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  • Articles

    Atrial Fibrillation: Common Questions and Answers About Diagnosis and Treatment

    Sarah Holder, Paula Amin

    Atrial fibrillation is the most common cardiac dysrhythmia in adults in the primary care setting. Diagnosis is based on history and physical examination findings and should be confirmed with 12-lead electrocardiography. Treatment includes rate and rhythm control; goals of...

    Depression: Managing Resistance and Partial Response to Treatment

    Heidi L. Gaddey, Brandyn Mason, Amol Naik

    Treatment-resistant depression is absence of remission despite trials of two or more antidepressant medications; partial response to treatment is less than 50% reduction in depression-rating scores. Management includes adding psychotherapy, switching antidepressant medication...

    Evaluation and Treatment of Nausea and Vomiting in Adults

    Tracy Johns, Elizabeth Lawrence

    In the absence of alarm symptoms, nausea and vomiting are typically treated symptomatically and without an extensive evaluation. Chronic symptoms require a careful history to narrow the differential diagnosis. When a specific etiology is not identified, a serotonin antagonist...

    Substance Misuse in Adults: A Primary Care Approach

    Alicia Kowalchuk, Sandra J. Gonzalez, Roger J. Zoorob

    The medical approach to substance use has significantly changed over the past decade. New tools for prevention, screening, assessment, and treatment have been adopted, and family physicians are well positioned to provide prevention and management.

    Acute Pericarditis: Rapid Evidence Review

    Thomas A. Peterson, Sean P. Turner, Katelyn A. Dolezal

    This article reviews patient-oriented evidence to guide the diagnosis and management of acute pericarditis.

    Falls in Older Adults: Approach and Prevention

    Jessica S. Coulter, Jessica Randazzo, Erinn E. Kary, Haroon Samar

    Clinicians should screen older adults for fall risk, and if results are abnormal, multicomponent interventions are indicated. These include optimizing care of chronic medical conditions, evaluating home safety, and avoiding polypharmacy and drugs that increase fall risk.

    Editorials

    Diagnostic and Therapeutic Advances in Cystic Fibrosis: How Family Physicians Can Partner in Care

    Melanie Sue Collins, Kenia Mansilla-Rivera

    Patients with cystic fibrosis are living longer, healthier lives and are now facing many of the same ongoing health challenges as people without the condition.

    Anxiety Screening Is Unlikely to Improve Mental Health Outcomes

    Brett D. Thombs, Sarah Markham, Danielle B. Rice, Roy C. Ziegelstein

    Adding anxiety screening tests takes time away from critical health care tasks and is not likely to benefit patients compared with good standard care.

    AFP Clinical Answers

    Esophageal Cancer, Uterine Bleeding, HIV, Bariatric Surgery and Pregnancy, Venous Thromboembolism, Renal Colic

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

    Medicine by the Numbers

    Hyaluronic Acid Products for Chronic Wound Healing

    Melinda W. Ng, Christina Valerio

    Because of the significant risk of blinding bias and imprecision in the results as well as inadequate assessment of harms, a color recommendation of yellow (unclear benefits) is assigned for use of hyaluronic acid for chronic wounds.

    Cochrane for Clinicians

    Saw Palmetto for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia

    Noa C. Hammer, Jill Thiede

    Saw palmetto, alone or in combination with other phytotherapeutic agents, does not improve urologic symptoms or quality of life in the short term (3 to 6 months) or long term (12 to 17 months). Also, it does not cause significant adverse events.

    Antidepressants to Aid in Smoking Cessation

    William D. Nettleton, Jessel Ramdass

    Bupropion facilitates tobacco cessation reported at 6 months of follow-up compared with placebo or no pharmacological treatment. More people discontinue using bupropion due to adverse effects than those using placebo or no pharmacological treatment.

    U.S. Preventive Services Task Force

    Screening for Anxiety Disorders in Adults

    The USPSTF recommends screening for anxiety disorders in adults, including pregnant and postpartum persons. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety disorders in older adults.

    Putting Prevention Into Practice

    Screening for Anxiety Disorders in Adults

    Iris Mabry-Hernandez, Susan J. Ching

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

    Implementing AHRQ Effective Health Care Reviews

    Pharmacotherapy for Adults With Alcohol Use Disorder

    Alyssa Bruehlman, Elizabeth Salisbury-Afshar

    Effects attributed to medications beyond nonpharmacologic interventions and placebo are reviewed.

    FPIN's Clinical Inquiries

    Baclofen for Alcohol Use Disorder

    Elin Kondrad, Abria Bonner, Stephanie Sandhu, Kathryn Seitz, Stephanie Weldon

    Baclofen with psychosocial therapy is modestly effective in helping patients with AUD achieve abstinence, increasing abstinent days by approximately 10%. A total of 40% to 50% of patients can achieve or maintain abstinence at 1 year after treatment initiation.

    Photo Quiz

    Persistent Pink Nodules and Hyperpigmented Plaques on Trunk and Extremities

    Daniela M. Mendez, Shayna C. Rivard

    A 68-year-old woman presented with persistent lesions on her trunk and extremities.

    Red, Verrucous Plaque on the Forearm

    Melinda Jean Gruber, Zachary Britstone, Katherine Schaefer

    A 63-year-old man presented with a nonpainful skin lesion on his left forearm.

    Diagnostic Tests

    Role of sFlt-1/PlGF Ratio in Diagnosing Preeclampsia

    Vidya Lala, Samone Franzese

    The sFlt-1/PlGF ratio cutoff must be standardized and further validated with additional clinical trials before implementation in the prediction and diagnosis of preeclampsia.

    STEPS

    Fecal Microbiota Spores, Live-Brpk (Vowst) to Prevent Clostridioides difficile Infection

    Andrew Smith, Tuhin Roy

    Vowst is simple to administer, well tolerated, and relatively effective for patients with recurrent C. difficile infection. However, it is significantly expensive. It may be considered for patients who have had 3 or more episodes of C. difficile infection within 12 months.

    Curbside Consultation

    Firearm Injury Prevention: Practical Office Tips

    James Bigham, Melissa Stiles, Mario Giacobassi

    Framework for how physicians can engage in patient-centered discussions that promote firearm injury prevention.

    POEMs

    Single Intramuscular Dose of Nirsevimab Reduces Likelihood of Hospitalization Due to RSV in Average-Risk Infants During First Year of Life

    Mark H. Ebell

    PCI Is Better Than Placebo for Stable Angina in Patients Who Do Not Take Antianginal Medications

    Mark H. Ebell

    Monoclonal Antibodies for Alzheimer Disease: a Lack of Clinically Meaningful Benefits, Plus Significant Harms

    Linda Speer

    Delivery of Bad News Via Telephone Is Equal to In-Person Delivery

    Allen F. Shaughnessy

    Practice Guidelines

    Evaluation of Mild Traumatic Brain Injury in Adults: Guidelines From the ACEP

    Michael J. Arnold

    The American College of Emergency Physicians (ACEP) has published new guidelines for evaluation of mild TBI.

    Management of First-Episode Psychosis and Schizophrenia: Guidelines From the VA/DoD

    Michael J. Arnold

    The U.S. Department of Veterans Affairs and U.S. Department of Defense (VA/DoD) published new recommendations for diagnosing and managing schizophrenia and first-episode psychosis.



    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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