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Articles

Recent-Onset Altered Mental Status: Evaluation and Management

Brian Veauthier, Jaime R. Hornecker, Tabitha Thrasher

Potential precipitating factors for the recent onset of altered mental status can be multifactorial and include central nervous system insults, systemic infections, metabolic disturbances, toxin exposure, medications, chronic systemic diseases, and psychiatric conditions....

Vocal Cord Dysfunction: Rapid Evidence Review

John Malaty, Velyn Wu

Vocal cord dysfunction can be severe and impair breathing or, more commonly, less severe and impact the patient's voice. Nasolaryngoscopy and pulmonary function testing can help in the diagnosis. Management includes treatment of triggers and referral for therapeutic breathing...

Medical Clearance for Common Dental Procedures

Kevin R. Herrick, Jennifer M. Terrio, Crispin Herrick

Integrating patients' medical and dental health care is important because there are correlations between periodontal disease and some medical conditions. Medical consultations before dental procedures present opportunities to integrate cross-disciplinary preventive care and...

Fetal Growth Restriction Before and After Birth

Andrea Westby, Laura Miller

Fetal growth restriction, formerly known as intrauterine growth restriction, is a condition in which estimated fetal weight is below the 10th percentile for gestational age. Early detection and management are essential. All pregnant patients should be screened for fetal...

End-Stage Renal Disease: Medical Management

Noah Wouk

End-stage renal disease is diagnosed when kidney function is no longer adequate for long-term survival without kidney transplantation or dialysis. This article provides an overview of the medical management of end-stage renal disease, as well as its comorbidities and...

Breast Implants: Common Questions and Answers

Sarina Schrager, Sarah M. Lyon, Samuel O. Poore

Breast implants are used for a range of cosmetic and reconstructive purposes. Several factors are important to consider preoperatively, including the impact on mammography, future lactation, and potential long-term implant complications.

Inside AFP

AFP Photo Contest Winners!

Sumi Sexton, Matthew Neff

This summer we held the first American Family Physician photo competition, which was intended to encourage students and residents to share their stories through photographs about how they use the AFP journal.

Editorials

Asthma Management Guidelines: Focused Updates for 2020

Kurtis S. Elward

The 2020 Focused Updates to the asthma management guidelines represent the first revision of the National Asthma Education and Prevention Program guidelines in more than 10 years. The report differs from the Global Initiative for Asthma recommendations because of the focused...

Translating the 2020–2025 U.S. Dietary Guidelines into Clinical Practice

Amy B. Locke, Rachel Goossen

The answer to the simple question “What should we eat?” is remarkably contentious and fraught with strongly held personal beliefs and preferences, as well as substantial financial and disease implications. It is a question that patients and families often ask their physicians...

AFP Clinical Answers Cochrane for Clinicians

Coenzyme Q10 for Heart Failure

Carlton Covey

In patients with chronic heart failure, supplementation with coenzyme Q10 may reduce all-cause mortality. Adverse effects are generally mild and may be only slightly increased with coenzyme Q10 supplementation.

Basal Cell Carcinoma: Comparison of Surgical and Nonsurgical Interventions

Ray Antonelli, Scott Plensdorf

The recurrence rate after surgical management of BCC by standard surgical excision or Mohs micrographic surgery is very low. Recurrence after management with imiquimod (Aldara) is also low and may result in more favorable cosmetic outcomes. Other nonsurgical options may have...

Implementing AHRQ Effective Health Care Reviews FPIN's Clinical Inquiries Putting Prevention Into Practice Diagnostic Tests

Aptima Assay for Detection of Mycoplasma genitalium Infection

Karl T. Clebak, Jarrett K. Sell, Ashley Koontz

The Aptima M. genitalium assay is highly sensitive and specific. The Centers for Disease Control and Prevention recommends the use of NAAT testing for M. genitalium infection in men with recurrent nongonococcal urethritis, in women with recurrent cervicitis, and possibly in...

STEPS

Tirbanibulin (Klisyri) for the Treatment of Actinic Keratosis

Kamini Geer

The cost and effectiveness profile of tirbanibulin make it a last-line option compared with current first-line therapies such as fluorouracil and imiquimod, which are less expensive and have a higher clearance rate of AK lesions. Further trials comparing the effectiveness of...

Photo Quiz

Firm Nodule on the Ear

Matthew Helm, Brandon Ng, Anne Mogavero

A patient presented with a crusted papule on the antihelix of the ear that had grown slowly over several years.

Facial Rash in a Newborn

Nicole T. Yedlinsky, David Embers

An infant is born with a yellowish linear plaque on the cheek.

Curbside Consultation Practice Guidelines Medicine by the Numbers POEMs Letters to the Editor Information from Your Family Doctor

Vocal Cord Dysfunction

It is when your vocal cords partly close while you are breathing. This may cause sudden, severe shortness of breath, tightness in your throat, or trouble speaking. Vocal cord dysfunction can sometimes be mistaken for asthma.

Breast Implants

Breast implants are fluid- or gel-filled devices that are put into your chest to change the shape or size of your breast. Most breast implants are used after breast cancer surgery (mastectomy) or when women want to increase their breast size (augmentation).

Corrections

Corrections

Incorrect measurement. In the article “Management of Infants Born to Mothers with HIV Infection,” (July 2021, p. 58) the HIV RNA load threshold for recommending a cesarean delivery was incorrect in the second sentence of the Perinatal Transmission section on page 58. The...

Corrections

Missing reference. In the article “Out-of-Hospital Birth,” (June 1, 2021, p. 672) the citation for reference 60 was inadvertently omitted (page 679). The citation should have read: “Ecker J, Minkoff H. Home birth: what are physicians' ethical obligations when patient choices...



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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