• Articles

    Osteoporosis: Common Questions and Answers

    Kira Harris, Christopher A. Zagar, Kelley V. Lawrence

    Osteoporosis affects 10.2% of adults older than 50 years and is expected to increase to 13.6% by 2030. Osteoporotic fractures, specifically hip fractures, have significant impacts on morbidity, mortality, and quality of life.

    Distinguishing Asthma and COPD in Primary Care: A Case-based Approach

    T. Aaron Zeller, Katherine Beben, Stephanie Walker

    Asthma and chronic obstructive pulmonary disease (COPD) affect more than 40 million Americans, and distinguishing between the two can be difficult. Accurate diagnosis requires spirometry that demonstrates a characteristic pattern.

    Glaucoma: Diagnosis and Management

    Thomas C. Michels, Oana Ivan

    Glaucoma is a group of eye disorders characterized by progressive deterioration of the optic nerve head and retinal nerve fiber layer. Primary open-angle glaucoma is the most common form in the United States.

    Polycystic Ovary Syndrome: Common Questions and Answers

    Tracy Williams, Justin B. Moore, Jared Regehr

    This article presents evidence-based answers to common questions about the diagnosis and management of polycystic ovary syndrome.

    Posttraumatic Stress Disorder: Evaluation and Treatment

    Zachary Sartor, Lance Kelley, Ryan Laschober

    Posttraumatic stress disorder (PTSD) can occur in response to a broad range of traumatic events. Psychological symptoms can be mistaken for anxiety or mood disorders, which are often comorbidities of PTSD. There are several assessment tools available to help diagnose PTSD and...

    Pulmonary Nodules: Common Questions and Answers

    Robert C. Langan, Andrew J. Goodbred

    Pulmonary nodules are commonly discovered incidentally on chest imaging or from dedicated lung cancer screening. Screening adults 50 to 80 years of age who have a 20-pack-year smoking history and currently smoke or have quit within the past 15 years with low-dose computed...

    Editorials

    Reconsidering the Use of Race in Spirometry Interpretation

    Bonzo Reddick

    An analysis of the Multi-Ethnic Study of Atherosclerosis Lung Study found that the use of race corrections in spirometry interpretation did not help to predict chronic lower respiratory disease events any more accurately than the use of race-neutral calculations.

    Multicancer Early Detection: A Promise Yet to Be Proven

    Chyke A. Doubeni, Philip E. Castle

    Because of known limitations and inadequate evidence, primary care clinicians should focus on providing USPSTF-recommended, evidence-based preventive services and only use multicancer early detection tests in the context of well-designed clinical research studies and not in...

    AFP Clinical Answers

    Pneumococcal Vaccine, Polymyalgia Rheumatica, Giant Cell Arteritis, Concussion, Malaria

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

    Medicine by the Numbers

    Corticosteroids for Low Back Pain

    Sean P. Haley, Leah A. Stem

    We assigned a color recommendation of yellow (unclear benefits) due to modest improvements for radicular back pain and an incomplete view of potential patient-oriented harms. The most clinically meaningful evidence to patients is the potential for corticosteroids to improve...

    Cochrane for Clinicians

    Antiplatelet Agents for the Treatment of Deep Venous Thrombosis

    Alexis Reedy-Cooper, Juan Perez

    Best medical practices for the initial treatment of uncomplicated DVT include anticoagulation, compression stockings, and physical exercise. In the management of DVT, adding an antiplatelet agent to standard practices does not show clear benefits or cause significant adverse...

    Foot Orthoses for Treating Flat Feet in Children

    Kathleen Barry, Craig Pille

    Customized or prefabricated foot orthoses do not result in significant improvements in pain, function, or parent and child quality-of-life scores. Importantly, quality-of-life scores were not reported in patients who were asymptomatic.

    Lown Right Care

    Is There Evidence of ADHD Overdiagnosis in Children?

    Elizabeth Wolf, Neil Sonenklar, Matthew Schefft, Helen Haskell, John James

    A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

    U.S. Preventive Services Task Force

    Screening for Obstructive Sleep Apnea in Adults

    The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea in the general adult population.

    Putting Prevention Into Practice

    Screening for Obstructive Sleep Apnea in Adults

    Justin Mills, Michael C. Harding

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

    FPIN's Clinical Inquiries

    Dry Needling for Low Back Pain

    Roxanne Radi, Wesley Ng, Raeanna Simcoe, Corey Lyon, Kristen DeSanto

    A comprehensive treatment program that includes dry needling may provide some benefit in decreasing pain scores and perceived disability vs. standard physical therapy and home physical therapy in the short term. However, this improvement is small, and the clinical...

