; common examples include catheter-associated urinary tract infections, central line–associated bloodstream infections, ventilator-associated pneumonia, surgical site...

    Alpha- and Beta-thalassemia: Rapid Evidence Review

    Drew C. Baird, Stuart H. Batten, Steven K. Sparks

    This rapid evidence review details screening, diagnostic testing, and treatment options for alpha- and beta-thalassemia, including indications for transfusion therapy, iron chelation therapy, and hematopoietic stem cell transplantation. Common complications from thalassemia...

    Telemedicine in Diabetes Care

    Rashmi S. Mullur, Joseph S. Hsiao, Khristina Mueller

    Telemedicine can be useful for the management of diabetes mellitus. Remote monitoring of glucose levels improves A1C levels in people with poor glucose control. When multiple daily injections of insulin are required, continuous glucose monitoring improves glycemic control and...

    Parathyroid Disorders

    Jarrett Sell, Sarah Ramirez, Michael Partin

    Parathyroid disorders are usually identified incidentally by abnormalities in serum calcium levels. They can be primary or secondary and treated with surgery or medical management. Initial laboratory testing can be used to identify potential etiologies of parathyroid...

    Photo Quiz

    Hair Loss in a Child

    Sam Longfellow, Jason Zhang

    A three-year-old boy presented with hair loss that started as a small patch on the back of his head and worsened over the last two months.

    Progressive Rash in an Infant

    Clota Snow, Sara Heard, Jonathan Karnes, Gabrielle Harpell

    An infant presented with a rash that first appeared on her chin and then spread to the diaper area, limbs, and chest.

    Practice Guidelines

    ACIP Approves 2022 Adult and Child/Adolescent Immunization Schedules

    Pamela G. Rockwell

    The 2022 adult and child/adolescent immunization schedules have been approved by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. These schedules now combine links to COVID-19 vaccination information, Vaccination Information...

    Colorectal Cancer Screening: Updated Guidelines From the American College of Gastroenterology

    Caitlyn de Kanter, Sukhamani Dhaliwal, Matthew Hawks

    The American College of Gastroenterology released updated guidelines for CRC screening.

    Editorials

    The Importance and Challenges of Reducing Low-Value Care in Children

    Kao-Ping Chua

    Eliminating the use of low-value care (interventions for which harms typically exceed benefits) in children is crucial.

    Curbing Cascades of Care: What They Are and How to Stop Them

    Ishani Ganguli

    Incidental findings on imaging studies and laboratory can lead to office visits, invasive tests, hospitalizations, and new diagnoses. These cascades of care will become even more common as imaging tests gain sensitivity.

    Curbside Consultation

    Gender-Based Requests for Physician Care

    Jacob M. Appel

    Many patients have personal preferences regarding their choice of physicians. These may include personal factors such as the physician’s race, ethnicity, religion, gender, sexual orientation, or age. These patient preferences, and requests to accommodate them, occur on a...

    STEPS

    Cellulose and Citric Acid (Plenity) for Weight Management in Overweight and Obese Adults

    Keri Sewell, Afi M. Semenya

    Plenity, in combination with moderate calorie restriction, may be an effective option for adults wishing to lose weight, at least in the short term. However, as a medical device, Plenity has not been held to the same standard of testing as would be expected with medications.

    Cochrane for Clinicians

    Can Mobile Phone–Based Interventions Improve Adherence to Medication for Primary Prevention of Cardiovascular Disease in Adults?

    Jedda Rupert, Anne Mounsey

    Mobile phone–based interventions improve adherence to cardiovascular medication regimens and may improve blood pressure control, but there is no patient-oriented evidence that these interventions are beneficial.

    Antibiotics for the Treatment of COVID-19

    Amy Crawford-Faucher

    Azithromycin (Zithromax) is the most consistently studied antibiotic for use in treating patients infected with the SARS-CoV-2 virus; it does not improve mortality after 28 days or affect the clinical course for hospitalized adults with COVID-19. In outpatient adults with...

