Items in FPM with MESH term: Risk Assessment
Risk-Assessment Tools for Detecting Undiagnosed Diabetes - Point-of-Care Guides
ABSTRACT: Solitary pulmonary nodules are common radiologic findings, typically discovered incidentally through chest radiography or computed tomography of the neck, chest, and abdomen. Primary care physicians must decide how to pursue an evaluation of a nodule once it has been identified. The differential diagnosis for pulmonary nodules includes benign and malignant causes. Diameter of 8 mm or more, "ground-glass" density, irregular borders, and doubling time between one month and one year suggest malignancy. The American College of Chest Physicians recently released guidelines for the evaluation of solitary pulmonary nodules, based primarily on nodule size and patient risk factors for cancer. Algorithms for the evaluation of lesions smaller than 8 mm and those 8 mm or greater recommend different imaging follow-up regimens. Fluorodeoxyglucose-positron emission tomography can be used to aid decision making when cancer pretest probability and imaging results are discordant. Any patient with evidence of a nodule with notable growth during follow-up should undergo biopsy for identification. The rationale for closely monitoring an incidentally found pulmonary lesion is that detection and treatment of early lung cancer might lead to decreased morbidity and mortality.
Universal Screening for Hearing Loss in Newborns - Putting Prevention into Practice
Universal Newborn Hearing Screening and Beyond - Editorials
Screening and Treatment for Major Depressive Disorder in Children and Adolescents - Putting Prevention into Practice
ABSTRACT: Coronary heart disease is the most common cause of death in the United States. The conventional risk factor approach to primary prevention excludes many patients who could benefit from preventive therapies. A global risk approach allows more accurate estimates of risk to guide clinical primary prevention efforts. Global risk of coronary heart disease is a calculation of the absolute risk of having a coronary heart disease event (e.g., death, myocardial infarction) over a specified period. It is based on an empiric equation that combines major risk factors, such as blood pressure and cholesterol levels. When physicians know a patient’s global risk of coronary heart disease, they are more likely to prescribe risk-reducing therapies such as antihypertensives, statins, and aspirin. In addition, patients who know their risk level are more likely to initiate risk-reducing therapies. Many tools are available to estimate global risk, including several Web-based calculators. In the United States, tools based on the Framingham Heart Study are recommended.
ABSTRACT: Ischemic heart disease is one of the most common disorders managed by family physicians. Stratifying patients according to risk is important early in the course of the disease to identify patients who require invasive (percutaneous or surgical) treatment. Physical examination, clinical history, noninvasive tests and angiography are all helpful in determining who will benefit most from medical therapy, percutaneous revascularization or coronary artery bypass surgery. Surgery improves morbidity and mortality in a well-defined group of patients with left ventricular dysfunction and left main coronary artery disease or triple-vessel disease. Patients with proximal left anterior descending artery disease and moderate or severe ischemia benefit from surgery as well. In all other patients, definitive treatment includes aspirin, beta-adrenergic blockers and lipid-lowering agents. Percutaneous revascularization should be considered primarily a palliative measure, because it has never been shown to improve mortality more than medical therapy.