    Point-of-Care Guides

    Diagnosing Appendicitis in Children and Adolescents With Abdominal Pain

    Mark H. Ebell

    In children and adolescents with lower abdominal pain, is there a way to identify low-, moderate-, and high-risk groups for suspected appendicitis?

    Diagnostic Tests

    Risk of Ovarian Malignancy Algorithm (ROMA) for Assessing Likelihood of Ovarian Cancer

    Carl Bryce

    Family physicians encounter patients with adnexal masses who require surgery, some of whom may have ovarian cancer. The ROMA test can assess the presurgical likelihood of malignancy in patients who already have a planned surgery.

    Photo Quiz

    Black Fingernail Discoloration

    Nada Al-Hashimi, Gurvinder Dhaliwal

    A patient presented with black discoloration of all fingernails, without pitting, spooning, or ulceration.

    Suspicious Lesion Under a Face Mask

    Stephen Carek, Christian Crowe

    A patient presented with an ulcerated and crusted erythematous plaque with well-demarcated borders on his lower lip that developed during the mask mandate.

    STEPS

    Viloxazine (Qelbree) for ADHD

    Kristen Goodell, Deborah Erlich

    Viloxazine reduces ADHD symptoms but has not been directly compared with atomoxetine or first-line stimulant medications. Adverse effects are common, and the risks of suicidal ideation and increased heart rate and blood pressure are a concern.

    Curbside Consultation

    Self-Monitoring of Blood Glucose in Patients With Non–Insulin-Dependent Diabetes Mellitus

    Isha Marina Di Bartolo, Mara Gordon

    This case addresses a common situation in primary care that can occur when new evidence changes practices that were once taken for granted by physicians and patients as contributing to quality care. Discontinuing low-value interventions can be challenging for patients and...

    POEMs

    Nirmatrelvir/Ritonavir Reduces Hospitalization, Mortality in Patients 65 Years and Older With COVID-19; Effect on Younger Patients Unclear

    Mark H. Ebell

    Amitriptyline, Duloxetine, and Pregabalin Each Effective in Decreasing Pain From Diabetic Peripheral Neuropathy; Combinations Even Better

    Henry C. Barry

    Tocilizumab Beneficial for Adults With Persistent Polymyalgia Rheumatica Symptoms Who Receive Steroid Therapy

    David C. Slawson

    Polypill Better for Secondary Cardiovascular Prevention Than Physician-Directed Care

    Mark H. Ebell

    Practice Guidelines

    ACIP Approves 2023 Child/Adolescent and Adult Immunization Schedules

    Pamela G. Rockwell

    The 2023 child/adolescent and adult immunization schedules have been approved by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. Notable changes include updates to COVID-19 recommendations and mpox (formerly monkeypox)...

    Management of Major Depression: Guidelines From the VA/DoD

    Andrew Buelt

    The U.S. Department of Veterans Affairs and U.S. Department of Defense published guidelines on the management of major depressive disorder.

    Letters to the Editor

    Additional Considerations for the Microscopic Evaluation of Urine

    Joseph V. Cook

    Reply: Nathan Hitzeman

    Case Report: Tinea Capitis in a 10-Year-Old Child

    Michael T. Tshudy, Shannan McCann

    Information from Your Family Doctor

    Osteoporosis

    Osteoporosis means bones (“osteo”) that are porous (“porosis”), or weak. When your body loses calcium, your bones become weaker and more likely to break.

    Spirometry: A Simple Test for Breathing Problems

    It is a test that measures how much and how quickly you can move air in and out of your lungs compared with other people who have breathing problems like yours. For the test, you will blow through a tube as hard, as fast, and as long as you can. After that, you may be given...

    Glaucoma

    Glaucoma (glaw-KOH-muh) is a disease that damages the nerve in the back of your eye called the optic nerve.

    Polycystic Ovary Syndrome

    Polycystic ovary syndrome (PCOS for short) is a common condition. It is usually related to your hormones being out of balance.

    Posttraumatic Stress Disorder

    Posttraumatic stress disorder (PTSD) is a mental health illness that can happen after you have had or witnessed a trauma, such as a life-threatening event, sexual violence, or serious injury. PTSD affects your mood and body. PTSD can last for months, or it can last for many...

    Lung Nodules

    A lung nodule (NA-jule; also known as pulmonary nodule) is a small, often ball-shaped tissue collection that can grow in the lungs. They can range in size from smaller than a pea to the size of a golf ball or larger. Most of the time, people with lung nodules have no symptoms...



    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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