• Articles

    Fibromyalgia: Diagnosis and Management

    Bradford T. Winslow, Carmen Vandal, Laurel Dang

    Fibromyalgia is characterized by diffuse musculoskeletal pain, fatigue, poor sleep, and other somatic symptoms. It can occur in children and adults, and is found worldwide and across cultures. Changes in the diagnostic criteria over the past decade have resulted in more...

    Acute Otitis Externa: Rapid Evidence Review

    Edward A. Jackson, Kamini Geer

    Acute otitis externa is an inflammatory condition that affects the external ear canal. It is usually of rapid onset and is the result of a bacterial infection. It presents with pain, redness, and swelling of the canal and is more common in children and young adults.

    Common Skin Conditions During Pregnancy

    Michael Erlandson, Maggie C. Wertz, Emily Rosenfeld

    Benign hormone-related changes, preexisting skin conditions, and pregnancy-specific disorders can affect patients in varying ways during pregnancy. This article summarizes these conditions and safe treatment options.

    Trigger Point Management

    Benjamin Shipton, Sunkesula Sagar, Jennifer K. Mall

    Myofascial trigger points occur in tight bands of skeletal muscle, causing pain, decreased range of motion, and musculoskeletal disability. They are commonly seen in primary care. Massage, physical therapy, and osteopathic manual medicine are initial noninvasive treatment...

    Peptic Ulcer Disease and H. pylori Infection: Common Questions and Answers

    John R. McConaghy, Amara Decker, Shalina Nair

    Although dyspepsia often occurs without underlying pathology, it can indicate the presence of peptic ulcer disease. The combination of Helicobacter pylori infection and NSAID use increases the risk of ulcers. The H. pylori test-and-treat strategy is the mainstay of outpatient...

    Pharmacologic Treatment of Depression

    Heather Kovich, William Kim, Anthony M. Quaste

    Shared decision-making that considers treatment history, comorbidities, costs, and risk of adverse effects should be used when choosing an antidepressant. When discontinuing an antidepressant, gradually tapering the dosage while concurrently providing cognitive therapy can...


    Comparing Clinical Guidelines for the Management of Major Depressive Disorder

    Andrew Buelt, John R. McQuaid

    This editorial highlights the similarities and differences in clinical practice guidelines that are most relevant to family physicians and other clinicians treating patients with major depressive disorder.

    Chronic Disease Management During Ramadan

    Salman Waqar, Nazim Ghouri, Rania Awaad

    This editorial provides guidance on chronic disease management and explores specific ways physicians can support patients who observe Ramadan.

    AFP Clinical Answers

    Constipation, Endometriosis, Spiritual Assessment, Medical Cannabis, Contraception, ITP

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

    Medicine by the Numbers

    Mu-Opioid Antagonists for the Treatment of Opioid-Induced Bowel Dysfunction

    Brandon Brown, S. Tucker Price

    The systematic review found that oral naldemedine improves opioid-induced bowel dysfunction over two weeks in patients with cancer, and subcutaneous methylnaltrexone improves opioid-induced bowel dysfunction over two weeks in patients receiving palliative care.

    Cochrane for Clinicians

    Strategies for Topical Corticosteroid Use in Children and Adults With Eczema

    Jordan Stouffer, Jennifer G. Chang

    High- and medium-potency topical corticosteroids increase treatment success compared with low-potency topical corticosteroids, but there is no difference in effectiveness between high- and medium-potency topical corticosteroids.

    Guaiac-Based FOBTs vs. FITs for Colorectal Cancer Screening in Average-Risk Adults

    Alan L. Williams, Sajeewane M. Seales

    FITs are more likely than gFOBTs to detect colorectal cancer or advanced adenomas in individuals at average risk.

    U.S. Preventive Services Task Force

    Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Clinical Summary of the USPSTF Recommendation

    The USPSTF recommends that clinicians prescribe a statin for the primary prevention of CVD for adults aged 40 to 75 years who have one or more CVD risk factors and an estimated 10-year risk of a cardiovascular event of 10% or greater.

    Putting Prevention Into Practice

    Statin Use for the Primary Prevention of Cardiovascular Disease in Adults

    Howard Tracer, Helen Barnhart

    This PPIP quiz is based on the recommendations of the USPSTF.

