• Articles

    Noninvasive Cardiac Testing

    William E. Cayley, Jr

    Noninvasive cardiac testing is most commonly used in the evaluation of patients with chest discomfort, shortness of breath, or other symptoms suspicious for acute coronary syndrome. Clinical prediction rules can guide risk assessment for patients with acute or stable chest...

    Mildly Elevated Liver Transaminase Levels: Causes and Evaluation

    Robert C. Langan, Kourtni A. Hines-Smith

    Elevated transaminase levels may be associated with significant underlying liver disease and increased risk of liver-related and all-cause mortality. Patients should be counseled about moderation or cessation of alcohol, weight loss, and avoidance of hepatotoxic drugs.

    Bone Stress Injuries: Diagnosis and Management

    Jeremy D. Schroeder, Steven D. Trigg, Gerardo E. Capo Dosal

    Bone stress injuries are reactions to stress fractures; they are indicated by localized pain and loss of function, most often in the setting of sudden load volume changes. Palpatory bony tenderness is the most significant examination finding.

    Management of Keloids and Hypertrophic Scars

    Justin Bailey, Megan Schwehr, Alexandra Beattie

    Prevention of these scars focuses on avoiding elective procedures in patients at high risk, reducing tension across the lesion, and decreasing the inflammatory response. Small keloids and most hypertrophic scars may respond well to conservative therapies, but large keloids...

    Anemia in Infants and Children: Evaluation and Treatment

    Meghan F. Raleigh, Ashley S. Yano, Nathan E. Shaffer

    Anemia in children is often asymptomatic. It can be caused by nutritional deficiency, genetic hemoglobin disorders, blood loss, or infection. Universal screening in the first year of life may be considered. Treatment typically involves oral iron supplementation or consumption...

    Acute Abdominal Pain in Children: Evaluation and Management

    Katie L. Buel, James Wilcox, Paul T. Mingo

    Acute abdominal pain in children is a common presentation in clinic and emergency department settings. Narrowing the differential diagnosis can be done by using the age and symptoms of the patient. History and physical examination are critical in determining which cases are...

    Editorials

    Protecting Continuous Coverage and Care for Children

    Stephanie E. Quinn

    COVID-19 federal funding tied to continuous Medicaid coverage has ended. A loss in coverage will result in children not receiving required care.

    Should Your Patients Avoid Sunscreen?

    Barry D. Weiss

    Given the growing anti-sunscreen movement and increasing rates of skin cancer, clinicians should routinely include sun protection in their prevention discussions with patients.

    Medicine by the Numbers

    SGLT-2 Inhibitors for Individuals With Diabetes and Chronic Kidney Disease

    Michael D. North, Alexei O. DeCastro

    SGLT-2 inhibitors are a valuable tool for preventing death and heart and kidney complications in patients with comorbid CKD and diabetes. Based on the evidence, we have assigned an NNT color of green (greater benefit than harm).

    AFP Clinical Answers

    Alzheimer Disease, Chronic Cough, Alopecia, Mild Traumatic Brain Injury, Cushing's Syndrome, Uncomplicated Febrile UTI

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

    Graham Center Policy One-Pager

    Opioid Prescribing Has Significantly Decreased in Primary Care

    Chrystal Pristell, Hoon Byun, Alison N. Huffstetler

    Prescription opioids continue to be commonly used for chronic noncancer pain, despite inherent risks. Primary care physicians and advanced practice clinicians have been integral to driving change in opioid prescribing, preventing overuse, and reducing risk.

    Cochrane for Clinicians

    Nonmedical Interventions to Enhance Return to Work for People With Cancer

    Prakhya Bhatnagar, Anthony Day

    Physical interventions improve the ability of people with cancer to return to work. Multidisciplinary training also improves the ability of people with cancer to return to work. However, neither of these types of interventions improves quality of life (QOL). Psychoeducational...

    Psychological Interventions for Depression and Anxiety in Patients With Coronary Heart Disease or Heart Failure

    Kento Sonoda, Catherine Peony Khoo

    Compared with no psychological intervention, psychological interventions are safe and effective for improving depression, anxiety, and mental health–related quality of life at 6 to 12 months in patients with coronary heart disease or heart failure.

