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Articles

Unintentional Weight Loss in Older Adults

Heidi L. Gaddey, Kathryn K. Holder

Unintentional weight loss in people older than 65 years is associated with increased morbidity and mortality. Treatment should focus on feeding assistance, addressing contributing medications, providing appealing foods, and social support.

Top 20 Research Studies of 2020 for Primary Care Physicians

Roland Grad, Mark H. Ebell

The annual installment of this series summarizes the top studies of 2020. These studies were summarized as POEMs (patient-oriented evidence that matters) and were highly rated by Canadian Medical Association members for their clinical relevance. This group of the highest...

Complex Regional Pain Syndrome

Emillia C. O. Lloyd, Bradley Dempsey, Lindsey Romero

Complex regional pain syndrome is a rare, chronic disorder that leads to pain that may last for years. The disease typically develops four to six weeks after direct trauma, such as an injury or surgery. Diagnosis is made clinically using standardized diagnostic criteria. The...

Management of Infants Born to Mothers with HIV Infection

Vini Vijayan, Fouzia Naeem, Angela F. Veesenmeyer

Strategies to prevent mother-to-child transmission include maternal and infant antiretroviral therapy and formula-feeding instead of breastfeeding. All infants born to mothers with HIV infection should receive antiretroviral postexposure prophylaxis within six to 12 hours...

Pharmacologic Therapy for Acute Pain

Octavia Amaechi, Miranda McCann Human, Kaleigh Featherstone

Acetaminophen and nonsteroidal anti-inflammatory drugs are the first-line treatment options for most patients with mild to moderate acute pain. Severe acute pain may necessitate reserved short-term use of opioids with attention to minimizing risk.

Costochondritis: Rapid Evidence Review

Timothy Mott, Gregory Jones, Kimberly Roman

Costochondritis is a common cause of chest pain. The diagnosis is largely based on history and a physical examination that demonstrates reproduction of pain through palpation of the parasternal region of the chest wall, performance of a crowing rooster maneuver, and/or a...

Editorials

Prioritizing Primary Care Can Save the U.S. Health Care System

Ada D. Stewart

Can prioritizing primary care save the U.S. health care system?

Pharmacogenetic Gene-Drug Associations: FDA Perspective on What Physicians Need to Know

Wendy S. Rubinstein, Michael Pacanowski

To share its perspective on the state of the science, the FDA has published a table of pharmacogenetic associations related to genetic variants that can affect drug concentrations, therapeutic responses, or adverse events.

AFP Clinical Answers

Heavy Menstrual Bleeding, Acute Pyelonephritis, Bacteriuria, IgA Vasculitis, Febrile UTIs

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

Medicine by the Numbers

Levonorgestrel-Releasing Intrauterine System for Regression of Endometrial Hyperplasia

Sabrina Silver, James J. Arnold

A Cochrane review compared the levonorgestrel-releasing intrauterine system with progesterone for the treatment of endometrial hyperplasia.

Cochrane for Clinicians

Acromioclavicular Joint Dislocation: Surgical vs. Conservative Interventions

Joseph R. Yancey, Michelle Szczepanik

Surgical treatment for AC joint dislocation of the shoulder does not appear to be superior to conservative management in adults. Surgical therapy increases the risk of hardware complications, infection, and continued discomfort.

Rapid Point-of-Care Antigen and Molecular Tests for Diagnosis of SARS-CoV-2 Infection

Sean Simmons, Aaron Saguil

SARS-CoV-2 antigen tests have an average sensitivity of 68.9% and an average specificity of 99.6%. Accuracy depends on symptom status, time from symptom onset, and test brand.

Putting Prevention Into Practice

Screening for Lung Cancer

Howard Tracer, James Pierre

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

Photo Quiz

Skin Inflammation After Immunization

Michael Grover

A patient develops erythema and warmth on the arm two weeks after receiving the first dose of the mRNA-1273 vaccine against the SARS-CoV-2 virus.

Nontender Rash on the Soles of the Feet in a Febrile Adult

Samuel Tiglao, Nickolas Hadley, Christopher Hodge

A patient with multiple medical conditions presented with nonpurulent cellulitis and MRSA bacteremia.