    Implementing AHRQ Effective Health Care Reviews

    Schedule of Visits and Televisits for Routine Antenatal Care

    Tyler S. Rogers, Brendan Lushbough

    What are the risks and benefits of less frequent antenatal in-person visits vs. traditional visit schedules and televisits replacing some in-person antenatal appointments?

    Photo Quiz

    Violaceous Facial Nodules and Dermal Vascular Plaques on the Extremities

    Matthew Helm, Shara Chopra

    A patient presented with a five-month history of well-demarcated, violaceous nodules on her face.

    Hypotension in an Adult With ST-Segment Depressions

    Kartik R. Shah, Charles Thacker

    A patient presented with headache, lightheadedness, loss of balance, and chest discomfort. Electrocardiography was performed.

    FPIN's Clinical Inquiries

    Is Trazodone Effective and Safe for Treating Insomnia?

    Anita Albanese, Brian Vukelic, Dominik Ose, Eliza Taylor, Katherine T. Fortenberry

    Trazodone should not be used to treat insomnia. Trazodone decreases the number of nightly awakenings and may slightly improve subjective sleep quality, but it does not significantly improve total sleep time, sleep efficiency (the ratio of time sleeping to time in bed), sleep...

    Diary of a Family Physician

    Diary of a Family Physician

    Megan Bradley, Dwight Humpherys

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


    Low FODMAP Diet Most Likely to Improve Symptoms in Patients With Irritable Bowel Syndrome

    Mark H. Ebell

    Likelihood of Long COVID Varies by Variant, Sex, and Vaccination Status

    David C. Slawson

    Ketorolac Plus Dexamethasone Is More Effective for Pain Relief Than Ketorolac Alone in Adults With Renal Colic

    Henry C. Barry

    Enoxaparin Is Better Than Aspirin for the Prevention of Venous Thromboembolism After Total Hip or Knee Arthroplasty

    Nita Shrikant Kulkarni

    Practice Guidelines

    Acute Diverticulitis: Diagnosis and Treatment Recommendations From the ACP

    Sajeewane M. Seales, Andre L. Jones, Katharine L. Neff

    The American College of Physicians (ACP) performed a systematic review to determine the most effective diagnosis and management options for acute left-sided colonic diverticulitis.

    Chest Pain Evaluation: Updated Guidelines From the AHA/ACC

    Andrew Buelt, Jack Kennady, Michael Arnold

    The American Heart Association/American College of Cardiology (AHA/ACC) updated guidelines for management of chest pain, which are endorsed by five other cardiology groups.

    Letters to the Editor

    Rapid Removal of a Bee Stinger

    Justin Schmidt, Richard S. Vetter, Li Schmidt

    Reply: Joel Herness, Matthew J. Snyder, Raquelle Suzanne Newman

    The Importance of Inclusivity During the Spiritual Assessment

    William B. Ventres

    Case Report: Onychodystrophy From Late-Onset Congenital Malalignment of the Great Toenails

    Shi Yu Derek Lim, Wei Na Suzanne Cheng

    Case Report: Induced Lactation in an Adoptive Parent

    Kevin Glover, Jeremy Jie Casey, Molly Gilbert

    Alcohol Use Disorder Following Metabolic Surgery

    Kento Sonoda

    Information from Your Family Doctor

    Information for Patients Living With Fibromyalgia

    Fibromyalgia (FI-bro-my-AL-juh) is a common condition that causes pain in muscles, joints, ligaments, and tendons. People with fibromyalgia often feel tired and stiff. They may also have trouble sleeping and may feel depressed. The symptoms of fibromyalgia can be different in...

    Treating Depression With Medicine

    They are thought to work by changing levels of natural chemicals in your brain called neurotransmitters. Neurotransmitters help cells in your brain communicate with each other, and this can change the way you feel. These medicines can help people with mild or moderate...

    Acute Otitis Externa (Swimmer's Ear)

    Acute otitis externa is an infection of the ear canal. Because the ear canal is warm and dark, bacteria (germs) and fungus can grow and cause an infection.


    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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