• Articles

    Syncope: Evaluation and Differential Diagnosis

    Max Bayard, Fereshteh Gerayli, James Holt

    Syncope is an abrupt, transient, and complete loss of consciousness caused by cerebral hypoperfusion. The condition is common, and evaluation focuses on history, physical examination (including orthostatic blood pressure measurements), and electrocardiographic results.

    Pleural Effusion: Diagnostic Approach in Adults

    Joy Shen-Wagner, Christine Gamble, Phyllis MacGilvray

    Evaluation of pleural effusion focuses on differentiating exudates from transudates, analyzing fluids, and determining the need for thoracentesis or specialty consultation. Accurate and early diagnosis is critical, with delays potentially causing complications and increased...

    Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia

    Nathaniel E. Miller, David Rushlow, Stephen K. Stacey

    Sodium abnormalities are electrolyte disorders associated with significant morbidity and mortality. An understanding of the pathophysiologic basis of these conditions can be helpful in diagnosis and treatment.

    Common Intestinal Parasites

    Natasha Pyzocha, Amanda Cuda

    Parasites are a source of significant illness worldwide, with more severe symptoms in children, older adults, and immunocompromised individuals. Intestinal parasites have a wide range of symptoms, and they should be suspected in those who present with diarrhea after seven days.

    Managing Difficult Patient Encounters

    Justin Bailey, Susan A. Martin, Angela Bangs

    Family physicians commonly find themselves in difficult patient encounters that can result in patient and physician dissatisfaction. This article reviews physician and patient factors that can contribute to difficult encounters and the tools to help navigate them.

    Dog and Cat Bites: Rapid Evidence Review

    David D. Ortiz, Federico Orlando Lezcano

    This article summarizes the best available evidence for the evaluation and management of dog and cat bites.

    Editorials: Controversies in Family Medicine

    Should Bone Turnover Markers Be Used Routinely to Monitor Oral Bisphosphonate Osteoporosis Therapy?

    Krupa B. Doshi

    Bone turnover markers show a decline with use of oral antiresorptive drugs, but they are not meant for the diagnosis of osteoporosis. Trials have shown an association between a decrease in bone turnover markers after initiation of oral bisphosphonate therapy and long-term...

    Should Bone Turnover Markers Be Used Routinely to Monitor Oral Bisphosphonate Osteoporosis Therapy?

    Herbert L. Muncie, Jr., David J. Mohr, Madeleine L. Maras

    Studies have not found improved outcomes with use of bone turnover markers, and assessment of the markers should be limited to specific populations and research studies. Bone turnover markers are not needed to assess bisphosphonate effectiveness and do not have a direct...

    AFP Clinical Answers

    Pelvic Pain, Food Allergies, Thyroid Disease, Mpox, Chronic Fatigue Syndrome, Alloimmunization

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

    Medicine by the Numbers

    Interventions for Treatment of Poststroke Depression

    Kento Sonoda, Mako Wakabayashi

    We assigned a color recommendation of yellow (unclear benefits) for the treatment of poststroke depression based on a high potential for bias, significant heterogeneity, and limited generalizability.

    Cochrane for Clinicians

    Environmental Interventions for Preventing Falls in Older People Living in the Community

    Joel Herness, Jacob Sanders, Patient Perspective by John James

    Programs that assess and address fall hazards in the home decrease the rate of falls among older people living in the community. In a group of 1,000 older patients at risk who would otherwise experience 1,319 falls in a year, a home-based fall-hazard intervention would...

    Class I and III Antiarrhythmic Drugs for Maintaining Sinus Rhythm After Catheter Ablation of Atrial Fibrillation

    Madhavi Singh, Joseph P. Wiedemer

    Compared with placebo, class I and III antiarrhythmic agents reduce the recurrence of atrial fibrillation after catheter ablation at three to six months postablation. There are no differences in all-cause mortality, thromboembolic events, or myocardial infarction during the...

    U.S. Preventive Services Task Force

    Screening for Chronic Obstructive Pulmonary Disease

    The USPSTF recommends against screening for chronic obstructive pulmonary disease in asymptomatic adults.

    Implementing AHRQ Effective Health Care Reviews

    Postpartum Care Up to One Year After Pregnancy: A Systematic Review and Meta-Analysis

    Sarah E. Stumbar, Suzanne Minor

    What are the results of the use of postpartum care and the clinical outcomes of that care up to one year after pregnancy that was affected by alternative strategies for postpartum health care delivery and extension of postpartum health insurance coverage?

    Photo Quiz

    Mucositis Following an Upper Respiratory Tract Infection

    Brodrick Hirai

    A 20-year-old man presented with odynophagia, conjunctival injection, and lesions on his lips.

    Postpartum Breast Mass

    Sarah Vengal, Bryce Ringwald

    A 38-year-old woman presented with a painful mass in her breast.


    Baricitinib (Olumiant) for the Treatment of Alopecia Areata

    Lauren Pheasant

    Baricitinib may be considered for healthy adults with extensive hair loss who desire treatment, have no contraindications, and can afford the ongoing expense of treatment.

    FPIN's Clinical Inquiries

    Effectiveness of ICS/LABA Compared With SABA as Relief Medications for Asthma

    Amber Karamanis, Heather Bleacher, Kristen DeSanto

    In mild asthma, as-needed ICS/LABA combinations should be used instead of as-needed SABAs without a maintenance inhaler because ICS/LABAs decrease the risk of severe exacerbations, increase the likelihood of having well-controlled asthma, and prolong the time to a first...

    Diagnostic Tests

    Seer Home and Ambulatory Video-EEG-ECG for the Diagnosis of Seizure Disorders

    Haroon Samar, Sarah Contreras-Ortiz

    The Seer Home system allows monitoring from home for up to one week and offers similar diagnostic yield as inpatient monitoring. Improved video technology has resulted in higher capture rates than previous ambulatory EEG products.

    Curbside Consultation

    Medical Assessment After Self-Managed Abortion

    Libby Wetterer, Christina Shenko, Linda Prine

    The family physician’s medical assessment of a patient’s bleeding after self-managed abortion is identical regardless of whether the patient’s bleeding is spontaneous or induced. Assessment includes determining whether the bleeding is normal and whether the abortion is complete.


    2023 AGS Update on Potentially Inappropriate Medication Use in Older Adults

    Henry C. Barry

    Older Treatments for Type 2 Diabetes Mellitus Do Not Affect Patient-Oriented Outcomes

    Allen F. Shaughnessy

    Adipose-Derived Stem Cell Injections Provide Borderline Meaningful Pain Relief in Adults With Degenerative Joint Disease of the Knee

    Henry C. Barry

    Testosterone Does Not Increase Major Adverse Cardiac Events, but Does Increase Risk of Atrial Fibrillation, Pulmonary Embolism, Acute Kidney Injury, and Arrhythmia

    Mark H. Ebell

    Practice Guidelines

    Prescribing Opioids for Pain: Guidelines From the Centers for Disease Control and Prevention

    Michael J. Arnold

    The CDC has released new recommendations for prescribing opioids. Given the continued overuse of opioids to treat pain, the guidelines continue to suggest limiting their use in patients with acute or chronic pain.

    Medications for Irritable Bowel Syndrome: Guidelines From the AGA

    Michael J. Arnold

    The American Gastroenterological Association (AGA) performed systematic reviews to create guidelines on how to manage IBS with pharmacotherapy.

    Letters to the Editor

    Guidelines for Performing Disability Evaluations

    Mark H. Hyman, Douglas W. Martin

    Reply: Ann Evensen, Jeff Hartman


    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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