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Articles

Prevention of Falls in Older Patients

SHOBHA S. RAO

Falls, which are associated with increased morbidity and mortality, are a common threat to the independence of older persons. Strategies that involve multifactorial risk assessment and interventions are most effective in preventing falls.

Diabetic Nephropathy: Common Questions

MICAH L. THORP

Diabetes has become the leading cause of end-stage renal disease in the United States. Early treatment delays or prevents the onset of diabetic nephropathy, but there is insufficient evidence to determine whether tight blood sugar control and use of angiotensin-converting...

Health Effects of Garlic

ELLEN TATTELMAN

Garlic has long been used medicinally, most recently for its cardiovascular, antineoplastic, and antimicrobial properties. Side effects generally are mild and uncommon.

Diagnosis and Management of Fragile X Syndrome

DANIEL J. WATTENDORF, MAXIMILIAN MUENKE

Fragile X syndrome is caused by a mutation in the Fragile X mental retardation 1 gene that can lead to mental retardation. Premature ovarian failure and ataxia may be present in some relatives of persons with fragile X syndrome. It is important to diagnose affected patients...

Diagnosis of Acute Coronary Syndrome

SURAJ A. ACHAR, SURITI KUNDU, WILLIAM A. NORCROSS

In a patient presenting with symptoms that suggest acute coronary syndrome, the initial assessment requires a focused history (including risk factor analysis), a physical examination, an electrocardiogram, and, frequently, serum cardiac marker determinations.

Inside AFP

Look What’s New in AFP

JOYCE A. MERRIMAN

This issue of AFP presents some new features that are intended to meet readers’ needs and increase the value of the publication. Please feel free to tell us how you like them; you can e-mail us atafpedit@aafp.org or mail the comment card included in every issue.

Newsletter

Newsletter

CARRIE A. MORANTZ

Five States Pass Medical Liability Reform Legislation | Physician Supply Increases in States with Caps on Malpractice Awards | HHS Approves Second Multistate Drug Purchasing Pool | AMA Primer Aims to Help Physicians Improve Immunization Rates | AHRQ Awards $8 Million in...

Quantum Sufficit

Quantum Sufficit

AMBER HUNTZINGER, LAURA COUGHLIN

When choosing a doctor, does a patient’s race influence the decision? Researchers surveyed more than 3,500 white, black, and Latino patients and found that many black and Latino patients believe racism exists in the health care system, and those who have this perception are...

Editorials

Genetic Testing: When to Test, When to Refer

ROBERTA A. PAGON

Although genetic testing includes the analysis of DNA, RNA, chromosomes, proteins, and certain metabolites, it is DNA- and RNA-based molecular genetic testing that has catapulted into mainstream medicine during the past decade.1,2 Molecular genetic testing is now available on...

Diary from a Week in Practice

Diary from a Week in Practice

TONY MIKSANEK

Competitive sports can bring out the best in people, but once in a while, athletics also bring to light something unexpected. “This is going to sound weird, but my heart’s not right,” Hailey disclosed in a previous visit. She began having episodes of rapid heart-pounding...

Cochrane for Clinicians

Low-Molecular-Weight Heparin for Initial Treatment of Venous Thromboembolism

DAN BREWER

LMWH is safer and more effective than unfractionated heparin for initial treatment of venous thromboembolism.

Antibiotics for Acute Laryngitis in Adults

MARK H. EBELL

Two small trials of antibiotic treatment in acute laryngitis do not support routine use of antibiotics in these patients. Most patients will feel better in five to seven days, and it is unlikely that they will experience a clinically important benefit from antibiotics.

Follow-up After Surgically Treated Breast Cancer

MARK H. EBELL

The best available evidence supports clinical breast examinations every three to six months for five years and annual mammography for asymptomatic breast cancer survivors. More intensive follow-up and subspecialist visits do not improve survival.

Clinical Evidence Handbook

Gonorrhea

JOHN MORAN

What are the effects of treatments for uncomplicated infections in men and nonpregnant women? What are the effects of treatments for uncomplicated infections in pregnant women? What are the effects of treatments for disseminated gonococcal infection?

