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Articles

Evaluation of Jaundice in Adults

Michelle Nelson, Shaunak R. Mulani, Aaron Saguil

Jaundice presents when impairment in bilirubin metabolism occurs. It is typically apparent when serum bilirubin levels are elevated and can indicate serious underlying disease of the liver or biliary tract; jaundice may occur because of intra- or extrahepatic pathology.

Early Childhood Concerns: Counseling on Sleep Issues, Thumb-Sucking, Picky Eating, School Readiness, and Oral Health

Carl Bryce, Theron Liddell, Geoffrey Gideon

Challenges in early childhood can involve a range of normal to problematic behaviors. These behaviors, including sleep issues, thumb sucking, picky eating, school readiness, and oral heath, can affect quality of life if not addressed appropriately.

Dysuria: Evaluation and Differential Diagnosis in Adults

Ariel Hoffman, Katelyn A. Dolezal, Rob Powell

Numerous infectious and inflammatory conditions affecting the genitourinary tract and adjacent structures can cause dysuria in adults. A comprehensive history, careful physical examination, and appropriate testing are key to correct diagnosis and treatment.

Acute Rhinosinusitis: Rapid Evidence Review

Faith M. Butler, Deborah Rivera Hernandez

Cardinal features of acute bacterial rhinosinusitis are unilateral facial pain or pressure, fever greater than 102°F, and purulent nasal discharge with obstruction of the nasal passages; antibiotics should be reserved for patients without improvement in symptoms after several...

Sudden Vision Loss: A Diagnostic Approach

J. Alexander Fraser, Maksim Son, Anastasiya Vinokurtseva

Common high-risk conditions that cause sudden vision loss include acute angle-closure glaucoma, retinal detachment, retinal artery occlusion, giant cell arteritis, and optic neuritis.

Gastroesophageal Reflux in Infants and Children: Diagnosis and Treatment

Brian Antono, Andrea Dotson

Gastroesophageal reflux symptoms are common, occurring daily in approximately 40% of infants. Gastroesophageal reflux can progress to gastroesophageal reflux disease (GERD) and may lead to complications, such as esophagitis or esophageal stricture. This article reviews the...

Inside AFP

Celebrating the 75th Year of American Family Physician

Sumi M. Sexton, Matthew Neff

American Family Physician (AFP) kicks off its 75th anniversary year.

Editorials

Use of AI in Family Medicine Publications: A Joint Editorial From Journal Editors

Sarina Schrager, Dean A. Seehusen, Sumi M. Sexton, Caroline Richardson, Jon Neher, Nicholas Pimlott, Marjorie Bowman, José Rodríguez, Christopher P. Morley, Li Li, James Dom Dera

This is a joint editorial written by multiple family medicine journal editors about the use of artificial intelligence in family medicine publications.

PSA Screening: Shared Decision-Making Is a Flawed Approach

Kenneth W. Lin

Using shared decision-making for PSA testing for prostate cancer screening is a flawed approach.

Practice Alert: Pneumococcal Conjugate Vaccines Approved for Adults

Doug Campos-Outcalt

In June 2024, the FDA approved PCV21 (Capvaxive) for adults 18 years and older to prevent invasive pneumococcal disease.

AFP Clinical Answers

Gender-Affirming Surgery, Trichotillomania, Lipid Disorders, Bacterial Prostatitis, Mastitis, Adhesive Capsulitis

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

Medicine by the Numbers

Triple Therapy (LABA-LAMA-Inhaled Corticosteroid) for COPD

Nicholas Salter, Alexei O. DeCastro

The GOLD report recommends considering inhaled corticosteroid therapy added to a LABA in patients with moderate to severe COPD. Triple therapy is considered, but the GOLD report noted limited available information.

Curbside Consultation

Physician-Patient Relationships: Obligations and Avoiding Sexual Misconduct Pitfalls

Kevin R. Herrick, Vladimir Shalkevich

Physicians may encounter situations that challenge the boundaries between themselves and their patients. These challenges can lead to instances or allegations of patient exploitation that can result in serious legal and professional consequences for the physician.

