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New Issue: Tinnitus, Polycythemia Vera, Out-of-Hospital Birth

 

                                               

 

An editorially independent, peer-reviewed journal of the American Academy of Family Physicians.

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JUNE 1, 2021

AFP Issue Frequency Change Coming Soon

Beginning with the July 2021 issue, AFP will publish 12 issues per year instead of 24, with twice the amount of editorial content and CME credit in each one. Look for the first “double issue” in mid-July. Additional information is available.


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Tinnitus: Diagnosis and Management

Tinnitus is the perception of sound in the absence of an objective internal or external source. Tinnitus is a symptom, not a disease, and although it is typically not associated with a dangerous condition, it can significantly affect an individual’s quality of life. Guidelines recommend a standard approach to history and physical examination to determine the etiology, followed by audiometric testing and imaging, laboratory studies, and other testing as appropriate. Cognitive behavior therapy is the only treatment that has been shown to improve quality of life in patients with tinnitus. Avoidance of noise exposure may prevent the development or progression of tinnitus.

FOR YOUR PATIENT ▶ TINNITUS [FREE FULL TEXT]
SEE MORE IN AFP BY TOPIC ▶ EAR AND HEARING DISORDERS
Polycythemia Vera: Rapid Evidence Review

Polycythemia vera is a common myeloproliferative neoplasm characterized by erythrocytosis, often with associated leukocytosis and thrombocytosis. It has a significant negative impact on overall mortality and morbidity in the form of arterial and venous clots, fatigue, pruritus, and conversion to leukemia and myelofibrosis. Major diagnostic criteria include elevated hemoglobin or hematocrit level, abnormal bone marrow biopsy, and presence of the Janus kinase 2 genetic mutation. First-line treatments, such as low-dose aspirin and goal-directed phlebotomy to a hematocrit level of less than 45% to reduce thrombotic events, improve quality of life and prolong survival.

 

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Out-of-Hospital Birth

Most out-of-hospital births occur at home and are assisted by midwives. U.S. studies have shown that home births increase perinatal mortality and neonatal morbidity compared with hospital births. However, planned community births also have lower odds of obstetric interventions, including cesarean delivery. Maternal and newborn health professionals who attend planned community births should be licensed and integrated into a maternity health care system. Family physicians are uniquely poised to counsel patients and their families on the risks and benefits of choosing community birth.

FOR YOUR PATIENT ▶ HAVING A BABY OUTSIDE OF A HOSPITAL [FREE FULL TEXT]
SEE MORE IN AFP BY TOPIC ▶ LABOR, DELIVERY AND POSTPARTUM ISSUES
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Are You Choosing the Best Options to Reduce Persistent Cardiovascular Risk (P-CVR)?

The staggering statistics around CV disease are increasing. CV disease is the leading cause of death in the US even in the context of the devastating deaths associated with the COVID-19 pandemic. Millions of patients take statins, they’re the first step – along with diet and exercise – but statins don’t fully protect against persistent CV risk (P-CVR).

 
AFP CLINICAL ANSWERS
Abdominal Aortic Aneurysm, Migraines in Children, Mucolytics for COPD, Paget Disease, ARDS
EDITORIALS
Promoting Safety in Community-Based Birth Settings [FREE FULL TEXT]
SEE MORE IN AFP BY TOPIC ▶ LABOR, DELIVERY, AND POSTPARTUM ISSUES
DIAGNOSTIC TESTS: WHAT PHYSICIANS NEED TO KNOW
Flash Continuous Glucose Monitoring (FreeStyle Libre 14-Day System) for Self-Management of Diabetes Mellitus
SEE MORE IN AFP BY TOPIC ▶ DIABETES: TYPE 2
PRACTICE GUIDELINES
Chronic Kidney Disease in Diabetes: Guidelines from KDIGO
SEE MORE IN AFP BY TOPIC ▶ KIDNEY DISEASE
COCHRANE FOR CLINICIANS
Pessaries for Managing Pelvic Organ Prolapse in Women
Psychological Therapies for Women Who Experience Intimate Partner Violence
FPIN'S CLINICAL INQUIRIES
Preoperative A1C Threshold in Patients with Diabetes
SEE MORE IN AFP BY TOPIC ▶ DIABETES: TYPE 2
MEDICINE BY THE NUMBERS
Oxytocin as First-line Uterotonic Therapy for Postpartum Hemorrhage
SEE MORE IN AFP BY TOPIC ▶ LABOR, DELIVERY, AND POSTPARTUM ISSUES
AFP By Topic

Find the best available content from AFP on more than 70 clinical topics in one place.

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Take the AFP CME Quiz on your computer or mobile device to receive instant credit. AAFP members and others who recieve AFP in their own name can earn 6 credits for this issue.

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AFP's COVID-19 Collection

New topics include avoiding unnecessary medical care during the COVID-19 pandemic and thrombotic thrombocytopenia after COVID-19 Janssen vaccination. See the latest resources in the collection that is open-access and frequently updated.

AAFP Career Link

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Online access to content in new issues of American Family Physician is restricted to AAFP members and paid subscribers. Free full text is available for selected items. All content of each issue is made freely available about one year after publication. The bulk of the online archives is open to all. For access to all AFP content, you may want to subscribe to the journal or join the AAFP.

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