September 15, 2015

Recommendations for several vaccinations have changed in recent years. Find out the latest on these vaccines: pneumococcal conjugate; rotavirus; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap); meningococcal; influenza; and human papillomavirus.

Management of skin and soft tissue infections is determined by the severity and location of the infection and by patient comorbidities. Simple infections are usually monomicrobial and present with localized clinical findings. Complicated infections may present with systemic…

The first priority is determining the need for urgent intervention to avoid life-threatening cardiac conduction and neuromuscular dysfunction. Hypokalemia is treated with oral or intravenous potassium. Treatment of hyperkalemia may include intravenous calcium; insulin, usually…

Key behavioral strategies for treating and preventing chronic constipation in older adults include increasing fiber intake, scheduled toileting after meals, and avoiding bedpans for defecation. Pharmacologic treatment should begin with the osmotic laxative polyethylene glycol…

Researchers Examine Whether ACO Payment Is Worth the Effort | Study Finds That Process Matters in Care Delivery to Vulnerable Patients | Health Plan Accreditation Standards Emphasize Better Patient Access to Care | Proposed Bill Would Increase Federal Support for Family…

Rural populations rely on physicians trained in primary care to provide emergency services. Less is known about primary care’s contribution to emergency services in urban and suburban settings. Two-thirds of family medicine and three-fourths of general internal medicine…

Family physicians have an opportunity to significantly reduce rates of cervical and oropharyngeal cancers with a safe and effective HPV vaccine. We should listen and address parental concerns, but also strongly recommend all childhood immunizations and use every opportunity to…

New guidelines in pneumococcal immunization policy reflect evidence for the expansion of PCV13 to persons older than 65 years and to some high-risk younger adults, and afford the opportunity to improve the health of adults.

J.W., a 34-year-old man who smokes, presents for his annual checkup for hypertension. Hisblood pressure is elevated (142/95 mm Hg), and he has gained 10 lb (4.5 kg) since his lastvisit. J.W. is now considered overweight, with a body mass index (BMI) of 27 kg per m2. He reports…

What are the effects of treatment for hyperemesis gravidarum and nausea and vomiting in early pregnancy?

In most children, solid foods may be introduced before four to six months of age without increasing the risk of atopic eczema.

A woman presented with a nonpruritic rash on her extremities, including palms and soles, and around her lips. The rash developed after symptoms of fever, sore throat, and headache.

Assigning patients to six weeks of physical therapy is as effective as initially sending them for decompression surgery, with fewer complications, even in patients who have a strong preference for surgery. A trial of six weeks of physical therapy makes sense for many patients…

In this well-designed observational study, older patients given an initial prescription of dabigatran had lower all-cause mortality and fewer ischemic and hemorrhagic strokes, but a higher risk of gastrointestinal (GI) bleeding, than a matched group of patients given warfarin.

In the United States, one in three deaths is from cardiovascular disease; coronary heart disease is the leading cause of death. This guideline from the American College of Physicians (ACP) provides recommendations on cardiac screening using these modalities.

Potassium is a mineral that helps the cells in your body work correctly. Foods with a lot of potassium include bananas, potatoes, yams, dried apricots, almonds, avocados, coconut water, soybeans, and bran. You can get potassium from eating most fruits, vegetables, meats, and…

Infections of the skin and underlying tissues happen when germs enter through breaks in the skin. Boils and abscesses are examples of simple skin infections. These kinds of infections are more common in children and older adults, in people who are frail or malnourished, and in…

Constipation is when you feel like you are not able to have a complete bowel movement. You can also have hard stool, stomach pain, bloating, or swelling.

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