JOURNAL OF FAMILY PRACTICE

Getting PrEP to the patients who need it
Foley AVA, Farrell DF and Reese PC
A fraction of those eligible for PrEP to prevent HIV infection receive a prescription. Newer drug regimens and updated recommendations can help you reduce that gap.
A new standard for treatment of torus fractures of the wrist?
Martin PM, Gaddini M and Cardon B
A large multicenter trial evaluated effects on pain and function for pediatric patients treated with a soft bandage vs rigid immobilization.
Preventing RSV in children and adults: A vaccine update
Campos-Outcalt D
In addition to 3 vaccines, there's also a new monoclonal antibody for prevention of respiratory syncytial virus. Learn how each can be used in infants and children, adults, and pregnant people.
An FP's guide to caring for patients with seizure and epilepsy
Tirol FG, Levine MR, Wang T, Cho YW and Motamedi GK
Optimizing your care requires that you distinguish between provoked and unprovoked seizures and focus on key elements of the patient's history.
Painless nodules on legs
Toh EQ, Juay L, Tee SI and Lim ZV
The location of the nodules and the patient's history were important diagnostic clues. The punch biopsy confirmed our suspicions.
55-year-old woman • Myalgias and progressive symmetrical proximal weakness • History of unilateral renal agenesis, type 2 diabetes, and hyperlipidemia • Dx?
Schoenherr DT, Dhaliwal S and Loncharich MF
► myalgias and progressive symmetrical proximal weakness ► history of unilateral renal agenesis, type 2 diabetes, and hyperlipidemia.
Is low-molecular-weight heparin superior to aspirin for VTE prophylaxis?
Rose M, Pang N and Conway S
Aspirin demonstrated a significantly higher rate of postoperative venous thromboembolic events compared with enoxaparin in this noninferiority study.
Renewing the dream
Viera AJ
51-year-old woman • History of Graves disease • General fatigue, palpitations, and hand tremors • Dx?
Maejima T, Mizumoto J, Ito Y and Suga T
► history of Graves disease ► general fatigue, palpitations, and hand tremors.
Essential oils: How safe? How effective?
Shah PA, Killeen D, Meninno E and Shine S
Given the ubiquity of these plant-based oils, your patients might ask about using them. Here's the evidence on safety and efficacy to guide your response.
Clinical Consult in NASH: Are Your Patients at Risk? Based on a Medscape Education Online Activity
Flamm SL
Nonalcoholic steatohepatitis, or NASH, is the most severe form of nonalcoholic fatty liver disease (NAFLD). If left untreated, NASH can develop into advanced liver disease, such as cirrhosis. Moreover, patients with NASH and cirrhosis are also at increased risk of developing hepatocellular carcinoma. Therefore, early detection and intervention are key components to prevent disease progression, particularly in the primary care setting where many patients with NASH are typically encountered.
Does vaginal estrogen use increase the risk for adverse cardiovascular outcomes?
Hendrix J, Chang E, Cheng V, Neher JO and Safranek S
NO. In general, nonoral estrogen use for menopausal symptoms is associated with a lower cardiovascular (CV) risk profile than oral estrogen use (strength of recommendation [SOR], B; meta-analysis of cohort studies). Vaginal estrogen use is associated with lower risk for coronary heart disease (CHD) and similar risk for myocardial infarction (MI), stroke, and deep vein thrombosis/pulmonary embolism (DVT/ PE) compared with nonuse (SOR, B; cohort studies). Vaginal estrogen therapy also is associated with lower CV-related mortality for 3 to 5 years compared withnonuse (SOR, B; cohort study). No high-quality randomized trials address this topic.
Does taking BP medicine at night (vs morning) result in fewer cardiovascular events?
Martin R and Guthmann R
PROBABLY NOT. In patients who have hypertension, the timing of administration of antihypertensive medications does not appear to impact cardiovascular outcomes (strength of recommendation: B; contradictory randomized controlled trials).
Not acne, but what?
Wills EE, Edwards LB, Brodell RT and Flischel AE
The diagnosis of this patient's inflammatory condition required us to dig deeper.
ACIP updates recommendations for influenza vaccination
Campos-Outcalt D
Although there are few changes from last year, there is a new approach to administering egg-based vaccine to those with a history of egg allergy.
Are manual therapies effective at reducing chronic tension headache frequency in adults?
Hager D and Guthmann R
MAYBE. Among patients with chronic tension headaches, manual therapies may reduce headache frequency more than sham manual therapy, usual care, or exercise treatments-by 1.5 to 4.2 headaches or days with headache per week (strength of recommendation, B; preponderance of evidence from primarily small, heterogeneous randomized controlled trials [RCTs]).
Allergic contact dermatitis
Edwards TM, Usatine RP and Heath CR
Feeling salty about our sodium intake
Viera AJ
How best to diagnose and manage abdominal aortic aneurysms
LeFevre N and Chase B
The evidence summarized here can help guide your approach to this life-threatening condition that often goes undetected until rupture.
52-year-old man • intermittent fevers • recently received second dose of COVID-19 vaccine • tremors in all 4 extremities • Dx?
Lear A, Itrat A and Sheridan KC
► intermittent fevers ► recently received second dose of COVID-19 vaccine ► tremors in all 4 extremities.
Updates in the Management of Erosive Esophagitis
Pandolfino JE, Spechler SJ and Yadlapati R
Upon completion of this activity, participants will:Have increased knowledge regarding the Mechanistic differences between proton pump inhibitors (PPIs) and potassium-competitive acid blockers (PCABs) Evidence comparing PPIs with PCABs for the treatment of GERD and EE Have greater competence related to Selecting evidence-based treatments for EE.