October 1, 2019

Hand-foot-and-mouth disease is most commonly caused by enterovirus 71 and coxsackievirus A16. Clinical diagnosis is based on the presentation of a low-grade fever with a maculopapular or papulovesicular rash on the hands and soles of the feet, and by painful oral ulcerations…

Opioid use disorder, a chronic relapsing condition, is highly prevalent and can be fatal; in 2016, it affected at least 2.1 million Americans 12 years and older. Family physicians are positioned to diagnose opioid use disorder and provide evidence-based treatment. Patients are…

Vitamin K antagonists, unfractionated heparin, low-molecular-weight heparin, and direct oral anticoagulants are commonly used for the prevention and treatment of systemic embolism associated with atrial fibrillation, stroke, and venous thromboembolism. Low-molecular-weight…

The antidote to the opioid use disorder epidemic is the thoughtful use of evidence-based medicine and an honest understanding of what we know—and what we don't know—about caring for people with substance use disorders.

Key clinical questions and their evidence-based answers directly from the journal's content, written by and for family physicians.

Compared with placebo, antihypertensive drug therapy for mild to moderate hypertension (defined by the authors as a blood pressure of 140 to 169 mm Hg systolic or 90 to 109 mm Hg diastolic) caused by chronic hypertension, gestational hypertension, or preeclampsia during…

Treatment of AFib with a factor Xa inhibitor results in a decrease in the combined end point of stroke and embolic events (odds ratio [OR] = 0.89; 95% CI, 0.82 to 0.97), as well as a decrease in intracranial hemorrhage (OR = 0.50; 95% CI, 0.42 to 0.59) and all-cause mortality…

A 44-year-old man presented with worsening scrotal swelling that began two weeks prior. He also had sharp, constant pain that radiated to both legs (left more than right) and his buttocks. He rated it as 10 out of 10 on a pain scale. The pain worsened with urination and was…

Bottle-fed infants with gastroesophageal reflux should be given thickened formula feedings.

Protecting patients from elder abuse scams.

In febrile infants up to 60 days of age, the combination of a normal urinalysis result, an absolute neutrophil count of less than 4,090 per mL (4.1 × 109 per L), and a serum procalcitonin level of less than 1.71 ng per mL is accurate at ruling out serious bacterial infections.

This study found no benefit to the addition of intermittent pneumatic compression to pharmacologic anticoagulation for the prevention of proximal DVT in critically ill patients.

Letter

Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

The American Academy of Pediatrics has released a policy statement regarding the integration of perinatal depression recognition and management into well-child visits.

Because of the relatively high rate of reported adverse effects and the high likelihood of resolution of symptoms with supportive care and symptomatic management, the authors recommend selective antibiotic use in patients with acute sinusitis. Read more.

Reply: Matthew Schefft, Alan R. Schroeder, Ricardo Quinonez

Reply: Erin Hendricks, Honor Macnaughton

Updated Guideline and Terminology. The article, “Testosterone Therapy: Review of Clinical Applications” (October 1, 2017, p. 441) included a section titled, “Testosterone Therapy in Female-to-Male Transgender Patients” beginning on page 447, which was based on information from…