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Articles

Diagnosis and Treatment of Community-Acquired Pneumonia

M. NAWAL LUTFIYYA, ERIC HENLEY, LINDA F. CHANG, STEPHANIE WESSEL REYBURN

When a patient presents with suspected community-acquired pneumonia, the physician should first assess the need for hospitalization, then choose an appropriate, cost-effective treatment using a mortality prediction tool combined with clinical judgment.

Nonhormonal Therapies for Hot Flashes in Menopause

DANA G. CARROLL

The risks of hormone therapy prompt many women with hot flashes to look for alternatives. Selective serotonin reuptake inhibitors and venlafaxine appear to be effective options; soy isoflavones, red clover, and black cohosh may be helpful, but the results of trials are...

Evaluation and Treatment of Constipation in Infants and Children

WENDY S. BIGGS, WILLIAM H. DERY

In most children, constipation is functional and the result of stool retention. However, family physicians should remain alert for warning signs that may indicate the presence of an organic cause of constipation. Treatment of functional constipation involves disimpaction...

Pancreatic Cancer: Diagnosis and Management

ROBERT FREELOVE, ANNE D. WALLING

Computed tomography is the first-line imaging and staging tool for pancreatic cancers. For those cancers advanced at the time of diagnosis, palliation is the best treatment. Pain can be managed with opioid analgesics, radiation therapy, chemotherapy, or celiac plexus neurolysis.

Inside AFP

Survey Results Guide Quality Improvement Efforts

JOYCE A. MERRIMAN

Everyone involved with AFP is dedicated to continuous quality improvement. We want and need to know what AFP readers want in their publication. One of the many ways we obtain input from readers is by conducting a survey of visitors to the publications booth at the American...

Newsletter

Newsletter

LIZ SMITH

HHS Awards $56.9 Million to Eliminate Health Disparities | FDA and AHRQ Collaborate to Strengthen Research and Communication | AAFP Board Releases List of Desired Retail Health Clinic Attributes | Fogarty Center Awards $6.5 Million to Drug Discovery Research Projects | Texas...

Quantum Sufficit

Quantum Sufficit

LISA GRAHAM

The trauma experienced by victims of stalking is often underestimated, according to a study published in the British Journal of Psychiatry. Authors of the study sent 3,700 surveys to men and women living in Victoria, Australia. Of the 1,844 people who completed and returned...

Editorials

Medicare Part D: Practical and Policy Implications for Family Physicians

GIRIDHAR MALLYA, ANDREW BAZEMORE

The Medicare Part D prescription drug benefit offers financial relief for many beneficiaries. However, it has attracted criticism for its complex structure, its onerous cost-sharing provisions, and its sizable taxpayer burden—the program’s expenses are estimated at $724...

Identifying Effective Alternative Therapies for Common Conditions

JANE L. MURRAY

Increasingly, our patients ask us about alternatives to prescription drugs for managing common conditions. This issue of American Family Physician features an article about nonhormonal therapies for hot flashes1—a concern we regularly encounter in our patients who are...

Graham Center Policy One-Pager

Medicare Part D: Who Wins, Who Loses?

The Medicare Part D prescription drug benefit aims to relieve the burden of out-of-pocket prescription drug costs for persons older than 65 years, but its effects will vary. Persons with low income and those without prior prescription coverage are projected to save the most,...

Out-of-Pocket Prescription Costs a Continuing Burden Under Medicare Part D

Of 29 million expected Part D beneficiaries, 6.9 million are projected to have annual out-of-pocket medication expenses greater than $750. Accounting for one fourth of all Part D enrollees, these beneficiaries also are most likely to have high aggregate health care costs,...

Mind the Gap: Medicare Part D’s Coverage Gaps May Affect Patient Adherence

Medicare Part D will lower medication expenditures for many older patients. However, its complex design incorporates a staggered series of cost-sharing mechanisms that create gaps in coverage and may have a negative impact on medication adherence.

Cochrane for Clinicians

Are Alpha-glucosidase Inhibitors Effective for Control of Type 2 Diabetes?

DAN BREWER

The use of alpha-glucosidase inhibitors has a modest effect on intermediate diabetes-control endpoints such as postprandial blood glucose, postprandial insulin levels, and A1C levels. There is no evidence, however, of improvement in mortality, morbidity, or quality of life....