FPIN's Clinical Inquiries

Raloxifene for Prevention of Osteoporotic Fractures

SABINA DIEHR, SARA MIJAL, MEDICAL STUDENT, JOAN NASHELSKY

Raloxifene (60 mg daily for three years) will prevent one vertebral fracture, including asymptomatic fractures, for every 46 postmenopausal women with osteoporosis or presence of previous vertebral fractures. Raloxifene has not been shown to prevent nonvertebral fractures. It...

Putting Prevention Into Practice

Screening for Genital Herpes

JANELLE GUIRGUIS-BLAKE, TRACY A. WOLFF

Case study: MS, a 26-year-old woman, has arrived for her first prenatal visit. She is in the eighth week of her third pregnancy. Her previous pregnancies were uncomplicated with normal-term deliveries. Although she has never had any sexually transmitted diseases or symptoms...

Photo Quiz

Multiple Erythematous Plaques of the Trunk

BRIAN B. ADAMS, VITALY BLATNOY

Photo Quiz presents readers with a clinical challenge based on a photograph or other image.

Graham Center Policy One-Pager

The Family Physician Workforce: The Special Case of Rural Populations

People living outside metropolitan areas, especially those living in rural counties, depend on family physicians. Resolving the disparities in physician distribution nationwide will require solutions to make rural practice a viable option for more health care workers.

POEMs

Melatonin Effective for Some Sleep Disorders

ALLEN F. SHAUGHNESSY

St. John’s Wort vs. Paroxetine in Moderate to Severe Depression

ALLEN F. SHAUGHNESSY

Once-Daily Topical Steroid Dosing Just as Effective for Atopic Eczema

MARK EBELL

Milk Intake and Increased Risk of Acne in Teenage Patients

DAVID SLAWSON

Celecoxib Increases Risk of Cardiovascular Complications

MARK EBELL

Practice Guidelines

ACOG Guidelines on Urinary Incontinence in Women

CARRIE A. MORANTZ

Recommendations on the diagnosis and treatment of urinary incontinence in women have been released by the American College of Obstetricians and Gynecologists (ACOG).

Practice Guideline Briefs

ACOG Guidelines on the Management of Human Papillomavirus Infection

CARRIE A. MORANTZ

The American College of Obstetricians and Gynecologists (ACOG) has released guidelines on the clinical management of women with human papillomavirus (HPV) infection.

Which Patients Benefit from CRT?

LAURA COUGHLIN

The American Heart Association has published a science advisory on selecting patients for cardiac resynchronization therapy (CRT).

Letters to the Editor

Discussion of Protective Effects of Hydrochlorothiazide

Weighing the Risks and Benefits of Emergency Contraception

Long-Term Standard-Dose Warfarin to Prevent Thrombosis

PATRICK J. DEPENBROCK

Imiquimod to Treat Basal Cell and Squamous Cell Carcinomas

CURTIS D. KELLER

Tips from Other Journals

Prevention of Breast Cancer with Tamoxifen

ANNE D. WALLING

Inappropriate Prescribing for Older Patients

KARL E. MILLER

Selecting Patients for Cardiac Resynchronization

RICHARD SADOVSKY

New Concepts in Bell’s Palsy Improve Treatment Options

ANNE D. WALLING

Androgen Therapy for Effects of Aging in Older Men

RICHARD SADOVSKY

Information from Your Family Doctor

How to Prevent Falling

Older people who fall can hurt themselves badly. Injuries from a fall can range from bruises and cuts to more serious problems like a broken hip. Falls may keep an older person from living alone. Some older people may not do certain things because they are afraid of falling.

Diabetic Nephropathy

Diabetes can affect many parts of the body, including the kidneys. Blood vessels in the kidneys clean the blood. These vessels can be damaged if diabetes is not controlled. This can cause kidney disease, also called nephropathy (say: nef-RAH-puh-thee). If the damage is bad...

Corrections

Correction



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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