• Articles

    Insulin Therapy for Type 2 Diabetes: Rescue, Augmentation, and Replacement of Beta-Cell Function

    JENNIFER A. MAYFIELD, RUSSELL D. WHITE

    Type 2 diabetes is characterized by progressive beta-cell failure. Indications for exogenous insulin therapy in patients with this condition include acute illness or surgery, pregnancy, glucose toxicity, contraindications to or failure to achieve goals with oral antidiabetic...

    Treatment of Degenerative Lumbar Spinal Stenosis

    DAVID L. SNYDER, DAVID DOGGETT, CHARLES TURKELSON

    Spinal stenosis is a narrowing of the vertebral canal that compresses spinal nerves and may cause leg pain and difficulty walking. The symptoms of degenerative lumbar stenosis commonly occur in elderly adults and can be treated conservatively with pain-relieving agents or...

    Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction: --Part I. Initial Evaluation and Management, and Hospital Care

    STEPHEN D. WIVIOTT, EUGENE BRAUNWALD

    Each year, more than 1 million patients are admitted to U.S. hospitals because of unstable angina and non–ST-segment elevation myocardial infarction (UA/NSTEMI). To help standardize the assessment and treatment of these patients, the American College of Cardiology and the...

    Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction: --Part II. Coronary Revascularization, Hospital Discharge, and Post-Hospital Care

    STEPHEN D. WIVIOTT, EUGENE BRAUNWALD

    In the guideline developed by the American College of Cardiology and the American Heart Association, the management of suspected unstable angina and non–ST-segment elevation myocardial infarction (UA/NSTEMI) has four components: initial evaluation and management; hospital...

    Diagnosis and Management of Galactorrhea

    ALEXANDER K.C. LEUNG, DANIELE PACAUD

    After infancy, galactorrhea usually is medication-induced. The most common pathologic cause of galactorrhea is a pituitary tumor. Other causes include hypothalamic and pituitary stalk lesions, neurogenic stimulation, thyroid disorders, and chronic renal failure. Patients with...

    Inside AFP

    Celebrating, Reflecting, and Farewells

    JANIS WRIGHT

    I’m devoting this column to three of AFP’s contributors who are reaching special milestones this summer and to whom I’d like to give my personal thanks and recognition: Kathy Mayfield, production director; LeAnn Fletcher, graphic associate; and Barrett Schroeder, senior...

    Newsletter

    Newsletter

    GENEVIEVE RESSEL

    Family Physician Named AMA President-Elect | AAFP Helps Develop Report Supporting Influenza Vaccine for Health Care Workers | AAFP Updates Online Tobacco Prevention and Cessation Resources | Report Indicates Cancer Incidence and Mortality Rates on Decline; Survival Rates...

    Quantum Sufficit

    Quantum Sufficit

    SARAH EVANS, LORI PARRY

    “Kangaroo care,” a technique for soothing premature infants through skin-to-skin contact, also can help term infants make the transition from fetal to neonatal life. In a randomized controlled study published in Pediatrics , 47 healthy term infants were assigned to be taken...

    Editorials

    Why Does a U.S. Primary Care Physician Workforce Crisis Matter?

    ROBERT L. PHILLIPS, JR., BARBARA STARFIELD

    In this issue of American Family Physician, the series of One-Pagers1–3 from the Robert Graham Center offer evidence that a primary care workforce crisis may once again be taking shape. The 1990s saw alignment of public policy and funding efforts to increase the primary care...

    Diary from a Week in Practice

    Diary

    JOHN O’HANDLEY

    When a patient has been out of three blood pressure medications for four months because of no income, one would expect to see a blood pressure out of control. The young woman had lost her job and health care coverage several months earlier, and had come to the mobile clinic...

    Cochrane for Clinicians

    Exercise-Based Rehabilitation for Coronary Heart Disease

    JASMINE CHEN GATTI

    Cardiac rehabilitation based on exercise alone and comprehensive cardiac rehabilitation reduce all-cause mortality by about one third. It is unclear which type of rehabilitation is more beneficial.

    Antihistamines for the Common Cold

    MARK H. EBELL

    Antihistamines are of minimal to no benefit as mono-therapy for the common cold, and first-generation antihistamines may increase sedation in patients with a cold. Antihistamine-decongestant combinations reduce nasal symptoms and improve the recovery rate in older children...

    Clinical Evidence Handbook

    Bronchitis (Acute)

    PETER A. WARK

    What are the effects of treatment in people without chronic respiratory disease?