    Lown Right Care

    Appropriate Use of Electrocardiography in Preparticipation Physical Evaluations

    Matthew Schefft, Elizabeth R. Wolf, Ricardo Quinonez, Helen Haskell, John James

    A collaboration between AFP and the Lown Institute promotes a vision of delivering health care that is based on the evidence, balanced in its approach, and focused on the patient.

    FPIN's Clinical Inquiries

    Thumb Spica Casts for Scaphoid Fractures

    Jason W. Deck, Lamont Cavanagh, Christopher Crane, Franklin T. Perkins, III, Christopher Jarrett, Toni Hoberecht

    The type of cast used does not appear to impact outcomes. A short arm cast allows the patient to have better function and mobility during immobilization without compromising the healing process. Thumb spica casts are no better than casts that do not include the thumb in...

    POEMs

    Limited Data Suggest That Music Improves Sleep Quality in Older Adults

    Henry C. Barry

    This study suggests that listening to music, especially sedative music, can improve sleep quality in older adults, but the underlying data are limited and of mixed quality.

    Universal Depression Screening in Primary Care: 77% False Positives

    Allen F. Shaughnessy

    There is considerable uncertainty, which is reflected in the disparate guidelines, about whether screening for depression is helpful to patients (rather than a way to label them as being depressed or not). Most of the positive scores on the Patient Health Questionnaire-9 tool...

    Predictive Values for Six Common Abdominal Symptoms

    Allen F. Shaughnessy

    Using a cutoff of 3% risk (from The National Institute for Health and Care Excellence), dysphagia or changes in bowel habits in men and rectal bleeding in women should trigger referral for further workup to exclude cancer or inflammatory bowel disease (IBD). Symptoms such as...

    Salt Substitute Reduces Mortality and Stroke in Older Adults Who Have a History or Are at Risk of Stroke

    Mark H. Ebell

    For older adults who have a history or are at risk of stroke, the use of a salt substitute safely reduces their risk of death or stroke.

    Diagnostic Tests

    UCH-L1 and GFAP Testing (i-STAT TBI Plasma) for the Detection of Intracranial Injury Following Mild Traumatic Brain Injury

    Jennifer Middleton

    UCH-L1 and GFAP are serum markers that may be used to reduce the need for head CT after mild TBI. However, there are no studies on the incorporation of these markers into existing head CT clinical decision rules or that describe the optimal use of the i-STAT TBI Plasma test...

    U.S. Preventive Services Task Force

    Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years

    The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride and apply fluoride varnish to the primary teeth of all infants and children starting at the age of...

    Medicine by the Numbers

    Azithromycin for Treatment of COVID-19

    Brit Long, Michael Gottlieb

    Learn more about azithromycin for treatment of COVID-19.

    Putting Prevention into Practice

    Screening and Interventions to Prevent Dental Caries in Children Younger Than Five Years

    Sheena Harris, Wigdan Farah, Christopher Snitchler

    Case study: Hispanic parents who are new to your practice bring in their two children, two years of age and four months of age, for routine wellness visits. Neither child has any known chronic medical conditions, and both are current on routine immunizations. The four-month...

    AFP Clinical Answers

    Human Papillomavirus, Depression, Onychomycosis, Sciatica, Headaches, Obstetric Lacerations

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

    Point-of-Care Guides

    Bacterial Meningitis in Children

    Stephen M. Young, Aaron Saguil

    Is it possible to predict the likelihood of bacterial meningitis in children with clinically suspected meningitis?

    Letters to the Editor

    Should Muscle Relaxants Be Used as Adjuvants in Patients With Acute Low Back Pain?

    Information from Your Family Doctor

    Sacroiliac Joint Dysfunction and Back Pain

    Sacroiliac (sa-krow-i-lee-ak) joint dysfunction is a type of low back pain. Pain is felt along the buttocks (see Photo 1) on one side or both sides, but not in the center. The pain can be felt (see Photo 2) up along the back muscles (red arrow), down along the back of the...

    Heart Murmurs in Children: What Parents Should Know

    A heart murmur is a noise that comes from the blood flowing through the heart. The doctor can hear it with a stethoscope. Most of the time, a murmur is just the sound of normal blood flow and it will go away over time. Once in a while, murmurs come from problems inside the...



    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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