Curbside Consultation

Addressing Loneliness and Social Isolation in Older Adults

Rita M. Lahlou, Timothy P. Daaleman

Social isolation and loneliness are increasingly recognized as complex clinical and public health problems, particularly in older adults, leading to adverse mental and physical health outcomes. The COVID-19 pandemic has led to physical distancing policies, which have...

Diagnostic Tests

GeneSight Psychotropic Genetic Testing for Psychiatric Medication Selection

Natasha Pyzocha

The GeneSight test may assist in drug selection and dosing for individuals having difficulty finding an effective option or who have had intolerable adverse effects after trials of several drugs. However, because only a small population of patients are expected to have...

FPIN's Clinical Inquiries

Pharmacologic Management of Agitation in Patients with Dementia

Aaron Gale, Kirsten Stoesser, Katherine Fortenberry, Dominik Ose, Alyssa Migdalski

Selective serotonin reuptake inhibitors and risperidone are moderately effective at decreasing agitation in all types of dementia. Olanzapine and risperidone reduce dementia-related agitation much longer than placebo. Dextromethorphan/quinidine may be effective at reducing...

STEPS

Clascoterone (Winlevi) for the Treatment of Acne

Chelsea Harris

More comparative data are needed to justify the use of clascoterone over less expensive, currently available therapies for moderate to severe acne. However, systemic absorption of clascoterone is low, and it may serve as a safe alternative for patients 12 years and older who...

POEMs

Low-Carb Diets May Produce Short-Term Diabetes Remission

Allen F. Shaughnessy

Single-Dose Opioid Analgesics Offer No Benefit over Nonopioid Analgesia for Musculoskeletal Pain

Allen F. Shaughnessy

Once-Weekly Semaglutide Is an Effective Adjunct for Weight Loss in Adults without Diabetes Who Are Overweight or Obese

David C. Slawson

Cryoablation Preferred as Initial Therapy for Paroxysmal Atrial Fibrillation

Mark H. Ebell

Practice Guidelines

Treatment of Chronic Obstructive Pulmonary Disease: Guidelines from the VA/DoD

Michael J. Arnold, Andrew Buelt

The U.S. Department of Veterans Affairs and U.S. Department of Defense published guidelines for the primary care management of COPD.

Treatment of Chronic Obstructive Pulmonary Disease Exacerbations: Guidelines from the American Academy of Family Physicians

Michael J. Arnold

The American Academy of Family Physicians has published guidelines for treating acute exacerbations of COPD based on a systematic review.

Treatment of Chronic Obstructive Pulmonary Disease: Guidelines from the American Thoracic Society

Michael J. Arnold

The American Thoracic Society published guidelines for pharmacologic management of COPD and long-term oxygen therapy for COPD and interstitial lung disease based on systematic reviews.

Pharmacologic Management of COPD Exacerbations: A Clinical Practice Guideline from the AAFP

James J. Stevermer, Lynn Fisher, Kenneth W. Lin, Robyn Liu, Daniel Goodenberger, Kenneth Schellhase, Bill Vaughan, Melanie D. Bird

The American Academy of Family Physicians has published guidelines for treating acute exacerbations of COPD.

Letters to the Editor

Mild Creatine Kinase Elevations Do Not Necessarily Reflect Rhabdomyolysis

Josef Finsterer, Fulvio Alexandre Scorza

Reply: Balraj Sing, Parminder Kaur

The Role of Weight Stigma in the Development of Eating Disorders

Andrea Westby, Cassandra M. Jones, Katie A. Loth

Reply: David A. Klein, Jillian Sylvester, Natasha A. Schvey

Additional Differential Diagnosis for Adult Hip Pain

David Sealy

Well-Woman Chart Is Useful in Guiding Preventive Care

Amy G. Cantor, Heidi D. Nelson

Reply: Heather L. Paladine, Himabindu Ekanadham, Daniela C. Diaz

Information from Your Family Doctor

Preventing HIV Infection in Your Baby

HIV is the virus that causes AIDS. It is possible to have HIV infection for a long time before developing AIDS.



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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