    Lown Right Care

    The Overdiagnosis of Myocardial Infarction

    Andy Lazris, Alan Roth, Helen Haskell, John James

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

    Photo Quiz

    Painless Black Toe

    Nolan E. Lee, Arielle Ilano, Ha Kirsten Do, Maylynn Tam

    A 68-year-old man presented with black discoloration of his great toe.

    Painful Finger Lesion

    Allison Vogl, Carlie Hoffman, Emeil Shenouda

    A 61-year-old woman presented with a painful cystic lump on her thumb.

    Point-of-Care Guides

    Predicting Bleeding Risk in Patients With Atrial Fibrillation Who Are Taking Direct Oral Anticoagulants

    Lindy Krebs, Aaron Saguil

    Is there an accurate tool to assess bleeding risk in patients with atrial fibrillation when starting a direct oral anticoagulant to minimize the risk of stroke?

    FPIN's Clinical Inquiries

    Weight Loss in Patients With Overweight or Obesity and Knee Osteoarthritis

    Thomas Troy, Hanh Ngo, Lauren Pham

    A total body weight loss of 5.1%, or 0.24% per week, results in clinically significant improvement in pain and disability in patients with overweight or obesity and knee osteoarthritis (OA). Although weight loss improves pain caused by knee OA, there is no known minimum level...

    Diary of a Family Physician

    Diary of a Family Physician

    Marwa Saleh, Dolly C. Penn

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

    POEMs

    Cannabis Use in Pregnancy Is Associated With an Increased Incidence of Low Birth Weight and Small-for-Gestational-Age Infants

    Linda Speer

    SGLT-2 Inhibitors, GLP-1 Agonists Provide Greater Benefit for Patients With Type 2 Diabetes

    Allen F. Shaughnessy

    Over 13.6 Years, Children With Hypertension Are Twice As Likely to Have Major Adverse Cardiovascular Events

    Henry C. Barry

    Children, and Adults Who Are Pregnant, Have Prediabetes, or Are Older Than 74 Years, May Benefit From Empiric Vitamin D

    Allen F. Shaughnessy

    Practice Guidelines

    Premenstrual Disorders: Guidelines From the American College of Obstetricians and Gynecologists

    Michael J. Arnold

    The American College of Obstetricians and Gynecologists has released recommendations for the management of premenstrual disorders in reproductive-aged adults and adolescents.

    Acute Bacterial Arthritis in Children: Guidelines From the Pediatric Infectious Diseases Society and Infectious Diseases Society of America

    Adedayo O. Jobi-Odeneye

    The Pediatric Infectious Diseases Society and Infectious Diseases Society of America have published guidelines for evaluation and treatment of suspected acute bacterial arthritis in otherwise healthy children older than 1 month.

    Letters to the Editor

    Case Report: Small Bowel Obstruction After Starting Tirzepatide (Mounjaro)

    Leandra Morgenthaler, Regina DePietro

    Gender Bias and Pay Disparity in Medicine

    Kevin C. Kelleher

    Reply: Grace Walter, Anam Siddiqi, Alison Huffstetler

    Information from Your Family Doctor

    Bone Stress Injuries (Including Stress Fractures)

    Bone stress injuries happen when bones get damaged from too much use. They can sometimes lead to fractures. They differ from traditional broken bones that happen after trauma, such as a fall. They are most common in the bones of your leg.

    Corrections

    Correction

    Incorrect CME Quiz Answers. In the “Answers to This Issue's CME Quiz” box (October 2024, p. 443), the answers listed for the first four questions were incorrect. The corrected answer box for the October 2024 CME quiz is reprinted below. The online CME quiz was not affected by...



    Disclosure

    All editors in a position to control content for this activity, AFP journal, are required to disclose any relevant financial relationships. View disclosures.


    Tag Legend

    Legend

    CME Continuing Medical Education Credit
    POC Point-of-Care Resource
    FREE Free Access
    Alg Algorithm
    DDx Differential Diagnosis
    PtEd Patient Education