Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection

JULIA FASHNER, ALFRED C. GITU

Peptic ulcer disease is most commonly caused by Helicobacter pylori infection or use of nonsteroidal anti-inflammatory drugs. The test-and-treat strategy for detecting H. pylori is appropriate in low-risk patients, although higher-risk patients should undergo upper endoscopy....

Hemoptysis: Evaluation and Management

JOHN SCOTT EARWOOD, TIMOTHY DANIEL THOMPSON

The initial step in the evaluation of hemoptysis is determining the origin of bleeding. Hemodynamic instability, abnormal gas exchange, cardiopulmonary comorbidities, and lesions at high risk of massive bleeding warrant inpatient evaluation. Chest radiography is recommended...

Lung Cancer: Diagnosis, Treatment Principles, and Screening

KELLY M. LATIMER, TIMOTHY F. MOTT

Most patients with lung cancer are symptomatic at presentation. High-risk patients who present with symptoms should undergo chest radiography. If an alternative diagnosis is not identified, computed tomography and possibly positron emission tomography should be performed. If...

AAFP News: AFP Edition

AAFP Reiterates Warning to CMS About Provider Network Inadequacy | MedPAC Recommends Higher Pay for Primary Care Physicians | Physicians Foundation's 2015 Watch List Includes Consolidation, ICD-10 | New Resource Helps Physicians Discuss Weight with Patients

Should Family Physicians Screen for Testosterone Deficiency in Men? Yes: Screening for Testosterone Deficiency Is Worthwhile for Most Older Men

JOEL J. HEIDELBAUGH

Normal physiologic functioning of the testes is mandatory for virilization, male reproduction, and maintenance of lean muscle and bone mass. Testosterone deficiency is caused by inadequate production of serum testosterone and typically results in decreased libido, erectile...

Should Family Physicians Screen for Testosterone Deficiency in Men? No: Screening May Be Harmful, and Benefits Are Unproven

ADRIANE FUGH-BERMAN

On September 17, 2014, an advisory committee of the U.S. Food and Drug Administration (FDA) recommended changing the labeling of testosterone products to exclude use in men with age-related decreases in testosterone.1 The FDA usually follows the advice of its advisory committees.

New-Onset Bullous Rash

SCOTT CORDTS, JENNIFER SITZMAN

A man presented with an asymptomatic rash that began one day after taking trimethoprim/sulfamethoxazole. Physical examination revealed multiple large, erythematous, sharply demarcated circular plaques.

Screening for Primary Hypertension in Children and Adolescents: Recommendation Statement

The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for primary hypertension in asymptomatic children and adolescents to prevent subsequent cardiovascular disease in...

Screening for Primary Hypertension in Children and Adolescents

IRIS MABRY-HERNANDEZ, KASI CHU

L.S. is a 14-year-old black adolescent who presents for a routine school physical examination. Her mother tells you that she and her husband have hypertension, and they worry about their daughter's blood pressure. She asks you whether L.S. should be periodically checked for...

Diagnosing and Managing Acute Heart Failure Guidelines: NICE

ALLEN F. SHAUGHNESSY

There is not much new in these guidelines except some caveats on what not to do. Diagnose new acute heart failure with a natriuretic peptide measurement and, if the level is high, follow with transthoracic echocardiography. Do not routinely treat with opiates, nitrates,...

Injection Equals Physical Therapy for Shoulder Impingement

ALLEN F. SHAUGHNESSY

Metformin Associated with Less Need for a Second Medicine

ALLEN F. SHAUGHNESSY

n this retrospective analysis, which benefits from large numbers of patients but suffers from possible biases, patients who initially took an oral hypoglycemic other than metformin (Glucophage) were significantly more likely to require a second oral agent.

Low-Carbohydrate Diet Better Than Low-Fat Diet to Reduce Cardiovascular Risk Factors and Cause Weight Loss

ALLEN F. SHAUGHNESSY

More than 40 years ago, Dr. Robert Atkins wrote his first book advocating for a low-carbohydrate diet to cause and sustain weight loss. This study (of mostly women) found that a low-carbohydrate diet—though not as severe a diet as the Atkins approach—caused an average 3.5 kg ...

ACIP Releases 2015 Adult Immunization Schedule

JAMIE LOEHR

The 2015 adult immunization schedule from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) has a few changes that are particularly relevant to family physicians.

ACIP Releases 2015 Childhood Immunization Schedules

JAMIE LOEHR

The 2015 immunization schedule for children and the catch-up schedule from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) have a few changes that are pertinent for family physicians.

H. pylori and Stomach Ulcers: What You Should Know

These ulcers are sores in your stomach. They are often caused by a bacteria called Helicobacter pylori (hel-i-ko-back-ter pie-lore-ee). They can also be caused by taking certain medicines, like ibuprofen, aspirin, or naproxen.

Lung Cancer

Lung cancer is a tumor inside your lung. It can cause you to cough, be short of breath, have chest pain, and cough up blood. As the cancer gets worse or spreads, you may not want to eat as much as normal, and you may lose weight, lose your energy, and become weak.