Atypical Moles

Atypical moles are associated with increased risk of melanoma and should prompt periodic, systematic skin examination. Management includes clinical assessment with dermoscopy, excisional biopsy, and postbiopsy monitoring.

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Climate-Smart Health Care: Role of the Family Physician

Climate change caused by humans continues to accelerate, causing more frequent and severe weather events. Physicians can play a pivotal role in managing environmental health risks, such as heat and air pollution, and counseling patients on plant-forward diets and active transportation.

Knee Pain in Adults and Adolescents: The Initial Evaluation

Knee pain is prevalent across age groups, commonly related to osteoarthritis in older adults and patellofemoral syndrome in younger adults. Assessment includes a detailed history, physical examination (inspection, palpation, range of motion, strength testing, and specialized maneuvers), and judicious use of imaging (typically plain radiography).

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Gambling Disorder: Diagnosis and Treatment

Gambling disorder is often underdiagnosed. Case-finding using a direct question about gambling in patients at increased risk is recommended. Pharmacotherapy, psychotherapy, and self-help groups, such as Gamblers Anonymous, may help reduce gambling severity.

Type 2 Diabetes: Outpatient Insulin Management

Insulin treatment remains a significant but complex aspect of managing type 2 diabetes. To optimize insulin use in the outpatient setting, family physicians must consider strategies for initiation, titration, and adherence.

Pacemaker Therapy: Indications and Recommendations

Pacemakers are indicated to improve symptoms of bradycardia, prevent high-degree atrioventricular block from degenerating into complete heart block, and promote ventricular synchrony and improve survival in select patients.

Nausea and Vomiting During Pregnancy

For mild or moderate cases of nausea and vomiting in pregnancy, first-line treatment is vitamin B6 with or without doxylamine. If it is ineffective, or in more severe cases, treatment can be advanced to alternative agents, taking care to balance patient-specific risk factors…

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Injections of the Foot and Ankle

Foot and ankle injections are commonly performed by family physicians for the management of several musculoskeletal conditions. If symptoms persist despite conservative measures, injections may improve function and reduce pain. Ultrasound guidance improves accuracy of injection…

Skin and Soft Tissue Infections

Skin and soft tissue infections are clinical diagnoses. They are classified as mild, moderate, or severe, depending on the structures involved and presence or absence of systemic symptoms. Treatment depends on severity and includes oral and intravenous antibiotics

Botulinum Toxin Procedures: A Practical Approach to Cosmetic Injections

Botulinum toxin injection offers predictable results, has few adverse effects, and is associated with high patient satisfaction. A review of facial anatomy, injection techniques, and complications for cosmetic botulinum toxin treatment, with a focus on glabellar lines, is…

Severe Hypertension: Evaluation and Treatment

Severe hypertension is defined as a blood pressure of 180/110 to 120 mm Hg or greater in the absence of new or worsening target organ damage. Multiple trials have shown no short-term benefit of treatment, which has been associated with increased risk of cardiovascular events…

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Foreign Body Ingestion in Children

Children commonly ingest foreign objects; prompt evaluation, imaging, and object-specific management may be necessary.

Thrombocytosis: Rapid Evidence Review

Thrombocytosis is defined by guidelines as a platelet count of 450 × 103/μL or greater. Elevated platelet counts result from a primary condition or secondary cause. Secondary causes of thrombocytosis must be ruled out before a primary diagnosis may be made.

Vaccine Adverse Effects: An Overview

Family physicians should be aware of the risks and benefits of recommended immunizations to accurately counsel about adverse effects and address vaccine hesitancy.

Systemic Sclerosis: Evaluation and Treatment

Systemic sclerosis is a rare autoimmune disease characterized by progressive skin fibrosis and associated with high morbidity. Early diagnosis is critical and requires a comprehensive, individualized approach.

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