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Articles

Osteoporosis: Common Questions and Answers

Kira Harris, Christopher A. Zagar, Kelley V. Lawrence

Osteoporosis affects 10.2% of adults older than 50 years and is expected to increase to 13.6% by 2030. Osteoporotic fractures, specifically hip fractures, have significant impacts on morbidity, mortality, and quality of life.

Distinguishing Asthma and COPD in Primary Care: A Case-based Approach

T. Aaron Zeller, Katherine Beben, Stephanie Walker

Asthma and chronic obstructive pulmonary disease (COPD) affect more than 40 million Americans, and distinguishing between the two can be difficult. Accurate diagnosis requires spirometry that demonstrates a characteristic pattern.

Glaucoma: Diagnosis and Management

Thomas C. Michels, Oana Ivan

Glaucoma is a group of eye disorders characterized by progressive deterioration of the optic nerve head and retinal nerve fiber layer. Primary open-angle glaucoma is the most common form in the United States.

Polycystic Ovary Syndrome: Common Questions and Answers

Tracy Williams, Justin B. Moore, Jared Regehr

This article presents evidence-based answers to common questions about the diagnosis and management of polycystic ovary syndrome.

Posttraumatic Stress Disorder: Evaluation and Treatment

Zachary Sartor, Lance Kelley, Ryan Laschober

Posttraumatic stress disorder (PTSD) can occur in response to a broad range of traumatic events. Psychological symptoms can be mistaken for anxiety or mood disorders, which are often comorbidities of PTSD. There are several assessment tools available to help diagnose PTSD and...

Pulmonary Nodules: Common Questions and Answers

Robert C. Langan, Andrew J. Goodbred

Pulmonary nodules are commonly discovered incidentally on chest imaging or from dedicated lung cancer screening. Screening adults 50 to 80 years of age who have a 20-pack-year smoking history and currently smoke or have quit within the past 15 years with low-dose computed...

Editorials

Reconsidering the Use of Race in Spirometry Interpretation

Bonzo Reddick

An analysis of the Multi-Ethnic Study of Atherosclerosis Lung Study found that the use of race corrections in spirometry interpretation did not help to predict chronic lower respiratory disease events any more accurately than the use of race-neutral calculations.

Multicancer Early Detection: A Promise Yet to Be Proven

Chyke A. Doubeni, Philip E. Castle

Because of known limitations and inadequate evidence, primary care clinicians should focus on providing USPSTF-recommended, evidence-based preventive services and only use multicancer early detection tests in the context of well-designed clinical research studies and not in...

AFP Clinical Answers

Pneumococcal Vaccine, Polymyalgia Rheumatica, Giant Cell Arteritis, Concussion, Malaria

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

Medicine by the Numbers

Corticosteroids for Low Back Pain

Sean P. Haley, Leah A. Stem

We assigned a color recommendation of yellow (unclear benefits) due to modest improvements for radicular back pain and an incomplete view of potential patient-oriented harms. The most clinically meaningful evidence to patients is the potential for corticosteroids to improve...

Cochrane for Clinicians

Antiplatelet Agents for the Treatment of Deep Venous Thrombosis

Alexis Reedy-Cooper, Juan Perez

Best medical practices for the initial treatment of uncomplicated DVT include anticoagulation, compression stockings, and physical exercise. In the management of DVT, adding an antiplatelet agent to standard practices does not show clear benefits or cause significant adverse...

Foot Orthoses for Treating Flat Feet in Children

Kathleen Barry, Craig Pille

Customized or prefabricated foot orthoses do not result in significant improvements in pain, function, or parent and child quality-of-life scores. Importantly, quality-of-life scores were not reported in patients who were asymptomatic.

Lown Right Care

Is There Evidence of ADHD Overdiagnosis in Children?

Elizabeth Wolf, Neil Sonenklar, Matthew Schefft, Helen Haskell, John James

A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

U.S. Preventive Services Task Force

Screening for Obstructive Sleep Apnea in Adults

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea in the general adult population.

Putting Prevention Into Practice

Screening for Obstructive Sleep Apnea in Adults

Justin Mills, Michael C. Harding

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

FPIN's Clinical Inquiries

Dry Needling for Low Back Pain

Roxanne Radi, Wesley Ng, Raeanna Simcoe, Corey Lyon, Kristen DeSanto

A comprehensive treatment program that includes dry needling may provide some benefit in decreasing pain scores and perceived disability vs. standard physical therapy and home physical therapy in the short term. However, this improvement is small, and the clinical...

