• Articles

    Common Oral Lesions

    David A. Randall, N. Lyn Wilson Westmark, Brad W. Neville

    Patients with oral disease may present to their family physician before a dentist. Some lesions are purely localized to the mouth, and others have systemic manifestations. Common conditions include aphthous stomatitis, candidiasis, herpetic stomatitis, leukoplakia,...

    Recurrent Venous Thromboembolism

    Hillary R. Mount, Megan Rich, Michael S. Putnam

    This article will help physicians assess risks and benefits of prolonged anticoagulation treatment and address considerations in specific populations to reduce the risk of recurrent venous thromboembolism.

    Chlamydial and Gonococcal Infections: Screening, Diagnosis, and Treatment

    Nicole Yonke, Miranda Aragón, Jennifer K. Phillips

    Screening for chlamydial and gonococcal infections is key to preventing transmission because most infections are asymptomatic. This article discusses which populations should be screened and how often, diagnostic testing and treatment options, and follow-up care.

    Common Sleep Disorders in Adults: Diagnosis and Management

    Sarah Holder, Navjot S. Narula

    The Institute of Medicine estimates that 50 million to 70 million adults in the United States report chronically disturbed sleep. Sleep disturbances have been associated with motor vehicle collisions, hypertension, decreased quality of life, and increased all-cause mortality.

    Ulcerative Colitis: Rapid Evidence Review

    Stephen M. Adams, Elizabeth D. Close, Aparna P. Shreenath

    This rapid evidence review summarizes risk factors, symptoms, and testing for ulcerative colitis. Treatment depends on severity and can include pharmacologic, surgical, complementary, and behavioral interventions. Preventive care considerations and recommendations for...

    Alcoholic Hepatitis: Diagnosis and Management

    Michelle Keating, Olivia Lardo, Maggie Hansell

    The diagnosis of alcoholic hepatitis is primarily clinical, including acute-onset jaundice, specific laboratory abnormalities, and a history of long-term heavy alcohol use. Treatment consists of abstaining from alcohol, optimizing nutrition, managing comorbid conditions, and,...

    Editorials

    Where Clinical Practice Guidelines Go Wrong

    Henry C. Barry, Lisa Cosgrove, David C. Slawson

    Clinical practice guidelines, essential tools for evidence-based practice, have proliferated over the past few decades but remain controversial for several reasons.

    Why Physicians Should Not Prescribe Aducanumab for Alzheimer Disease

    Mark H. Ebell, Henry C. Barry

    Guidance to clinicians about how to approach use of the Alzheimer treatment aducanumab (Aduhelm) and other newly approved medications.

    Graham Center Policy One-Pagers

    Primary Care, Public Health, and Social Assets Are Essential to the COVID-19 Response

    Yalda Jabbarpour, Anuradha Jetty, Ann Greiner, Jack Westfall

    The COVID-19 pandemic has underscored the need for a more effective and equitable health care system in the United States. County-level variations in COVID-19 positivity rates, hospitalizations, and number of deaths demonstrate that community-level factors are essential to...

    AFP Clinical Answers

    Opioids, Vision Screening, Altered Mental Status, Hemochromatosis, Osteomyelitis, Renal Disease

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

    Cochrane for Clinicians

    Cilostazol for Intermittent Claudication Caused by Peripheral Artery Disease

    Rebecca Lauters, Danielle Wilkin

    Cilostazol improves initial and absolute walking distances in patients with intermittent claudication secondary to PAD and appears to be equivalent in effect to pentoxifylline (Trental). Adverse effects of cilostazol include headache, diarrhea, dizziness, and palpitations.

    Oral vs. Intravaginal Antifungal Treatments for Uncomplicated Vulvovaginal Candidiasis

    Alexis Reedy-Cooper, Sarah Ramirez, Stacey Thomas

    Clinical resolution of symptoms is similar for oral and intravaginal antifungal medications at both short-term (five to 15 days) and long-term (two to 12 weeks) follow-up. However, mycological cure rates (fungal spores cleared from vaginal secretions) are higher in patients...

