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Articles

Care of the College Student

Brian K. Unwin, Jeffrey Goodie, Brian V. Reamy, Jeffrey D. Quinlan

Although generally healthy, about 20% of students who attend college have special health care needs, including asthma, diabetes mellitus, and learning, mental health, and substance use disorders. Physicians can facilitate the transition of a youth to an adult model of health...

Human Papillomavirus: Screening, Testing, and Prevention

Jeffrey D. Quinlan

There are more than 200 types of human papillomavirus (HPV). HPV infection can be latent and subclinical, or have a presentation ranging from benign cutaneous and mucosal lesions to life-threatening clinical carcinomas. Screening for HPV infection effectively identifies...

Dysmenorrhea

Kathryn A. McKenna, Corey D. Fogleman

Dysmenorrhea is common and usually independent of pelvic pathology. Secondary dysmenorrhea may present with progressive worsening of pain, abnormal uterine bleeding, or dyspareunia. Nonsteroidal anti-inflammatory drugs and hormonal contraceptives are first-line medical...

Breast Cancer Treatment

Kathryn P. Trayes, Sarah E.H. Cokenakes

Breast cancer is the leading cause of cancer deaths in women worldwide and the second most common cause of death from cancer in women in the United States. Primary care physicians are often the first point of contact for patients with a new diagnosis of breast cancer.

Sinus Node Dysfunction

Matthew Kendall Hawks, Madison L.B. Paul, Omojo Odihi Malu

Sinus node dysfunction describes disorders related to abnormal conduction and propagation of electrical impulses at the sinoatrial node that interfere with pacemaker function. A diagnosis is made by directly correlating symptoms with a brady-arrhythmia and eliminating...

Pertussis: Common Questions and Answers

Jonathan M. Kline, Eleanor A. Smith, Adrienne Zavala

The presentation of pertussis, or whooping cough, is variable and evolves over the course of illness, which often includes a catarrhal, paroxysmal, and convalescent stage. Diagnosis should be confirmed using polymerase chain reaction testing. Immunity typically wanes two to...

Editorials

Fallacies and Dangers of Practicing Race-Based Medicine

Bonzo Reddick

Race does not have a biologic definition, but rather a political and social one that is fluid and independent of science. Nevertheless, the medical community uses race as a scientific variable in several prominent clinical situations, including calculation of atherosclerotic...

Graham Center Policy One-Pagers Provide Perspectives on the State of Primary Care

Kenneth W. Lin, Yalda Jabbarpour, John M. Westfall

Previous Graham Center Policy One-Pagers published in AFP have provided timely perspectives on a range of topics. In 2020, the Graham Center, in collaboration with IBM Watson Health and the American Board of Family Medicine, produced a chartbook of statistics on the current...

Graham Center Policy One-Pager

State-Level Variation in Primary Care Physician Density

Karissa Merritt, Yalda Jabbarpour, Stephen Petterson, John M. Westfall

Despite representing only one-third of the physician workforce in the United States, primary care physicians (PCPs) are the first contact with the health care system for most patients. A 2010 report by the Council on Graduate Medical Education recommended that 40% of the...

Medicine by the Numbers

Accuracy of Ultrasonography for the Diagnosis of Small Bowel Obstruction

Brit Long, Michael Gottlieb

According to a meta-analysis including prospective observational studies evaluating the accuracy of ultrasonography for the diagnosis of small bowel obstruction, ultrasonography appears to be highly sensitive and specific for this use.

AFP Clinical Answers

Prenatal Vitamins, Patellofemoral Pain Syndrome, Alcohol Misuse, Hernia, Anaphylaxis, Gout

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

Cochrane for Clinicians

Levonorgestrel-Releasing Intrauterine System for Reducing Heavy Menstrual Bleeding

Michael Loeven, Emily Brown

The levonorgestrel-releasing intrauterine system is more effective than other medical therapies at reducing menstrual bleeding volume, with similar rates of adverse effects. The effectiveness of the levonorgestrel-releasing intrauterine system compared with endometrial...

