Adolescent Idiopathic Scoliosis: Common Questions and Answers

Angela L. Kuznia, Anita K. Hernandez, Lydia U. Lee

Adolescent idiopathic scoliosis is defined by a Cobb angle of at least 10 degrees in the absence of underlying congenital or neuromuscular abnormalities. It may be detected via the forward bend test and should be confirmed with scoliometer measurement. Several studies have...

Benign Anorectal Conditions: Evaluation and Management

Mark W. Cohee, Ashlee Hurff, John D. Gazewood

Common anorectal conditions include hemorrhoids, pruritus, anal fissures, functional pain, abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should always be considered....

Lymphoma: Diagnosis and Treatment

William D. Lewis, Seth Lilly, Kristin L. Jones

Lymphoma can involve lymphatic tissue, bone marrow, or extranodal sites. Lymphoma is traditionally classified as non-Hodgkin or Hodgkin, and there are approximately 82,000 new U.S. patients diagnosed with lymphoma annually. Lymphoma typically presents as painless adenopathy,...

Breast Implant–Associated Anaplastic Large Cell Lymphoma

Binita S. Ashar, Sung W. Yoon, Steven Nagel

In 2011, the U.S. Food and Drug Administration (FDA) identified a possible association between breast implants and the development of anaplastic large cell lymphoma (ALCL).1 At that time, the FDA knew of so few cases of the disease that it was not possible to determine which...

Warfarin Dosages, PCOS, Varicose Veins, Gastroenteritis in Children, Plantar Fasciitis

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

A Shrinking Primary Care Workforce in Puerto Rico

Elizabeth Wilkinson, David Killeen, Gabriel José Pérez-López, Yalda Jabbarpour

In 2018, two-thirds of primary care physicians in Puerto Rico were older than 55 years, compared with 43% nationwide. Meanwhile, only four out of every 10 graduates of family medicine residencies from 2011 to 2017 remained on the island in 2018, placing Puerto Rico’s new...

Positional Therapy for Obstructive Sleep Apnea

Karl T. Clebak, Theodore J. Demetriou, Stephanie Carey

Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate...

Antepartum Omega-3 Fatty Acid Intake and Length of Gestation

Corey Fogleman, Melody Martin

Omega-3 fatty acids, whether taken as supplements or consumed as part of the diet, reduce the risk of preterm birth (number needed to treat = 68) and early preterm birth (number needed to treat = 55).

Exercise to Reduce Falls in Older Adults

Ginger Poulton, Brittany Funderburke Matney, Travis Williams, Stephen Hulkower, Sue Stigleman

Exercise programs should be recommended for community-dwelling adults 60 years and older because they lead to fewer falls.

PLAC Test for Lp-PLA2 Activity to Predict Coronary Heart Disease

Jennifer G. Chang

The PLAC test is a blood test used to measure serum activity of lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme that breaks down oxidized low-density lipoprotein in the vascular wall. Higher levels of Lp-PLA2 activity are thought to promote atherosclerotic plaque...

Nodules on the Knuckles

Micah Pippin

A 55-year-old man presented with nonpainful, red masses on his knuckles that had been recurring for years. The lesions generally lasted for one month then resolved spontaneously. He was a mechanic, and job-related trauma exacerbated the condition. He also had arthralgias in...

Tapering Long-Term Opioid Therapy

Anna Lembke

My patient is a 54-year-old construction worker who has been taking prescribed opioids for more than a decade for chronic knee and back pain.

Fasting and Nonfasting Lipid Levels Similarly Predict Cardiovascular Disease Risk

Allen F. Shaughnessy

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an Increase in Cancer Detection

Allen F. Shaughnessy

C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute Exacerbation of COPD

Mark H. Ebell

Addition of Steroids Improves Outcomes in Children and Adults with CAP

Allen F. Shaughnessy

Beers Criteria for Inappropriate Medication Use in Older Patients: An Update from the AGS

Lisa Croke

The 2019 American Geriatrics Society update of the Beers Criteria uses the five criteria outlined in 2015; these include medications that should typically be avoided in most older patients, medications that should be avoided in older patients with certain conditions,...

Branched-chain Amino Acids for Patients with Hepatic Encephalopathy

Ahmed Hamed, Amira Hamed, Karissa Lambert

Hepatic encephalopathy is a brain dysfunction that can be mild with minimal confusion, or overt and severe with coma. Learn more about branched-chain amino acids for the treatment of hepatic encephalopathy.

Positive Chest Radiograph Findings Are Not Enough to Warrant Antibiotics in Patients with Acute Cough

Michael Tanael

Reply: Mark Ebell

Screening for Atrial Fibrillation to Initiate Stroke-Protective Therapy

Emma Svennberg, Johan Engdahl, Mårten Rosenqvist

Reply: John Mandrola, Andrew Foy

Physicians Can Help Patients Begin Grieving Process for Loss of a Loved One

Jonathan Rosen

Reply: Steve Dudley

Lymphoma: Diagnosis and Treatment

Lymphoma is a cancer that affects your lymph nodes. Lymph nodes are small bean-shaped bumps under the skin. They are normally found all over your body, including your neck, armpits, and groin. Lymph nodes help your body to fight disease. There are many types of lymphoma that...