Cochrane for Clinicians

Psychosocial Interventions to Reduce Alcohol Use During Pregnancy

Alyssa Bruehlman, Elizabeth Salisbury-Afshar

Psychosocial interventions may increase the rate of sustained alcohol cessation during pregnancy. However, they may have little to no effect on the number of drinks consumed per day or treatment retention.

ACE Inhibitor or ARB Therapy Can Prevent Diabetic Kidney Disease Progression

Arindam Sarkar, Briana Jarrett, Rashmi Rode

Use of ACE inhibitor or ARB therapy reduces progression to end-stage kidney disease in patients with diabetic kidney disease. Neither ACE inhibitor nor ARB therapy has been associated with reduced all-cause or cardiovascular mortality compared with placebo in patients with...

FPIN's Help Desk Answers

Supplements to Slow Progression of Age-Related Macular Degeneration

Danish Abdul Alla, Louis Gerges, Judith Philip, Carrie Wirth

Use of antioxidant vitamin or zinc supplements may delay progression of age-related macular degeneration (ARMD) compared with placebo. The addition of docosahexaenoic acid, lutein, zeaxanthin, resveratrol, and hydroxytyrosol to the supplements used in the original Age-Related...

FPIN's Clinical Inquiries

Antibiotic Treatment for Uncomplicated Acute Appendicitis in Children

Timothy Mott, Carrie Gray

Nonoperative treatment with antibiotics for uncomplicated acute appendicitis in children is an option but leads to higher numbers of hospital readmissions and subsequent surgeries. The nonoperative approach has a treatment failure rate of approximately 20%, with most...

Photo Quiz

Irregular Pigmented Lesion

Courtney Humphrey, Minuette Laessig

A 71-year-old woman presented with a skin lesion on her right cheek.

Rash After Immunizations

Angela Puthenveetil, Sameer Suhale

A 3-month-old boy presented with a circular rash.

Putting Prevention Into Practice

Screening for Hypertensive Disorders of Pregnancy

Iris R. Mabry-Hernandez, Elizabeth Lees

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

U.S. Preventive Services Task Force

Screening for Hypertensive Disorders of Pregnancy

The USPSTF recommends screening for hypertensive disorders in pregnant persons with blood pressure measurements throughout pregnancy.

POEMs

Probiotics Reduce the Likelihood of Recurrence of UTI in Women With Frequent UTIs

Mark H. Ebell

SGLT-2 Inhibitors Reduce Cardiovascular Mortality, but Benefit Is Modest, Even in Patients With Established Heart Disease

Mark H. Ebell

Antibiotic Treatment Is Effective for Acute Sinusitis in Children

Allen F. Shaughnessy

In Adults With Degenerative Joint Disease of the Hip, Steroid injections Improve Pain After 3 Months but Not After 6 Months

Henry C. Barry

STEPS

Gepirone (Exxua) for the Treatment of Major Depressive Disorder

Stephen R. Foster, Kodi M. Liddell

Gepirone produces minimal reductions in symptoms compared with placebo. Adverse effects are common, and baseline testing is required before starting treatment with gepirone. Given these issues and the high cost of the medication, its use should be limited.

Practice Guidelines

Hip Osteoarthritis: Guidelines From the American Academy of Orthopaedic Surgeons

Michael J. Arnold

The American Academy of Orthopaedic Surgeons has published guidelines for management of hip osteoarthritis.

Rapid Sequence Intubation of Critically Ill Patients: Guidelines From the Society of Critical Care Medicine

Patrick Bagley, David Smith

The Society of Critical Care Medicine developed guidelines to optimize rapid sequence intubation.

Letters to the Editor

Case Report: Delayed Anaphylaxis Following Meat Consumption and Tick Exposure

Marissa Liveris

Concurrent Cocaine Use in Individuals With Alcohol Use Disorder

Kento Sonoda

Reply: Elisabeth Poorman, Brianna M. McQuade, Sarah Messmer

Timely and Effective Outpatient Benzodiazepine Withdrawal Protocol

Jeff Unger

Reply: Sandy Robertson, Emily E. Peacock, Robert Scott



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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