Heart Failure With Reduced Ejection Fraction, Mallet Finger, Septic Arthritis, Fibromyalgia Medications, Seborrheic Dermatitis, Colorectal Cancer, Graves Disease

American Family Physician. 2026;113(6):531.

How should medications be initiated for individuals with heart failure with reduced ejection fraction?

Guideline-directed medical therapy (renin-angiotensin system/neprilysin inhibitors, beta blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors) should be initiated and titrated to target dosing within 6 to 12 weeks of heart failure diagnosis to improve symptoms and reduce mortality and heart failure readmissions.

How long should bony mallet finger injuries be immobilized?

For bony mallet finger injuries, the affected distal interphalangeal joint should be continuously splinted and immobilized in a neutral or slightly hyperextended position for at least 6 to 8 weeks, and then for 2 additional weeks at night.

Read more: Fingertip Injuries; July 2025

What are the initial diagnostic steps for patients with suspected septic arthritis?

In patients with suspected septic arthritis, synovial fluid should be analyzed via arthrocentesis (Gram stain, culture, white blood cell count with differential, and crystal analysis) before starting antibiotics.

For fibromyalgia pain, consider pregabalin (when tolerated at a therapeutic dose) or consider duloxetine or milnacipran.

What topical agents can be used to treat refractory seborrheic dermatitis?

Topical calcineurin inhibitors (eg, pimecrolimus 1%, tacrolimus 0.1%)—which are safe and effective treatments for seborrheic dermatitis of the face or body—are recommended in cases unresponsive to antifungals or corticosteroids or to avoid the consequences of long-term corticosteroid use.

In what age range should periodic screening for colorectal cancer be completed?

Adults at average risk of colorectal cancer and without any colon cancer–related signs or symptoms should undergo periodic screening between 45 and 75 years of age. Patients older than 75 years should consider periodic screening for colorectal cancer based on shared decision-making that includes health status, screening history, and patient preference.

What is the best test to confirm Graves disease?

The presence of thyrotropin receptor antibodies is an accurate and more cost-effective way to confirm Graves disease than radiographic imaging.

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