THOMAS J. GATES
Although there are many accepted screening tests for cancer, and patients have come to expect them, there can be good reasons not to screen. Because of possible bias in the evaluation of screening tests, the best method for determining the benefit of screening tests is a...
JEFFREY D. QUINLAN
The most common causes of acute pancreatitis are gallstones and chronic alcohol use. Patients typically present with sudden onset of abdominal pain in the left upper quadrant. Contrast-enhanced computed tomography is the preferred imaging method to predict disease severity...
AARON SAGUIL, SHAWN KANE, EDWIN FARNELL
Symptoms of multiple sclerosis include sensory disturbances, motor weakness, optic neuritis, Lhermitte sign, fatigue, and impaired coordination. The diagnosis is clinical and requires two neurologic deficits separated in time and space. Magnetic resonance imaging is the...
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ANUPAM B. JENA, VINAY PRASAD
News stories of gun violence have ignited the debate about what public health measures are appropriate for reducing the epidemic of gun injury and death. With the shooting rate climbing, primary care physicians may reasonably ask what role they can play in reducing injuries.
COREY D. FOGLEMAN
Albuterol does not improve any clinical outcomes in the outpatient or inpatient setting and should not be used in the treatment of bronchiolitis in a child 24 months or younger.
DEAN A. SEEHUSEN, J. SCOTT EARWOOD
Oral contraceptives are not an effective treatment for ovarian cysts, whether the cysts are spontaneous or associated with medically induced ovulation. Most cysts resolve without intervention within two to three months. Those that do not resolve in this time frame are more...
AMY M. ZACK, MIRCEA OLTEANU, IYABODE ADEBAMBO
A man presented with diffuse erythema of the gums with mild edema and tenderness. The patient had thick deposits at the gum line that could not be wiped off.
DOUGLAS S. BISHOP, RINA RAMIREZ
The surge of unaccompanied minors from Central America crossing the United States–Mexico border in recent months has made national headlines, creating an “urgent humanitarian situation.” The reasons for this migration are multifactorial, and the resultant politics are deeply...
ALLEN F. SHAUGHNESSY
How often do patients walk into our offices with a problem and walk out cured? The Epley maneuver, which is not particularly difficult to do, results in the long-term (at least one year) resolution of posterior canal benign paroxysmal positional vertigo. A video of the...
MARK H. EBELL
NITA SHRIKANT KULKARNI
For older patients hospitalized with pneumonia, the use of combination antibiotic therapy including azithromycin is associated with decreased mortality but an increased risk of myocardial infarction (MI). You would need to treat 21 patients with azithromycin to prevent one...
ALLEN F. SHAUGHNESSY
Omega-3 fatty acid supplementation does not decrease the risk of cardiovascular outcomes in this older population. Although the numbers are small, supplementation may prevent heart disease in patients already at low risk; that is, patients without a history of cardiovascular...
Recommended vaccination schedules for immunocompetent children and adults are published annually by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention. Vaccination of immunocompromised patients is important because...
The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians engage in shared, informed decision making with women who are at increased risk of breast cancer about medications to reduce their risk. For women who are at increased risk of breast cancer and at low...
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