January 2022

Patients with cluster headache experience severe unilateral pain located in the orbital, supraorbital, and/or temporal region that occurs from every other day up to eight times per day and lasts from 15 to 180 minutes. Attacks occur in clusters, are episodic or chronic, and are…

Adenomyosis is a clinical condition where endometrial glands are found in the myometrium. One in three patients with adenomyosis is asymptomatic, but the rest may present with heavy menstrual bleeding, pelvic pain, or infertility.

Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or more, or a decrease in diastolic blood pressure of 10 mm Hg or more within three minutes of standing from the supine position. Goals of treatment are reducing symptoms and improving…

Transient global amnesia is a clinical syndrome characterized by anterograde amnesia, mild retrograde amnesia, and confusion for up to 24 hours. It most commonly occurs in patients older than 50 years and results from the temporary impairment of short-term memory formation.

The etiology of pruritus is complex and can include histamine, serotonin, and neuropeptide release, and neuronal itch signal transmission. General management includes trigger avoidance, liberal emollient use, limiting water exposure, and administration of oral antihistamines…

Atherosclerotic vascular disease is a leading cause of death worldwide. The most significant risk factors for atherosclerotic vascular disease are hypertension, diabetes mellitus, hyperlipidemia, and smoking. The U.S. Preventive Services Task Force recommends one-time screening…

Error in algorithm. In the article, “Urethritis: Rapid Evidence Review,” (May 1, 2021, p. 553) the next steps in Figure 1 (page 556) after “Trichomonas vaginalis infection suspected based on risk factors or local prevalence?” were inadvertently switched. The next step after Yes…

Treatment options for patients with type 2 diabetes mellitus have increased with the addition of three new drug classes. Large clinical trials have investigated cardiovascular outcomes with all three classes in patients who have diabetes. The primary outcome was a composite of…

Because of the lack of effective treatments, prevention remains the best strategy for reducing the burden of dementia. Rather than attempting to identify and intervene on early disease through screening, a primary prevention strategy seeks to prevent cognitive decline by…

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

For individuals with severe peanut allergy, peanut allergen powder may lessen the likelihood of life-threatening consequences of accidental ingestion of small amounts of peanuts. Patients must still adhere to a peanut-avoidant diet, which likely has far bigger preventive impact…

Walking lowers systolic blood pressure by 4.11 mm Hg. It lowers diastolic blood pressure by 1.79 mm Hg and resting heart rate by 2.76 beats per minute.

Compression stockings are effective at reducing asymptomatic deep venous thrombosis in airline passengers taking flights longer than five hours in both high-risk and low-risk populations.

Series of short reports and quizzes based on guidelines from the USPSTF.

A man presented with a progressive pruritic rash affecting his entire body.

A man presented with a 10-year history of severe scrotal swelling. The scrotal skin was tender, thickened, and hyperpigmented.

The PrecivityAD test is a widely available blood test for older persons with mild cognitive impairment and is marketed to aid in the diagnosis of Alzheimer disease. The APS produced by the test is accurate in predicting the likelihood of positive PET findings, which may reduce…

There may be an association between the use of hormonal contraception and suicide. Women using oral contraceptives had an increase in completed suicides and suicidal behaviors (i.e., suicidal thoughts and suicide attempts without success).

Platelet-rich plasma injections more effectively increase hair density vs. usual treatment in men with androgenic alopecia.

Patients engaged in high-risk activities are often ambivalent about changing their behavior. Harm reduction is an approach that focuses on limiting harm and improving quality of life for patients who persist with high-risk behaviors; the foundations of harm reduction are…

The guidelines give clear guidance on selecting an SGLT2 inhibitor, a GLP-1 receptor agonist, or neither in patients with type 2 diabetes. The guidelines are a bit conservative to some, but guideline development is a two-step process: determining the evidence and then weighing…

Giving an infant carrier to mothers before or at delivery increases sustained breastfeeding from three to six months following birth. The authors speculate that this outcome is caused by increased physical contact.

Although corticosteroid bursts have potential for improving outcomes for many acute illnesses, this study shows that the potential harms are not trivial.

Nonsteroidal anti-inflammatory drugs are a better choice for the treatment of low back pain. Despite benzodiazepine and nonbenzodiazepine muscle relaxants being used for almost 50 years to treat low back pain, the supporting evidence is of low certainty. None of the treatments…

Chronic insomnia is a common sleep disorder that causes impairment, and treatment historically has been limited to sleep hygiene recommendations. The American Academy of Sleep Medicine has updated its clinical practice guidelines on behavioral treatments for chronic insomnia…

Stroke is a common source of morbidity and mortality in the United States. The American Heart Association and American Stroke Association (AHA/ASA) published updated guidelines for preventing recurrent ischemic stroke, focusing on overall cardiovascular risk reduction and…

Learn more about the effects of reducing saturated fat intake on cardiovascular disease risk.

The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions.

Reply: Honor MacNaughton, Melissa Nothnagle, Jessica Early

Reply: Stephen A. Wilson, Leah A. Stem, Richard D. Bruehlman

Reply: Stephen A. Wilson, Leah A. Stem, Richard D. Bruehlman

Adenomyosis (say: ADD-uh-no-mai-OH-sis) is when the tissue that lines your uterus (endometrium) grows into the next layer (myometrium) of your uterus.

A cluster headache is a rare type of headache that causes pain on one side of the head, often around the eye. These headaches could happen every other day or as often as eight times in a single day. The pain can last from 15 minutes to three hours, and it often comes back…

Orthostatic hypotension (ORTH-oh-sta-tik HI-po-TEN-shun) happens when your blood pressure drops right after you sit up or stand. This can make you feel dizzy, like you are about to pass out, or have blurred vision. You may feel weak or sick to your stomach, or have chest pain…

Pruritus (proo-RYE-tis) is itchy skin or a feeling that you need to scratch. It might hurt and can cause sleep problems and depression if it becomes severe.