Home Blood Pressure Monitoring

Jeffrey M. Weinfeld, Kathryn M. Hart, Jose D. Vargas

Home blood pressure monitoring can confirm the diagnosis of hypertension after an elevated in-office blood pressure measurement. Although ambulatory blood pressure monitoring is the diagnostic standard for measurement, home blood pressure monitoring is more practical and...

Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: An Overview and Comparison

John B. Darby, Jennifer M. Jackson

Kawasaki disease and multisystem inflammatory syndrome in children are inflammatory conditions that present with overlapping features; however, they are two distinct conditions. Kawasaki disease predominantly affects children younger than five years, whereas multisystem...

Alcohol Withdrawal Syndrome: Outpatient Management

Samuel M. Tiglao, Erica S. Meisenheimer, Robert C. Oh

Approximately one-half of patients with alcohol use disorder who abruptly stop or reduce their alcohol use will develop signs or symptoms of alcohol withdrawal syndrome. Alcohol withdrawal syndrome can lead to tremors, insomnia, nausea and vomiting, hallucinations, anxiety,...

Hereditary Hemochromatosis: Rapid Evidence Review

Shawn F. Kane, Caroline Roberts, Ryan Paulus

Hereditary hemochromatosis results in systemic iron overload, leading to tissue damage and organ failure. There is no typical presentation or pathognomonic signs and symptoms, although a common initial presentation is an asymptomatic patient with mildly elevated liver enzymes...

Splenomegaly: Diagnosis and Management in Adults

Sommer Aldulaimi, Ana M. Mendez

The most common causes of splenomegaly in the United States are liver disease, malignancy, and infection. Patient habits, travel, and medical conditions can increase the risk of splenomegaly, and symptoms can suggest infectious, malignant, hepatic, or hematologic causes.

Neglected Parasitic Infections: What Family Physicians Need to Know—A CDC Update

Paul T. Cantey, Susan P. Montgomery, Anne Straily

Neglected parasitic infections affect millions of people in the United States. Family physicians should understand the basic principles of clinical presentation, diagnosis, and treatment of diseases such as Chagas disease, cysticercosis, and toxoplasmosis.

Neonatal Abstinence Syndrome: A Call for Mother-Infant Dyad Treatment Approach

Roschanak Mossabeb, Kevin Sowti

Neonatal abstinence syndrome (NAS) is a constellation of symptoms observed in newborns exposed to opioids during pregnancy.1 Between 50% and 80% of infants exposed to opioids in utero will develop NAS.2 In October 2017, the U.S. Department of Health and Human Services...

Parasitic Infections: Do Not Neglect Strongyloidiasis

Johnnie Yates

The article on neglected parasitic infections in this issue of American Family Physician reviews infections of increasing relevance to family physicians in the United States because of demographic changes and increased ability for or access to international travel.1 Although...

Chronic Musculoskeletal Pain, NAFLD, Peripheral Neuropathy, Myocardial Infarction

In chronic musculoskeletal pain, what nonpharmacologic and noninvasive treatments are effective? | What diagnostic tools are appropriate for patients with NAFLD? | How should patients presenting with suspected peripheral neuropathy be evaluated? | Is administering beta...

Pelvic Floor Muscle Training to Prevent and Treat Urinary and Fecal Incontinence in Antenatal and Postnatal Patients

Pamela Vnenchak

Does pelvic floor muscle training (PFMT) help prevent or treat urinary or fecal incontinence during pregnancy or after delivery?

Reducing Saturated Fat Intake to Decrease the Risk of Cardiovascular Disease

Drew Baird, Vanessa Rivera

Does reducing saturated fat intake decrease morbidity and mortality related to cardiovascular disease (CVD)?

Using Race with Caution in the ASCVD Calculator

Mara Gordon, Isha Marina Di Bartolo

A 58-year-old man, J.D., with a history of hypertension and tobacco use comes to my office to discuss his laboratory results. J.D. had a lipid panel drawn before the visit and wants to know whether he has high cholesterol. I use the American College of Cardiology/American...

