www.aafp.org/afp AMERICAN FAMILY PHYSICIAN 1269 involves human papillomavirus (HPV) infection, which leads to VIN and predisposes the patient to vulvar cancer. The second type involves vulvar non-neoplastic epithelial disorders (VNED) and advanced age, leading to cellular atypia and cancer (Table 1). Vulvar cancer most frequently occurs in women 65 to 75 years of age. It can develop in younger ...

Patient Evaluation Most fishhook injuries are penetrating soft tissue injuries to the hand, face, head or upper extremity but can involve any body part. These injuries usually do not involve deeper tissue structures because of the linear forces applied along the fishing line to the fishhook that drive the point parallel to the skin and keep it from deep penetration. Many different types and siz...

OBJECTIVES By identifying strategies that practicing physicians use in managing patients with medically unexplained physical symptoms (MUPS), we present an interim practical management guide (IPMG) that clinical practitioners may find useful in their clinical practices and that may help guide future research. DESIGN A qualitative research study based on interview data from practicing physicia...

Uses and Efficacy Currently, the primary use of black cohosh extract is for alleviation of menopausal symptoms. The American College of Obstetrics and Gynecology guidelines on the use of botanicals for the management of menopausal symptoms support this use for up to six months, especially in treating the symptoms of sleep and mood disturbance, and hot flushes. [Evidence level C, consensus/exper...

Dermatophytoses Because dermatophytes require keratin for growth, they are restricted to hair, nails, and superficial skin. Thus, these fungi do not infect mucosal surfaces. Dermatophytoses are referred to as “tinea” infections. They are also named for the body site involved. Some dermatophytes are spread directly from one person to another (anthropophilic organisms). Others live in and are tra...

CONTEXT The US government is expanding the capacity of community health centers (CHCs) to provide care to underserved populations. OBJECTIVE To examine the status of workforce shortages that may limit CHC expansion. DESIGN AND SETTING Survey questionnaire of all 846 federally funded US CHCs that directly provide clinical services and are within the 50 states and the District of Columbia, co...

Abstract Background It is recommended that primary care-based physicians refer children with overweight and obesity to multidisciplinary paediatric management, which can help improve weight health. Objective To determine predictors of referral management. Methods This retrospective, population-level study included who could 2–17 years old a body mass index ≥85th percentile one three management ...

Background Rational prescription is a considerable issue which must be paid more attention to assess the behavior of prescribers. The aim of this study was to examine factors affecting family physicians’ drug prescribing.   Methods We carried out a retrospective cross-sectional study in Khuzestan province, Iran in 2011. Nine hundred eighty-six prescriptions of 421 family physicians (including 3...

Background & aim: Midwives, as a part of the healthcare team, have a remarkable role in providing health to families and societies. Midwives have a prominent role in the family physician program (FPP); therefore, the lack of proper attention to their challenges results in a decline in their efficiency and quality of care. Therefore, this study was performed to explore the midwives’ perceptions ...