    Putting Prevention Into Practice

    Routine Vitamin Supplementation to Prevent Cancer and Cardiovascular Disease

    JANELLE GUIRGUIS-BLAKE

    Case study: JB, a 35-year-old smoker, comes to your office for a well-woman examination. Reviewing her medication list, you learn that she is taking numerous vitamin supplements, including vitamins A, C, E, and beta-carotene.

    FPIN's Clinical Inquiries

    What Clinical Findings Can Be Used to Diagnose Deep Venous Thrombosis?

    JOHN SMUCNY, RAMTIN COHANIM

    No single clinical finding can accurately diagnose DVT.

    Photo Quiz

    Rash in an Adolescent

    JOSHUA G. HACKEL, VINCENT M. NICHOLIAS, J. GARRIS MORGAN

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

    POEMs

    High-Dosage Inhaled Steroids and Fracture Risk

    HENRY BARRY

    No Link Between Breast Cancer and Abortion

    HENRY BARRY

    Is Acupuncture Effective for Chronic Headache?

    ALLEN F. SHAUGHNESSY

    Infant Care Continuity and Emergency Department Use

    ALLEN F. SHAUGHNESSY

    Ginkgo Does Not Prevent Acute Mountain Sickness

    ALLEN F. SHAUGHNESSY

    C-reactive Protein Is a Weak Predictor of CAD

    HENRY BARRY

    Three Days of Amoxicillin for Pneumonia in Children

    ALLEN F. SHAUGHNESSY

    Tai Chi May Improve Symptoms of Osteoarthritis

    ALLEN F. SHAUGHNESSY

    Practice Guidelines

    CDC and HICPAC Release Updated Guidelines on the Prevention of Health-Care–Associated Pneumonia

    MATTHEW J. NEFF

    The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) has issued recommendations on reducing the incidence of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals...

    Practice Guideline Briefs

    Practice Guideline Briefs

    CARRIE MORANTZ, BRIAN TORREY

    Nausea and Vomiting in Pregnancy

    Practice Guideline Briefs

    CARRIE MORANTZ, BRIAN TORREY

    Use of Transcranial Doppler Ultrasonography

    Practice Guideline Briefs

    CARRIE MORANTZ, BRIAN TORREY

    Increases in Fluoroquinolone-Resistant <i>Neisseria Gonorrhoeae</i>

    Curbside Consultation

    When Patients Cannot Afford Their Medications

    CHIEN-WEN TSENG

    For physicians who realize that drug costs can be a problem, we offer some practical solutions and discussion about how to help these patients.

    Letters to the Editor

    Home Schooling Can Be a Beneficial Educational Option

    ERIKA THOST

    Treatment of Polycystic Ovary Syndrome in Adolescents

    KIRSTEN STOESSER

    Differentiating Types of Dementia During Diagnosis

    CRAIG BENNET

    Importance of Continuous Doula Support During Labor

    DENISE PUNGER

    Tips from Other Journals

    Determining Appropriate Use: COX-2 Inhibitors vs. NSAIDs

    KARL E. MILLER

    Deep Sedation Options During Cardioversion

    RICHARD SADOVSKY

    Clinical vs. MRI Assessment of Vaginal Vault Prolapse

    ANNE D. WALLING

    Quality of End-of-Life Care by Location of Death

    CAROLINE WELLBERY

    Vasopressin vs. Epinephrine for Patients in Cardiac Arrest

    BILL ZEPF

    Antiparasitic Treatment in Patients with Cysticercosis

    BILL ZEPF

    Supplemental Nutrition for Elderly Immune Function

    CAROLINE WELLBERY

    Information from Your Family Doctor

    Your Insulin Therapy

    Your doctor has given you insulin to help control your diabetes. You need two kinds of insulin: basal and mealtime insulin. Sometimes insulin is premixed for you. Keep a record of your blood sugar and insulin shots every day so the amounts of insulin can be changed to fit...

    Galactorrhea: What You Should Know About It

    Sometimes a woman's breasts make milk even though she is not pregnant or breastfeeding. This condition is called galactorrhea (say: guh-lack-tuh-ree-ah). The milk may come from one or both breasts. It may leak on its own or only when the breasts are touched. Men can have...



    Disclosure

    All editors in a position to control content for this activity, AFP journal, are required to disclose any relevant financial relationships. View disclosures.


    Tag Legend

    Legend

    CME Continuing Medical Education Credit
    POC Point-of-Care Resource
    FREE Free Access
    Alg Algorithm
    DDx Differential Diagnosis
    PtEd Patient Education