Screening for Colorectal Cancer

Tina Fan, Ruth Stefanos

A 47-year-old patient presents for a routine physical examination. The patient does not have a history of colorectal cancer, inflammatory bowel disease, or adenomatous polyps or a family history of colorectal cancer. The patient's body mass index is 29 kg per m2, and the A1C...

Melatonin to Treat Insomnia in Older Adults

Jon O. Neher, Anna Goebel, Diana K.N. Louden

How safe and effective are melatonin receptor agonists for treating insomnia in older adults?

Slow-Growing, Painless Periungual Nodule

Jay Haynes, Corley Pruneda, Amanda Hernandez

A 53-year-old patient presented with a painless lesion on the left third digit that had been slowly growing for about 20 years. The lesion arose after the patient removed an ingrown nail from the lateral nail bed. The cosmetic appearance of the nodule was bothersome to the...

Hyperpigmentation of the Hands, Feet, and Tongue

Jacob Tuttle, Shea Giaquinto

A 55-year-old patient presented with a one-month history of a painless, nonpruritic rash involving the palms, soles, and tongue. Apart from intermittent tingling of the hands and dry skin, the rash was not bothersome and was improving with the application of petroleum jelly....

Fecal Calprotectin for the Evaluation of Inflammatory Bowel Disease

Carl Bryce, Merima Bucaj

Calprotectin is a protein expressed by neutrophils. The presence of fecal calprotectin is a sensitive indicator of gastrointestinal inflammation, with higher levels representing more inflammation. The U.S. Food and Drug Administration has approved the use of fecal...

Efficient Approach to the Evaluation of Syncope

Andy Lazris, Alan R. Roth, Helen Haskell, John James

A 78-year-old patient in good health has hypertension that is well controlled with medication. One fall afternoon, the patient was raking leaves when they suddenly passed out. The patient had no dizziness or other symptoms before or after the event. Their partner saw them...

Applying a Clinical Prediction Rule to Distinguish Lower Extremity Cellulitis from Its Mimics

Lia Pierson Bruner

How can a clinician best determine whether a patient with lower leg erythema has cellulitis?

Remdesivir (Veklury) for the Treatment of COVID-19 in Hospitalized Patients

Shyam Odeti, Venkata K. Yellepeddi

Remdesivir (Veklury) is an antiviral drug that inhibits the replication of pathogenic human coronaviruses, including SARS-CoV-2 and SARS-CoV-1.1 Remdesivir is approved by the U.S. Food and Drug Administration for the treatment of COVID-19 in adults, and it can be given to...

Diary of a Family Physician

Priscilla Auguste

Priscilla Auguste, MD

Cervical Cancer Screening: Updated Guidelines from the American Cancer Society

Priscilla Auguste

Key Points for Practice

Outpatient Primary Care Management of Headaches: Guidelines from the VA/DoD

Brian Ford, Michael Dore, Ethan Harris

Key Points for Practice

Comparison of Treatment Regimens for Helicobacter pylori Infection

Brit Long, Michael Gottlieb

Study Population: 68 randomized controlled trials (RCTs) comprising 22,975 patients with Helicobacter pylori infection

Epidural Corticosteroid Injections Provide Minimal, If Any, Benefit in Low Back Pain with Sciatica

Mark H. Ebell

The Risk of Progression from Prediabetes to Diabetes in Older Adults Is Low

Allen F. Shaughnessy

In Older Adults, Aspirin Increases the Risk of Metastatic or Stage 4 Cancers and Cancer Mortality

Henry C. Barry

Take-and-Hold Prescriptions for Children with Respiratory Tract Infections Decrease Antibiotic Use with Similar Outcomes

Allen F. Shaughnessy

Checking Your Blood Pressure at Home

Checking your blood pressure at home is more accurate than checking it at the doctor's office. If your blood pressure is high, treating it can lower the risk of problems with your heart, kidneys, and eyes.