Point-of-Care Guides

Diagnosing Appendicitis in Children and Adolescents With Abdominal Pain

Mark H. Ebell

In children and adolescents with lower abdominal pain, is there a way to identify low-, moderate-, and high-risk groups for suspected appendicitis?

Diagnostic Tests

Risk of Ovarian Malignancy Algorithm (ROMA) for Assessing Likelihood of Ovarian Cancer

Carl Bryce

Family physicians encounter patients with adnexal masses who require surgery, some of whom may have ovarian cancer. The ROMA test can assess the presurgical likelihood of malignancy in patients who already have a planned surgery.

Photo Quiz

Black Fingernail Discoloration

Nada Al-Hashimi, Gurvinder Dhaliwal

A patient presented with black discoloration of all fingernails, without pitting, spooning, or ulceration.

Suspicious Lesion Under a Face Mask

Stephen Carek, Christian Crowe

A patient presented with an ulcerated and crusted erythematous plaque with well-demarcated borders on his lower lip that developed during the mask mandate.

STEPS

Viloxazine (Qelbree) for ADHD

Kristen Goodell, Deborah Erlich

Viloxazine reduces ADHD symptoms but has not been directly compared with atomoxetine or first-line stimulant medications. Adverse effects are common, and the risks of suicidal ideation and increased heart rate and blood pressure are a concern.

Curbside Consultation

Self-Monitoring of Blood Glucose in Patients With Non–Insulin-Dependent Diabetes Mellitus

Isha Marina Di Bartolo, Mara Gordon

This case addresses a common situation in primary care that can occur when new evidence changes practices that were once taken for granted by physicians and patients as contributing to quality care. Discontinuing low-value interventions can be challenging for patients and...

POEMs

Nirmatrelvir/Ritonavir Reduces Hospitalization, Mortality in Patients 65 Years and Older With COVID-19; Effect on Younger Patients Unclear

Mark H. Ebell

Amitriptyline, Duloxetine, and Pregabalin Each Effective in Decreasing Pain From Diabetic Peripheral Neuropathy; Combinations Even Better

Henry C. Barry

Tocilizumab Beneficial for Adults With Persistent Polymyalgia Rheumatica Symptoms Who Receive Steroid Therapy

David C. Slawson

Polypill Better for Secondary Cardiovascular Prevention Than Physician-Directed Care

Mark H. Ebell

Practice Guidelines

ACIP Approves 2023 Child/Adolescent and Adult Immunization Schedules

Pamela G. Rockwell

The 2023 child/adolescent and adult immunization schedules have been approved by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. Notable changes include updates to COVID-19 recommendations and mpox (formerly monkeypox)...

Management of Major Depression: Guidelines From the VA/DoD

Andrew Buelt

The U.S. Department of Veterans Affairs and U.S. Department of Defense published guidelines on the management of major depressive disorder.

Letters to the Editor

Additional Considerations for the Microscopic Evaluation of Urine

Joseph V. Cook

Reply: Nathan Hitzeman

Case Report: Tinea Capitis in a 10-Year-Old Child

Michael T. Tshudy, Shannan McCann

Information from Your Family Doctor

Osteoporosis

Osteoporosis means bones (“osteo”) that are porous (“porosis”), or weak. When your body loses calcium, your bones become weaker and more likely to break.

Spirometry: A Simple Test for Breathing Problems

It is a test that measures how much and how quickly you can move air in and out of your lungs compared with other people who have breathing problems like yours. For the test, you will blow through a tube as hard, as fast, and as long as you can. After that, you may be given...

Glaucoma

Glaucoma (glaw-KOH-muh) is a disease that damages the nerve in the back of your eye called the optic nerve.

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS for short) is a common condition. It is usually related to your hormones being out of balance.

Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a mental health illness that can happen after you have had or witnessed a trauma, such as a life-threatening event, sexual violence, or serious injury. PTSD affects your mood and body. PTSD can last for months, or it can last for many...

Lung Nodules

A lung nodule (NA-jule; also known as pulmonary nodule) is a small, often ball-shaped tissue collection that can grow in the lungs. They can range in size from smaller than a pea to the size of a golf ball or larger. Most of the time, people with lung nodules have no symptoms...



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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