October 1, 2014

Children four years and older with behavioral concerns or poor academic progress should be evaluated for attention-deficit/hyperactivity disorder using validated assessment tools, ideally including observers from several settings, such as the home and school. Treatment of…

Dyspareunia, or persistent pain with sexual activity, has many possible causes. The history and physical examination are usually sufficient to make the diagnosis. Treatment depends on the diagnosis and may include pelvic floor physical therapy or cognitive behavior therapy for…

Patients with limited English proficiency are less able to access health care and are at higher risk of adverse outcomes. Title VI of the Civil Rights Act mandates that interpreter services be provided for patients who need it, despite the lack of reimbursement in most states…

VA Adds Primary Care Services to Contract Program for Veterans' Health | More Physicians Using EHRs, but Data Sharing, Patient Engagement Lag Behind | October 1, 2015, ICD-10 Deadline Finalized | Study: Smaller Primary Care Practices May Help Keep Patients Out of Hospitals

Evidence-based guidelines are indispensable and assist clinicians in providing the most effective care for patients. The Eighth Joint National Committee (JNC 8) recently issued the most anticipated guideline in some time.1 The JNC 8 committee was initially appointed in 2008 by…

LABAs appear to be safe when used with inhaled corticosteroids. LABA monotherapy is associated with an increase in asthma-related mortality and nonfatal serious adverse events, but not in all-cause mortality.

Trauma-focused cognitive behavior therapy (CBT) and eye movement desensitization and reprocessing (EMDR) are more effective than other therapies in reducing PTSD symptom severity up to four months after treatment, but more robust studies are needed to evaluate the long-term…

Does outpatient case management for adults with medical illness and complex care needs improve patient-centered outcomes, quality of care, or resource utilization?

A man on active military duty presented with severe sweating in both feet, and multiple discrete punctate depressions on the plantar surface.

In cases such as this, patients are often told, “You don't need treatment now,” but they only hear, “You are fine.” Subsequent failure to follow up may result from a combination of issues related to health literacy, educational attainment, linguistic barriers, and cultural…

Surviving 10 months after a pancreatic cancer diagnosis, a patient decides whether or not he should undergo the Whipple procedure, a potential cure.

Treatment of children with oseltamivir will decrease symptom duration by approximately one day, but will not reduce hospitalizations and does not seem to be effective in children with asthma. In adults, symptom reduction is less striking (less than one day), and hospitalization…

POEMs

Prolonging dual antiplatelet therapy with aspirin plus clopidogrel (Plavix) for more than one year after the placement of a drug-eluting stent confers no clinical benefit.

• In the general population, pharmacologic treatment should be initiated when blood pressure is 150/90 mm Hg or higher in adults 60 years and older, or 140/90 mm Hg or higher in adults younger than 60 years.

Dyspareunia (DIS-puh-ROO-nee-uh) is pain that occurs during sex. The pain may begin the first time you have sex, or it can begin later. The pain may be near or in the opening of the vagina or deep inside your pelvis. It may feel like a muscle spasm that makes entry into the…