Gabapentin for Pain: Balancing Benefit and Harm

MARK EBELL

At high dosages, gabapentin is moderately effective for neuropathic pain, although adverse effects are experienced as often as benefit.

Adalimumab for Rheumatoid Arthritis?

CLARISSA KRIPKE

Combined with methotrexate, subcutaneous adalimumab at a dosage of 40 mg every two weeks slows the progression of rheumatoid arthritis at one year. The combination is more effective than adalimumab monotherapy. Limited evidence suggests that adalimumab is also safe and...

U.S. Preventive Services Task Force

Screening for Peripheral Arterial Disease: Recommendation Statement

This statement summarizes the USPSTF recommendations on screening for peripheral arterial disease and the supporting scientific evidence and updates the 1996 recommendations contained in theGuide to Clinical Preventive Services, 2nd ed.

Clinical Evidence Handbook

Nonsteroidal Anti-inflammatory Drugs

PETER C. GØTZSCHE

Are there any important differences between available nonsteroidal anti-inflammatory drugs (NSAIDs)? What are the effects of cotreatments on reducing the risk of the adverse gastrointestinal effects of NSAIDs? What are the effects of topical NSAIDs?

FPIN's Clinical Inquiries

Vaginal Misoprostol for Cervical Ripening in Term Pregnancy

SALLY P. WEAVER, JESSICA COOK, JOAN NASHELSKY

Low-dose (25 mcg) intravaginal misoprostol appears to be safe and effective for cervical ripening in term pregnancy for patients without a history of cesarean section. Compared with other cervical ripening methods, misoprostol has an increased rate of vaginal delivery within...

Photo Quiz

Asymptomatic Penile Rash

GARY N. FOX, JULIE M. STAUSMIRE

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

POEMs

Influenza Vaccine Effective for Older Patients

HENRY BARRY

Magnetic Insoles Ineffective for Nonspecific Foot Pain

ALLEN F. SHAUGNESSY

Positive Feedback Is Effective for Decreasing Stuttering

ALLEN F. SHAUGHNESSY

Curbside Consultation

At-Home Genetic Tests

PHYLLIS FROSST, DANIEL J. WATTENDORF

Current genetic tests for complex diseases are not diagnostic. They instead provide important information about susceptibility and can be key in prevention.

Practice Guidelines

AHA Releases Dietary Recommendations for Children and Adolescents

CARRIE A. MORANTZ

The American Heart Association (AHA) has released revised nutritional guidelines for children and adolescents, with new focuses on total caloric intake and eating behaviors. This is in response to significant changes in the prevalence of cardiovascular risk factors and...

Practice Guideline Briefs

CDC Recommendations to Reduce Central Line Infections

MEREDITH DESMOND

The Centers for Disease Control and Prevention (CDC) has released a report detailing interventions to help prevent central line bloodstream infections in hospitals.

ACSM Recommendations for Endurance Athletes

MEREDITH DESMOND

The American College of Sports Medicine (ACSM) has released evidence-based recommendations for athletes to prevent hyponatremia and dehydration during sporting events.

Letters to the Editor

Jellyfish Species Distinction Has Treatment Implications

CEDRIC M. YOSHIMOTO

Dysmorphic Findings in Persons with Fragile X Syndrome

Tips from Other Journals

Acupuncture Benefits Patients with Chronic Low Back Pain

KENNETH LIN

Screening and Counseling for Obesity in Children

CAROLINE WELLBERY

Adherence to Medications for Reducing CVD

KARL E. MILLER

Progestin-Releasing IUDs for Women with Diabetes

ANNE D. WALLING

Information from Your Family Doctor

Nonhormonal Options for Hot Flashes

For most women, a hot flash is a warm feeling from the chest up to the head. During a hot flash, you may have a headache or flushed skin, or feel your heart beating faster. You may also start to sweat or feel queasy or dizzy.

Chronic Constipation in Your Child

Constipation is when bowel movements happen less often than every two days.

Help for Your Child’s Constipation

If your child has constipation or stool leakage, it is important for you to maintain a positive attitude. Getting angry or making your child feel ashamed can make matters worse.

Corrections

Corrections

Corrections



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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