    Diary of a Family Physician

    Diary of a Family Physician

    Maya Bass, Arindam Sarkar

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

    Photo Quiz

    Erythematous Mass on the Posterior Cervical Triangle

    Mami Ichinose, Kazuki Iio, Hiroshi Sakakibara

    An 11-month-old girl presented with a fever and right neck mass a week after being diagnosed with hand-foot-and-mouth disease.

    Slow Growing Mass on the Thumb

    T. Aaron Zeller, Katrina Quick, Kasey McDonald

    A 65-year-old man presented with an erythematous mass on his thumb that had been slowing enlarging for the past 10 years.

    FPIN's Clinical Inquiries

    Patient Education Interventions Improve A1C Values

    Sean Llewellyn, Melissa Neuman, Corey Lyon, Kristen DeSanto

    Patient education interventions, specifically those including face-to-face interactions with trained educators or nurses, improve A1C values in patients by 0.3% to 1.4% compared with usual diabetes care.

    FPIN's Help Desk Answers

    SSRIs vs. SNRIs for Vasomotor Symptoms of Menopause

    Laura Morton Newhouser, Mandy Maneval, Kiran Rayalam, Ghazala Sabeeh, Lionel Varela

    Both SSRIs and SNRIs are effective at relieving vasomotor symptoms of menopause. No studies have directly compared the two classes of medication. SNRIs are associated with more adverse effects. Venlafaxine is preferred in women with breast cancer because SSRIs may interfere...

    Practice Guidelines

    Medical Care for Adults With Down Syndrome: Guidelines From the Global Down Syndrome Foundation

    Christopher W. Bunt, Stephanie K. Bunt

    The Global Down Syndrome Foundation (GLOBAL) has published the first medical care guidelines for adults with Down syndrome.

    Prevention or Delay of Type 2 Diabetes Mellitus: Recommendations From the American Diabetes Association

    Jeanmarie B. Rey, Matthew Hawks

    The American Diabetes Association (ADA) has released updated guidelines for the prevention or delay of diabetes.

    U.S. Preventive Services Task Force

    Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality

    The USPSTF recommends the use of low-dose aspirin (81 mg/day) as preventive medication after 12 weeks of gestation in persons who are at high risk for preeclampsia.

    Medicine by the Numbers

    Splint vs. Cast for Forearm Buckle Fracture in Children

    Marc Zwillenberg, Esther Kwak

    Learn more about splint vs. cast for forearm buckle fracture in children.

    POEMs

    Relapse of Depression More Likely After Discontinuation of Medication

    Mark H. Ebell

    Primary care patients who discontinued antidepressant medications were more likely to experience relapse of their depression than those who continued to take their antidepressants. The interpretation is that 44% of patients with depression who discontinue their antidepressant...

    Midodrine Is Worth a Trial in People With Frequent Episodes of Vasovagal Syncope

    Allen F. Shaughnessy

    Midodrine is a vasoconstrictor used to prevent orthostatic hypotension and may reduce the likelihood of recurrence of vasovagal syncope in patients with frequent episodes. It seems to work completely or not at all; during this study, the patients who had at least one episode...

    Empagliflozin Reduces Hospitalization for Heart Failure With Preserved Ejection Fraction, but Not Mortality Outcomes

    Mark H. Ebell

    In patients who have heart failure with preserved ejection fraction, empagliflozin, 10 mg once daily, reduces the likelihood of hospitalization for heart failure. There is no effect on cardiovascular or all-cause mortality.

    Platelet-Rich Plasma Injections Are Not Superior to Placebo Injections for Ankle Osteoarthritis

    David C. Slawson

    This study found no evidence that supports a benefit of platelet-rich plasma injections compared with saline placebo injections for improving function or reducing pain in adults with symptomatic ankle osteoarthritis.

    Letters to the Editor

    AAFP Clinical Preventive Services Recommendation Development Process Explained

    Information from Your Family Doctor

    Chlamydia

    Chlamydia (kluh-MID-ee-uh) is the most common sexually transmitted infection, or STI. It can affect the penis, vagina, or rectal area.

    Gonorrhea

    Gonorrhea (gon-or-REE-uh) is a sexually transmitted infection, or STI. It can affect the penis, vagina, throat, or rectal area. Rarely, if it is not treated, it can spread to other places like the blood, joints, skin, heart, and brain.



    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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