Can Pioglitazone Prevent or Delay Type 2 Diabetes in Patients with Prediabetes?

Pamela O. Obi

Pioglitazone prevents or delays the incidence of type 2 diabetes in individuals with prediabetes when compared with placebo or no intervention. Compared with metformin, however, pioglitazone does not reduce the incidence of type 2 diabetes in those with prediabetes.

Putting Prevention Into Practice

Screening for Hypertension in Adults

Tina Fan, Marissa Tan

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

Implementing AHRQ Effective Health Care Reviews

Diagnosis and Initial Management of Acute Colonic Diverticulitis

Jacqueline DuBose, Dean Seehusen

What are the benefits and harms of diagnostic testing, and what is the effectiveness of treatment options for acute colonic diverticulitis?

Diary of a Family Physician

Diary of a Family Physician

Sarah Cheek, Alexandra Schieber

First-person accounts from the front lines of family medicine.

Photo Quiz

Red, Raised Papule on the Chest

Julia Carroll, Natalie DiMaio

A patient presented with a red, slightly raised papule on the anterior chest wall.

Acute Sharp Flank Pain

Phillip Kim, Alvin Vong

A patient presented with stiffness and pain in his lower back and both thighs and an abnormal CT scan.

FPIN's Help Desk Answers

Hydrochlorothiazide vs. Chlorthalidone for the Treatment of Hypertension

Jason M. Barnes, Wendra J. Galfand

Chlorthalidone reduces systolic blood pressure by 10 mm Hg more than hydrochlorothiazide at equal dosages in patients using monotherapy. Low-dose chlorthalidone and controlled-release hydrochlorothiazide reduce 24-hour ambulatory systolic blood pressure and diastolic blood...

FPIN's Clinical Inquiries

Physical Activity and the Prevention of Depression

Corey Lyon, Allison Johnson, Kristen DeSanto

Physical activity appears to be associated with a lower risk of developing depression and depressive symptoms.

POEMs

SGLT2 Inhibitors or GLP-1 Receptor Agonists Reduce Cardiovascular Outcomes in Patients with Type 2 Diabetes

Allen F. Shaughnessy

More than One-Half of Adults Hospitalized for COVID-19 Still Report Significant Symptoms at Four Months Postdischarge

Henry C. Barry

Inhaled Budesonide Reduces the Risk of Emergency Department Evaluation or Hospitalization in Early COVID-19

Mark H. Ebell

Tighter Blood Pressure Control Does Not Increase the Likelihood of Orthostatic Hypotension

Allen F. Shaughnessy

Practice Guidelines

Management of Gout: Update from the American College of Rheumatology

MaryAnn Dakkak, Howard Lanney

The American College of Rheumatology published updated guidelines for gout management focused on improving prevention of flare-ups.

Iron Deficiency Anemia: Guidelines from the American Gastroenterological Association

Kento Sonoda

The American Gastroenterological Association developed guidelines for the evaluation of IDA in adults.

Letters to the Editor

Automated Office Blood Pressure for Diagnosing Hypertension

Lenard I. Lesser

Community Alcoholics Anonymous Programs Are Not a Replacement for Formal Treatment

Bridget Foley

Reply: Elizabeth Salisbury-Afshar

Strangulation as a Cause of Dysphagia

Rebecca Giusti, Anita Ravi

Reply: John M. Wilkinson, Don (Chamil) Codipilly, Robert P. Wilfahrt

Case Report: Consequences of Misdiagnosed Anal Cancer

Anuja Trivedi, Ruksana Nazneen

Information from Your Family Doctor

Painful Menstrual Periods

Many people have some crampy pain with their periods, especially as teenagers. The pain often is low in the pelvis and starts just before your period or at the beginning of your period. It often lasts one to three days. The pain can be bad enough to keep you from doing things...



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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